Ronald W. Berkowsky

You can teach an old dog new tricks: a qualitative analysis of how residents of senior living communities may use the web to overcome spatial and social barriers.

For adults in senior living communities, information and communication technologies (ICTs) can be used to increase and expand communication for a population that is often spatially and socially separated from the general public. Using qualitative observational data from a longitudinal study of the impact of ICT usage on the quality of life among residents in assisted and independent living communities, the authors examine whether ICTs can mitigate the effects of social and spatial barriers. The authors find that ICTs have the potential to allow individuals to transcend social and spatial barriers, providing residents with the ability to maintain and enhance social networks as well as provide a greater sense of connection to the world at large.

WHEN YOU JUST CANNOT GET AWAY

The continuing evolution of information and communication technologies (ICTs), such as Internet-connected computers and cellular phones, provides a means for increased work/home permeability and for current work/home boundaries to be redefined as workers can potentially be accessible by employers and family/friends at all times. This transformation of work/home boundaries can open the individual to increased levels of negative spillover, wherein aspects of one role negatively impact or impede upon another. This investigation uses data from the Work-Life and Technology Use Survey to determine if ICT use plays a role in defining work/home boundaries and serves as a significant predictor of negative spillover in both the work-to-home and home-to-work directions. Results show that frequency of engaging in ICT-related activities (e.g. checking email and using Facebook) is associated with negative spillover in both directions, suggesting that ICTs may play a significant role in facilitating negative work/home spillover.

Online Information Search Performance and Search Strategies in a Health Problem-Solving Scenario

Although access to Internet health information can be beneficial, solving complex health-related problems online is challenging for many individuals. In this study, we investigated the performance of a sample of 60 adults ages 18 to 85 years in using the Internet to resolve a relatively complex health information problem. The impact of age, Internet experience, and cognitive abilities on measures of search time, amount of search, and search accuracy was examined, and a model of Internet information seeking was developed to guide the characterization of participants’ search strategies. Internet experience was found to have no impact on performance measures. Older participants exhibited longer search times and lower amounts of search but similar search accuracy performance as their younger counterparts. Overall, greater search accuracy was related to an increased amount of search but not to increased search duration and was primarily attributable to higher cognitive abilities, such as processing speed, reasoning ability, and executive function. There was a tendency for those who were younger, had greater Internet experience, and had higher cognitive abilities to use a bottom-up (i.e., analytic) search strategy, although use of a top-down (i.e., browsing) strategy was not necessarily unsuccessful. Implications of the findings for future studies and design interventions are discussed.

The Impact of Activity Interventions on the Well-Being of Older Adults in Continuing Care Communities

As the U.S. population ages, interventions are needed to ensure quality of life continues as boomers enter assisted and independent living communities (AICs). These transitions can significantly affect quality of life. Activity and continuity theories maintain that participation in discretionary/informal activities is crucial for psychosocial health and well-being (aspects of quality of life). This study evaluates the impacts of participation in discretionary activities on life satisfaction, social isolation, and loneliness, using data from a longitudinal study of older adults in AICs. Older adults who participated in 8 weeks of discretionary activities reported greater life satisfaction and lower levels of social isolation compared with non-participants. Forming alliances and group identities is the key for building new relationships and maintaining relationships in the community. Determining the impact participation in activities has on residents is vital to being able to help develop a more comprehensive understanding of how quality of life can be maintained in AICs.

Signing off: Predicting discontinued ICT usage among older adults in assisted and independent living: A survival analysis

While previous research examining digital inequality among older adults has exposed factors that prevent older adults from using information and communication technologies (ICTs), less has been done focusing on factors that may contribute to ICT discontinuation. This investigation uses data from a randomized controlled intervention study to examine possible predictors of discontinued ICT usage among older adults in assisted and independent living communities. Survival analysis shows that participating in a non-technology activities intervention can increase the odds of stopping the use of ICTs over time. In addition, an increase in the number of instrumental activities of daily living (IADLs) an individual needs assistance with was associated with increased odds of discontinuing ICT use. Results suggest that those promoting continued usage of ICTs among older adults in assisted and independent living need to address the social activities that may prevent use and account for the increasing frailty of residents over time.

Seeking and resolving complex online health information: Age differences in the role of cognitive abilities

Presently, adults can exploit a vast amount of online health information for solving relatively complex health problems. This study examined the performance of 60 adults ranging in age from 18-82 years on a complex online health information search task. Measures of search time, amount of search, search accuracy, and six cognitive abilities were obtained. The older participants exhibited similar search accuracy, significantly less amount of search, and significantly longer time to complete the problem compared to the younger participants. For the younger participants having higher cognitive ability typically translated into significantly better search accuracy and greater amount of search accomplished. For the older participants, only processing speed significantly distinguished the lower and higher ability older adults on search accuracy and none of the ability measures differentiated these participants on amount of search. These differences and their implications are discussed in the context of supporting older online health information seekers.

Factors Predicting Decisions About Technology Adoption Among Older Adults

Abstract Background and Objectives Numerous technology applications are available that have the potential to improve the quality of life (QoL) of older adults. However, older adults are less likely to adopt new and emerging technologies and reap the potential benefits. This study examines factors that influence older adults’ decisions about the adoption of new technology. Research Design and Methods Fifty-two older adults participated in a mixed-method procedure, which entailed: (1) observing presentations detailing nine differing technologies, (2) assessing the technologies using tailored questionnaires, and (3) participating in focus group discussions. Participants were assigned into one of seven groups separated by age (65–74, 75+) and language (English, Spanish). The outcome was willingness to adopt technology. Predictors included self-assessed abilities (e.g., numeric ability), computer/Internet skills and knowledge, technology readiness, age, language, and technology ratings (e.g., perceived value). Analyses included Spearman’s ρ, t-tests, and regression analysis. Focus group discussions were examined for supportive examples. Results Self-assessed abilities and computer/Internet skills were predictive of willingness to adopt technologies although the relationship varied according to the technology examined. Technology readiness, age, and language group showed weak associations with the outcome. Of the technology ratings, perceived value, confidence in ability to learn the technology, and the perceived impact on QoL were the most robust predictors of willingness to adopt technology. Discussion and Implications Findings indicate that various stakeholders in technology adoption among older adults must be cognizant of a technology’s functionality and complexity as well as the characteristics and abilities of older adults. However, certain factors such as perceptions about the value of the technology and potential impact on QoL are also critically important to decisions regarding technology adoption among older people.

Challenges associated with online health information seeking among older adults

Abstract Information and communication technologies, such as Internet-connected computers and smartphones, provide new means to search for health information (including, but not limited to, information on illnesses, diseases, medications, and healthcare providers) and provide unprecedented potential for older adults to assume a more pronounced role in managing their own health and healthcare decision-making. Yet, while more older adults are turning to the Internet to search for health information, there remain significant barriers and challenges to conducting searches that prevent older adults from successfully interpreting and using the information found. This chapter discusses such challenges, including physical health limitations, cognitive limitations, literacy (i.e., health literacy, numeracy, and digital literacy), and negative attitudes toward technology. This chapter also discusses ways in which technology designers and training interventionists may help older adults overcome these challenges.

Discontinued Information and Communication Technology Usage among Older Adults in Continuing Care Retirement Communities in the United States

Background: Older adults are increasingly using information and communication technologies (ICTs). Recent studies show beneficial effects of using ICTs for older adults, particularly in terms of reducing loneliness and depression. However, little is known about the factors that may prevent discontinued ICT use in populations that may be at greater risk, such as those in continuing care retirement communities (CCRCs). Objectives: The purpose of this study is to examine a range of factors that may influence discontinued (1) ICT use, (2) searching for health information, and (3) searching for general information over time among CCRC residents. Methods: We use longitudinal data from a randomized controlled trial conducted with residents of 19 CCRCs. We use flexible parametric models to estimate the hazard ratio or hazard rate over 5 waves of data to determine what factors significantly predict discontinued (1) ICT use, (2) health information searching, and (3) general information searching. Results: The analysis reveals that independent living residents who took part in an 8-week ICT training intervention were less likely to stop using ICTs. Age and the number of instrumental activities of daily living (IADL) impairments significantly predicted an increased likelihood of stopping ICT use. When examining specific ICT-related activities, the analysis reveals that independent living residents who took part in the ICT training intervention were less likely to stop searching for health information and general information online. In addition, age and the number of IADL impairments were associated with increased likelihood of discontinued health information searches and discontinued general information searches. Conclusion: ICT training interventions may motivate residents of CCRCs to stay connected by increasing the ICT skill level and promoting confidence, thus decreasing the probability that they will discontinue using ICTs and searching for general information. However, the effects of ICT training on motivating continued ICT usage may be more pronounced among independent living residents. Limitations in the number of IADL impairments is a key factor leading to discontinued use of ICTs among CCRC residents, suggesting that designers of ICTs should be cognizant of the cognitive and physical limitations among this group.

Designing a Web-Based Application to Train Aging Adults to Successfully Use Technologies Important to Independent Living

The purpose of this study was to develop and pilot-test a web-based application that could train a diverse group of aging adults to more successfully use technologies vital to functional tasks and independent, everyday living. The training application simulated the use of automatic teller machines (ATMs) and the use of a mobile phone to call and fill a prescription. Thirty-two adults (age range 28–71, 63 % aged 55+) were assessed at baseline on functional task performance by being given an ATM task and a prescription task assessment to complete. Participants then underwent 2 weeks of training before being given a follow-up assessment; informal evaluation interviews were also administered. Overall, participants found it easy to use the training interface and that the presentation of material was favorable, however some would have preferred less repetition in training tasks. Recommendations on application-development and design as well as training structure are discussed.