literature review on sense of place

Literature review: Historic environment, sense of place, and social capital

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Sense of place in geography and environmental education: a literature review of empirical research

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Published Online : Jun 29, 2024

Page range: 37 - 52, received : feb 22, 2024, accepted : may 16, 2024, doi: https://doi.org/10.2478/geosc-2024-0003, keywords sense of place , primary and secondary education , geography education , environmental education , literature review, © 2024 dominik rubáš et al., published by sciendo, this work is licensed under the creative commons attribution-noncommercial-noderivatives 3.0 license..

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• Corpus ID: 141030317

Literature Review: Historic Environment, Sense of Place, and Social Capital

• H. Graham , Rhiannon Mason , A. Newman
• Published 1 June 2009
• Environmental Science, Sociology, History

52 Citations

Local residents exploring heritage in the north pennines of england: sense of place and social sustainability, two concepts of community in the niger delta: social sense of communality, and a geographical sense of place. are they compatible, modeling the relationship between sense of place, social capital and tourism support, cultural heritage in building and enhancing social capital, sense shaping place: repositioning the role of sense of place in social-ecological systems from a bioregional planning viewpoint, is social capital higher in areas with a higher density of historic assets analyses of 11,112 adults living in england, sense of place as a determinant of people's attitudes towards the environment: implications for natural resources management and planning in the great barrier reef, australia., mapping the geographies of luxury cognitive “purity”, a conceptual framework for understanding sense of place dimensions in the heritage context, fostering rural sense of place: the missing piece in uturu, nigeria, 101 references, heritage as knowledge: capital or culture, presumption, policy and practice, relationality, place, and absence: a three-dimensional perspective on social memory, topophilia: a study of environmental perception, attitudes, and values, sense of place: an empirical measurement, sense of place, authenticity and character: a commentary, maintaining research traditions on place: diversity of thought and scientific progress, the meaning of place: attachments to femundsmarka national park, norway, among tourists and locals, forms of capital, place-identity: physical world socialization of the self, related papers.

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CONCEPTUAL ANALYSIS article

Sense of place, fast and slow: the potential contributions of affordance theory to sense of place.

• 1 Department of Landscape Architecture, Planning and Management, Swedish University of Agricultural Sciences, Uppsala, Sweden
• 2 Department of Built Environment, Aalto University, Espoo, Finland
• 3 Department of Natural Resources, Cornell University, Ithaca, NY, United States

Over the past 40 years, the sense of place concept has been well-established across a range of applications and settings; however, most theoretical developments have “privileged the slow.” Evidence suggests that place attachments and place meanings are slow to evolve, sometimes not matching material or social reality (lag effects), and also tending to inhibit change. Here, we present some key blind spots in sense of place scholarship and then suggest how a reconsideration of sense of place as “fast” and “slow” could fill them. By this, we mean how direct and immediate perception–action processes presented in affordance theory (resulting in immediately perceived place meanings) can complement slower forms of social construction presented in sense of place scholarship. Key blind spots are that sense of place scholarship: (1) rarely accounts for sensory or immediately perceived meanings; (2) pays little attention to how place meanings are the joint product of attributes of environmental features and the attributes of the individual; and (3) assumes that the relationship between place attachment and behavior is linear and not constituted in dynamic relations among mind, culture, and environment. We show how these blind spots can begin to be addressed by reviewing key insights from affordance theory, and through the presentation of applied examples. We discuss future empirical research directions in terms of: (1) how sense of place is both perceived and socially constructed; (2) whether perceived and socially constructed dimensions of place can relate to one another when perceived meanings become unsituated; and (3) how place attachment may change over different stages of the life course based upon dynamic relationships between processes of perception–action and social construction. We conclude with insights into how processes of perception–action and social construction could be included in the design and management of urban landscapes.

Introduction

Interest in sense of place has grown rapidly in recent years, with the concept extended from leisure and recreation to a wide range of applications and settings. The concept broadly describes human connection to places, including place attachment and place meaning ( Stedman, 2003 ; Farnum et al., 2005 ; Smaldone et al., 2005 ). Place attachment refers to the emotional bonds between an individual and a geographic locale, or how strongly a person is connected to a place ( Low and Altman, 1992 ; Jorgensen and Stedman, 2001 ; Raymond et al., 2010 ), whereas place meaning is the descriptive, symbolic meaning that people ascribe to a place ( Smaldone et al., 2008 ; Stedman, 2008 , 2016 ).

Historically, sense of place research, including emphases on both meaning and attachment (Figure 1 ), has “privileged the slow.” We see this in the “conservativism” of place critique(s) which views place meanings as slow to evolve, sometimes not matching material or social reality (lag effects), and also place meanings as tending to inhibit change (the maladaptive nature of place meanings) ( Marshall et al., 2012 ; Stedman, 2016 ; Masterson et al., 2017 ). It is also generally accepted that place attachment endures over time ( Giuliani, 2003 ; Lewicka, 2011 ), and slowly changes in intensity or structure with one’s length of residence in a given place ( Hammitt et al., 2004 ; Brown and Raymond, 2007 ), or waxing and waning over the course of one’s connection to a place ( Smaldone et al., 2008 ). Its stability can be affected by life stage ( Elder et al., 1996 ), by economic, social, political, and other external disruptions to a place ( Brown and Perkins, 1992 ; Feldman, 1996 ; Devine-Wright, 2009 ), and across short-term and long-term residents ( Kaltenborn and Williams, 2002 ; Stedman, 2006 ). Despite these limited engagements of variability, the general tendency in research has been to emphasize the steady, “slow” development of strong attachments and stable meanings.

FIGURE 1. Three perspectives of place considered in this paper.

Within sense of place scholarship, Williams (2014a) identifies two branches of enquiry: “place as a locus of attachment” and place as a “center of meaning” (Figure 1 ). The former refers to an operational construct designed to measure the intensity or strength of a bond to a geographic locale. Scholars rarely acknowledge that this branch of enquiry is based on an interactionist worldview in psychology ( Altman and Rogoff, 1987 ). In this worldview: (1) reality comes divided into subjects and objects in that aspects of the environment are seen as independent of the properties of human minds or bodies ( Altman and Rogoff, 1987 ; Lakoff and Johnson, 1999 ); (2) the individual is driven by factors located outside in the surroundings, including biological determinants; and (3) the bases for change in the state of the individual are the impacts stemming from entities and conditions in the surroundings, as well pushes from within the individual ( Heft, 2013 ). Researchers commonly employ top-down information processing strategies using deductive approaches. Contextual information is used as “inputs” (in the forms of cognitions, beliefs, attitudes, or other mental representations about a place, see Williams, 2014a ) in order to create meaningful mental perceptions (“output”) ( Bernstein, 2010 ).

In contrast, “place as a center of meaning” refers to the broader processes of meaning-making, and how to characterize experience, meaning, and relationships to places in more experiential qualitative terms ( Williams, 2014a ). Emphasis is placed on an interpretative approach to cognition ( Bruner, 1990 ), with hermeneutic, discursive, dialogical, or phenomenological research paradigms used to interpret how place meanings form, or are collectively shared, disseminated and deployed (see Table 1 and section “Sense of Place Scholarship Rarely Accounts for Sensory or Immediately Perceived Meanings” for further explanation).

TABLE 1. An overview of the differing approaches to sense of place and affordance scholarship.

Regardless of differences between the above perspectives, they have in common a general emphasis on “slow” progression of meanings and attachment, and are often interested in the social construction of meaning. Unlike in the sense of place scholarship, there is a wider body of literature in Ecological Psychology which “engages the fast,” as reflected in the theory of affordances (Figure 1 ). An affordance refers to the “possibility for action” provided to an individual by an environment – by the substances, surfaces, objects, and other living creatures that surround the social actor ( Gibson, 1979 ). Affordances are the result of real-time or direct perception–action processes in that they depend on the existence of an organism that can perceive them and the actions which the organisms can undertake within a particular setting ( Chemero, 2003 ). For example, a ledge approximately 6 inches high in a public area may function as an edge marker for adults; however, for a young child it can function as a place to sit, as a structure to climb on and to leap over, and as a challenging edge on which to walk ( Heft, 2010 ). The geographic scale of place in this context refers to one’s immediately perceivable environment. Three core principles underpin Gibson’s ecological approach ( Chemero, 2003 ): (1) perception is direct in that it does not involve computational or mental representations; (2) direct perception–action processes are primarily for the guidance of action; and (3) because perception does not involve mental computational or mental representations yet it can still guide behavior, all the information and meaning necessary to guide adaptive behavior must be available in the environment to be perceived ( Chemero, 2009 ).

We now articulate and engage a new branch of place enquiry that engages with the fast as “place as a perception–action process” (Figure 1 ), resulting in the formation of immediately perceived place meanings. This branch takes a bottom-up view of information processing whereby it is assumed that the world provides sufficient contextual information for our visual systems to directly perceive what is there without the need for lengthy cognitive abstraction. It is based on a transactional worldview of psychology, akin to embodied scientific realism, which supports the inseparability of subject and object ( Maturana and Varela, 1987 ; Lakoff and Johnson, 1999 ). In other words, dynamic, multi-level relationships are possible between elements of mind, body, culture, and environment ( Raymond et al., 2017 ).

In this conceptual paper, we highlight the potential contributions of affordance theory to sense of place scholarship. We first critically discuss a set of “blind spots” in sense of place scholarship and suggest how affordance theory may address them. We then outline a set of future research directions for reconceptualizing sense of place theory to take account of fast and slow processes of cognition associated with perception–action and social construction, respectively.

Key Blind Spots in Sense of Place Scholarship

Sense of place scholarship rarely accounts for sensory or immediately perceived meanings.

Sense of place scholars have largely focused their investigations on the social construction of place attachment or place meaning using interpretative or top-down information processing approaches (Table 1 ). Each approach has a different emphasis on place. Briefly, at the risk of over-simplification, interpretive approaches within “place as a center of meaning” often focus on the meanings that shape actions or everyday experiences ( Wagenaar, 2011 ). Within the diversity of interpretive traditions, sense of place scholars usually employ hermeneutic, discursive, dialogical, and/or phenomenological approaches. In a hermeneutic approach, meaning is generated in the individual subjective mind through the interpretation of texts. Landscape legibility or being able to “read” the landscape is therefore crucial to the formation of a sense of place ( Drenthen, 2011 ). In a discursive approach, place meanings are treated as a social practice that cannot be understood outside of interactional, cultural, and institutional contexts in which they emerge. They are formed through everyday language use and social practice and have important rhetorical relevance ( Di Masso et al., 2014 ). Dialogical approaches emphasize the central role of actions and practices in producing place meaning ( West, 2016 ). A phenomenological approach seeks to qualify the long-term relationship between an individual and a place through lived experience ( Relph, 1976 ; Norberg-Schulz, 1980 ; Seamon, 2014 ). Emphasis is placed on subjective place experience, deep emotional ties, and individually constructed place meaning ( Tuan, 1974 , 1977 ; Relph, 1976 ). Meaning is not solely a person–environment relation, but an intersubjective matter of people–environment relations. It is the shared performance of individuals (e.g., by inventing, constructing, and deconstructing structures) that turn lived space into a special place ( Graumann, 2002 ). Much of the early work on sense of place and place attachment focused on this holistic approach ( Stedman, 2002 ).

In contrast, in “place as a locus of attachment” scholars have frequently employed a top-down information processing approach in order to quantify the relationships between activities, physical attributes, and meanings ( Moore, 2014 ). How top-down information processing is used can vary across different levels of processing. In cognitive psychology, three levels of information processing are commonly discussed: computational, algorithmic–representational, and implementational ( Marr, 1982 ; Newell, 1990 ). Computational level addresses questions such as what is the goal of computation? What problems does the system solve or overcome ( Marr, 1982 )? Here, we need to consider what drives different attitudes or beliefs about place. In contrast, algorithmic–representational approaches describe how the system represents the problem and what processes are employed to manipulate inputs and outputs ( David et al., 2004 ). Most quantitative research on place attachment has focused on this level of computation. For example, researchers have attempted to psychometrically distinguish between functional goals using the dimension of place dependence and symbolic meanings using the dimension of place identity ( Kyle et al., 2004 ; Hammitt et al., 2006 ; Raymond et al., 2010 ; Ramkissoon et al., 2013a ; Brown et al., 2015 ). Psychometric scales that measure these two dimensions of place attachment have been widely used in environmental psychology ( Lewicka, 2011 ), and have been extended to measure the bonds developed between an individual and broader elements of the social and biophysical context to place ( Kyle et al., 2005 ; Jorgensen and Stedman, 2006 ; Raymond et al., 2010 ; Ramkissoon et al., 2013b ). Implementation-level theory answers the question of how representations and algorithms can be realized physically in the human brain ( David et al., 2004 ). For example, what happens in the human brain when one becomes attached to a given place? No studies have as yet employed neuroscience approaches to the assessment of sense of place.

These differences notwithstanding, common to all these approaches to sense of place is that they rely on a high level of intellectual abstraction of cognitions, beliefs, attitudes, or other mental representations about the physical, social, or personal qualities of a setting and comparatively neglect the role of the local context in direct perception ( Vanclay et al., 2008 ). We also see this intellectual abstraction in studies that question the relative contribution of physical, social, or personal dimensions of place (e.g., Beckley et al., 2007 ). For example, Williams (2014b) discusses four layers of place meaning: inherent, instrumental, socio-cultural, and identity–expressive (Figure 1 ). Places can have inherent meaning ( Lynch, 1960 ) which transcends any culture, and reflects essential properties of a place that many people perceive. Places can have instrumental meanings associated with their material properties that contribute to desired social or economic goals. They can have socio-cultural meaning which recognizes that places can be socially or symbolically constructed within the cultural, historical, and geographical contexts of day-to-day life ( Hay, 1998 ; Gustafson, 2001 ; Seamon, 2014 ). The identity-expressive layer focuses on how individuals become attracted to and attached to place because those places possess intangible emotional, symbolic, and spiritual meaning.

Despite the above, it remains unclear how the immediately perceived and sensory dimensions of sight, smell, hearing, taste, and touch (i.e., aspects of sensory experience) contribute to overall place meaning. Crucially, these perceived meanings do not involve mental computational or mental representations. Rather, they involve a bottom-up theory of perception whereby perception starts at the sensory input, the stimulus ( Bernstein, 2010 ). Sense of place scholarship has been largely silent on this question with general assumptions made that aspects of the senses represent a particular category of place meaning ( Russ et al., 2015 ). Others imply that sensory experience reflects an intensity of place meaning. For example, Hay (1998) showed that as the amount of time spent in a place increases, the relationship to the place, and in particular the attachment, intensifies and becomes deeper (from “aesthetic experience” to “part of place”). A wider view of the literature suggests that senses themselves are an important element of place perception. Vanclay et al. (2008) suggest that full experience of a place can only be experienced through the senses (smell, taste, feel, sight, and spiritual dimensions), whether we are aware of them or not, and call for the consideration of both intellectual abstraction and sensory perception. They highlight the importance of different senses to people with disabilities, as in the case of the history of “deaf places of silence” which are commonly known to deaf people ( Gulliver, 2008 ). In the marketing and branding literatures, scholars have found that aesthetics and visual cues are powerful ways of tailoring products to the perceived desires of consumers (e.g., Porter, 2013 ). Other work considers the way in which non-visual senses can, or could, play in the way places are branded ( Medway, 2015 ; Medway et al., 2016 ).

The complex relations among sensory, inherent, instrumental, socio-cultural, and identity-expressive meanings have not been adequately engaged in the sense of place literature. A holistic assessment would require scholars to accept that sense of place can form through both immediate and direct perception–action processes in addition to the longer-term processes of intellectual abstraction, representation, or computation, which are better represented in the sense of place literature (mainly in terms of social construction). Doing so will require a general willingness to explore sense of place across time, including a consideration of how sense of place forms and changes in response to both immediate perceptions and longer-term processes of social construction.

Sense of Place Scholarship Pays Little Attention to How Place Meanings Are the Joint Product of Attributes of Environmental Features and the Attributes of the Individual

Many of the debates in sense of place scholarship focus on the relative contribution of social relationships and physical environments to place attachment and place meanings. In psychology, place has been presented as a socio-physical construct comprising of physical, social, and personal/individual components. However, few papers discuss the potential for sense of place to be simultaneously determined by the intersection of attributes of the environmental feature in question and attributes of the particular individual. In a review of the literature, Lewicka (2011) found that physical factors have been found to be stronger predictors of place attachment among higher income respondents, whereas social ties are more important among lower income respondents. Scannell and Gifford (2010) found that physical factors were more important reasons for attachment to the city whereas social factors were more important to the home and region. Place meanings can also be influenced by a range of ecological characteristics ( Russ et al., 2015 ) and features of the biophysical environment ( Stedman, 2003 ), whereas others involve pivotal moments or other significant life experiences that happened in a place ( Manzo, 2005 ).

The focus on the relative contribution of different dimensions of place meaning implies a duality between individuals, culture, and the environment in human–nature relationship assessments and stifles discussion on a more holistic concept of “relatedness.” Absent in most discussions is the way in which sense of place is formed based on the nature of the setting, the kind/amount of experience with that setting, and socio-demographic characteristics of the individual ( Stedman, 2003 ). The concept of “situated cognition” is one way to understand such relatedness of the conjoining of people and place. By situated cognition we refer to how meaningful actions are spatially and temporally located (i.e., situated ) ( Chemero, 2009 ) alongside socially and culturally constructed meaning ( Lave and Wenger, 1991 ; Wenger, 1998 ). For example, how decisions concerning the speed at which you ride your bike are shaped by your characteristics as an individual (e.g., are you in good physical condition, and are you generally risk averse or risk seeking), the visual perception of a bike trail on a given day (e.g., has it rained and are there muddy spots where you might fall), your previous experiences on that bike trail tied to deeply held place meanings and the social expectations of significant others accrued over time ( Raymond et al., 2017 ). Such dynamic relations imply an inseparability of subject and object ( Maturana and Varela, 1987 ; Lakoff and Johnson, 1999 ), which sense of place scholarship – at least as currently articulated – cannot clearly explain or describe. Gustafson (2001) has provided one of the most pivotal accounts of the potential for dynamic relations among person, physical environment, and social environment. He found evidence for a network of relational place meanings with some meanings situated in the relationship between self, others, and/or the environment. However, even this work has not seriously engaged the kind of situated cognition we envision.

Sense of Place Scholarship Implicitly Assumes That the Relationship between Place Attachment and Behavior Is Linear and Not Constituted in Dynamic Relations Among Mind, Culture, and Environment

Scholars have often assumed that sense of place is analytically separable from behavior and therefore it can be used to systematically predict it. For example, results showing that place attachment directly predicts self-reported pro-environmental behavior ( Vaske and Kobrin, 2001 ; Stedman, 2002 ; Brehm et al., 2013 ) or place attachment indirectly predicts behavior through values, beliefs, and norms ( Raymond et al., 2011 ). In most instances, the effect sizes of these linear models are only modest (<20%), raising questions about how to model the relationships between sense of place and action, and what the other “missing” predictors of behavior might be. These models also tend to test the relationships between place attachment and behavior at a point in time rather than how these dynamics may vary across time. Rather than a new model, perhaps we require a new set of assumptions about the links between sense of place and behavior. The above assumptions about the relationships between sense of place and behavior change if we engage an alternative worldview of “transactionalism,” which emphasizes the inseparability of subject and object ( Maturana and Varela, 1987 ; Lakoff and Johnson, 1999 ). Here, dynamic, multi-level relationships are possible between elements of the mind, environmental and cultural system, which imply that one cannot understand aspects of behavior without also understanding aspects of the intertwined socio-cultural system. There is growing evidence for this worldview in human–environment relationship studies, but not in sense of place research per se . Cooke et al. (2016) eloquently show that human–environment connections are not produced solely within the mind, but through relations between mind, body, and environment over time. Fischer and Eastwood (2016) find intersections between the co-production of ecosystem structures, ecosystem services, and the social construction of these structures and services. Brown (2016) demonstrates how the experience of textured terrain (e.g., the resistance, gradient, shape lumpiness, and irregularities of the terrain) can produce sensory and emotional experiences that motivate regular exercise.

Sense of Place Scholarship Does Not Account for How Both Place Meanings and Place Attachment Vary Across the Life Course

The sense of place literature typically engages experience and time over a longer time horizon. It is generally accepted across all approaches that place attachment slowly changes in intensity with one’s length of residence in a given place ( Hammitt et al., 2004 ; Brown and Raymond, 2007 ), and is shaped by economic, social, political, and other external disruptions to a place ( Brown and Perkins, 1992 ; Feldman, 1996 ; Devine-Wright, 2009 ). Research has also considered how place attachment develops across long-term residents, with sequential stages in the development found across time in a given place [ Hay, 1998 ; but see Stedman (2006) for a dissenting view; Rowles, 1983 ], and the role of nostalgia in facilitating attachments to place ( Lewicka, 2011 ). Scholars have used identity theories to describe how physical changes (both actual and proposed changes) to place may threaten place-based identities ( Proshansky et al., 1983 ; Stedman et al., 2002 ; Devine-Wright, 2009 ); and how place attachment may be both threatened and/or enhanced across place change ( Devine-Wright and Howes, 2010 ). Place attachment can also vary across life-place trajectories of: long-term residence in a single place, return to the home place, residential mobility with continuity in settlement, residential mobility with discontinuity in settlement, and high residential mobility ( Bailey et al., 2016 ).

Despite the above, the role of place experience in shaping place meanings and attachments across the life course has not been thoroughly considered. Scholars have made a general assumption that place meanings are sustained by regular environmental actions and routines, that are in turn maintained and strengthened across one’s depth of experience with place ( Seamon, 1979 ; Fullilove, 2004 ). For example, from a phenomenological perspective, place meanings are embedded in stories and metaphors, each highly dependent on context, and embedded or contained within an evolving set of experiences ( Patterson, 1998 ). But how may these meanings change across place experiences at different life stages, and what role do these changing meanings have on one’s overall place attachment? Sense of place scholarship cannot fully answer such questions. They are important to consider because wider psychology research has shown that the connections that we have with family and friends and the experiences we have in place during important transition times in life (e.g., children approaching decisions to leave home) are related to mobility preferences ( Elder et al., 1996 ). Studying these relationships may help us better understand and predict the determinants of mobility and migration, which is a mega-trend of the 21st century and also addresses a major gap in sense of place theory concerning the interrelationships between place meaning and place attachment. Current discussions often become confounded by conflicting views about the relative merits of qualitative vs. quantitative studies implemented over short time spans as opposed to understanding how they together may inform sense of place over different life stages.

How Affordance Theory Can Address Blind Spots in Sense of Place Scholarship

Affordance theory demonstrates how direct perception and actualization inform place meanings.

Two processes underpin the theory of affordances, namely direct perception and actualization ( Kyttä, 2002 , 2004 ). In contrast to most sense of place scholarship, an individual does not require mental computation or representations because the perception of meaningful behaviors is readily available in the environment, hence direct . An individual directly perceives what are his/her opportunities for action in an environment given the relations among the observer’s knowledge, intentions, action abilities (constrained by body morphology, physiology, and emotional/intellectual development), and the properties of the environment itself ( Canal-Bruland and van der Kamp, 2015 ). Perception is directly functional for the guidance of action rather than for gathering information ( Chemero, 2009 , p. 18). Actualization is then the processes of complementing environmental opportunities with personal abilities. In other words, the environment provides something that the individual perceives as offering the potential for activity, but actualization of the activity only emerges when the different characteristics of the individual, such as his or her physical abilities, social needs, and personal intentions, are matched in meaningful relations with the environmental features ( Kyttä, 2004 ).

These relations mean that affordances can rapidly change from potential to perceived, used or shaped depending on the relationships between the individual, culture, and setting ( Kyttä, 2003 ). Kyttä (2002) describes this dynamic. All environments have countless numbers of potential affordances that no agent has yet perceived. The array of potential affordances available to any given individual is defined by the individual’s qualities such as the children’s physical skills or bodily proportions. The qualities of the individual as well as his or her current intentions and other cultural factors determine which affordances out of all potential affordances the individual perceives in different situations (i.e., perceived affordances ). Some of these affordances are used in the here and now. Individual and socio-cultural factors can have an influence on what affordances are utilized and when this occurs. It is also possible to actively shape the environment to create new affordances, or to change existing ones, in what is referred to as shaped affordances . Modifying the physical environment can open space for the identification of new affordances and new possible activities ( Kyttä, 2002 , 2004 ).

Hence, through direct perception and action we create various forms of perceived place meanings related to functional, social, or symbolic elements of a given area. Meanings are assigned to places within one’s immediately perceivable environment. These places have clear material and perceptual components. Hereafter, we refer to them as “immediately perceived place meanings” to distinguish them from the more commonly known place meanings formed through social construction.

Affordance Theory Demonstrates That Cognitions Are Situated in Relation to the Environment, the Individual, and One’s Socio-Cultural Context

In affordance theory, perception–action process and associated cognitions always occur in a situation . Because perception is direct, meaningful actions are always spatially and temporally located (i.e., situated ), providing information about “here,” “there,” “me,” and “now” ( Chemero, 2009 ). Information perceivable in any given situation will specify patterns of relations between the organism and the environment ( Shapiro, 2011 ). Situations can then have motivating qualities: as in the case of a low ledge for children (as a “climbing place”), or repelling like an aggressive dog ( Heft, 2010 ) suggesting an affective dimension to affordances ( Kyttä, 2003 ; Roe and Aspinall, 2011 ; Withagen et al., 2012 ). Thus, patterns at any given situation not only offer the opportunity to act, but also can invite and attract the action ( Withagen et al., 2012 ) or repel and detract the action. Any given place can therefore have an array of positive and negative affordances that promote or inhibit action, respectively.

These perceptions and actions are not only situated with reference to a physical context ( Heft, 2013 ). Associations between bodily experiences and abstract concepts are situated in a socio-cultural context, informed by cultural imperatives, values, and habits ( Gibson, 1979 ; Varela et al., 1991 ; Leung et al., 2011 ), and social learning ( Bandura, 1977 ), which can be readily applied to gaining competence in place. Individual and sociocultural factors together determine which of the perceived affordances become used affordances within a given experience (e.g., sat on, swam in, climbed on), as in the case of socialization during childhood development. During development, a child learns to perceive not only the affordances for the self, but also how those same objects furnish similar affordances to another ( Gibson, 1979 ). Parents or significant others can introduce children to the conventional meaning of an object by manipulating which objects command attention and demonstrating how to use the object through performing its central function. For example, in a study of a kindergarten in central Norway, some 3–5-year olds needed to be socially invited into physical play, to realize the potential affordances for physical activity ( Bjørgen, 2016 ). Encouraging invitations from others, responses, imitations, and sharing moment of fun were of significance in the involvement and duration level of physical activity. Hence, the physical activity is not always created by the children, but requires invitations from others in the environment where they are playing and regulation by significant others who promote certain behaviors.

In summary, this section highlights that immediately perceived place meanings are both temporally and physically located and are influenced by a range of physical and social elements in one’s immediately perceivable environment and by socio-cultural processes.

Affordance Theory Suggests That Bodily Action Is Constituted within Dynamic Relations among Mind, Body, Culture, and the Environment

Affordance theory suggests that cognition is not an activity of the mind alone, but is instead distributed across the entire relationship situation, including mind, body, culture, and physical environment ( Heft, 1989 ). Through direct perception–action processes an individual actualizes those relations among environment, culture, body, and mind that reflect and support his or her capabilities and intended actions at any moment in time ( Kyttä, 2002 ). How they are actualized depends on the real-time relationship between a mental system in a body with particular capabilities with an environment that offers opportunities for acting on those services. Hence, bodily action is constituted within dynamic relations.

The coupling of perception and action in the social affordance literature is one example of these dynamic relations. It has been found that eye gaze patterns influence postural coordination, and gaze co-ordination is related to mutual understanding [see Shockley et al. (2009) for a review]. For example, pairs of individuals who are asked to perform a rhythmic task such as rocking in a chair rock independently in their chairs are pulled to spontaneously synchronize their movements ( Richardson et al., 2005 , 2007 ). The patterns of behavior that occur between the two individuals rocking independently in separate chairs with no mechanical (only informational) links obey the same dynamics as coupled components ( Marsh et al., 2009 ). Studies have also shown coupling across a range of other behaviors including walking, running, and plank lifting ( Anderson et al., 2012 ).

It is important to note that these perception–action processes are not static, but since they are related to activities, they happen over time and their actualization changes the subsequent patterns of relations between individual and environment ( Chemero, 2009 ). In other words, an individual’s perception–action in the environment influences both surrounding (e.g., by manipulating objects, affecting others, moving) and abilities (e.g., by learning, acquiring new skills), and in doing so opens up possibilities for new activities and thus novel or reshaped patterns of affordances ( Shotter, 1983 ; Heft, 1996 ). Raymond et al. (2017) provide the example of a mountain bike rider to show a dynamic relation among the condition of the rider, perception of the environment, and riding speed (behavior). They note that the act of riding improves individual body condition and confidence, which in-turn has an effect on what kind of environment can be perceived as safe and enjoyable. Skills are embodied by repeatedly practicing mountain-biking allowing a rider to perceive a rocky and wet slope as safe and enjoyable, thereby enabling the rider to approach it and enjoy it at faster riding speed.

In summary, this section highlights that elements of our own mind and bodily condition inform what types of meanings we immediately perceive in a given place. Human have the ability to learn new skills and to improve their physical condition which opens the potential for new forms of immediately perceived place meanings. We also change a place through our actions, which opens spaces for new meanings.

The objective of this paper was to highlight the potential contributions of affordance theory to sense of place scholarship. We asserted that most sense of place scholarship is preoccupied with the “slow” in that most research suggests that place meanings as slow to evolve, sometimes not matching material or social reality (lag effects), and thus as tending to inhibit change. Little attention is paid to the role of sensory or immediately perceived meanings in the formation of sense of place; how place meanings are the joint product of attributes of environmental features and the attributes of the individual (i.e., the importance of situated cognition); the non-linear dynamics between sense of place and behavior, including the dynamic relations among mind, culture, and environment; and how place meanings vary across the life course. In contrast, affordance theory engages the “fast” – the more immediate perception–action processes between an individual and their social and cultural environment. Affordance theory demonstrates how direct perception and actualization inform immediately perceived place meanings that cognitions are situated in relation to the environment, the individual, and one’s socio-cultural context, and behavior is constituted within (and simultaneously determined by) dynamic relations among mind, body, culture, and the environment.

How do these different views on human–environment relationships influence our approach to sense of place research? Rather than viewing sense of place as exclusively (or even primarily) a social construction or representation, we suggest it could be seen as a property of the relationship between perception–action and social construction processes both within and across place-based experiences . Along these lines, we encourage sense of place researchers to assess the relationships among immediately perceived place meanings and other forms of place meaning that are socially constructed through longer-term processes of cognition and how each may contribute – independently, and collectively – to one’s place attachment. To understand these relationships, we encourage place scholars to move away from a focus on concept development and measurement, based firmly in the social construction approach, to enquiries of place as a multi-channel process which provides for an understanding of the relational dynamics between perception–action processes and socially constructed processes. Integrating the perceptual and conceptual domains will require place scholars to engage with the theory of embodied cognition, dynamic systems, as well as multiple views of cognition and behavior. In the next section, we propose pathways through which to consider the potential relationships between these two understandings of human–environment relationships.

Embracing the “Fast” and “Slow” in Future Sense of Place Research

Future research could investigate how the qualities of both sense of place scholarship and affordance theory could be applied to solve important issues in sense of place scholarship, such as how place attachment may form and change in a given place. The dual-process theory of higher cognition could be a fertile ground through which to explore or examine the intersections between place meanings formed through socially constructed process and meanings formed through affordances, i.e., perception–action process. According to this theory, both slow and fast forms of cognition exist ( Kahneman, 2003 ; Evans, 2010 ; Evans and Stanovich, 2013 ). Type 1 cognition is grounded in perception and intuition – thinking is fast, automatic, effortless, and associative, while Type 2 which is grounded in reasoning – thinking is slow, serial, controlled, effortful, and rule-governed. Type 1 generates impressions of the attributes of objects of perception and thought. In contrast, Type 2 is involved in judgments, irrespective of whether they originate in impressions or in deliberative reasoning ( Kahneman, 2003 ). While there have been a number of criticisms of dual-process theories (see overview in Evans and Stanovich, 2013 ), there is general acceptance that Type 1 represents a set of modes of cognition associated with rapid autonomous processes that yield habitual responses unless they are intervened on by higher order reasoning processes of Type 2 ( Evans and Stanovich, 2013 ). Within each type there are modes of cognitive processing styles or thinking dispositions ( Stanovich, 2009 ) which can vary continuously according to personality characteristics and cultural factors ( Evans and Stanovich, 2013 ).

Following this view, is it possible that direct perception–action processes operate as a subset of Type 1, fast, automatic processes (following Herschbach, 2015 )? In contrast, can socially constructed process be considered a subset of Type 2, slow processes? Three research areas worth considering under this line of thought are:

Research Direction 1 – Investigate How Sense of Place Is Both Directly Perceived (Type 1) and Socially Constructed in a Given Place (Type 2)

Perceived meanings, as we have described above, may play a bigger role in “sense of place” than we typically think. We propose that in any experience in life, sense of place can be associated with immediately perceived place meanings (related to Type 1 cognition) and/or place meanings formed through longer-term processes of social construction (related to Type 2 cognition). For example, the fireplace a couple sits next to after getting married enables the used affordance of warmth and light, plus a cozy atmosphere. Equally, that fireplace can be related to a diverse set of inherent, instrumental, socio-cultural, and identity–expressive meanings ( Williams, 2014b ), which can be positive and negative in nature ( Manzo, 2005 ). At the time of the wedding they may be related to feelings of romance and love, but if the fireplace was the backdrop for the scene of agreement to divorce it could also be associated with feelings of grief and loss, or if during a winter power outage, simply a pragmatic source of warmth or cooking. It follows from above that direct perceptions can be repeated in behavior.

We also propose that the relationships between direct perceptions and social construction are unlikely to be direct and linear. At small geographic scales, we hypothesize that place attachment will be a property of both immediately perceived and socially constructed place meanings, and that these meanings collectively help guide behavior. To investigate this hypothesis, a fruitful area of enquiry may be to specify physical characteristics of the environment that are perceived positively for a certain set of affordances and are known (at least anecdotally) to be a source of place attachment. Starting with a set of known relationships would help researchers to identify the mechanisms through which Type 1 and Type 2 processes occur.

Understanding the duration of focus of direct perception and social construction is also crucial to this line of enquiry. It is assumed that direct perception is immediate and social construction takes longer, but what are the actual time differences? Quasi-experiments may play an important role in understanding the time differences in cognitions resulting from direct perception and social construction so as to form a more holistic understanding of place.

To date we have avoided the question of how different types of place meanings inform each other at different geographic scales. To understand how sense of place is both perceived and socially constructed, we need to clarify the spatial scale of “place” and thus to what extent an affordance is a “place.” Here, we argued that there are parallels between affordances and sense of place when focusing on one’s immediate perceivable environment, such as a room, home, street, or small urban park (i.e., fine geographic scales). Yet how do direct perception and social construction occur at coarser geographic scales such as a neighborhood, city, or region? In short, we don’t yet know. An important future research direction is to examine whether affordances can be nested or sequenced in ways that enable us to understand direct perception at larger spatial scales. Such research would need to challenge some of the fundamental assumptions of affordance theory concerning how humans directly perceive the environment. For example, researchers would need to consider the potential for a collection of affordances in a place, a network of places in the neighborhood, a set of familiar and unfamiliar neighborhoods in a metropolitan area, etc. We consider this question of the scalability of affordance-based thinking an exciting area of future inquiry.

Research Direction 2 – Explore and Examine Whether Perceived (Type 1) and Socially Constructed (Type 2) Dimensions of Place Relate to One Another When Perceived Meanings Become Unsituated

The previous research direction investigates whether place as a perception–action process and place as a socially constructed process exist concurrently in a given place. But how do they relate? We propose that perceived and socially constructed meanings relate when perceived meanings become unsituated. This may occur through the process of “offline cognition.” According to Wilson (2002) , humans build up in long-term memory a set of reactions, movements, sensations, perceptions, feelings which are available for various purposes including cultural ones. In this process, mental structures that originally evolved for perception or action are co-opted and run “off-line,” to assist in thinking and knowing ( Glenberg, 1997 ; Wilson, 2002 ). Just thinking about an object produces states as if the object were actually there, as does perceiving a symbol, such as the name of the person or object ( Spackman and Yanchar, 2014 ). Cognition can therefore become “unsituated.” The evidence for offline cognition is widespread. It is included in discussions of mental imagery (including visual, audio, and kinesthetic imagery), working memory, episodic memory, implicit memory, and reasoning and problem-solving [see Wilson (2002) for a review].

No empirical work has tested the potential relationships between perceived and socially constructed meanings using ideas of offline cognition, but we can describe it from a practical perspective at fine geographic scales such as a room. Imagine a room in our home that we have been living in for a long time. We enter and exit that room multiple times on a daily basis and our action is guided by a range of perceptions concerning the size, light, and warmth of that room. Now imagine that we get married in that room. Through processes of social construction, that room is now associated with a range of socio-cultural meanings like love and social connection, and inherent meanings like the ambience of the room on the wedding day. Through processes of offline cognition, these perceived meanings associated with the sights, smells, and sounds of the wedding day become engrained in memory and in language, which provides the pathway through which perceived and socially constructed meanings relate.

We propose that perceived and socially constructed meanings are most likely to conjoin when memories are activated. In future studies, researchers could draw on phenomenological approaches in order to investigate the relationships between different components of living memory. That is, how different types of affordances are contained within (or independent to) inherent, instrumental, socio-cultural, and identity–expressive meanings within a given place and/or across places. Also, researchers could identify which types of affordances become “lost in space,” i.e., are rarely associated with different types of socially constructed meanings, but rather are part of our everyday navigation through life.

Research Direction 3 – Explore How Place Attachment Changes Over Different Stages of the Life Course Based upon Dynamic Relationships between Processes of Social Construction and Perception–Action

While research has considered how place attachment varies with respect to length of residence, place disruption, or nostalgia, no studies have considered how the structure of place attachment may change with reference to different forms of place experiences and place meanings across the life course. By bringing together the qualities of sense of place and affordance theories, we propose that place attachment could be considered as an emergent property of the dynamic sets of meanings associated experiences across the life course . By this we mean that types of perceived and socially constructed meanings formed during experiences at an early life stage (e.g., during a 6th birthday) are likely to inform the perceived and socially constructed meanings during experiences at a later life stage (e.g., getting married), assuming those experiences occur in the same place. The integration of the affordance perspective and how it relates – for example – to the changes in physical capacities associated with aging (e.g., the ledge we referred to earlier may be a challenging climbing place to a child, but too easy for the adult, and beyond the capacity of the elderly) may prove a very useful framework for understanding changes in attachment through the life course (e.g., Cuba and Hummon, 1993 ) or among the elderly in particular ( Rubinstein and Parmelee, 1992 ).

We don’t know how these immediately perceived and socially constructed place meanings combine within and across time to inform changes in the intensity or structure of place attachment. To establish this process, we require new mechanisms for not only examining how place as a perception–action process and socially constructed process relate at any given point in time (i.e., research area 2), but also how they may relate across significant experiences in a given place. Longitudinal research is needed to establish whether and how the memories associated with given affordances earlier in life inform later experiences in the same place .

Certain elements of early place experiences could also be transferrable to new settings, requiring an improved understanding of how perception–action processes and socially constructed meanings relate across time and different places . Longitudinal research is also needed to understand how the affordances perceived in one place early in life are held in memories to inform the affordances and social constructions of other places later in life.

Understanding place attachment as an emergent property of a complex system also has major implications for the assessment of the relationships between place attachment and pro-environmental behavior. If place attachment is an emergent property of both perception–action and socially constructed processes which are changing across one’s time in place then such phenomena cannot be fully understood using traditional linear cause and effect models, as often applied in place research when understanding place as a locus of attachment. Rather, we encourage a new approach to the assessment of pro-environmental behavior which is based on non-linear, complex dynamics. Such dynamics are already the source of intense investigation through areas such as social learning ( Cheng and Mattor, 2010 ), complexity science, and sustainability transitions ( Andersson, 2014 ) and co-production of knowledge ( Armitage et al., 2011 ; Tengö et al., 2014 ; Reyers et al., 2015 ), and initial thinking has occurred in the sense of place realm as well ( Stedman, 2016 ; Masterson et al., 2017 ). We urge a more spatial and relational view of these dynamics recognizing how individual minds and bodies and constituted within places that are both perceived and socially constructed, and how both direct perception and abstractions can lead to formation and change in behavior across places and time.

Implications of Fast and Slow Processes for the Design and Management of Urban Landscapes

If urban settings are repositories for a range of socially constructed and perceived meanings (Research Direction 1) then these settings need to be designed with both fast and slow cognitive processes in mind and thus multiple layers of place meaning. By layers we mean planning, designing, and implementing new forms of architecture in urban landscapes that cater for clusters of different types of immediately perceived and socially constructed place meanings, including functional, affective, and symbolic. These clusters could be tailored to different user groups so as to address important elements of environmental justice ( Raymond et al., 2016 ).

Stemming from Research Direction 2, it may be possible for urban environments to be designed with affordances that immediately evoke different forms of place meanings. Such urban designs may have multiple important uses for highly mobile individuals or migrants seeking to integrate into new communities rapidly. Certain types of affordances could be created in urban environments to bridge place meanings between their place of origin and their new (sometimes temporary) place of residence. For example, by creating “open spaces” which enable new migrants to shape and reshape affordances in that setting through art, craft, and music, informed by place meanings and memories from their place of origin. However, we acknowledge that designing urban environments for a diversity of meanings can lead to the potential for conflicts between different interest groups, which also needs to be managed ( Stedman, 1999 ).

Accepting place attachment as an emergent property (Research Direction 3) requires urban planners to take account of both short-term and long-term processes of cognition when designing cities. For example, forecasting how citizens’ experiences in a given setting could inform future experiences (and associated immediately perceived and socially constructed meanings), as opposed to designing solely for immediate, functional uses. This strategy would also suggest that city planners recognize that the end goal may not be to “increase place attachment” per se , but rather create settings that cater for a diversity of experiences and place meanings, each informing diverse (and sometimes oscillating) trajectories of place attachment across time. It also requires planners to recognize that initiatives for encouraging “sense of place” among different ethnic and migrant groups may achieve fast results in some areas (e.g., providing a playground so that children have the opportunity to play in their local environment), but have slow results in other areas (e.g., building the social capital so that individuals feel they belong in that place).

In this paper, we urged a systematic consideration of how both slow and fast processes of cognition inform sense of place scholarship. We asserted that sense of place scholarship has been conservative, non-dynamic, and principally focused on aspects of place meaning that unfold over time through a process of social construction. Theory development has largely excluded the role of immediate sensory and direct perception–action processes in meaning making, otherwise referred to as immediately perceived place meanings, but instead focused on place meanings formed through longer-term processes of social construction. In response, we suggest how affordance theory could overcome a number of blind spots in sense of place scholarship and then suggest research directions for empirically justifying how place as perception–action processes (a subset of Type 1 thinking in the dual-process model) and place as socially constructed processes (a subset of Type 2 thinking) relate to each other across place experiences and time. Reconceptualizing sense of place as fast and slow presents opportunities to consider how immediate perceptual processes can contribute to longer-term processes of social construction and vice versa. It also paves the way to addressing one of the most contentious aspects of sense of place scholarship and wider psychology: how processes of intellectual abstraction and computation based on interactionist worldviews can be united with immediate sensory experience based on transactional worldviews to better account for not only for place meanings and place attachment, but also environmental behavior across the life course.

Author Contributions

CR reviewed the literature and developed the key arguments for the paper, also wrote most sections of the paper with additions from MK and RS. MK provided insightful contributions to the affordance theory section of the paper, and to the future directions and management implications sections. RS provided insightful contributions regarding the argumentation and framing of the paper, and also provided key theoretical insights into sense of place, and the discussion section of the paper.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgment

This paper was funded by the PLAN-Health (PLANH) project through the Academy of Finland. Project number: 13297753.

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Keywords : ecological psychology, place meanings, human–environment relationships, place attachment, embodied cognition, affordances, dual-process models

Citation: Raymond CM, Kyttä M and Stedman R (2017) Sense of Place, Fast and Slow: The Potential Contributions of Affordance Theory to Sense of Place. Front. Psychol. 8:1674. doi: 10.3389/fpsyg.2017.01674

Received: 02 June 2017; Accepted: 11 September 2017; Published: 29 September 2017.

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Copyright © 2017 Raymond, Kyttä and Stedman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Christopher M. Raymond, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Literature review: Historic environment, sense of place, and social capital

Graham, Helen , Mason, Rhiannon and Newman, Andrew , International Centre for Cultural and Heritage Studies (2009) Literature review: Historic environment, sense of place, and social capital Newcastle upon Tyne, GB. English Heritage 44 pp.

This literature review considers whether it is possible to identify relationships between the historic environment, sense of place and social capital. It asks the following questions: 1. What theories can we find to explain the relationship between sense of place, historic environment and social capital? 2. What evidence can we find to explain the relationship between sense of place, historic environment and social capital? 3. What is the quality of this evidence and these theories? If international, how applicable are they to the UK? 4. Are there any key studies which are of particular relevance to this project? 5. What conclusions can we draw from this literature review to inform the questions to be asked in the research undertaken by CURDS?

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Literature Review: Historic Environment, Sense of Place, and Social Capital

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URL: http://www.english-heritage.org.uk/hc/upload/pdf/sense_of_place_lit_review_web.pdf?1261982907

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2 Sense of Place: Humanistic Geography, Literature, and Spatial Identity

• Published: October 2022
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‘Sense of place’, a buzzword in the sphere of modern humanistic geography, has been interpreted differently by different critics. To some it is the idea or feeling of a place in the mind of people living on it. It may also stand for some typical traits that a place displays and some places do not. The idea of a certain place cannot inherently be positive always—there are feelings like fear of living in a place or hatred for a particular place. Again responses to a certain place can be different to two different individuals given their social, cultural, or political positions. Through a study of Seamus Heaney’s representation of Northern Ireland in his poetry, the chapter seeks to locate the idea of sense of place in literature.

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What is Sense of Place

2001, 12th Headwater's Conference

As noted in the call for this year’s papers, “Sense of place has become a buzzword used to justify everything from a warm fuzzy appreciation of a natural landscape to the selling of home sites in urban sprawl. The truth is we probably have no single “sense of place;” instead, we bring to the places we live a whole set of cultural preconceptions that shape the way we respond to the place, and in some measure reshape the place to fit those preconceptions….” This lack of a common definition or understanding of sense of place results both from the fact that it has become a buzzword used to suit various purposes, and from the interdisciplinary nature of the concept. To provide a little background for the use of the term, I will review some of the definitions used by various social scientists, and then review my own contribution to that literature by summarizing and expanding on a few of the ideas presented at last year’s Headwaters Conference.

Related Papers

International Encyclopedia of Geography: People, the Earth, Environment, and Technology, Douglas Richardson, Editor-in-Chief. NY: Wiley

David Seamon

Sense of place is closely related to genius loci (spirit of place) and can be defined as the specific character, atmosphere, and expressive energy of a particular environment or locale. Though allied to sensory, perceptual, emotional, and cognitive dimensions of human experience, sense of place cannot be fully described or understood by these experiential dimensions alone. Sense of place is greater than its environmental and spatial parts and can evoke both positive and negative qualities. Most broadly, sense of place relates to the customary ways in which a place makes itself felt-its specific manner of being as perceived, encountered, known, and remembered by the human beings engaging with that place. As a phenomenon in human life, sense of place has a millennia-old history, beginning with archaic peoples who experienced specific places as receptacles of expressive energy envisioned as gods, spirits, or other ineffable presences. In the English-speaking world, sense of place and genius loci first became significant in the eighteenth and nineteenth centuries as industrialization and urbanization supplanted agriculture and rural ways of life. Most recently, sense of place and genius loci have been interpreted via the concept of atmosphere, which provides one helpful means for identifying and articulating the less visible features that makes an environment unique and confers on that environment a specific sense of place and genius loci. In the early 2020s, research on sense of place incorporates three contrasting conceptual traditions: first, phenomenological research, which examines experiential aspects of sense of place; second, empiricist-analytic research, which considers sense of place via measurable criteria and correlates respondents' degree of place involvement with independent variables like social status, home ownership, and community ties; and, third, social-constructionist research, which examines how human attributions of sense of place are a social and cultural construction of reality.

Joanna Storie

A “Sense of place” is o􏰀en used to convey the rela- tionship that people have to the place where they live, while “place attachment” can refer to a signifi- cant place in a person’s life or a place of inspiration, as well as the place where they may live. These are just two of the terms used by many different disci- plines, such as human geographers, psychologists, sociologists, urban planners, landscape architects and so on, to convey the connectedness of people to a specific place or a type of environment. The terms have become confused, as each discipline brings with it its own understandings. A review by Scan- nell and Gifford (2010) brought some clarity to the topic and they proposed a tripartite model to take the concept further. Whilst this model brings coher- ence to the subject it suffers by dividing the concept into people, place and process as separate entities. It is proposed in this paper that the concept would be better viewed holistically, with people and place connected through the process, with landscape at its heart. By redesigning the tripartite model it is possible to demonstrate the process of people affect- ing the landscape and vice versa. Although in using this process orientated model the questions gener- ated would essentially remain the same, how they are viewed and integrated would change however. “Sense of place” is used to convey the relation- ship people have to the place where they live, work or spend their leisure time, yet it “is a paradoxical concept with a meaning that is readily grasped, but difficult to define” (Morgan 2010:11). Some authors have divided the concept into different components, such as place identity, place attachment, and place dependence, illustrated here by interviews organ- ised by the author and examples in literature.

Journal of Planning Literature

Goran Erfani

While sense of place has been increasingly used in planning literature over the last five decades, its conceptualisation varies by discipline and theoretical orientation, with disjointed elements. This study develops a three-theme conceptual framework articulating individual-community-place interrelationships by critically reviewing the literature on sense of place and place-based constructs of attachment, identity, and satisfaction. Theorising the interactions in-between contributes to theoretical debates on sense of place and developing conceptual clarity to understand the planning context, processes, and outcomes, informing decision-and policy-making. It also facilitates the analysis and synthesis of complex narratives in qualitative studies of people-place relations.

Leisure Sciences

Garry Chick , Gerard Kyle

Chapter 3 in John Eyles and Allison Williams (eds) Sense of Place, Health and Quality of Life (Ashgate)

edward relph

An argument for a pragmatic approach to place as a way to cope with emerging environmental and social challenges in the 21st century. It develops an argument for three types of sense of place - one ontological, one sense of a particular place, and one an extended sense of many places, and proposes that the combination of these will be needed to cope with the complex challenges, such as climate change, for which standardized policies will be unable to provide strategies appropriate for local communities.

International Journal of Advanced Research (IJAR)

IJAR Indexing

Concern on a sense of place in cultural landscape setting of the historic city has been a global perennial issue. Literature search shows that there have been enormous effort to sustain the idea of sense of place or local wisdom in the cultural landscape studies. This paper discusseson landscape elements that help to elevate the feeling of sense of place in the context of culture. This paper deliberates on the idea of people?s perception, experience and responses towards their surroundings based on intangible and landscape elements that relate to their culture and norms. Content analysis has been used in reviewing on the prominent researchers discussing on the idea of ?sense of place? are adopted in this study. It was conducted to analyse the fundamental notions of place, perception and experience. This paper concludes thatplaces add value and significantly contribute in establishing the urban setting while elevating a sense of place in the cultural context.

ICONARP International Journal of Architecture and Planning

Neslinur Hızlı Erkılıç , Elifnaz Durusoy Özmen , Cengiz yilmaz

Purpose Over the past few decades, cities have been subject to dramatic interventions such as rapid developments, increased modernization and capitalist production of spaces. These changes, occurring in parallel with globalization, have changed the long-lasting environmental perception and damaged the sense of attachment by transforming urban spaces into unidentified areas. In this regard, the main purpose of this paper is to explore the components of the sense of place and identifying its factors under the changing conditions. This conception aims to develop an integrated proposal that provides a better understanding of fluxional urban areas. Design/Methodology/Approach The methodology of this study consists of two parts; literature review and, field survey which adopts a qualitative approach through a web-based survey and semi-structured short interviews with locals. Within this scope, by chronologically reviewing the literature, the first part of the article questions how the sense of place can be defined and what components can serve to define its perception. In the second part, Kuzguncuk, which is one of the historical and most liveable neighbourhoods of Istanbul, is examined as the case study of this research. Due to its recent designation as an urban transformation area, the study focuses on to reinterpret Kuzguncuk according to its residents’ sense of place. Findings After the findings are obtained and evaluated with a five-point Likert scale, the effect levels of the components on the quality of urban areas and the satisfaction of the people in the neighbourhood are determined. Research Limitations/Implications Due to the pandemic measures, the survey conducted to the residents of Kuzguncuk was carried out digitally, and the interviews were realized by taking into account social distance. Originality/Value This paper foresees to contribute to the literature by developing an empirical study on the concept of sense of place with its descriptive and interpretive approach. Further studies, which can utilize the results of this article, may answer questions about how the components related to sense of place sought out and reinterprets these factors over historical places.

Izzati Hanani Rosli

shmuel shamai

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Place-based perspectives on understanding the value of sustainable heritage-inspired arts and crafts in jordan.

1. Introduction

2. methodology, 2.1. document and policy analysis, 2.2. semi-structured interviews, 2.3. community and government training initiatives.

• Design workshop (Phase 1—September 2022): Held in Umm Qais, this workshop focused on artistic design principles and colour theory, providing participants with hands-on experience in integrating heritage patterns into contemporary crafts. Sessions ranged from creative idea generation to final product presentations ( Figure 1 ), fostering skills that bridge traditional craftsmanship and modern design practices. Lefebvre’s notion of representational space is applied here to highlight how artisans’ designs reflect the lived experience of their cultural environments and contribute to the production of culturally meaningful spaces.
• Business model workshop (Phase 2—February 2023): This workshop concentrated on converting creative ideas into viable business models. Participants, mostly women, engaged in exercises aimed at identifying business opportunities, understanding customer needs, and constructing entrepreneurial strategies ( Figure 2 ). The training focused on transforming the artisans’ habitus by equipping them with the tools to operate within market-driven fields while retaining their cultural authenticity. Bourdieu’s idea of field is relevant here, as the artisans learned to navigate the intersections between cultural capital and economic capital in a competitive market.
• Broader community impact and knowledge exchange (Phase 3): The third phase involved expanding the impact of training to the wider community. The initial 7 participants recruited community members with relevant craft knowledge, particularly youth aged 18–35, based on their connection to the identity of Umm Qais [ 24 ]. These community-driven workshops and training sessions focused on establishing businesses while assessing the strengths and weaknesses of various crafts. This phase culminated in the production of heritage-inspired arts and crafts that reflect the community’s identity. By fostering the co-production of knowledge and expanding skill sets, this initiative strengthened community cohesion and contributed to local economic resilience ( Figure 3 ).

2.4. Validation and Reliability

3. crafting the local.

“ Primary sites for this activity are Petra, Wadi Rum, the Dead Sea, the Baptism Site and Amman will aim to upgrade cultural and heritage offerings in these and other secondary locations ”.

“ Jordan’s cultural heritage conservation policies and strategies end up being documents on the shelf. The strategies lack real practical work, they are not able to reach to the micro roots for implementation… understanding the available resources for the community and how they can be integrated with a clear executive plan ”.

4. Why Community Involvement in Safeguarding ICH?

“All grants and assistance that are given are taken by certain individuals based on mutual relationships and interests, without giving a chance to different people. However, the same individuals who receive these aids are repeated,” one participant notes (A1, A3, A6, A7, 2023).

5. Arts and Crafts and the Creative Economy in Jordan

5.1. jordan’s handicraft sector, 5.2. institutional and governance framework, 6. perspectives on cultural identity and spatial dynamics in jordan’s handicraft sector, 6.1. place-based perspectives.

“The Dead Sea has various shades of red and yellow in its soil… This inspired the establishment of the project using the natural colours in nature in our production” (Participant A16).

“Mosaics… since I was young, seeing mosaics has been a cultural heritage… It would be a shame to overlook their significance” (Participant A18).

6.2. Spatial and Temporal Perspectives

“Because I am using chemical materials, I am afraid that children may be exposed to them” (Participant A17).

“Soap in Palestine and Jordan was made using the kufiya method… Now I work similarly but sometimes trainees pay for the traditional method” (Participant A17).

6.3. Regulative Perspectives

“I struggled and exhausted myself with the licensing process and eventually cancelled the license… I spent two months going back and forth dealing with paperwork and requirements” (Participant A7).

7. Challenges and Recommendations

7.1. challenges for multiple stakeholders.

• Other stakeholders

7.2. Comprehensive Recommendations

7.2.1. opportunities.

• Establishing one official body responsible for the handicraft sector;
• Providing legislative mechanisms;
• Promoting and marketing handicrafts;
• Providing raw materials;
• Providing funds;
• Providing studies and research on handicrafts;
• Building up the artisan’s abilities;
• Introducing and awareness of handicrafts.

7.2.2. Examples from Other Regions

• Morocco’s Handicraft Sector and Vision 2020 [ 65 ]
• Preservation of Palestinian Embroidery (Tatreez) [ 66 ]
• Revival of Traditional Crafts in Egypt (Khayamiya and Fustat Pottery) [ 67 ]
• Tunisia’s Handicraft Strategy [ 68 ]

7.2.3. Guidelines for Jordan’s Handicraft Industry

8. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Newisar, M.; Selim, G.; Li, M. Place-Based Perspectives on Understanding the Value of Sustainable Heritage-Inspired Arts and Crafts in Jordan. Sustainability 2024 , 16 , 7547. https://doi.org/10.3390/su16177547

Newisar M, Selim G, Li M. Place-Based Perspectives on Understanding the Value of Sustainable Heritage-Inspired Arts and Crafts in Jordan. Sustainability . 2024; 16(17):7547. https://doi.org/10.3390/su16177547

Newisar, May, Gehan Selim, and Meng Li. 2024. "Place-Based Perspectives on Understanding the Value of Sustainable Heritage-Inspired Arts and Crafts in Jordan" Sustainability 16, no. 17: 7547. https://doi.org/10.3390/su16177547

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• Published: 31 August 2024

Knowledge mapping and evolution of research on older adults’ technology acceptance: a bibliometric study from 2013 to 2023

• Xianru Shang   ORCID: orcid.org/0009-0000-8906-3216 1 ,
• Zijian Liu 1 ,
• Chen Gong 1 ,
• Zhigang Hu 1 ,
• Yuexuan Wu 1 &
• Chengliang Wang   ORCID: orcid.org/0000-0003-2208-3508 2  

Humanities and Social Sciences Communications volume  11 , Article number:  1115 ( 2024 ) Cite this article

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• Science, technology and society

The rapid expansion of information technology and the intensification of population aging are two prominent features of contemporary societal development. Investigating older adults’ acceptance and use of technology is key to facilitating their integration into an information-driven society. Given this context, the technology acceptance of older adults has emerged as a prioritized research topic, attracting widespread attention in the academic community. However, existing research remains fragmented and lacks a systematic framework. To address this gap, we employed bibliometric methods, utilizing the Web of Science Core Collection to conduct a comprehensive review of literature on older adults’ technology acceptance from 2013 to 2023. Utilizing VOSviewer and CiteSpace for data assessment and visualization, we created knowledge mappings of research on older adults’ technology acceptance. Our study employed multidimensional methods such as co-occurrence analysis, clustering, and burst analysis to: (1) reveal research dynamics, key journals, and domains in this field; (2) identify leading countries, their collaborative networks, and core research institutions and authors; (3) recognize the foundational knowledge system centered on theoretical model deepening, emerging technology applications, and research methods and evaluation, uncovering seminal literature and observing a shift from early theoretical and influential factor analyses to empirical studies focusing on individual factors and emerging technologies; (4) moreover, current research hotspots are primarily in the areas of factors influencing technology adoption, human-robot interaction experiences, mobile health management, and aging-in-place technology, highlighting the evolutionary context and quality distribution of research themes. Finally, we recommend that future research should deeply explore improvements in theoretical models, long-term usage, and user experience evaluation. Overall, this study presents a clear framework of existing research in the field of older adults’ technology acceptance, providing an important reference for future theoretical exploration and innovative applications.

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Introduction.

In contemporary society, the rapid development of information technology has been intricately intertwined with the intensifying trend of population aging. According to the latest United Nations forecast, by 2050, the global population aged 65 and above is expected to reach 1.6 billion, representing about 16% of the total global population (UN 2023 ). Given the significant challenges of global aging, there is increasing evidence that emerging technologies have significant potential to maintain health and independence for older adults in their home and healthcare environments (Barnard et al. 2013 ; Soar 2010 ; Vancea and Solé-Casals 2016 ). This includes, but is not limited to, enhancing residential safety with smart home technologies (Touqeer et al. 2021 ; Wang et al. 2022 ), improving living independence through wearable technologies (Perez et al. 2023 ), and increasing medical accessibility via telehealth services (Kruse et al. 2020 ). Technological innovations are redefining the lifestyles of older adults, encouraging a shift from passive to active participation (González et al. 2012 ; Mostaghel 2016 ). Nevertheless, the effective application and dissemination of technology still depends on user acceptance and usage intentions (Naseri et al. 2023 ; Wang et al. 2023a ; Xia et al. 2024 ; Yu et al. 2023 ). Particularly, older adults face numerous challenges in accepting and using new technologies. These challenges include not only physical and cognitive limitations but also a lack of technological experience, along with the influences of social and economic factors (Valk et al. 2018 ; Wilson et al. 2021 ).

User acceptance of technology is a significant focus within information systems (IS) research (Dai et al. 2024 ), with several models developed to explain and predict user behavior towards technology usage, including the Technology Acceptance Model (TAM) (Davis 1989 ), TAM2, TAM3, and the Unified Theory of Acceptance and Use of Technology (UTAUT) (Venkatesh et al. 2003 ). Older adults, as a group with unique needs, exhibit different behavioral patterns during technology acceptance than other user groups, and these uniquenesses include changes in cognitive abilities, as well as motivations, attitudes, and perceptions of the use of new technologies (Chen and Chan 2011 ). The continual expansion of technology introduces considerable challenges for older adults, rendering the understanding of their technology acceptance a research priority. Thus, conducting in-depth research into older adults’ acceptance of technology is critically important for enhancing their integration into the information society and improving their quality of life through technological advancements.

Reviewing relevant literature to identify research gaps helps further solidify the theoretical foundation of the research topic. However, many existing literature reviews primarily focus on the factors influencing older adults’ acceptance or intentions to use technology. For instance, Ma et al. ( 2021 ) conducted a comprehensive analysis of the determinants of older adults’ behavioral intentions to use technology; Liu et al. ( 2022 ) categorized key variables in studies of older adults’ technology acceptance, noting a shift in focus towards social and emotional factors; Yap et al. ( 2022 ) identified seven categories of antecedents affecting older adults’ use of technology from an analysis of 26 articles, including technological, psychological, social, personal, cost, behavioral, and environmental factors; Schroeder et al. ( 2023 ) extracted 119 influencing factors from 59 articles and further categorized these into six themes covering demographics, health status, and emotional awareness. Additionally, some studies focus on the application of specific technologies, such as Ferguson et al. ( 2021 ), who explored barriers and facilitators to older adults using wearable devices for heart monitoring, and He et al. ( 2022 ) and Baer et al. ( 2022 ), who each conducted in-depth investigations into the acceptance of social assistive robots and mobile nutrition and fitness apps, respectively. In summary, current literature reviews on older adults’ technology acceptance exhibit certain limitations. Due to the interdisciplinary nature and complex knowledge structure of this field, traditional literature reviews often rely on qualitative analysis, based on literature analysis and periodic summaries, which lack sufficient objectivity and comprehensiveness. Additionally, systematic research is relatively limited, lacking a macroscopic description of the research trajectory from a holistic perspective. Over the past decade, research on older adults’ technology acceptance has experienced rapid growth, with a significant increase in literature, necessitating the adoption of new methods to review and examine the developmental trends in this field (Chen 2006 ; Van Eck and Waltman 2010 ). Bibliometric analysis, as an effective quantitative research method, analyzes published literature through visualization, offering a viable approach to extracting patterns and insights from a large volume of papers, and has been widely applied in numerous scientific research fields (Achuthan et al. 2023 ; Liu and Duffy 2023 ). Therefore, this study will employ bibliometric methods to systematically analyze research articles related to older adults’ technology acceptance published in the Web of Science Core Collection from 2013 to 2023, aiming to understand the core issues and evolutionary trends in the field, and to provide valuable references for future related research. Specifically, this study aims to explore and answer the following questions:

RQ1: What are the research dynamics in the field of older adults’ technology acceptance over the past decade? What are the main academic journals and fields that publish studies related to older adults’ technology acceptance?

RQ2: How is the productivity in older adults’ technology acceptance research distributed among countries, institutions, and authors?

RQ3: What are the knowledge base and seminal literature in older adults’ technology acceptance research? How has the research theme progressed?

RQ4: What are the current hot topics and their evolutionary trajectories in older adults’ technology acceptance research? How is the quality of research distributed?

Methodology and materials

Research method.

In recent years, bibliometrics has become one of the crucial methods for analyzing literature reviews and is widely used in disciplinary and industrial intelligence analysis (Jing et al. 2023 ; Lin and Yu 2024a ; Wang et al. 2024a ; Xu et al. 2021 ). Bibliometric software facilitates the visualization analysis of extensive literature data, intuitively displaying the network relationships and evolutionary processes between knowledge units, and revealing the underlying knowledge structure and potential information (Chen et al. 2024 ; López-Robles et al. 2018 ; Wang et al. 2024c ). This method provides new insights into the current status and trends of specific research areas, along with quantitative evidence, thereby enhancing the objectivity and scientific validity of the research conclusions (Chen et al. 2023 ; Geng et al. 2024 ). VOSviewer and CiteSpace are two widely used bibliometric software tools in academia (Pan et al. 2018 ), recognized for their robust functionalities based on the JAVA platform. Although each has its unique features, combining these two software tools effectively constructs mapping relationships between literature knowledge units and clearly displays the macrostructure of the knowledge domains. Particularly, VOSviewer, with its excellent graphical representation capabilities, serves as an ideal tool for handling large datasets and precisely identifying the focal points and hotspots of research topics. Therefore, this study utilizes VOSviewer (version 1.6.19) and CiteSpace (version 6.1.R6), combined with in-depth literature analysis, to comprehensively examine and interpret the research theme of older adults’ technology acceptance through an integrated application of quantitative and qualitative methods.

Data source

Web of Science is a comprehensively recognized database in academia, featuring literature that has undergone rigorous peer review and editorial scrutiny (Lin and Yu 2024b ; Mongeon and Paul-Hus 2016 ; Pranckutė 2021 ). This study utilizes the Web of Science Core Collection as its data source, specifically including three major citation indices: Science Citation Index Expanded (SCIE), Social Sciences Citation Index (SSCI), and Arts & Humanities Citation Index (A&HCI). These indices encompass high-quality research literature in the fields of science, social sciences, and arts and humanities, ensuring the comprehensiveness and reliability of the data. We combined “older adults” with “technology acceptance” through thematic search, with the specific search strategy being: TS = (elder OR elderly OR aging OR ageing OR senile OR senior OR old people OR “older adult*”) AND TS = (“technology acceptance” OR “user acceptance” OR “consumer acceptance”). The time span of literature search is from 2013 to 2023, with the types limited to “Article” and “Review” and the language to “English”. Additionally, the search was completed by October 27, 2023, to avoid data discrepancies caused by database updates. The initial search yielded 764 journal articles. Given that searches often retrieve articles that are superficially relevant but actually non-compliant, manual screening post-search was essential to ensure the relevance of the literature (Chen et al. 2024 ). Through manual screening, articles significantly deviating from the research theme were eliminated and rigorously reviewed. Ultimately, this study obtained 500 valid sample articles from the Web of Science Core Collection. The complete PRISMA screening process is illustrated in Fig. 1 .

Presentation of the data culling process in detail.

Data standardization

Raw data exported from databases often contain multiple expressions of the same terminology (Nguyen and Hallinger 2020 ). To ensure the accuracy and consistency of data, it is necessary to standardize the raw data (Strotmann and Zhao 2012 ). This study follows the data standardization process proposed by Taskin and Al ( 2019 ), mainly executing the following operations:

(1) Standardization of author and institution names is conducted to address different name expressions for the same author. For instance, “Chan, Alan Hoi Shou” and “Chan, Alan H. S.” are considered the same author, and distinct authors with the same name are differentiated by adding identifiers. Diverse forms of institutional names are unified to address variations caused by name changes or abbreviations, such as standardizing “FRANKFURT UNIV APPL SCI” and “Frankfurt University of Applied Sciences,” as well as “Chinese University of Hong Kong” and “University of Hong Kong” to consistent names.

(2) Different expressions of journal names are unified. For example, “International Journal of Human-Computer Interaction” and “Int J Hum Comput Interact” are standardized to a single name. This ensures consistency in journal names and prevents misclassification of literature due to differing journal names. Additionally, it involves checking if the journals have undergone name changes in the past decade to prevent any impact on the analysis due to such changes.

(3) Keywords data are cleansed by removing words that do not directly pertain to specific research content (e.g., people, review), merging synonyms (e.g., “UX” and “User Experience,” “aging-in-place” and “aging in place”), and standardizing plural forms of keywords (e.g., “assistive technologies” and “assistive technology,” “social robots” and “social robot”). This reduces redundant information in knowledge mapping.

Bibliometric results and analysis

Distribution power (rq1), literature descriptive statistical analysis.

Table 1 presents a detailed descriptive statistical overview of the literature in the field of older adults’ technology acceptance. After deduplication using the CiteSpace software, this study confirmed a valid sample size of 500 articles. Authored by 1839 researchers, the documents encompass 792 research institutions across 54 countries and are published in 217 different academic journals. As of the search cutoff date, these articles have accumulated 13,829 citations, with an annual average of 1156 citations, and an average of 27.66 citations per article. The h-index, a composite metric of quantity and quality of scientific output (Kamrani et al. 2021 ), reached 60 in this study.

Trends in publications and disciplinary distribution

The number of publications and citations are significant indicators of the research field’s development, reflecting its continuity, attention, and impact (Ale Ebrahim et al. 2014 ). The ranking of annual publications and citations in the field of older adults’ technology acceptance studies is presented chronologically in Fig. 2A . The figure shows a clear upward trend in the amount of literature in this field. Between 2013 and 2017, the number of publications increased slowly and decreased in 2018. However, in 2019, the number of publications increased rapidly to 52 and reached a peak of 108 in 2022, which is 6.75 times higher than in 2013. In 2022, the frequency of document citations reached its highest point with 3466 citations, reflecting the widespread recognition and citation of research in this field. Moreover, the curve of the annual number of publications fits a quadratic function, with a goodness-of-fit R 2 of 0.9661, indicating that the number of future publications is expected to increase even more rapidly.

A Trends in trends in annual publications and citations (2013–2023). B Overlay analysis of the distribution of discipline fields.

Figure 2B shows that research on older adults’ technology acceptance involves the integration of multidisciplinary knowledge. According to Web of Science Categories, these 500 articles are distributed across 85 different disciplines. We have tabulated the top ten disciplines by publication volume (Table 2 ), which include Medical Informatics (75 articles, 15.00%), Health Care Sciences & Services (71 articles, 14.20%), Gerontology (61 articles, 12.20%), Public Environmental & Occupational Health (57 articles, 11.40%), and Geriatrics & Gerontology (52 articles, 10.40%), among others. The high output in these disciplines reflects the concentrated global academic interest in this comprehensive research topic. Additionally, interdisciplinary research approaches provide diverse perspectives and a solid theoretical foundation for studies on older adults’ technology acceptance, also paving the way for new research directions.

Knowledge flow analysis

A dual-map overlay is a CiteSpace map superimposed on top of a base map, which shows the interrelationships between journals in different domains, representing the publication and citation activities in each domain (Chen and Leydesdorff 2014 ). The overlay map reveals the link between the citing domain (on the left side) and the cited domain (on the right side), reflecting the knowledge flow of the discipline at the journal level (Leydesdorff and Rafols 2012 ). We utilize the in-built Z-score algorithm of the software to cluster the graph, as shown in Fig. 3 .

The left side shows the citing journal, and the right side shows the cited journal.

Figure 3 shows the distribution of citing journals clusters for older adults’ technology acceptance on the left side, while the right side refers to the main cited journals clusters. Two knowledge flow citation trajectories were obtained; they are presented by the color of the cited regions, and the thickness of these trajectories is proportional to the Z-score scaled frequency of citations (Chen et al. 2014 ). Within the cited regions, the most popular fields with the most records covered are “HEALTH, NURSING, MEDICINE” and “PSYCHOLOGY, EDUCATION, SOCIAL”, and the elliptical aspect ratio of these two fields stands out. Fields have prominent elliptical aspect ratios, highlighting their significant influence on older adults’ technology acceptance research. Additionally, the major citation trajectories originate in these two areas and progress to the frontier research area of “PSYCHOLOGY, EDUCATION, HEALTH”. It is worth noting that the citation trajectory from “PSYCHOLOGY, EDUCATION, SOCIAL” has a significant Z-value (z = 6.81), emphasizing the significance and impact of this development path. In the future, “MATHEMATICS, SYSTEMS, MATHEMATICAL”, “MOLECULAR, BIOLOGY, IMMUNOLOGY”, and “NEUROLOGY, SPORTS, OPHTHALMOLOGY” may become emerging fields. The fields of “MEDICINE, MEDICAL, CLINICAL” may be emerging areas of cutting-edge research.

Main research journals analysis

Table 3 provides statistics for the top ten journals by publication volume in the field of older adults’ technology acceptance. Together, these journals have published 137 articles, accounting for 27.40% of the total publications, indicating that there is no highly concentrated core group of journals in this field, with publications being relatively dispersed. Notably, Computers in Human Behavior , Journal of Medical Internet Research , and International Journal of Human-Computer Interaction each lead with 15 publications. In terms of citation metrics, International Journal of Medical Informatics and Computers in Human Behavior stand out significantly, with the former accumulating a total of 1,904 citations, averaging 211.56 citations per article, and the latter totaling 1,449 citations, with an average of 96.60 citations per article. These figures emphasize the academic authority and widespread impact of these journals within the research field.

Research power (RQ2)

Countries and collaborations analysis.

The analysis revealed the global research pattern for country distribution and collaboration (Chen et al. 2019 ). Figure 4A shows the network of national collaborations on older adults’ technology acceptance research. The size of the bubbles represents the amount of publications in each country, while the thickness of the connecting lines expresses the closeness of the collaboration among countries. Generally, this research subject has received extensive international attention, with China and the USA publishing far more than any other countries. China has established notable research collaborations with the USA, UK and Malaysia in this field, while other countries have collaborations, but the closeness is relatively low and scattered. Figure 4B shows the annual publication volume dynamics of the top ten countries in terms of total publications. Since 2017, China has consistently increased its annual publications, while the USA has remained relatively stable. In 2019, the volume of publications in each country increased significantly, this was largely due to the global outbreak of the COVID-19 pandemic, which has led to increased reliance on information technology among the elderly for medical consultations, online socialization, and health management (Sinha et al. 2021 ). This phenomenon has led to research advances in technology acceptance among older adults in various countries. Table 4 shows that the top ten countries account for 93.20% of the total cumulative number of publications, with each country having published more than 20 papers. Among these ten countries, all of them except China are developed countries, indicating that the research field of older adults’ technology acceptance has received general attention from developed countries. Currently, China and the USA were the leading countries in terms of publications with 111 and 104 respectively, accounting for 22.20% and 20.80%. The UK, Germany, Italy, and the Netherlands also made significant contributions. The USA and China ranked first and second in terms of the number of citations, while the Netherlands had the highest average citations, indicating the high impact and quality of its research. The UK has shown outstanding performance in international cooperation, while the USA highlights its significant academic influence in this field with the highest h-index value.

A National collaboration network. B Annual volume of publications in the top 10 countries.

Institutions and authors analysis

Analyzing the number of publications and citations can reveal an institution’s or author’s research strength and influence in a particular research area (Kwiek 2021 ). Tables 5 and 6 show the statistics of the institutions and authors whose publication counts are in the top ten, respectively. As shown in Table 5 , higher education institutions hold the main position in this research field. Among the top ten institutions, City University of Hong Kong and The University of Hong Kong from China lead with 14 and 9 publications, respectively. City University of Hong Kong has the highest h-index, highlighting its significant influence in the field. It is worth noting that Tilburg University in the Netherlands is not among the top five in terms of publications, but the high average citation count (130.14) of its literature demonstrates the high quality of its research.

After analyzing the authors’ output using Price’s Law (Redner 1998 ), the highest number of publications among the authors counted ( n  = 10) defines a publication threshold of 3 for core authors in this research area. As a result of quantitative screening, a total of 63 core authors were identified. Table 6 shows that Chen from Zhejiang University, China, Ziefle from RWTH Aachen University, Germany, and Rogers from Macquarie University, Australia, were the top three authors in terms of the number of publications, with 10, 9, and 8 articles, respectively. In terms of average citation rate, Peek and Wouters, both scholars from the Netherlands, have significantly higher rates than other scholars, with 183.2 and 152.67 respectively. This suggests that their research is of high quality and widely recognized. Additionally, Chen and Rogers have high h-indices in this field.

Knowledge base and theme progress (RQ3)

Research knowledge base.

Co-citation relationships occur when two documents are cited together (Zhang and Zhu 2022 ). Co-citation mapping uses references as nodes to represent the knowledge base of a subject area (Min et al. 2021). Figure 5A illustrates co-occurrence mapping in older adults’ technology acceptance research, where larger nodes signify higher co-citation frequencies. Co-citation cluster analysis can be used to explore knowledge structure and research boundaries (Hota et al. 2020 ; Shiau et al. 2023 ). The co-citation clustering mapping of older adults’ technology acceptance research literature (Fig. 5B ) shows that the Q value of the clustering result is 0.8129 (>0.3), and the average value of the weight S is 0.9391 (>0.7), indicating that the clusters are uniformly distributed with a significant and credible structure. This further proves that the boundaries of the research field are clear and there is significant differentiation in the field. The figure features 18 cluster labels, each associated with thematic color blocks corresponding to different time slices. Highlighted emerging research themes include #2 Smart Home Technology, #7 Social Live, and #10 Customer Service. Furthermore, the clustering labels extracted are primarily classified into three categories: theoretical model deepening, emerging technology applications, research methods and evaluation, as detailed in Table 7 .

A Co-citation analysis of references. B Clustering network analysis of references.

Seminal literature analysis

The top ten nodes in terms of co-citation frequency were selected for further analysis. Table 8 displays the corresponding node information. Studies were categorized into four main groups based on content analysis. (1) Research focusing on specific technology usage by older adults includes studies by Peek et al. ( 2014 ), Ma et al. ( 2016 ), Hoque and Sorwar ( 2017 ), and Li et al. ( 2019 ), who investigated the factors influencing the use of e-technology, smartphones, mHealth, and smart wearables, respectively. (2) Concerning the development of theoretical models of technology acceptance, Chen and Chan ( 2014 ) introduced the Senior Technology Acceptance Model (STAM), and Macedo ( 2017 ) analyzed the predictive power of UTAUT2 in explaining older adults’ intentional behaviors and information technology usage. (3) In exploring older adults’ information technology adoption and behavior, Lee and Coughlin ( 2015 ) emphasized that the adoption of technology by older adults is a multifactorial process that includes performance, price, value, usability, affordability, accessibility, technical support, social support, emotion, independence, experience, and confidence. Yusif et al. ( 2016 ) conducted a literature review examining the key barriers affecting older adults’ adoption of assistive technology, including factors such as privacy, trust, functionality/added value, cost, and stigma. (4) From the perspective of research into older adults’ technology acceptance, Mitzner et al. ( 2019 ) assessed the long-term usage of computer systems designed for the elderly, whereas Guner and Acarturk ( 2020 ) compared information technology usage and acceptance between older and younger adults. The breadth and prevalence of this literature make it a vital reference for researchers in the field, also providing new perspectives and inspiration for future research directions.

Research thematic progress

Burst citation is a node of literature that guides the sudden change in dosage, which usually represents a prominent development or major change in a particular field, with innovative and forward-looking qualities. By analyzing the emergent literature, it is often easy to understand the dynamics of the subject area, mapping the emerging thematic change (Chen et al. 2022 ). Figure 6 shows the burst citation mapping in the field of older adults’ technology acceptance research, with burst citations represented by red nodes (Fig. 6A ). For the ten papers with the highest burst intensity (Fig. 6B ), this study will conduct further analysis in conjunction with literature review.

A Burst detection of co-citation. B The top 10 references with the strongest citation bursts.

As shown in Fig. 6 , Mitzner et al. ( 2010 ) broke the stereotype that older adults are fearful of technology, found that they actually have positive attitudes toward technology, and emphasized the centrality of ease of use and usefulness in the process of technology acceptance. This finding provides an important foundation for subsequent research. During the same period, Wagner et al. ( 2010 ) conducted theory-deepening and applied research on technology acceptance among older adults. The research focused on older adults’ interactions with computers from the perspective of Social Cognitive Theory (SCT). This expanded the understanding of technology acceptance, particularly regarding the relationship between behavior, environment, and other SCT elements. In addition, Pan and Jordan-Marsh ( 2010 ) extended the TAM to examine the interactions among predictors of perceived usefulness, perceived ease of use, subjective norm, and convenience conditions when older adults use the Internet, taking into account the moderating roles of gender and age. Heerink et al. ( 2010 ) adapted and extended the UTAUT, constructed a technology acceptance model specifically designed for older users’ acceptance of assistive social agents, and validated it using controlled experiments and longitudinal data, explaining intention to use by combining functional assessment and social interaction variables.

Then the research theme shifted to an in-depth analysis of the factors influencing technology acceptance among older adults. Two papers with high burst strengths emerged during this period: Peek et al. ( 2014 ) (Strength = 12.04), Chen and Chan ( 2014 ) (Strength = 9.81). Through a systematic literature review and empirical study, Peek STM and Chen K, among others, identified multidimensional factors that influence older adults’ technology acceptance. Peek et al. ( 2014 ) analyzed literature on the acceptance of in-home care technology among older adults and identified six factors that influence their acceptance: concerns about technology, expected benefits, technology needs, technology alternatives, social influences, and older adult characteristics, with a focus on differences between pre- and post-implementation factors. Chen and Chan ( 2014 ) constructed the STAM by administering a questionnaire to 1012 older adults and adding eight important factors, including technology anxiety, self-efficacy, cognitive ability, and physical function, based on the TAM. This enriches the theoretical foundation of the field. In addition, Braun ( 2013 ) highlighted the role of perceived usefulness, trust in social networks, and frequency of Internet use in older adults’ use of social networks, while ease of use and social pressure were not significant influences. These findings contribute to the study of older adults’ technology acceptance within specific technology application domains.

Recent research has focused on empirical studies of personal factors and emerging technologies. Ma et al. ( 2016 ) identified key personal factors affecting smartphone acceptance among older adults through structured questionnaires and face-to-face interviews with 120 participants. The study found that cost, self-satisfaction, and convenience were important factors influencing perceived usefulness and ease of use. This study offers empirical evidence to comprehend the main factors that drive smartphone acceptance among Chinese older adults. Additionally, Yusif et al. ( 2016 ) presented an overview of the obstacles that hinder older adults’ acceptance of assistive technologies, focusing on privacy, trust, and functionality.

In summary, research on older adults’ technology acceptance has shifted from early theoretical deepening and analysis of influencing factors to empirical studies in the areas of personal factors and emerging technologies, which have greatly enriched the theoretical basis of older adults’ technology acceptance and provided practical guidance for the design of emerging technology products.

Research hotspots, evolutionary trends, and quality distribution (RQ4)

Core keywords analysis.

Keywords concise the main idea and core of the literature, and are a refined summary of the research content (Huang et al. 2021 ). In CiteSpace, nodes with a centrality value greater than 0.1 are considered to be critical nodes. Analyzing keywords with high frequency and centrality helps to visualize the hot topics in the research field (Park et al. 2018 ). The merged keywords were imported into CiteSpace, and the top 10 keywords were counted and sorted by frequency and centrality respectively, as shown in Table 9 . The results show that the keyword “TAM” has the highest frequency (92), followed by “UTAUT” (24), which reflects that the in-depth study of the existing technology acceptance model and its theoretical expansion occupy a central position in research related to older adults’ technology acceptance. Furthermore, the terms ‘assistive technology’ and ‘virtual reality’ are both high-frequency and high-centrality terms (frequency = 17, centrality = 0.10), indicating that the research on assistive technology and virtual reality for older adults is the focus of current academic attention.

Research hotspots analysis

Using VOSviewer for keyword co-occurrence analysis organizes keywords into groups or clusters based on their intrinsic connections and frequencies, clearly highlighting the research field’s hot topics. The connectivity among keywords reveals correlations between different topics. To ensure accuracy, the analysis only considered the authors’ keywords. Subsequently, the keywords were filtered by setting the keyword frequency to 5 to obtain the keyword clustering map of the research on older adults’ technology acceptance research keyword clustering mapping (Fig. 7 ), combined with the keyword co-occurrence clustering network (Fig. 7A ) and the corresponding density situation (Fig. 7B ) to make a detailed analysis of the following four groups of clustered themes.

A Co-occurrence clustering network. B Keyword density.

Cluster #1—Research on the factors influencing technology adoption among older adults is a prominent topic, covering age, gender, self-efficacy, attitude, and and intention to use (Berkowsky et al. 2017 ; Wang et al. 2017 ). It also examined older adults’ attitudes towards and acceptance of digital health technologies (Ahmad and Mozelius, 2022 ). Moreover, the COVID-19 pandemic, significantly impacting older adults’ technology attitudes and usage, has underscored the study’s importance and urgency. Therefore, it is crucial to conduct in-depth studies on how older adults accept, adopt, and effectively use new technologies, to address their needs and help them overcome the digital divide within digital inclusion. This will improve their quality of life and healthcare experiences.

Cluster #2—Research focuses on how older adults interact with assistive technologies, especially assistive robots and health monitoring devices, emphasizing trust, usability, and user experience as crucial factors (Halim et al. 2022 ). Moreover, health monitoring technologies effectively track and manage health issues common in older adults, like dementia and mild cognitive impairment (Lussier et al. 2018 ; Piau et al. 2019 ). Interactive exercise games and virtual reality have been deployed to encourage more physical and cognitive engagement among older adults (Campo-Prieto et al. 2021 ). Personalized and innovative technology significantly enhances older adults’ participation, improving their health and well-being.

Cluster #3—Optimizing health management for older adults using mobile technology. With the development of mobile health (mHealth) and health information technology, mobile applications, smartphones, and smart wearable devices have become effective tools to help older users better manage chronic conditions, conduct real-time health monitoring, and even receive telehealth services (Dupuis and Tsotsos 2018 ; Olmedo-Aguirre et al. 2022 ; Kim et al. 2014 ). Additionally, these technologies can mitigate the problem of healthcare resource inequality, especially in developing countries. Older adults’ acceptance and use of these technologies are significantly influenced by their behavioral intentions, motivational factors, and self-management skills. These internal motivational factors, along with external factors, jointly affect older adults’ performance in health management and quality of life.

Cluster #4—Research on technology-assisted home care for older adults is gaining popularity. Environmentally assisted living enhances older adults’ independence and comfort at home, offering essential support and security. This has a crucial impact on promoting healthy aging (Friesen et al. 2016 ; Wahlroos et al. 2023 ). The smart home is a core application in this field, providing a range of solutions that facilitate independent living for the elderly in a highly integrated and user-friendly manner. This fulfills different dimensions of living and health needs (Majumder et al. 2017 ). Moreover, eHealth offers accurate and personalized health management and healthcare services for older adults (Delmastro et al. 2018 ), ensuring their needs are met at home. Research in this field often employs qualitative methods and structural equation modeling to fully understand older adults’ needs and experiences at home and analyze factors influencing technology adoption.

Evolutionary trends analysis

To gain a deeper understanding of the evolutionary trends in research hotspots within the field of older adults’ technology acceptance, we conducted a statistical analysis of the average appearance times of keywords, using CiteSpace to generate the time-zone evolution mapping (Fig. 8 ) and burst keywords. The time-zone mapping visually displays the evolution of keywords over time, intuitively reflecting the frequency and initial appearance of keywords in research, commonly used to identify trends in research topics (Jing et al. 2024a ; Kumar et al. 2021 ). Table 10 lists the top 15 keywords by burst strength, with the red sections indicating high-frequency citations and their burst strength in specific years. These burst keywords reveal the focus and trends of research themes over different periods (Kleinberg 2002 ). Combining insights from the time-zone mapping and burst keywords provides more objective and accurate research insights (Wang et al. 2023b ).

Reflecting the frequency and time of first appearance of keywords in the study.

An integrated analysis of Fig. 8 and Table 10 shows that early research on older adults’ technology acceptance primarily focused on factors such as perceived usefulness, ease of use, and attitudes towards information technology, including their use of computers and the internet (Pan and Jordan-Marsh 2010 ), as well as differences in technology use between older adults and other age groups (Guner and Acarturk 2020 ). Subsequently, the research focus expanded to improving the quality of life for older adults, exploring how technology can optimize health management and enhance the possibility of independent living, emphasizing the significant role of technology in improving the quality of life for the elderly. With ongoing technological advancements, recent research has shifted towards areas such as “virtual reality,” “telehealth,” and “human-robot interaction,” with a focus on the user experience of older adults (Halim et al. 2022 ). The appearance of keywords such as “physical activity” and “exercise” highlights the value of technology in promoting physical activity and health among older adults. This phase of research tends to make cutting-edge technology genuinely serve the practical needs of older adults, achieving its widespread application in daily life. Additionally, research has focused on expanding and quantifying theoretical models of older adults’ technology acceptance, involving keywords such as “perceived risk”, “validation” and “UTAUT”.

In summary, from 2013 to 2023, the field of older adults’ technology acceptance has evolved from initial explorations of influencing factors, to comprehensive enhancements in quality of life and health management, and further to the application and deepening of theoretical models and cutting-edge technologies. This research not only reflects the diversity and complexity of the field but also demonstrates a comprehensive and in-depth understanding of older adults’ interactions with technology across various life scenarios and needs.

Research quality distribution

To reveal the distribution of research quality in the field of older adults’ technology acceptance, a strategic diagram analysis is employed to calculate and illustrate the internal development and interrelationships among various research themes (Xie et al. 2020 ). The strategic diagram uses Centrality as the X-axis and Density as the Y-axis to divide into four quadrants, where the X-axis represents the strength of the connection between thematic clusters and other themes, with higher values indicating a central position in the research field; the Y-axis indicates the level of development within the thematic clusters, with higher values denoting a more mature and widely recognized field (Li and Zhou 2020 ).

Through cluster analysis and manual verification, this study categorized 61 core keywords (Frequency ≥5) into 11 thematic clusters. Subsequently, based on the keywords covered by each thematic cluster, the research themes and their directions for each cluster were summarized (Table 11 ), and the centrality and density coordinates for each cluster were precisely calculated (Table 12 ). Finally, a strategic diagram of the older adults’ technology acceptance research field was constructed (Fig. 9 ). Based on the distribution of thematic clusters across the quadrants in the strategic diagram, the structure and developmental trends of the field were interpreted.

Classification and visualization of theme clusters based on density and centrality.

As illustrated in Fig. 9 , (1) the theme clusters of #3 Usage Experience and #4 Assisted Living Technology are in the first quadrant, characterized by high centrality and density. Their internal cohesion and close links with other themes indicate their mature development, systematic research content or directions have been formed, and they have a significant influence on other themes. These themes play a central role in the field of older adults’ technology acceptance and have promising prospects. (2) The theme clusters of #6 Smart Devices, #9 Theoretical Models, and #10 Mobile Health Applications are in the second quadrant, with higher density but lower centrality. These themes have strong internal connections but weaker external links, indicating that these three themes have received widespread attention from researchers and have been the subject of related research, but more as self-contained systems and exhibit independence. Therefore, future research should further explore in-depth cooperation and cross-application with other themes. (3) The theme clusters of #7 Human-Robot Interaction, #8 Characteristics of the Elderly, and #11 Research Methods are in the third quadrant, with lower centrality and density. These themes are loosely connected internally and have weak links with others, indicating their developmental immaturity. Compared to other topics, they belong to the lower attention edge and niche themes, and there is a need for further investigation. (4) The theme clusters of #1 Digital Healthcare Technology, #2 Psychological Factors, and #5 Socio-Cultural Factors are located in the fourth quadrant, with high centrality but low density. Although closely associated with other research themes, the internal cohesion within these clusters is relatively weak. This suggests that while these themes are closely linked to other research areas, their own development remains underdeveloped, indicating a core immaturity. Nevertheless, these themes are crucial within the research domain of elderly technology acceptance and possess significant potential for future exploration.

Discussion on distribution power (RQ1)

Over the past decade, academic interest and influence in the area of older adults’ technology acceptance have significantly increased. This trend is evidenced by a quantitative analysis of publication and citation volumes, particularly noticeable in 2019 and 2022, where there was a substantial rise in both metrics. The rise is closely linked to the widespread adoption of emerging technologies such as smart homes, wearable devices, and telemedicine among older adults. While these technologies have enhanced their quality of life, they also pose numerous challenges, sparking extensive research into their acceptance, usage behaviors, and influencing factors among the older adults (Pirzada et al. 2022 ; Garcia Reyes et al. 2023 ). Furthermore, the COVID-19 pandemic led to a surge in technology demand among older adults, especially in areas like medical consultation, online socialization, and health management, further highlighting the importance and challenges of technology. Health risks and social isolation have compelled older adults to rely on technology for daily activities, accelerating its adoption and application within this demographic. This phenomenon has made technology acceptance a critical issue, driving societal and academic focus on the study of technology acceptance among older adults.

The flow of knowledge at the level of high-output disciplines and journals, along with the primary publishing outlets, indicates the highly interdisciplinary nature of research into older adults’ technology acceptance. This reflects the complexity and breadth of issues related to older adults’ technology acceptance, necessitating the integration of multidisciplinary knowledge and approaches. Currently, research is primarily focused on medical health and human-computer interaction, demonstrating academic interest in improving health and quality of life for older adults and addressing the urgent needs related to their interactions with technology. In the field of medical health, research aims to provide advanced and innovative healthcare technologies and services to meet the challenges of an aging population while improving the quality of life for older adults (Abdi et al. 2020 ; Wilson et al. 2021 ). In the field of human-computer interaction, research is focused on developing smarter and more user-friendly interaction models to meet the needs of older adults in the digital age, enabling them to actively participate in social activities and enjoy a higher quality of life (Sayago, 2019 ). These studies are crucial for addressing the challenges faced by aging societies, providing increased support and opportunities for the health, welfare, and social participation of older adults.

Discussion on research power (RQ2)

This study analyzes leading countries and collaboration networks, core institutions and authors, revealing the global research landscape and distribution of research strength in the field of older adults’ technology acceptance, and presents quantitative data on global research trends. From the analysis of country distribution and collaborations, China and the USA hold dominant positions in this field, with developed countries like the UK, Germany, Italy, and the Netherlands also excelling in international cooperation and research influence. The significant investment in technological research and the focus on the technological needs of older adults by many developed countries reflect their rapidly aging societies, policy support, and resource allocation.

China is the only developing country that has become a major contributor in this field, indicating its growing research capabilities and high priority given to aging societies and technological innovation. Additionally, China has close collaborations with countries such as USA, the UK, and Malaysia, driven not only by technological research needs but also by shared challenges and complementarities in aging issues among these nations. For instance, the UK has extensive experience in social welfare and aging research, providing valuable theoretical guidance and practical experience. International collaborations, aimed at addressing the challenges of aging, integrate the strengths of various countries, advancing in-depth and widespread development in the research of technology acceptance among older adults.

At the institutional and author level, City University of Hong Kong leads in publication volume, with research teams led by Chan and Chen demonstrating significant academic activity and contributions. Their research primarily focuses on older adults’ acceptance and usage behaviors of various technologies, including smartphones, smart wearables, and social robots (Chen et al. 2015 ; Li et al. 2019 ; Ma et al. 2016 ). These studies, targeting specific needs and product characteristics of older adults, have developed new models of technology acceptance based on existing frameworks, enhancing the integration of these technologies into their daily lives and laying a foundation for further advancements in the field. Although Tilburg University has a smaller publication output, it holds significant influence in the field of older adults’ technology acceptance. Particularly, the high citation rate of Peek’s studies highlights their excellence in research. Peek extensively explored older adults’ acceptance and usage of home care technologies, revealing the complexity and dynamics of their technology use behaviors. His research spans from identifying systemic influencing factors (Peek et al. 2014 ; Peek et al. 2016 ), emphasizing familial impacts (Luijkx et al. 2015 ), to constructing comprehensive models (Peek et al. 2017 ), and examining the dynamics of long-term usage (Peek et al. 2019 ), fully reflecting the evolving technology landscape and the changing needs of older adults. Additionally, the ongoing contributions of researchers like Ziefle, Rogers, and Wouters in the field of older adults’ technology acceptance demonstrate their research influence and leadership. These researchers have significantly enriched the knowledge base in this area with their diverse perspectives. For instance, Ziefle has uncovered the complex attitudes of older adults towards technology usage, especially the trade-offs between privacy and security, and how different types of activities affect their privacy needs (Maidhof et al. 2023 ; Mujirishvili et al. 2023 ; Schomakers and Ziefle 2023 ; Wilkowska et al. 2022 ), reflecting a deep exploration and ongoing innovation in the field of older adults’ technology acceptance.

Discussion on knowledge base and thematic progress (RQ3)

Through co-citation analysis and systematic review of seminal literature, this study reveals the knowledge foundation and thematic progress in the field of older adults’ technology acceptance. Co-citation networks and cluster analyses illustrate the structural themes of the research, delineating the differentiation and boundaries within this field. Additionally, burst detection analysis offers a valuable perspective for understanding the thematic evolution in the field of technology acceptance among older adults. The development and innovation of theoretical models are foundational to this research. Researchers enhance the explanatory power of constructed models by deepening and expanding existing technology acceptance theories to address theoretical limitations. For instance, Heerink et al. ( 2010 ) modified and expanded the UTAUT model by integrating functional assessment and social interaction variables to create the almere model. This model significantly enhances the ability to explain the intentions of older users in utilizing assistive social agents and improves the explanation of actual usage behaviors. Additionally, Chen and Chan ( 2014 ) extended the TAM to include age-related health and capability features of older adults, creating the STAM, which substantially improves predictions of older adults’ technology usage behaviors. Personal attributes, health and capability features, and facilitating conditions have a direct impact on technology acceptance. These factors more effectively predict older adults’ technology usage behaviors than traditional attitudinal factors.

With the advancement of technology and the application of emerging technologies, new research topics have emerged, increasingly focusing on older adults’ acceptance and use of these technologies. Prior to this, the study by Mitzner et al. ( 2010 ) challenged the stereotype of older adults’ conservative attitudes towards technology, highlighting the central roles of usability and usefulness in the technology acceptance process. This discovery laid an important foundation for subsequent research. Research fields such as “smart home technology,” “social life,” and “customer service” are emerging, indicating a shift in focus towards the practical and social applications of technology in older adults’ lives. Research not only focuses on the technology itself but also on how these technologies integrate into older adults’ daily lives and how they can improve the quality of life through technology. For instance, studies such as those by Ma et al. ( 2016 ), Hoque and Sorwar ( 2017 ), and Li et al. ( 2019 ) have explored factors influencing older adults’ use of smartphones, mHealth, and smart wearable devices.

Furthermore, the diversification of research methodologies and innovation in evaluation techniques, such as the use of mixed methods, structural equation modeling (SEM), and neural network (NN) approaches, have enhanced the rigor and reliability of the findings, enabling more precise identification of the factors and mechanisms influencing technology acceptance. Talukder et al. ( 2020 ) employed an effective multimethodological strategy by integrating SEM and NN to leverage the complementary strengths of both approaches, thus overcoming their individual limitations and more accurately analyzing and predicting older adults’ acceptance of wearable health technologies (WHT). SEM is utilized to assess the determinants’ impact on the adoption of WHT, while neural network models validate SEM outcomes and predict the significance of key determinants. This combined approach not only boosts the models’ reliability and explanatory power but also provides a nuanced understanding of the motivations and barriers behind older adults’ acceptance of WHT, offering deep research insights.

Overall, co-citation analysis of the literature in the field of older adults’ technology acceptance has uncovered deeper theoretical modeling and empirical studies on emerging technologies, while emphasizing the importance of research methodological and evaluation innovations in understanding complex social science issues. These findings are crucial for guiding the design and marketing strategies of future technology products, especially in the rapidly growing market of older adults.

Discussion on research hotspots and evolutionary trends (RQ4)

By analyzing core keywords, we can gain deep insights into the hot topics, evolutionary trends, and quality distribution of research in the field of older adults’ technology acceptance. The frequent occurrence of the keywords “TAM” and “UTAUT” indicates that the applicability and theoretical extension of existing technology acceptance models among older adults remain a focal point in academia. This phenomenon underscores the enduring influence of the studies by Davis ( 1989 ) and Venkatesh et al. ( 2003 ), whose models provide a robust theoretical framework for explaining and predicting older adults’ acceptance and usage of emerging technologies. With the widespread application of artificial intelligence (AI) and big data technologies, these theoretical models have incorporated new variables such as perceived risk, trust, and privacy issues (Amin et al. 2024 ; Chen et al. 2024 ; Jing et al. 2024b ; Seibert et al. 2021 ; Wang et al. 2024b ), advancing the theoretical depth and empirical research in this field.

Keyword co-occurrence cluster analysis has revealed multiple research hotspots in the field, including factors influencing technology adoption, interactive experiences between older adults and assistive technologies, the application of mobile health technology in health management, and technology-assisted home care. These studies primarily focus on enhancing the quality of life and health management of older adults through emerging technologies, particularly in the areas of ambient assisted living, smart health monitoring, and intelligent medical care. In these domains, the role of AI technology is increasingly significant (Qian et al. 2021 ; Ho 2020 ). With the evolution of next-generation information technologies, AI is increasingly integrated into elder care systems, offering intelligent, efficient, and personalized service solutions by analyzing the lifestyles and health conditions of older adults. This integration aims to enhance older adults’ quality of life in aspects such as health monitoring and alerts, rehabilitation assistance, daily health management, and emotional support (Lee et al. 2023 ). A survey indicates that 83% of older adults prefer AI-driven solutions when selecting smart products, demonstrating the increasing acceptance of AI in elder care (Zhao and Li 2024 ). Integrating AI into elder care presents both opportunities and challenges, particularly in terms of user acceptance, trust, and long-term usage effects, which warrant further exploration (Mhlanga 2023 ). These studies will help better understand the profound impact of AI technology on the lifestyles of older adults and provide critical references for optimizing AI-driven elder care services.

The Time-zone evolution mapping and burst keyword analysis further reveal the evolutionary trends of research hotspots. Early studies focused on basic technology acceptance models and user perceptions, later expanding to include quality of life and health management. In recent years, research has increasingly focused on cutting-edge technologies such as virtual reality, telehealth, and human-robot interaction, with a concurrent emphasis on the user experience of older adults. This evolutionary process demonstrates a deepening shift from theoretical models to practical applications, underscoring the significant role of technology in enhancing the quality of life for older adults. Furthermore, the strategic coordinate mapping analysis clearly demonstrates the development and mutual influence of different research themes. High centrality and density in the themes of Usage Experience and Assisted Living Technology indicate their mature research status and significant impact on other themes. The themes of Smart Devices, Theoretical Models, and Mobile Health Applications demonstrate self-contained research trends. The themes of Human-Robot Interaction, Characteristics of the Elderly, and Research Methods are not yet mature, but they hold potential for development. Themes of Digital Healthcare Technology, Psychological Factors, and Socio-Cultural Factors are closely related to other themes, displaying core immaturity but significant potential.

In summary, the research hotspots in the field of older adults’ technology acceptance are diverse and dynamic, demonstrating the academic community’s profound understanding of how older adults interact with technology across various life contexts and needs. Under the influence of AI and big data, research should continue to focus on the application of emerging technologies among older adults, exploring in depth how they adapt to and effectively use these technologies. This not only enhances the quality of life and healthcare experiences for older adults but also drives ongoing innovation and development in this field.

Research agenda

Based on the above research findings, to further understand and promote technology acceptance and usage among older adults, we recommend future studies focus on refining theoretical models, exploring long-term usage, and assessing user experience in the following detailed aspects:

Refinement and validation of specific technology acceptance models for older adults: Future research should focus on developing and validating technology acceptance models based on individual characteristics, particularly considering variations in technology acceptance among older adults across different educational levels and cultural backgrounds. This includes factors such as age, gender, educational background, and cultural differences. Additionally, research should examine how well specific technologies, such as wearable devices and mobile health applications, meet the needs of older adults. Building on existing theoretical models, this research should integrate insights from multiple disciplines such as psychology, sociology, design, and engineering through interdisciplinary collaboration to create more accurate and comprehensive models, which should then be validated in relevant contexts.

Deepening the exploration of the relationship between long-term technology use and quality of life among older adults: The acceptance and use of technology by users is a complex and dynamic process (Seuwou et al. 2016 ). Existing research predominantly focuses on older adults’ initial acceptance or short-term use of new technologies; however, the impact of long-term use on their quality of life and health is more significant. Future research should focus on the evolution of older adults’ experiences and needs during long-term technology usage, and the enduring effects of technology on their social interactions, mental health, and life satisfaction. Through longitudinal studies and qualitative analysis, this research reveals the specific needs and challenges of older adults in long-term technology use, providing a basis for developing technologies and strategies that better meet their requirements. This understanding aids in comprehensively assessing the impact of technology on older adults’ quality of life and guiding the optimization and improvement of technological products.

Evaluating the Importance of User Experience in Research on Older Adults’ Technology Acceptance: Understanding the mechanisms of information technology acceptance and use is central to human-computer interaction research. Although technology acceptance models and user experience models differ in objectives, they share many potential intersections. Technology acceptance research focuses on structured prediction and assessment, while user experience research concentrates on interpreting design impacts and new frameworks. Integrating user experience to assess older adults’ acceptance of technology products and systems is crucial (Codfrey et al. 2022 ; Wang et al. 2019 ), particularly for older users, where specific product designs should emphasize practicality and usability (Fisk et al. 2020 ). Researchers need to explore innovative age-appropriate design methods to enhance older adults’ usage experience. This includes studying older users’ actual usage preferences and behaviors, optimizing user interfaces, and interaction designs. Integrating feedback from older adults to tailor products to their needs can further promote their acceptance and continued use of technology products.

Conclusions

This study conducted a systematic review of the literature on older adults’ technology acceptance over the past decade through bibliometric analysis, focusing on the distribution power, research power, knowledge base and theme progress, research hotspots, evolutionary trends, and quality distribution. Using a combination of quantitative and qualitative methods, this study has reached the following conclusions:

Technology acceptance among older adults has become a hot topic in the international academic community, involving the integration of knowledge across multiple disciplines, including Medical Informatics, Health Care Sciences Services, and Ergonomics. In terms of journals, “PSYCHOLOGY, EDUCATION, HEALTH” represents a leading field, with key publications including Computers in Human Behavior , Journal of Medical Internet Research , and International Journal of Human-Computer Interaction . These journals possess significant academic authority and extensive influence in the field.

Research on technology acceptance among older adults is particularly active in developed countries, with China and USA publishing significantly more than other nations. The Netherlands leads in high average citation rates, indicating the depth and impact of its research. Meanwhile, the UK stands out in terms of international collaboration. At the institutional level, City University of Hong Kong and The University of Hong Kong in China are in leading positions. Tilburg University in the Netherlands demonstrates exceptional research quality through its high average citation count. At the author level, Chen from China has the highest number of publications, while Peek from the Netherlands has the highest average citation count.

Co-citation analysis of references indicates that the knowledge base in this field is divided into three main categories: theoretical model deepening, emerging technology applications, and research methods and evaluation. Seminal literature focuses on four areas: specific technology use by older adults, expansion of theoretical models of technology acceptance, information technology adoption behavior, and research perspectives. Research themes have evolved from initial theoretical deepening and analysis of influencing factors to empirical studies on individual factors and emerging technologies.

Keyword analysis indicates that TAM and UTAUT are the most frequently occurring terms, while “assistive technology” and “virtual reality” are focal points with high frequency and centrality. Keyword clustering analysis reveals that research hotspots are concentrated on the influencing factors of technology adoption, human-robot interaction experiences, mobile health management, and technology for aging in place. Time-zone evolution mapping and burst keyword analysis have revealed the research evolution from preliminary exploration of influencing factors, to enhancements in quality of life and health management, and onto advanced technology applications and deepening of theoretical models. Furthermore, analysis of research quality distribution indicates that Usage Experience and Assisted Living Technology have become core topics, while Smart Devices, Theoretical Models, and Mobile Health Applications point towards future research directions.

Through this study, we have systematically reviewed the dynamics, core issues, and evolutionary trends in the field of older adults’ technology acceptance, constructing a comprehensive Knowledge Mapping of the domain and presenting a clear framework of existing research. This not only lays the foundation for subsequent theoretical discussions and innovative applications in the field but also provides an important reference for relevant scholars.

Limitations

To our knowledge, this is the first bibliometric analysis concerning technology acceptance among older adults, and we adhered strictly to bibliometric standards throughout our research. However, this study relies on the Web of Science Core Collection, and while its authority and breadth are widely recognized, this choice may have missed relevant literature published in other significant databases such as PubMed, Scopus, and Google Scholar, potentially overlooking some critical academic contributions. Moreover, given that our analysis was confined to literature in English, it may not reflect studies published in other languages, somewhat limiting the global representativeness of our data sample.

It is noteworthy that with the rapid development of AI technology, its increasingly widespread application in elderly care services is significantly transforming traditional care models. AI is profoundly altering the lifestyles of the elderly, from health monitoring and smart diagnostics to intelligent home systems and personalized care, significantly enhancing their quality of life and health care standards. The potential for AI technology within the elderly population is immense, and research in this area is rapidly expanding. However, due to the restrictive nature of the search terms used in this study, it did not fully cover research in this critical area, particularly in addressing key issues such as trust, privacy, and ethics.

Consequently, future research should not only expand data sources, incorporating multilingual and multidatabase literature, but also particularly focus on exploring older adults’ acceptance of AI technology and its applications, in order to construct a more comprehensive academic landscape of older adults’ technology acceptance, thereby enriching and extending the knowledge system and academic trends in this field.

Data availability

The datasets analyzed during the current study are available in the Dataverse repository: https://doi.org/10.7910/DVN/6K0GJH .

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This research was supported by the Social Science Foundation of Shaanxi Province in China (Grant No. 2023J014).

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Shang, X., Liu, Z., Gong, C. et al. Knowledge mapping and evolution of research on older adults’ technology acceptance: a bibliometric study from 2013 to 2023. Humanit Soc Sci Commun 11 , 1115 (2024). https://doi.org/10.1057/s41599-024-03658-2

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The right care in the right place: a scoping review of digital health education and training for rural healthcare workers

• Leanna Woods 1 , 2 ,
• Priya Martin 3 ,
• Johnson Khor 1 , 4 ,
• Lauren Guthrie 1 &
• Clair Sullivan 1 , 2 , 5  

BMC Health Services Research volume  24 , Article number:  1011 ( 2024 ) Cite this article

Metrics details

Digital health offers unprecedented opportunities to enhance health service delivery across vast geographic regions. However, these benefits can only be realized with effective capabilities and clinical leadership of the rural healthcare workforce. Little is known about how rural healthcare workers acquire skills in digital health, how digital health education or training programs are evaluated and the barriers and enablers for high quality digital health education and training.

To conduct a scoping review to identify and synthesize existing evidence on digital health education and training of the rural healthcare workforce.

Inclusion criteria

Sources that reported digital health and education or training in the healthcare workforce in any healthcare setting outside metropolitan areas.

We searched for published and unpublished studies written in English in the last decade to August 2023. The databases searched were PubMed, Embase, Scopus, CINAHL and Education Resources Information Centre. We also searched the grey literature (Google, Google Scholar), conducted citation searching and stakeholder engagement. The JBI Scoping Review methodology and PRISMA guidelines for scoping reviews were used.

Five articles met the eligibility criteria. Two case studies, one feasibility study, one micro-credential and one fellowship were described. The mode of delivery was commonly modular online learning. Only one article described an evaluation, and findings showed the train-the-trainer model was technically and pedagogically feasible and well received. A limited number of barriers and enablers for high quality education or training of the rural healthcare workforce were reported across macro (legal, regulatory, economic), meso (local health service and community) and micro (day-to-day practice) levels.

Conclusions

Upskilling rural healthcare workers in digital health appears rare. Current best practice points to flexible, blended training programs that are suitably embedded with interdisciplinary and collaborative rural healthcare improvement initiatives. Future work to advance the field could define rural health informatician career pathways, address concurrent rural workforce issues, and conduct training implementation evaluations.

Review registration number

Open Science Framework: https://doi.org/10.17605/OSF.IO/N2RMX .

Peer Review reports

Introduction

Globally, healthcare workers (HCWs) face multiple pressures simultaneously: increasing demand for care, co-morbidities and condition complexity, budget pressures, and rapid digital disruption [ 1 ]. The digital disruption in healthcare promises an unprecedented circumstance to improve outcomes and strengthen health systems [ 2 ]. However, this opportunity depends on a capable healthcare workforce with adequate skills and knowledge in data and emerging technologies [ 3 ]. HCW capability in digital health and clinical informatics is increasingly acknowledged as an essential component to the delivery of high-quality patient care [ 4 ]. Universities do not yet routinely teach these curricula in clinical degrees, and the capability gap in the current workforce is often filled by brief, reactive, and on-the-job training [ 5 ]. Sustainability of healthcare includes developing a skilled healthcare workforce educated and competent in digital health [ 6 ].

The rural healthcare workforce is faced with the location-based issues of resource constraints, workforce shortages, high staff turnover rates, stress, burnout, and an ageing workforce [ 7 ]. The World Health Organization has acknowledged in a recent report (2021) the complex challenge of shortage of healthcare workers globally in rural areas [ 7 ]. This report has acknowledged that the workforce density is lower than national averages in most of these areas. In places where there isn’t a national shortage, maldistribution of the workforce has been noted [ 7 ]. Digitally enabled models of care are well placed to enhance health service delivery across vast and distributed geographic regions. However, rural health service organizations require uplift to align with their metropolitan counterparts in workforce digital readiness [ 8 ]. Building digital health capability in rural settings is critical because higher digital health capability is associated with better outcomes, including the ability to maintain an accurate patient health record, track patient experience data, track the patient journey, and mitigate clinical risks [ 9 ]. Rurality is contributing to widening digital health inequities [ 10 ] with significant efforts required to adequately manage the rural digital divide [ 11 , 12 ]. Building digital capabilities of healthcare providers in rural and remote settings through education, training and support is needed [ 13 ].

Existing evidence on the education and training the rural healthcare workforce is limited. Firstly, while health science faculties are progressively integrating digital health into the undergraduate curricula for the future workforce [ 14 , 15 , 16 ], it is unclear how the education of current HCW is approached [ 14 ]. Despite global exemplars such as fellowship training for physicians [ 17 ], certification for nurses [ 18 ], and advanced education for clinical and non-clinical professionals [ 19 ], limited evidence of successful workforce programs to build digital health skills exist [ 4 ]. None focus on the rural healthcare setting.

Secondly, in literature reporting digital health in rural settings, there is a notable scarcity on workforce training programs. Existing studies focus on efficacy of delivered healthcare [ 20 , 21 ], workforce perceptions of digital health tool implementation [ 22 , 23 ] or are limited to training of specific interventions (e.g., clinical telehealth [ 24 ]). This review sought to explore the literature where these two gaps coexist, the intersection of digital health education and training and the rural healthcare workforce, and synthesize the available evidence on digital health education and training for the rural healthcare workforce.

Review question

The research questions for this review were:

What are the existing practices and approaches to digital health education and training for rural HCWs?

How has digital health education and training been evaluated following implementation?

What are the barriers and enablers for high quality digital health education and training in the rural healthcare workforce?

Participants

The review considered studies and reports on any members of the workforce in healthcare settings outside of metropolitan areas. The healthcare workforce refers to ‘all individuals who deliver or assist in the delivery of health services or support the operation of health care facilities’ [ 3 ]. All clinical (e.g., medical doctors, nurses, allied health professionals, pharmacists, Indigenous HCWs, pre-registration/qualification students undertaking placements in health care facilities) and non-clinical workers (e.g., administration, executive and management, clinical support, and volunteers) were considered regardless of professional body or government registration status. Patients, healthcare consumers, and the public were excluded.

The core concepts of digital health and training were combined in this review. Digital health and clinical informatics are often used interchangeably, and both were considered in this review. While digital health refers to the use of digital technologies for health [ 25 ], clinical informatics refers to more specialized practice of analyzing, designing, implementing and evaluating information and communication systems [ 26 ]. Specific digital health systems (e.g., IT infrastructure, telehealth, electronic medical records) were included. Training relates to the education or training initiatives (e.g., programs, curriculum, course) that build an individuals’ digital health capability to confidently use technologies to respond to the needs of consumers now and into the future [ 1 ]. Both education and training activities were considered. Education often refers to theoretical learning (e.g., by an academic institution, qualification), and training often teaches practical skills (e.g., employer-provided professional development, ‘just-in-time’ training) [ 3 , 24 ]. This review did not consider HCW education delivered at a distance through technologies (e.g., telesupervision for clinical skills training).

This review considered studies and reports from rural healthcare settings defined as outside metropolitan cities, inclusive of regional, rural, remote, and very remote settings. When the term ‘rural’ is used in this review, it refers to all areas outside major metropolitan cities as described by authors of individual studies and reports. All healthcare facilities across primary, secondary, and tertiary care settings were included in any country.

Types of sources

All research studies, irrespective of the study design, were considered. Reviews, conference abstracts and non-research sources (e.g., policy documents, program or course curriculum) were considered. The grey literature was included to capture reactionary training developed by rural health services that were not published as peer-reviewed research studies.

This review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews [ 27 ] and reported as per the Preferred Reporting of Systematic Reviews and Meta-analyses for scoping reviews (PRISMA-ScR) [ 28 ] (Additional file 1 ). The review protocol was registered in Open Science Framework [ https://doi.org/10.17605/OSF.IO/N2RMX ].

A scoping review approach was chosen over a systematic review to address a general, formative review question on this topic that is emerging in the literature and where the literature is complex and heterogenous [ 29 ]. An initial preliminary search of the topic in the academic databases, Cochrane Library, Open Science Framework and Prospero registry resulted in a very small number of relevant articles. It was determined that a broader search strategy and inclusion of non-research sources was required, consistent with the scoping review methodology [ 29 ]. Scoping review format is also well suited to the vast, diverse healthcare education topic across different disciplines, interventions and outcomes realised [ 30 ]. Mapping and synthesis across sources in this scoping review aims to inform research agendas and identify implications for policy and practice [ 31 ].

Deviations from the protocol

There were no deviations to the protocol.

Search strategy

The three phase JBI search process was followed. An initial limited search of PubMed was performed to identify keywords on the topic, followed by an analysis of the text words and index terms contained in the title and abstract. A subsequent preliminary search in Prospero registry, Cochrane Library and Open Science Framework informed the development of a full search strategy in PubMed. The search strategy, including all identified keyworks and index terms, was adapted for each included database and information source after refining the strategy with an information specialist. The reference lists of all included sources of evidence were screened for additional studies.

The review included only studies and reports in English (due to translation resourcing limitations) in the last 10 years (due to the relative novelty of the digital transformation of healthcare). The search was conducted in August 2023. The databases searched included PubMed, Scopus, Cumulative Index for Nursing and Allied Health Literature (CINAHL), Embase, and Education Resources Information Center (ERIC). Scopus was chosen over Web of Science as it provides 20% more coverage and the relative recency of articles indexed (publish date after 1995 [ 32 ]) was not a concern for our research question. The search for unpublished studies and grey literature included Google and Google Scholar, using a modified search strategy as required. In addition, national and international stakeholders ( n  = 29) from Asia, the Pacific Islands, Australia, USA and the UK known to have subject matter expertise on the topic were contacted via direct email. Stakeholders were asked to share any relevant work underway or otherwise undiscoverable using our scoping review methods. The full search strategy for each information source is provided in Additional file 2 .

Study selection

Following the search, identified articles were collated and uploaded into Covidence review software (Veritas Health Innovation Ltd; Melbourne, Australia) and duplicates removed. Two reviewers (among LW, JK and LG) then independently screened the title and abstract of each citation and selected studies that met the inclusion criteria. The full text articles were retrieved and uploaded into Covidence. These studies and reports were assessed independently by two reviewers (listed previously) for full assessment against the inclusion criteria. Any disagreements that arose between the reviewers at each stage of the selection process were resolved through discussion or with an additional reviewer (among LG and PM). Three meetings occurred to discuss any voting conflicts that occurred during title and abstract screening and full-text screening. Articles that did not satisfy the criteria were excluded with reasons for exclusion recorded. Search results and study selection process is presented in accordance to the PRISMA-ScR flow diagram (Fig. 1 ) [ 28 ]. Quality appraisal of selected studies was not conducted, consistent with scoping reviews methods [ 33 ].

Search results and source selection and inclusion process

Data extraction

Extracted data included the specific details about the participants, concept, context, study methods and key findings relevant to each review question. Data was extracted by one reviewer (JK) and checked by a second reviewer (LW). Data were extracted using the data extraction tool developed and piloted by the team (Additional file 3 ).

Data synthesis and presentation

The characteristics of the included studies were analyzed and organized in tabular format, accompanied by a narrative summary. Results of each research question was presented under separate headings. The data analysis for research question three (barriers and enablers of high-quality digital health education and training) was enhanced. We adopted the socio-institutional framework described by Smith et al [ 34 ] and used in education research [ 35 ] to classify macro, meso, micro level enablers and barriers to help improve the generalizability of the synthesized insights and identify stakeholders that are able to influence change. Gaps and limitations of the current literature were discovered from the evidence with recommendations for policy, practice and future research provided.

Study inclusion

Database searching yielded 1005 articles and stakeholder engagement yielded two articles. After removing duplicates, 660 articles were screened for title and abstract, after which 29 articles underwent full text review. Of the 29 articles, 24 articles were excluded: the setting was metropolitan or otherwise inadequately described as non-metropolitan ( n  = 6); the intervention was not a training or education initiative for digital health or clinical informatics ( n  = 16), or the population was not rural healthcare workers ( n  = 2). In total, following full-text screening, five articles were included in the final review (Fig.  1 ).

Characteristics of included studies

Of the five included articles, three were academic publications including two case studies [ 36 , 37 ] and one feasibility study [ 38 ] (Table 1 ). The two articles identified through stakeholder engagement presented course summaries [ 39 , 40 ] where one described a micro-credential [ 40 ] and the other described a fellowship [ 39 ]. Most articles ( n  = 3) were published recently between 2021 and 2023 [ 38 , 39 , 40 ]. Healthcare workforce settings were distributed across the continents of the United States of America [ 36 ], Asia [ 37 ], Africa [ 38 ] and Australia [ 39 , 40 ], with no articles reporting a setting in the European continent. Further study characteristics are available in Table 1 .

Review findings

What are the existing approaches to digital health education and training for rural hcws.

Training and education programs were needed due to identified gaps in knowledge, skills and expertise to support healthcare delivery in rural contexts with digital health [ 36 , 37 , 38 ], [ 40 ]. One article reported the target learners as village doctors, who may have “limited training and inadequate medical knowledge, yet they are generally the mainstay of health services” [ 37 ]. The mode of teaching in the included studies were four modular online learning courses [ 36 , 37 , 38 ], [ 40 ] and one fellowship [ 39 ]. Of the four modular online learning courses, one was supplemented by a facilitator-led train-the-trainer model [ 38 ], informed by an academic framework [ 41 ], with cohort-based discussion via a social media platform. The second was a certification in the form of a self-paced micro-credential completed individually [ 40 ]. Of the four modular online learning courses, the number of modules ranged from three to eight and covered a variety of digital health topics including innovation, commercialization, bioinformatics, technology use, data and information, professionalism, implementation and evaluation. One had a particular focus on information and communication technology tool use [ 37 ] while another focused on remote consulting [ 38 ]. The mode of delivery of the fellowship was not reported in the article.

Four [ 36 , 37 , 39 , 40 ] of the five included articles did not report an evaluation. One article in rural Tanzania described the evaluation of the train-the-trainer digital health training program using a mixed-method design [ 38 ]: (1) questionnaire informed by Kirkpatrick’s model of evaluation to capture knowledge gained and perceived behavior change on a Likert scale, (2) qualitative interviews to explore training experiences and views of remote consulting, and (3) document analysis from texts, emails and training reports [ 38 ]. Of the tier 1 trainees (senior medical figure trainers who were trained to educate their peers) that completed the questionnaire ( n  = 10, 83%), nine (90%) recommended the training program and reported receiving relevant skills and applying learning to daily work, demonstrating satisfaction, learning and perceived behavior change [ 38 ]. Overall, the feasibility study confirmed that remotely delivered training supported by cascade training was technically and pedagogically feasible and well received in rural Tanzania [ 38 ].

What are the barriers and enablers for high quality digital health education and training of the rural healthcare workforce?

Reported enablers and barriers are presented using the macro, meso, micro framework [ 34 ] (Table 2 ).

This scoping review reflects the scarcity of reported digital health education and training programs in existence for rural HCWs globally. This review responds to the World Health Organization (WHO) recommendation to design and enable access to continuing education and professional development programs that meet the needs of rural HCWs [ 7 ], and the Sustainable Development Goal for inclusive and equitable quality education [ 42 ].

Concurrent challenges of people (workforce), setting (rural) and content (digital health) are reported in included articles alongside enablers and barriers to education and training programs. Included studies reported a shortage of doctors and specialists [ 36 ], lack of technical knowledge [ 36 ] (people); higher cost of delivering rural healthcare, high burden of illness [ 40 ], medically underserved population due to rural hospital closures [ 36 ] (setting); and limited use of digital health tools due to coordination challenges among non-government organisations [ 37 ] (content). These additional macro, meso and micro level factors are described by authors firstly as influencing the need for digital health programs in rural settings, and secondly, as contributing to the challenges of implementing effective programs. The rural health workforce challenges in digital health education and training reflect the broader workforce development issues experienced globally [ 7 ]. While this review sought to identify workforce development programs, the WHO model indicates the need for attractiveness, recruitment and retention to enable workforce performance (i.e., appropriate and competent multidisciplinary teams providing care) and health system performance (i.e., improving universal health coverage) [ 7 ].

In low-resource settings such as rural areas, education and training may not be prioritized among other competing workload demands. As the value of digital health transformations are realized for strengthening healthcare systems [ 25 , 43 ], the value of digital health education or training programs may become realized. This value was evidenced in the implementation of the teleconsulting training intervention in rural Tanzania [ 38 ] in rapid response to supporting care delivery during the COVID-19 pandemic period. With evaluations of programs largely absent from an already small number of programs globally, it will be important for future research to focus on implementation evaluation studies. As Table 2 presents only limited enablers and barriers, more evidence is needed to build on the findings from this scoping review to inform strategies for policy and practice.

The interdisciplinarity of digital health presents challenges and opportunities for nurturing digital health expertise across the rural healthcare workforce. Included articles largely described the target learners of education and training programs as clinicians, practitioners and healthcare workforce. Walden et al. further indicated that users of online content may extend beyond rural health clinicians to healthcare administrators, researchers and providers relevant to address the regulatory factors of clinical validation and implementation [ 36 ]. Therefore, for their program of work, the University of Arkansas for Medical Sciences identified and fostered collaboration with an interprofessional team of clinicians, researchers, informaticists, a bioethicist, lawyers, technology investment experts, and educators [ 36 ]. No articles in the review described education or training health informaticians or similar digital health leadership role types, yet building defined career pathways for health informaticians is recommended [ 4 ]. Existing pedagogy shows that the learning principles of interprofessional practice is grounded in understanding one’s own practice as well as the practice of other health professionals and remains aligned to the educational needs of specific professions [ 44 ] (i.e., medicine, nursing, pharmacy). Defining new career pathways for interdisciplinary leaders in digital health within a specific clinical context, like the ‘rural health informatician’, will be important to identify or define the (hidden) specialized workforce.

Local, informal organizational initiatives for digital health learning were discovered alongside formal education or training programs in included studies. Programs were often reported in articles alongside concurrent digital health implementation or healthcare improvement programs, sometimes referred to as ‘outreach’ [ 36 ] activities. These informal initiatives included special interest groups, in-person conferences, networking events, working groups [ 36 ] and seminars [ 37 ]. Current evidence from this scoping review suggests that the efficacy and sustainability of education or training programs are reliant on integrated approaches, like the train-the-trainer [ 38 ] or academic organization approach [ 36 ], that foster translational research for rural healthcare improvement. As illustrated by Walden et al., success in digital health is likely to require a foundational environment where technologies can be discussed, developed and deployed [ 36 ]. Success in rural digital health skills acquisition likely requires a similar, longitudinal and collaborative approach beyond the confines of an online course completed individually. Previous research shows us that blended learning, which merges face-to-face with online learning, translates to better knowledge outcomes [ 44 ]. Blended learning can also overcome the barrier of rural HCWs travelling large distances to attend face-to-face training that comes at a great cost to themselves and the work unit. A key recommendation to improve the digital health training program described by Downie et al. was more face-to-face time with trainers, from the perspective of both trainee and facilitator [ 38 ]. This, however, can only be realized with targeted planning and budgeting of such offerings by involved rural healthcare organizations.

The opportunities to advance digital health education and training for rural HCWs are presented across the macro, meso and micro levels in the socio-institutional framework, with suggested relevant stakeholders suited to actioning the recommendations (Table  3 ). While the context for this is likely to vary across the globe, these recommendations and stakeholders are expected to provide a starting point to initiate a dialogue that can influence change. These recommendations are not meant to be prescriptive or rigid, but rather meant to flag actionable solutions that can be contextualized for any given setting.

Strengths and limitations

It is possible that there is a greater number of published educational and training programs than those reported in this review (i.e., publication bias). To mitigate this, we used a scoping review methodology and stakeholder engagement activity to identify unpublished or emerging programs that answer the review question but may not be discoverable in the academic databases. The review is limited to articles available in the English language. The small number of programs, heterogeneity of programs and limited evaluation of programs significantly limit generalizability of findings. Due to data availability, the barriers and enablers findings summary contain an overrepresentation from a small number of studies limiting conclusions that can be drawn.

Digital health offers the best opportunity for innovative sustainable change to address critical issues in health and care in rural settings. Workforce education and training initiatives in rural healthcare settings are scarce, largely delivered via online training, and are rarely evaluated. Current best practice points to flexible, blended (online and face-to-face) training programs that are suitably embedded with interdisciplinary, collaborative rural healthcare improvement initiatives. More research will expand the evidence base to deliver high-quality digital health education to strengthen rural healthcare delivery. Future work to advance the field could define rural health informatician career pathways, address concurrent rural workforce issues, and conduct implementation evaluations.

Availability of data and materials

No datasets were generated or analysed during the current study.

Abbreviations

Cumulative Index for Nursing and Allied Health Literature

Education Resources Information Centre

Healthcare worker

Joanna Briggs Institute

Preferred Reporting of Systematic Reviews and Meta-analyses for scoping reviews

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Leanna Woods, Johnson Khor, Lauren Guthrie & Clair Sullivan

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LW, PM and CS designed the study. LW, PM, JK and LG acquired data; analyzed and interpreted results and drafted the manuscript and all subsequent drafts. CS read and contributed to manuscript drafts. All authors read and approved the final manuscript draft.

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12913_2024_11313_moesm1_esm.docx.

Additional File 1. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist.

Additional File 2. Full search strategy for each information source.

Additional file 3. data extraction instrument template., rights and permissions.

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Woods, L., Martin, P., Khor, J. et al. The right care in the right place: a scoping review of digital health education and training for rural healthcare workers. BMC Health Serv Res 24 , 1011 (2024). https://doi.org/10.1186/s12913-024-11313-4

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Received : 13 March 2024

Accepted : 15 July 2024

Published : 02 September 2024

DOI : https://doi.org/10.1186/s12913-024-11313-4

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