Gamification and Escape Rooms for the Validation of Assistive Technologies: A Participatory Experience with Older Adults in Cross-Border Rural Settings

Abstract

This study evaluates escape room gamification as a participatory methodology for validating assistive technologies with older adults in cross-border rural areas through the VIVEMAIS INTERREG project. Deployed via the "Diversiverso" mobile living lab across eight Spain-Portugal municipalities (April–July 2025), the intervention engaged 331 participants (mean age 78.4 years) testing 18 assistive devices through challenge-based interactions. A mixed-methods approach combined quantitative surveys (n = 331; TAM attitudes, technology recall) with caregiver interviews (n = 11). Complementary triangulation identified three dimensions: technological appropriation, pedagogical function, and validation potential. Escape rooms fostered initial engagement but modest adoption intent (34% willing to take devices home), moderated by cognitive impairment and rural connectivity barriers. The study introduces "pedagogical realism", a dual effect where gamified interaction simultaneously generates enthusiasm and critical awareness of practical limitations. This distinguishes escape rooms from purely motivational approaches, positioning them as diagnostic tools bridging design, evaluation, and implementation phases. Discussion demonstrates that Technology Acceptance Model (TAM) limitations are addressed by Senior TAM (STAM), while supervised exergame meta-analyses confirm mediation effects in cognitive impairment. Caregivers emerge as essential intermediaries, particularly in rural contexts. Conclusions recommend integrating escape rooms within comprehensive strategies incorporating sustained mediation and transfer activities. The approach reveals a critical gap between experiential engagement and sustained adoption, informing user-centred innovation ecosystems for aging-in-place technologies.