Background: The aging society posits new socioeconomic challenges to which a potential solution is active and assisted living (AAL) technologies. Visual-based sensing systems are technologically among the most advantageous forms of AAL technologies in providing health and social care; however, they come at the risk of violating rights to privacy. With the immersion of video-based technologies, privacy-preserving smart solutions are being developed; however, the user acceptance research about these developments is not yet being systematized. Objective: With this scoping review, we aimed to gain an overview of existing studies examining the viewpoints of older adults and/or their caregivers on technology acceptance and privacy perceptions, specifically toward video-based AAL technology. Methods: A total of 22 studies were identified with a primary focus on user acceptance and privacy attitudes during a literature search of major databases. Methodological quality assessment and thematic analysis of the selected studies were executed and principal findings are summarized. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines were followed at every step of this scoping review. Results: Acceptance attitudes toward video-based AAL technologies are rather conditional, and are summarized into five main themes seen from the two end-user perspectives: caregiver and care receiver. With privacy being a major barrier to video-based AAL technologies, security and medical safety were identified as the major benefits across the studies. Conclusions: This review reveals a very low methodological quality of the empirical studies assessing user acceptance of video-based AAL technologies. We propose that more specific and more end user– and real life–targeting research is needed to assess the acceptance of proposed solutions.

Introduction: The use of video-based ambient assisted living (AAL) technologies represents an innovative approach to supporting older adults living as independently and autonomously as possible in their homes. These visual devices have the potential to increase security, perceived safety, and relief for families and caregivers by detecting, among others, emergencies or serious health situations. Despite these potentials and advantages, using video-based technologies for monitoring different activities in everyday life evokes concerns about privacy intrusion and data security. For a sustainable design and adoption of such technical innovations, a detailed analysis of future users' acceptance, including perceived benefits and barriers is required and possible effects and privacy needs of different activities being filmed should be taken into account.Methods: Therefore, the present study investigated the acceptance and benefit-barrier-perception of using video-based AAL technologies for different activities of daily living based on a scenario-based online survey (N = 146).Results: In the first step, the results identified distinct evaluation patterns for 25 activities of daily living with very high (e.g., changing clothes, showering) and very low privacy needs (e.g., gardening, eating, and drinking). In a second step, three exemplary activity types were compared regarding acceptance, perceived benefits, and barriers. The acceptance and the perceived benefits of using video-based AAL technologies revealed to be higher in household and social activities compared to intimate activities. The strongest barrier perception was found for intimate activities and mainly regarded privacy concerns.Discussion: The results can be used to derive design and information recommendations for the conception, development, and communication of video-based AAL technologies in order to meet the requirements and needs of future users.

An aged population, increasing care needs, and a lack of (in)formal caregivers represent major challenges for our society today. Addressing these challenges fuels efforts and developments in innovative technologies leading to various existing AAL applications aiming at improving autonomy, independence, and security in older age. Here, the usage of video-based AAL technologies is promising as detailed information can be obtained and analyzed. Simultaneously, this type of technology is strongly connected with privacy concerns due to fears of unauthorized data access or inappropriate use of recorded data potentially resulting in rejection and non-use of the applications. As privacy-preserving visualizations of video data can diminish those concerns, this empirical study examines the acceptance and privacy perceptions of video-based AAL technology applying different visualization modes for privacy preservation (n = 161). These visualization modes differed in their degrees of visibility and identifiability, covering different levels of privacy preservation (low level: “Blurred” mode; medium level: “Pixel” and “Grey” modes; high level: “Avatar” mode) and are specifically evaluated based on realistic video sequences. The results of our study indicate a rather low acceptance of video-based AAL technology in general. From the diverse visualization modes, the “Avatar” mode is most preferred as it is perceived as best suitable to protect and preserve the users’ privacy. Beyond that, distinct clusters of future users were identified differing in their technology evaluation as well as in individual characteristics (i.e., privacy perception, technology commitment). The findings support the understanding of potential users’ needs for a successful future design, development, and implementation of video-based, but still privacy-preserving AAL technology.