Lower heart-rate variability (but not heart-rate) is associated with increased self-reported stigma toward low vision assistive devices

Abstract

Purpose : The perceptions surrounding assistive devices have been shown to be increasingly stigmatizing in older adult populations. This stigmatization can lead to the abandonment of the assistive device (AD). Until now, methods of identifying or predicting stigma surrounding ADs has mostly been qualitative. We present a novel quantitate and qualitative study that uses heart-rate and heart-rate variability in addition to a new version of the Explanatory Model Interview Catalogue (EMIC) questionnaire, designed to investigate the stigma associated with ADs. Therefore, this approach plays a major role in understanding and predicting the physiological correlates associated to self-reported stigma.

Methods : 34 adults aged 50+ took part in the study. To determine the psychophysiological predictors of stigma surrounding ADs, we monitored heart rate using a custom-built Arduino heart-rate monitor. Participants viewed a series of images in different social settings (e.g. at coffee shop) on a 21” CRT display. In each scenario, the individual uses either a low stigmatizing device (e.g. iPad), a high stigmatizing device (e.g. magnifier), or no device. After viewing all images, we administered the EMIC.

Results : Self-reported Stigma assessed with the EMIC, shows differences in invidual question responses between high-stigma (sum EMIC>6) and low-stigma (sum EMIC<=6) groups.
We present analysis of heart rate and heart-rate variability, measured by the Root Mean Square of Successive Differences (RMSSD). We find no significant difference between the high- and low-stigma groups for raw heart-rate (p>.1, Hedges g<.1, BF₀₁>3). For heart-rate variability, RMSSD is less variable among the high-stigma group (Mean RMSSD=500ms) compared to low-stigma group (Mean RMSSD=1800ms, p<.05, Hedges g=.51, BF₁₀=4). These findings agree with previous researchers that have demonstrated that lower values of RMSSD are linked to increased physiological arousal. Therefore, the high stigma group demonstrates increased physiological arousal in response to the assistive devices.

Conclusions : These initial observations would indicate that heart rate variability may be a useful predictor of negative stereotype that can be associated with assistive devices. Future research aims to expand this prediction to those actively using assistive devices, and if heart-rate variability can predict abandonment over time.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.