Silver surfers from a European perspective: technology communication usage among European seniors

Using Two-Step Cluster Analysis and Latent Class Analysis to Construct a Typology of Internet Users Among Community-Dwelling Older People

This study utilizes data, spanning 2016-2021, from the Belgian Ageing Studies and presents a typology of older internet users based on nine internet activities. Two-step Cluster Analysis and Latent Class Analysis revealed three groups: (1) "Basic users" primarily engage in information search and mailing, (2) "Allrounders" participate in nearly all internet activities and (3) "Selective users" are intermediary, predominantly using the internet for information search, mailing, e-banking and communication with (grand)children. These clusters varied in sociodemographic characteristics, with "Allrounders" being younger, more educated, wealthier and predominantly male, compared to "Selective users" and "Basic users," respectively.

A focus group study for the design of a web-based tool for improving problem-solving in older adults

The development of easily accessible and usable social and cognitive enhancement trainings is becoming a priority to reduce the impact of aging on quality of life. Since most activities of daily living (e.g., making a meal) require problem-solving skills, problem-solving interventions could be used to improve and/or maintain functional abilities in aging to prolong independence. To design an effective problem-solving training and increase older adults' adherence to the training, this study examined older adults' perceptions of their challenges in activities of daily living, their skills and difficulties in using information technology (IT), and their motivations and expectations for participating in a web-based problem-solving training activity. Four focus groups (two in Italy and two in the Netherlands) were conducted with older adults aged between 65 and 84 years, a total of 27 participants. The data were analyzed using the Atlas.ti 8 software for the thematic analysis. The analysis identified five thematic areas: interests and activities, difficulties and concerns, experiences and motivations for training, expertise and resources, suggestions for the design of the new training. The results were used to develop a first prototype of a Shared, Web-based, Intelligent Flexible Thinking Training (SWIFT), adapted to future user needs. The participation of older adults in this design phase was critical to understanding their needs, motivations, and expectations regarding the implementation and use of a cognitive enhancement training.

Toward Innovation in Healthcare: An Analysis of the Digital Behavior of Older People in Europe and Japan for the Introduction of a Technological Coaching System

(1) Background: The increasing older population and demographic shifts highlight the need to understand the digital profiles of older adults, a pivotal factor in developing innovative technologies like the e-VITA virtual coach. This personalized coach provides recommendations for sustainable well-being in a smart home environment. (2) Methods: This study focuses on analyzing the characteristics of older individuals categorized as Internet users (onliners) and non-users (offliners). European Social Survey data from 2021 were utilized for European analysis, determining Internet usage based on frequency. Offliners are defined as users who never use the Internet, and onliners as those who use it, albeit with different frequencies. In Japan, data from the 9th International Comparative Survey on the Lives and Attitudes of the Elderly were employed, based on the responses of 1367 subjects, which defined onliners as individuals using communication devices and offliners as those not utilizing fax machines, cell phones, or the Internet. (3) Results: This paper presents a primary analysis of older end-user context and perspectives, outlining effective strategies for the diffusion of an active and healthy aging coaching system in the market and society. (4) Conclusions: the study emphasizes the importance of analyzing digital behavior in any user-centered design approach to ensure the system's acceptance after deployment.

Usability of Electronic Patient-Reported Outcome Measures for Older Patients With Cancer: Secondary Analysis of Data from an Observational Single Center Study

BACKGROUND

Patient-reported outcomes are considered the gold standard for assessing subjective health status in oncology patients. Electronic assessment of patient-reported outcomes (ePRO) has become increasingly popular in recent years in both clinical trials and practice. However, there is limited evidence on how well older patients with cancer can complete ePRO assessments.

OBJECTIVE

We aimed to investigate how well adult patients with cancer of different age ranges could complete ePRO assessments at home and in a treatment facility and to identify factors associated with the ability to complete questionnaires electronically.

METHODS

This retrospective longitudinal single-center study involved survivors of cancer who participated in inpatient rehabilitation. Patients completed ePRO assessments before rehabilitation at home (T1) and after rehabilitation at the facility (T2). We analyzed the rate of patients who could complete the ePRO assessment at T1 and T2, the proportion of patients who required assistance, and the time it took patients to complete standardized questionnaires. Multivariate logistic regression analyses were conducted to identify predictors of ePRO completion rate and the need for assistance.

RESULTS

Between 2017 and 2022, a total of 5571 patients were included in this study. Patients had a mean age of 60.3 (SD 12.2) years (range 18 to 93 years), and 1135 (20.3%) of them were classified as geriatric patients (>70 years). While more than 90% (5060/5571) of all patients completed the ePRO assessment, fewer patients in the age group of >70 years (924/1135, 81.4% at T1 vs 963/1135, 84.8% at T2) completed the assessment. Approximately 19% (1056/5571) of patients reported a need for assistance with the ePRO assessment at home, compared to 6.8% (304/4483) at the institution. Patients older than 70 years had a significantly higher need for assistance than those in younger age groups. Moreover, a gender difference was observed, with older women reporting a higher need for assistance than men (71-80 years: women requiring assistance 215/482, 44.6% vs men 96/350, 27.4%; P<.001 and >80 years: women 102/141, 72.3% vs men 57/112, 50.9%; P<.001). On average, patients needed 4.9 (SD 3.20) minutes to remotely complete a 30-item questionnaire (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire) and patients in the older age groups took significantly longer compared to younger age groups. Lower age and higher physical functioning were the clearest predictors for both the ePRO completion rate and the need for assistance in the multivariate regression analysis.

CONCLUSIONS

This study's results indicate that ePRO assessment is feasible in older individuals with cancer, but older patients may require assistance (eg, from relatives) to complete home-based assessments. It may be more feasible to conduct assessments in-house in this population. Additionally, it is crucial to carefully consider which resources are necessary and available to support patients in using ePRO devices.

Smart senior care cognition and health among Chinese elderly: A moderated mediation model featuring parent-child relationship and internet use

In the context of digital transformation, smart senior care (SSC) cognition among elderly individuals has become an important contributor to their health. Using a sample of 345 older adults derived from the cross-sectional data of a questionnaire survey on the application of home-based SSC services and products among elderly individuals, this study explored how the parent‒child relationship mediated the linkage between SSC cognition and elderly health. To examine the moderating role of internet use, we applied the multigroup structural equation modeling (SEM) approach to test whether significant disparities exist between older adults who use the internet and those who do not on the pathways in the mediation model. After controlling for gender, age, hukou (household registration permit), ethnicity, income, marital status, and education level, we found that SSC cognition exerted significant positive effects on elderly health, in which the parent‒child relationship exerted a mediating effect. As for differences between the elderly with internet use and those without, on the three pathways connecting SSC cognition and health, SSC cognition and parent‒child relationship, and parent‒child relationship and health among elderly individuals, older adults who used the internet were more susceptible than those who did not. The findings are helpful for improving the policy-making on elderly health and may serve as a practical guide and theoretical reference for the promotion of active aging.

The role of the Internet in later life autonomy: Silver surfers in Spain

The new digital panorama has enhanced the importance of the Internet, as well as Information and Communications Technology (ICT), in developing a society in which seniors play a proactive role. The main purpose of this article is to define a taxonomy of silver surfers according to the ways they use the Internet and ICT, with a special focus on e-commerce and e-government. A quantitative methodology was used, based on the study of 405 Spanish internet users between 60 and 79 years of age, which was conducted by telephone in February of 2019. Seven groups were identified through a combination of dimensionality reduction techniques and cluster analysis. The results indicate neither a consistent pattern in the specific ways older adults use the Internet nor a homogeneous level of digital knowledge among this demographic group. To some extent, this is a result of disparities in both the perception of digital security that seniors associate with e-commerce and/or e-government and the level of trust engendered by such operations. The Able and Daring are the most numerous clusters, which coincide with the categories of the most active and prepared users. The Sceptical take third place in terms of number of users, as they display limited use of the Internet and claim to have a low digital skills level. However, carrying out both online shopping and administrative procedures without the need for assistance is becoming increasingly frequent among all of those surveyed.

Prohibit, Protect, or Adapt? The Changing Role of Volunteers in Palliative and Hospice Care Services During the COVID-19 Pandemic. A Multinational Survey (Covpall)

BACKGROUND

Volunteers are common within palliative care services, and provide support that enhances care quality. The support they provided, and any role changes, during the coronavirus disease 2019 (COVID-19) pandemic are unknown. The aim of this study is to understand volunteer deployment and activities within palliative care services, and to identify what may affect any changes in volunteer service provision, during the COVID-19 pandemic.

METHODS

Multi-national online survey disseminated via key stakeholders to specialist palliative care services, completed by lead clinicians. Data collected on volunteer roles, deployment, and changes in volunteer engagement. Analysis included descriptive statistics, a multivariable logistic regression, and analysis of free-text comments using a content analysis approach.

RESULTS

458 respondents: 277 UK, 85 rest of Europe, and 95 rest of the world. 68.5% indicated volunteer use pre-COVID-19 across a number of roles (from 458): direct patient facing support (58.7%), indirect support (52.0%), back office (48.5%) and fundraising (45.6%). 11% had volunteers with COVID-19. Of those responding to a question on change in volunteer deployment (328 of 458) most (256/328, 78%) indicated less or much less use of volunteers. Less use of volunteers was associated with being an in-patient hospice, (odds ratio [OR]=0.15, 95% CI=0.07-0.3, P<.001). This reduction in volunteers was felt to protect potentially vulnerable volunteers, with policy changes preventing volunteer support. However, adapting was also seen where new roles were created, or existing roles pivoted to provide virtual support.

CONCLUSION

Volunteers were mostly prevented from supporting many forms of palliative care which may have quality and safety implications given their previously central roles. Volunteer re-deployment plans are needed that take a more considered approach, using volunteers more flexibly to enhance care while ensuring safe working practices. Consideration needs to be given to widening the volunteer base away from those who may be considered to be most vulnerable to COVID-19.

An Assessment of the Structural Validity and Measurement Invariance of the Web-Use Skills Scale for Aging Internet Users

Research on digital inequality has found that aging adults are often at risk of digital exclusion. Understanding the validity of survey measures assessing Internet skills in this population is critical to providing the high-quality data needed for effective digital inclusion policy interventions. This cross-validation study examines the structural validity and measurement invariance (across age, gender, and education groups) of the Web-Use Skills scale (WUS), which is commonly used as a proxy measure of Internet skills. We tested the 14-item version of the WUS. The scale was translated into the Slovenian language and pretested with older Internet users. Data were collected from two independent samples of Internet users aged 50+ years (N₁ = 259 and N₂ = 256) drawn from an online opt-in panel in Slovenia. The examination of structural validity confirmed that the WUS adequately reflects the one-factor structure of the web-use skills construct, although in a shorter six-item form. Moreover, the analysis confirmed strict measurement invariance between the two samples and, at least, scalar invariance between age, gender, and education groups. The results support the applicability of WUS in cross-group comparisons of Internet skills in the population of aging Internet users and point to several opportunities for future work.

Modes of relating to the new ICTs among older internet users: a qualitative approach

Older people have increasingly been using the new information and communication technologies (ICTs), namely the internet. Seeking to contribute with substantive information on their digital inclusion, this paper focuses on the adoption and use of ICTs by older adults, highlighting their experiences and considering their plurality. Taking a qualitative approach, the core goal of the empirical research underlying this paper was to understand what mechanisms and modalities configure the relationship of older internet users with the new ICTs. With that objective in mind, interviews were conducted with 20 internet users over the age of 60. Those interviews, which included a biographical element, were subjected to multi-categorical analysis. Results suggest a typology of modes of relating to the new ICTs among older internet users that reflects different trajectories, practices, skills, significances and impacts. The analysis shows how life trajectories and differentiated uses are reflected in equally differentiated impacts for older adults, contributing to their quality of life in different ways and to different degrees. Digital skills play a fundamental role in enhancing or limiting those effects. The results of this research help break down the stereotypes associated with the older generations and may have relevant implications for the design of digital inclusion policies and initiatives.

Internet use and cognitive frailty in older adults: a large-scale multidimensional approach

Although research on sociodemographic correlates of internet use in older adults without and with pronounced cognitive impairment is already quite extensive, much less is known about the relationship between cognitive frailty (CF) and this behaviour. As CF is associated to multidimensional frailty aspects, this study explored the relationship between internet use and CF, operationalised as Subjective Cognitive Impairment, in older adults by means of a comprehensive explanatory model including sociodemographic factors and multiple frailty measures. The dataset included a sample of community-dwelling 60 + older adults that were included in the Belgian Ageing Studies (BAS) and that completed survey questions on (i) internet use frequency and (ii) internet activities. Multidimensional frailty was measured with the CFAI-Plus. The analysis comprised a structural equation modelling (SEM) procedure. Internet use was frequent; however, it became less frequent with higher CF. Moreover, the latter used less tablets as compared to the no-low CF group. Navigating the web, sharing email and online banking were the most frequently reported activities. Tele-communicating with Skype, online shopping and using e-government services were the least frequent. Age, female gender, lower income and living with a partner were also negatively associated with internet use. To conclude, CF, along with other frailty and sociodemographic factors, was negatively related to internet use in older adults. Future research should focus, amongst others, on the dynamic processes underlying internet use in the population of older adults affected by CF.

Effectiveness of Instructional Strategies Designed for Older Adults in Learning Digital Technologies: A Systematic Literature Review

An ageing population is a universal phenomenon experienced worldwide. In parallel with these demographic changes, a significant breakthrough in digital devices has also influenced this digital age. Designing instructional strategies to promote meaningful learning among older adult learners has been a long-standing challenge. To enhance older adults’ life-long learning experiences, implementing instructional strategies in the process through which such adults learn can help to improve effective learning. Despite significant calls for research in this area, there is still insufficient research that systematically reviews the existing literature on older adult learning needs and preferences. Hence, in the present article, a systematic literature review was conducted of the effectiveness of instructional strategies designed for older adult learners through the use of digital technologies. The review was guided by the publication standard, which is ROSES (Reporting Standard for Systematic Evidence Syntheses). This study involves articles selected from two established databases, Web of Science and Scopus. Data from the articles were then analysed using the thematic analysis, which resulted in six main themes: (1) collaborative learning; (2) informal learning setting; (3) teaching aids; (4) pertinence; (5) lesson design; and (6) obtaining and providing feedback. The six main themes produced a further 15 sub-themes. The results from this study make significant contributions in the areas of instructional design and gerontology. The findings from this study highlight several important strategies of teaching digital technology, particularly for older adults, as follows: (1) to enhance instructional design use in teaching digital technology based on the needs and preferences of older adult learners; and (2) to highlight the factors for, and impact of, learning digital technologies among older adults.

Perceptions and Attitudes of Spanish “Digital Seniors” Towards E-Government

A typology of user was explored as to behaviour and perception of e-Government through a telephone survey involving 405 Internet users between 60 and 79 years of age. Ten different groups were identified by means of dimensionality reduction techniques followed by a cluster analysis. The main conclusion is that there is no consistent pattern, although among the groups which do use e-Government, they have less concerns than the rest and see less need for modifications to be applied to adapt the websites to the needs of seniors. Within this older age group, two types are clearly identified. Those who feel uncomfortable, which explains their avoidance of e-Government, and to a lesser degree, those whose lack of contact with public administration may be due to a lack of interest for such services. It appears that a senior-friendly offering together with learning opportunities would increase interest for this channel.

Factors Influencing Intention to Technological Use in Older Adults. The TAM Model Aplication

The use of digital technology by older adults has improved in recent years in response to the need for their functional adaptation to an increasingly technological social context. Understanding this type of technological adaptation has recently become an important field of inquiry in both social and gerontological studies. Working within this framework, the aim of this study is to identify the main determinants that influence the intention of older people to use digital technology in their daily lives, using the Technological Acceptance Model. A study was carried out with the participation of 1155 people over 65 years of age in Spain. Confirmatory Factor Analysis and structural equation models (SEM) were performed. The results show that the TAM is a useful model to explain the intention of older adults to use Digital Technology, showing a high predictive power, highlighting Perceived Usefulness and Perceived Ease of Use as the main predictor variables.

Physically distant but socially close? Changes in non-physical intergenerational contacts at the onset of the COVID-19 pandemic among older people in France, Italy and Spain

Physical distancing is intended to mitigate the spread of the SARS-CoV-2 virus. However, the impact of a decrease in face-to-face contacts on non-physical social contacts of older people remains unclear. In particular, we focus on intergenerational contacts that are especially relevant for older people's mental health. Our analyses rely on an online quota sampling survey conducted in France, Italy and Spain during April 14-24, 2020. We considered the subsample of individuals aged 50 + (N = 4207). We calculated post-stratification weights based on official statistics and used logistic regressions to analyze how changes in intergenerational contacts differed by socioeconomic factors and to what extent non-physical contacts (via phone, social media, etc.) have compensated the reduction in face-to-face contacts. Finally, the change in digital devices' use has been explored as a consequence of both decreased physical intergenerational contacts (PIC) and increased non-physical intergenerational contacts (NPIC). We found that about 50% of older people have increased their NPIC during the first lockdown. Younger individuals, those with medium level of education, and those economically better off displayed higher probabilities of increased NPIC as compared to their counterparts. NPIC increased especially for individuals whose face-to-face contacts decreased, particularly so if this happened with respect to contacts with children. A large share of older people has increased their use of video calls and instant messages, while only some increased the use of social media. These findings are relevant to understand how intergenerational contacts changed during the pandemic and may be central to better plan future outbreak responses.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10433-021-00621-x.

Analysis of the Effectiveness of Promotion Strategies of Social Platforms for the Elderly with Different Levels of Digital Literacy

This paper aimed to examine the effectiveness of social platform promotion strategies for the elderly with different digital literacy. Despite extensive research on the development of youth-oriented social platforms, research on the development of social platforms specifically targeting older adults with varying levels of digital literacy is lacking. The elderly population is divided into passive information receivers (PIRs) and active information seekers (AISs) according to their information seeking expertise, and an empirical study was conducted to assess the behavioral characteristics of PIRs and AISs. Grounded in innovation diffusion research and our empirical results, an agent-based model was developed, and the impact of the proportion of PIRs on the macro result of the social platform adoption (i.e., market penetration) and the impact of promotional strategies on market penetration under different proportions of PIRs were analyzed. The results demonstrate a direct negative effect of the proportion of PIRs on market penetration and a moderating effect on the effectiveness of various promotional strategies.

The Enabling Role of ICT to Mitigate the Negative Effects of Emotional and Social Loneliness of the Elderly during COVID-19 Pandemic

(1) Background: The COVID-19 pandemic has been especially hard on the elderly owing to their particular vulnerability to the virus. Their confinement to prevent the spread of the virus resulted in social isolation, often linked to the unwanted loneliness that hinders their emotional well-being. The enabling capacity of ICT (Information and Communication Technology) to overcome the negative effects of this isolation requires special attention. The purpose of this research is to understand the impact of the use of ICT on the emotional well-being of elderly people during their confinement. (2) Methods: A qualitative exploration method based on four focus groups with elderly people aged 60 years or older and three in-depth personal interviews with experts in education of the elderly were carried out. (3) Results: Research results evidence a negative emotional impact of the confinement (lack of physical contact with their loved ones, fear and uncertainty, feeling of loneliness, sadness at the loss of family members) on the emotional well-being of study participants. Furthermore, the operational capacity of ICT to prevent infection, as well as their positive emotional and humanizing role in providing access to entertainment and hobbies, and in improving self-esteem was also acknowledged. (4) Conclusions: ICT have become a valuable ally for elderly people aged 60 years and older to mitigate the negative effects of social isolation and loneliness imposed by the confinement.

Digital Identity Levels in Older Learners: A New Focus for Sustainable Lifelong Education and Inclusion

Identifying the digital identity of older adults entails an essential step for their effective digital inclusion grounded in a holistic and sustainable human development in hyperconnected societies. This paper proposes a theoretical framework with three levels of digital identity based on motives and practices: location, action, and significance. This framework was used for designing an ad-hoc scale, tested with a sample of senior learners (n = 659) aged 55 and over involved in active aging programs in Adult Education in Spain. Participants filled out a five-point 20-item Likert scale measuring their agreement with the digital identity factors, along with two complementary scales evaluating their internet uses and motivations, as well as other items on living arrangements and perceived social support. Exploratory and confirmatory analyses showed a factorial structure with three levels of digital identity for older adults. The results revealed that active older adults with diverse motives for using the internet and variety in digital practices recorded a higher digital identity level, as did those who felt more isolated or with less social support. As a conclusion, the educational implications according to instrumental, social, and motivational variables are key for the progressive construction of a digital identity in older adults and for their digital inclusion.

The Use of Internet-Based Health and Care Services by Elderly People in Europe and the Importance of the Country Context: Multilevel Study

Background

Digital health care is becoming increasingly important, but it has the risk of further increasing the digital divide, as not all individuals have the opportunity, skills, and knowledge to fully benefit from potential advantages. In particular, elderly people have less experience with the internet, and hence, they are in danger of being excluded. Knowledge on the influences of the adoption of internet-based health and care services by elderly people will help to develop and promote strategies for decreasing the digital divide.

Objective

This study examined if and how elderly people are using digital services to access health and social care. Moreover, it examined what personal characteristics are associated with using these services and if there are country differences.

Methods

Data for this study were obtained from the Special Eurobarometer 460 (SB 460), which collected data on Europeans’ handling of and attitudes toward digital technologies, robots, and artificial intelligence, including data on the use of internet-based health and social care services, among 27,901 EU citizens aged 15 years or older. Multilevel logistic regression models were adopted to analyze the association of using the internet for health and social care services with several individual and country-level variables.

Results

At the individual level, young age, high education, high social class, and living in an urban area were positively associated with a high probability of using internet-based health and social services. At the country level, the proportion of elderly people who participated in any training activity within the last month was positively associated with the proportion of elderly people using these services.

Conclusions

The probability of using internet-based health and social services and their accompanying advantages strongly depend on the socioeconomic background. Training and educational programs might be helpful to mitigate these differences.