title: The effect of an information and communication technology (ICT) on older adults' quality of life: study protocol for a randomized control trial.
abstract: BACKGROUND
  This study investigates the use of an information and communication technology (Elder Tree) designed for older adults and their informal caregivers to improve older adult quality of life and address challenges older adults face in maintaining their independence (for example, loneliness and isolation, falling, managing medications, driving and transportation).
  
  
  METHODS
  This study, an unblinded randomized controlled trial, will evaluate the effectiveness and cost of Elder Tree. Older adults who are at risk for losing their independence - along with their informal caregivers, if they name them - are randomized to two groups. The intervention group has access to their usual sources of information and communication as well as to Elder Tree for 18 months while the control group uses only their usual sources of information and communication. The primary outcome of the study is older adult quality of life. Secondary outcomes are cost per Quality-Adjusted Life Year and the impact of the technology on independence, loneliness, falls, medication management, driving and transportation, and caregiver appraisal and mastery. We will also examine the mediating effect of self-determination theory. We will evaluate the effectiveness of Elder Tree by comparing intervention- and control-group participants at baseline and months 6, 12, and 18. We will use mixed-effect models to evaluate the primary and secondary outcomes, where pretest score functions as a covariate, treatment condition is a between-subjects factor, and the multivariate outcome reflects scores for a given assessment at the three time points. Separate analyses will be conducted for each outcome. Cost per Quality-Adjusted Life Year will be compared between the intervention and control groups. Additional analyses will examine the mediating effect of self-determination theory on each outcome.
  
  
  CONCLUSIONS
  Elder Tree is a multifaceted intervention, making it a challenge to assess which services or combinations of services account for outcomes in which subsets of older adults. If Elder Tree can improve quality of life and reduce healthcare costs among older adults, it could suggest a promising way to ease the burden that advancing age can place on older adults, their families, and the healthcare system.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02128789 . Registered on 26 March 2014.
authors.affiliation: Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA. dhgustaf@wisc.edu.
authors.forename: David H
authors.initials: DH
authors.lastname: Gustafson
authors.affiliation: Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA. fmmctavi@wisc.edu.
authors.forename: Fiona
authors.initials: F
authors.lastname: McTavish
authors.affiliation: Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA. dgustafson@wisc.edu.
authors.forename: David H
authors.initials: DH
authors.lastname: Gustafson
authors.affiliation: Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health and Executive Director, Wisconsin Institute for Health Aging, Madison, WI, 53792, USA. jm2@medicine.wisc.edu.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Mahoney
authors.affiliation: Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA. rjohnson24@wisc.edu.
authors.forename: Roberta A
authors.initials: RA
authors.lastname: Johnson
authors.affiliation: Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, 53705, USA. jdlee@engr.wisc.edu.
authors.forename: John D
authors.initials: JD
authors.lastname: Lee
authors.affiliation: Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA. arquanbe@wisc.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Quanbeck
authors.affiliation: Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA. aatwood@wisc.edu.
authors.forename: Amy K
authors.initials: AK
authors.lastname: Atwood
authors.affiliation: Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA. ajisham@wisc.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Isham
authors.affiliation: College of Engineering and School of Business and Executive Director, University of Wisconsin E-Business Institute, University of Wisconsin-Madison, Madison, WI, 53706, USA. raj.veeramani@uwebc.wisc.edu.
authors.forename: Raj
authors.initials: R
authors.lastname: Veeramani
authors.affiliation: Aging, Work & Health Research Group, Faculty of Health Sciences, University of Sydney, Sydney, Australia. lindy.clemson@sydney.ed.au.
authors.forename: Lindy
authors.initials: L
authors.lastname: Clemson
authors.affiliation: Mass Communication Research Center, School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, WI, 53706, USA. dshah@wisc.edu.
authors.forename: Dhavan
authors.initials: D
authors.lastname: Shah
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000523:psychology*; D001292:Attitude to Computers; D017028:Caregivers / Q000523:psychology; D054626:Consumer Health Information / Q000191:economics; D003362:Cost-Benefit Analysis; D004644:Emotions; D005260:Female; D015577:Geriatric Assessment; D017048:Health Care Costs; D063005:Health Information Systems / Q000191:economics; D007722:Health Knowledge, Attitudes, Practice; D006299:Health Services for the Aged / Q000191:economics; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D008490:Medical Informatics / Q000191:economics; D015999:Multivariate Analysis; D026684:Personal Autonomy; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012107:Research Design; D013997:Time Factors; D014922:Wisconsin