Digital Engagement of Older Adults: Scoping Review
- Author(s): Abraham Sahilemichael Kebede; Lise-Lotte Ozlins; Hanna Holst; Kathleen Galvin
- Published: Journal of Medical Internet Research – https://www.jmir.org/2022/12/e40192
Abstract
Background:Digital technologies facilitate everyday life, social connectedness, aging at home, well-being, and dignified care. However, older adults are disproportionately excluded from these benefits. Equal digital opportunities, access, and meaningful engagement require an understanding of older adults’ experience across different stages of the technological engagement life cycle from nonuse and initial adoption to sustained use, factors influencing their decisions, and how the experience changes over time.
Objective:Our objectives were to identify the extent and breadth of existing literature on older adults’ perspective on digital engagement and summarize the barriers to and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement.
Methods:We used the Arksey and O’Malley framework for the scoping review process. We searched MEDLINE, PsycINFO, CINAHL, Web of Science, and ACM digital library for primary studies published between 2005 and 2021. The inclusion and exclusion criteria were developed based on the Joanna Briggs Institute (participants, content, and context) framework. Studies that investigated the digital engagement experience as well as barriers to and facilitators of older adults’ digital technology engagement were included. The characteristics of the study, types of digital technology, and digital engagement levels were analyzed descriptively. Content analysis was used to generate tentative elements using a congruent theme, and barriers and facilitators were mapped over the capability, opportunity, and motivation behavior change model (COM-B) and the theoretical domain framework. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews).
Results:In total, 96 publications were eligible for the final charting and synthesis. Most of the studies were published over the past 5 years, investigated the initial adoption stage of digital engagement, and focused on everyday technologies. The most cited barriers and facilitators across the engagement stages from each COM-B component were capability (eg, physical and psychological changes and lack of skill), opportunity (eg, technological features, environmental context, and resources), and motivation (eg, optimism from perceived usefulness and beliefs about capability).
Conclusions:The COM-B model and theoretical domain framework provide a guide for identifying multiple and intertwined barriers and facilitators at each stage of digital engagement. There are limited studies looking into the whole spectrum of older adults’ digital technology experience; in particular, studies on technological nonuse and sustained use stages are rare. Future research and practice should focus on tailored interventions accounting for the barriers to older adults’ digital engagement and addressing capabilities, motivation, and opportunities; affordable, usable, and useful digital technologies, which address the changes and capability requirements of older adults and are cocreated with a value framework; and lifelong learning and empowerment to develop older adults’ knowledge and skills to cope with digital technology development.
Co-designing Digital Health Technologies with Older People in Homecare Settings
- Author(s): Shuvarthi Bhattacharjee; Dr. Kathleen T Galvin; Dr. Theo Fotis; Dr. Lisbeth Uhrenfeldt
- Published: Clinicaltrials.gov – https://clinicaltrials.gov/study/NCT04884711?term=NCT04884711&rank=1
Abstract
One of the crucial components of successful ageing is to live independently in old age. Yet in UK alone, nearly 300000 older people require assistance with 3 or more essential daily tasks like eating, bathing and mobility which compromises on their independent living. Additionally, in a crisis where health system in UK is already overstretched to its resources to combat the recent Coronavirus Disease 2019 (COVID-19) pandemic, allocating resources for regular homecare services has become challenging. In this situation, Digital Health Technologies (DHTs) can be a potential solution to promote healthy ageing, support psycho-social wellbeing and enhance independent living for older people. Such technologies comprise a wide range of products used in the health and care services including apps, software and online platforms to benefit people. Yet DHTs are barely adopted by older people as they do not reflect their actual user needs leading to poor appropriation of DHTs in homecare settings. The investigators aim to address this gap by involving older people living at the Leach Court, UK under the eco system of the Brighton & Hove Digital Health Living Lab (BHLL) to co-design with us DHTs that addresses the barriers & facilitators they face in adopting to DHTs. This participatory research approach has a qualitative study design which is sensitive to basic human values like ‘dignity’, appreciates that older people are ‘expert of their experiences’ and methodologically has phenomenological underpinnings gathering the researcher’s understanding from the lived experiences of older people. This unique project, part of the European Union (EU) Horizon 2020 funded INNOVATEDIGNITY project, will be aiming to translate intangible human values like ‘dignity’ into tangible technology design through better understanding of the barriers & facilitators older people face to DHTs adoption. With global population of older people increasing faster than all other age groups currently, this project stands to meet the future demands of the ageing population through dignity sensitive better designed DHTs .
Older adults’ sense of dignity in digitally-led healthcare
Authors: Moonika Raja1, Lisbeth Uhrenfeldt1, Kathleen T. Galvin2, Ingjerd G. Kymre1
1Nord University, Norway
2University of Brighton, United Kingdom
Abstract
Background: Health ministries in Europe are investing increasingly in innovative digital technologies. Older adults, who have not grown up with digital innovation, are expected to keep up with technological shifts as much as other age groups. This is ethically challenging, as it may threaten a sense of dignity and well-being in older adults.
Research objective: To clarify the phenomenon of sense of dignity experienced in older adults, concerning how their expectations and needs are met within the context of digitally led healthcare in Norway.
Research design: A Reflective Lifeworld Research design was chosen, and purposive, in-depth interviews were conducted.
Participants and research context: The participants were 13 adults 75 years and older from Northern Norway, living at home and not receiving consistent assistance.
Ethical considerations: Followed the principles of the Helsinki Declaration. This study was approved by the Social Science Data Services in Norway (project number 916119). Interviews were conducted carefully within a safe environment chosen by the participants.
Findings: Older adults experience that using new digital systems in healthcare makes them become dependent with experiences of helplessness. They feel an increased sense of dependency on other people, and that recognition can assail their experience of personal dignity. Older adults expect digitally-led healthcare to give them a feeling of safety, but also experience feeling insecure concerning privacy and loss of possibilities for dialogue with healthcare providers. They are met by demands from society, which they often struggle to achieve.
Conclusion: The phenomenon of sense of dignity experienced in older adults, concerning how their expectations and needs are met within digitally-led healthcare indicates a sense of feeling lost in the digital world. Further, innovative healthcare lacks focus on ethical performance. This impacts their perception of dignity, as loss of dignity is noticed especially in its rupture.
You can read the whole article here: https://doi.org/10.1177/09697330221095140
The Digital Engagement of Older People: Systematic Scoping Review Protocol
Authors: Abraham Sahilemichael Kebede1, MHS; Lise-Lotte Ozolins2, PhD; Hanna Holst2, PhD; Kathleen Galvin1, PhD
1School of Health Sciences, University of Brighton, Brighton, United Kingdom
2Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
Abstract
Background: There is an ongoing negative narrative about aging that portrays older people as a socioeconomic burden on society. However, increased longevity and good health will allow older adults to contribute meaningfully to society and maximize their well-being. As such, a paradigm shift toward healthy and successful aging can be potentially facilitated by the growing digital technology use for mainstream (day-to-day activities) and assisted living (health and social care). Despite the rising digital engagement trend, digital inequality between the age groups persists.
Objective: The aims of this scoping review are to identify the extent and breadth of existing literature of older people’s perspectives on digital engagement and summarize the barriers and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement.
Methods: This review will be based on the Arksey and O’Malley framework for scoping reviews. The 6-stage framework includes: identifying research questions, identifying relevant studies, study selection, charting the data, summarizing and reporting the results, and a consultation exercise. Published literature will be searched on primary electronic databases such as the Association of Computing Machinery, Web of Science, MEDLINE, PsycINFO, CINAHL, and ScienceDirect. Common grey literature sources will complement the database search on the topic. A two-stage (title/abstract and full article) screening will be conducted to obtain eligible studies for final inclusion. A standardized data extraction tool will be used to extract variables such as the profile of the study population, technologies under investigation, stage of digital engagement, and the barriers and facilitators. Identified and eligible studies will be analyzed using a quantitative (ie, frequency analysis) and qualitative (ie, content analysis) approach suitable for comparing and evaluating literature to provide an evaluation of the current state of the older person’s digital engagement. Inclusion will be based on the Joanna Briggs Institute–recommended participant, concept, and context framework. Articles on older people (65 years and older), on digital technology engagement, and from a global context will be included in our review.
Results: The results of this review are expected in July 2021.
Conclusions: The findings from this review will identify the extent and nature of empirical evidence on how older people digitally engage and the associated barriers and facilitators.
International Registered Report Identifier (IRRID): PRR1-10.2196/25616
You can read the whole article here: https://www.researchprotocols.org/2021/7/e25616
doi: 10.2196/25616
Telehealth and digital developments in society that persons 75 years and older in European countries have been part of: a scoping review
Authors: Moonika Raja, Jorunn Bjerkan, Ingjerd G. Kymre, Kathleen T. Galvin, Lisbeth Uhrenfeldt
Abstract
Background: Demographic changes are leading to an ageing population in Europe. People are becoming more dependent on digital technologies and health ministries invest increasingly in digitalisation. Societal digital demands impact older people and learning to use new telehealth systems and digital devices are seen as a means of securing their needs.
Methods: The present study undertakes a scoping review in order to map relevant evidence about telehealth and digital developments in society involving citizens aged 75 and over in European countries. It focuses on their experiences and the main barriers to, and facilitators of, societal digital demands. A framework proposed by Arksey and O`Malley was used to guide the scoping review process. The studies included in the review covered telehealth, digital technology and digital devices, and the context covered participants` own home or surroundings. A comprehensive search on PubMed/MEDLINE, CINAHL, Scopus, Embase and Open Grey was undertaken.
Results: Out of 727 identified citations, 13 sources which met the inclusion criteria (9 original study articles, 2 theses, 1 letter about a product and 1 project report). Few of the studies identified have investigated European citizens 75 years and older separately. The studies included varied in their design, location and focus. Older people have experienced both telehealth and digital devices making life easier and the opposite. The outstanding facilitator found was that technology should be easy to use, and difficulty in remembering the instructions was seen as an important barrier. Interestingly, both social support and lack of social support were found as facilitators of using new devices.
Conclusions: Telehealth may give a sense of security but learning to use a new device often takes extra effort. Older people were more open to new devices if the possible advantages of the new technology outweighed the effort that would be involved in adopting a new strategy. As technology develops rapidly, and life expectancy in Europe is anticipated to rise continually, there is a need for new and additional research among older European citizens. Future research should cover the technical solutions most relevant to older people today, social support and participants` access to the devices.
You can read the whole article here: https://doi.org/10.1186/s12913-021-07154-0
The digital development within society that persons of 75 years and older in European countries have been part of: A scoping review protocol
Authors: Moonika Raja1, Jorunn Bjerkan2, Ingjerd G. Kymre1, Kathleen T. Galvin3, Lisbeth Uhrenfeldt1
1Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
2Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
3School of Health Sciences, University of Brighton, Brighton, United Kingdom
Journal of Nursing Education and Practice, January 25 2021, Vol 11, No 6.
Abstract
Over the past decades countries of the world have experienced increase in the share of older people in demographics and the number is expected to rise even more. People are becoming more than ever dependent on digital technologies. The aim of this study is to map the body of literature concerning historical digital development over the last 20 years that people of 75 years and older in European countries have been part of. Moreover the goal is to identify research gaps in the existing literature in order to inform future research. The five-staged Arksey and O’Malley methodology framework is used to guide the scoping review process. Research strategy and eligibility criteria are defined. The study selection is made based on the eligibility criteria. A framework developed for the scoping review informs the charting of data from the included studies. Results will be summarized with criteria relevant for policy-makers, healthcare providers and the public. You can read the whole article here:
