Computer, Internet, and E-mail Use Among Older Adults: Benefits and Barriers
TL;DR: Benefits of computer use listed by these elders included a sense of connectedness, satisfaction, utility, and positive learning experiences, and barriers included frustration, physical and mental limitations, mistrust, and time issues.
Abstract: An increasing number of older adults are using computers for communication, entertainment, and information. This descriptive study examined the perceived benefits and barriers encountered by 58 older adults. Benefits of computer use listed by these elders included a sense of connectedness, satisfaction, utility, and positive learning experiences. Barriers included frustration, physical and mental limitations, mistrust, and time issues. Professionals who teach and care for older adults need to be aware of the characteristics of older computer users. They also need to know the perceived barriers and benefits of computer, Internet, and e-mail use in order to tailor education and interventions to this population.
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TL;DR: Internet use patterns, reasons for discontinued use, eHealth literacy, and attitudes toward computer/Internet use among low-income homebound individuals aged 60 and older in comparison to their younger counterparts—homebound adults under age 60 are examined.
Abstract: Background: Internet technology can provide a diverse array of online resources for low-income disabled and homebound older adults to manage their health and mental health problems and maintain social connections. Despite many previous studies of older adults’ Internet use, none focused on these most vulnerable older adults. Objective: This study examined Internet use patterns, reasons for discontinued use, eHealth literacy, and attitudes toward computer/Internet use among low-income homebound individuals aged 60 and older in comparison to their younger counterparts—homebound adults under age 60. Methods: Face-to-face or telephone surveys were conducted with 980 recipients of home-delivered meals in central Texas (78% were age 60 years and older and 22% under age 60). The eHealth Literacy Scale (eHEALS) and the efficacy and interest subscales of the Attitudes Toward Computer/Internet Questionnaire (ATC/IQ) were used to measure the respective constructs. Age groups were compared with chi-square tests and t tests. Correlates of Internet use were analyzed with multinomial logistic regression, and correlates of eHEALS and ATC/IQ scores were analyzed with OLS regression models. Results: Only 34% of the under-60 group and 17% of the 60 years and older group currently used the Internet, and 35% and 16% of the respective group members reported discontinuing Internet use due to cost and disability. In addition to being older, never users were more likely to be black (OR 4.41; 95% CI 2.82-6.91, P <.001) or Hispanic (OR 4.69; 95% CI 2.61-8.44, P <.001), and to have lower incomes (OR 0.36; 95% CI 0.27-0.49, P <.001). Discontinued users were also more likely to be black or Hispanic and to have lower incomes. Among both age groups, approximately three-fourths of the current users used the Internet every day or every few days, and their eHEALS scores were negatively associated with age and positively associated with frequency of use. Among the 60 and older group, a depression diagnosis was also negatively associated with eHEALS scores. ATC/IQ efficacy among never users of all ages and among older adults was positively associated with living alone, income, and the number of medical conditions and inversely associated with age, Hispanic ethnicity, and Spanish as the primary language. Although ATC/IQ interest among older adults was also inversely associated with age, it was not associated with Hispanic ethnicity and Spanish as the primary language. Conclusions: This study is the first to describe in detail low-income disabled and homebound adults’ and older adults’ Internet use. It shows very low rates of Internet use compared to the US population, either due to lack of exposure to computer/Internet technology; lack of financial resources to obtain computers and technology; or medical conditions, disabilities, and associated pain that restrict use. Recommendations to reduce the digital divide among these individuals are provided. [J Med Internet Res 2013;15(5):e93]
514 citations
Cites background from "Computer, Internet, and E-mail Use ..."
...Older-adult Internet users indeed report multiple benefits of using this technology including convenience of accessing health-and nonhealth-related information; increased communication and social connections with family, friends, and others regardless of geographical distance; keeping abreast of news and other happenings in their immediate and global communities; participating in a variety of online educational, social, and recreational activities; and convenience of online shopping, banking, and travel arrangements [12-18]....
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...Older adults themselves report the following reasons for not using computer/Internet technology: the cost of the computer/other equipment and Internet access, functional impairments such as arthritis and joint pain that interfere with typing, visual deficits, ergonomic barriers (eg, small font sizes), lack of computer knowledge, lack of computer-efficacy (beliefs about their ability to use computers/Internet technology) and general self-efficacy (eg, “too old to learn new things”), and mistrust of Internet systems and privacy-related concerns [15,21,28]....
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TL;DR: Being younger and possessing more education was associated with greater eHealth literacy among baby boomers and older adults and females and those highly educated, particularly at the post graduate level, reported greater use of Web 2.0 for health information.
Abstract: Background: Baby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information. Objective: The intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults. Methods: A random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information. Results: Almost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t 217.60 =−2.98, P =.003. Younger age ( b =−0.10), more education ( b =0.48), and use of more electronic devices ( b =1.26) were significantly associated with greater eHealth literacy ( R 2 =.17, R 2 adj =.14, F 9,229 =5.277, P <.001). Women were nearly three times more likely than men to use Web 2.0 for health information (OR 2.63, Wald= 8.09, df=1, P =.004). Finally, more education predicted greater use of Web 2.0 for health information, with college graduates (OR 2.57, Wald= 3.86, df =1, P =.049) and post graduates (OR 7.105, Wald= 4.278, df=1, P =.04) nearly 2 to 7 times more likely than non-high school graduates to use Web 2.0 for health information. Conclusions: Being younger and possessing more education was associated with greater eHealth literacy among baby boomers and older adults. Females and those highly educated, particularly at the post graduate level, reported greater use of Web 2.0 for health information. More in-depth surveys and interviews among more diverse groups of baby boomers and older adult populations will likely yield a better understanding regarding how current Web-based health information seeking and sharing behaviors influence health-related decision making. [J Med Internet Res 2015;17(3):e70]
484 citations
Cites background from "Computer, Internet, and E-mail Use ..."
...0 for a number of reasons, including the high cost of devices and Internet access, insufficient knowledge about device function, and poor perceived self-efficacy [31,45]....
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TL;DR: Using the Internet may be beneficial for decreasing loneliness and increasing social contact among older adults in assisted and independent living communities.
Abstract: Background: Older adults are at increased risk of experiencing loneliness and depression, particularly as they move into different types of care communities. Information and communication technology (ICT) usage may help older adults to maintain contact with social ties. However, prior research is not consistent about whether ICT use increases or decreases isolation and loneliness among older adults. Objective: The purpose of this study was to examine how Internet use affects perceived social isolation and loneliness of older adults in assisted and independent living communities. We also examined the perceptions of how Internet use affects communication and social interaction. Methods: One wave of data from an ongoing study of ICT usage among older adults in assisted and independent living communities in Alabama was used. Regression analysis was used to determine the relationship between frequency of going online and isolation and loneliness (n=205) and perceptions of the effects of Internet use on communication and social interaction (n=60). Results: After controlling for the number of friends and family, physical/emotional social limitations, age, and study arm, a 1-point increase in the frequency of going online was associated with a 0.147-point decrease in loneliness scores ( P =.005). Going online was not associated with perceived social isolation ( P =.14). Among the measures of perception of the social effects of the Internet, each 1-point increase in the frequency of going online was associated with an increase in agreement that using the Internet had: (1) made it easier to reach people ( b =0.508, P <.001), (2) contributed to the ability to stay in touch ( b =0.516, P <.001), (3) made it easier to meet new people ( b =0.297, P =.01, (4) increased the quantity of communication with others ( b =0.306, P =.01), (5) made the respondent feel less isolated ( b =0.491, P <.001), (6) helped the respondent feel more connected to friends and family ( b =0.392, P =.001), and (7) increased the quality of communication with others ( b =0.289, P =.01). Conclusions: Using the Internet may be beneficial for decreasing loneliness and increasing social contact among older adults in assisted and independent living communities. [J Med Internet Res 2013;15(2):e39]
428 citations
Cites background from "Computer, Internet, and E-mail Use ..."
...A wealth of research indicates that ICT usage may help older adults maintain contact with social ties [20-22,24,27,30-46] with relationships taking place both online and offline [38]....
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TL;DR: A community-centered socio-ecological model is proposed to factor in these dispositional characteristics of ICT adoption in future ICT training programs to reflect the older population's age, education, attitudes, and personalities.
314 citations
Cites background from "Computer, Internet, and E-mail Use ..."
...However, when older adults successfully use online social networking, studies show that concerns diminish and connectedness with others becomes a frequently cited benefit (Gatto & Tak, 2008)....
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TL;DR: A positive contribution of Internet use to mental well-being of retired older adults in the United States is found, where Internet use reduced the probability of a depression state by one third.
Abstract: Method. Analyzing data from four waves (2002–2008) of the Health and Retirement Survey, we assess whether an available and commonly used index of a depression state was affected by prior values of the index and Internet use. The sample includes 3,075 respondents observed over 4 waves of data, yielding a total of 12,300 observations. We analyzed the effect on depression of Internet use and past depression in a full sample and a matched sample. We also conducted informal tests for confounders. Finally, we tested a basic mediation model to determine whether Internet use affected depression through its relationship with loneliness and social isolation. Results. Across methods, we found a positi ve contribution of Internet use to mental well-being of retired older adults in the United States, where Internet use reduced the probability of a depression state by one third. We found no evidence of confounding. Some evidence of mediation was found. Discussion. Our dynamic probit model indicates that for retired older adults in the United States, Internet use w as found to reduce the probability of a depressed state by about 33%. Number of people in the household partially mediates this relationship, with the reduction in depression largest for people living alone. This provides some evidence that the mechanism linking Internet use to depression is the remediation of social isolation and loneliness. Encouraging older adults to use the Internet may help decrease isolation and depression.
267 citations
Additional excerpts
...…social contact, social connectedness, and greater satisfaction with that contact (Bradley & Poppen, 2003; Cotten, Goldner, Hale, & Drentea, 2011; Gatto & Tak, 2008; Mellor, Firth, & Moore, 2008; Sum, Mathews, Hughes, & Campbell, 2008; Sum, Mathews, Pourghasem, & Hughes, 2009; Trocchia & Janda,…...
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References
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TL;DR: The development of health-related online support groups are reviewed, research conducted within these communities is examined, their utility with traditional support groups is compared, and the implications of these groups for health education are discussed.
Abstract: Online support groups are expanding as the general public becomes more comfortable using computer-mediated communication technology. These support groups have certain benefits for users who may not be able to or do not have the desire to attend face-to-face sessions. Online support groups also present challenges when compared to traditional face-to-face group communication. Communication difficulties may arise resulting from lack of visual and aural cues found in traditional face-to-face communication. Online support groups have emerged within health care as a result of the need individuals have to know more about health conditions they are confronting. The proliferation of these online communities may provide an opportunity for health educators to reach target populations with specific messages. This paper reviews the development of health-related online support groups, examines research conducted within these communities, compares their utility with traditional support groups and discusses the implications of these groups for health education.
592 citations
"Computer, Internet, and E-mail Use ..." refers background in this paper
...Personal one-on-one instruction and computer mentors who provide step-by-step printed instructions or use computer games to teach basic computer skills have provided the best outcomes (Dauz, Moore, Smith, Puno, & Schaag, 2004; Nahm & Resnick, 2001; Saunder, 2004; White & Dorman, 2001)....
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TL;DR: There was a trend toward decreased loneliness and depression in intervention subjects compared to controls, and there were no statistically significant changes from baseline to the end of trial between groups.
Abstract: The Internet (electronic mail and the World Wide Web) may provide new opportunities for communication that can help older adults avoid social isolation. This randomized controlled trial assessed the psychosocial impact of providing Internet access to older adults over a five-month period. One hundred volunteers from four congregate housing sites and two nursing facilities were randomly assigned to receive Internet training or to a wait list control group. The pre & post measures included the UCLA Loneliness scale, modified CES Depression scale, a measure of locus of control, computer attitudes, number of confidants, and overall quality of life. Participants received nine hours of small group training in six sessions over two weeks. Computers were available for continued use over five months and the trainer was available two hours/week for questions. At the end of the trial, 60% of the intervention group continued to use the Internet on a weekly basis. Although there was a trend toward decreased loneliness and depression in intervention subjects compared to controls, there were no statistically significant changes from baseline to the end of trial between groups. Among Internet users (n = 29) in the intervention group there were trends toward less loneliness, less depression, more positive attitudes toward computers, and more confidants than among intervention recipients who were not regular users (n = 19) of this technology. Most elderly participants in this trial learned to use the Internet and the majority continued to use it on a weekly basis. The psychosocial impact of Internet use in this sample suggested trends in a positive direction. Further research is needed to determine more precisely, which older adults, residing in which environmental contexts are more likely than others to benefit from this rapidly expanding information and communication link.
384 citations
"Computer, Internet, and E-mail Use ..." refers background in this paper
...They are eager to learn to use the Internet and once online are just as enthusiastic as younger users (Fox, 2004; Vanderwerker & Perigerson, 2004; White et al., 2002)....
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TL;DR: In this paper, the authors investigated the ways in which older adults use the Internet for social support and found that greater involvement with the on-line community was predictive of lower perceived life stress.
Abstract: One important new context of communication for older adults is computer-mediated communication (CMC). Although the Internet has become an important resource for information, little is known about the ways in which individuals use this technology for social support. Older adults (mean age = 62) using SeniorNet and other related websites completed an on-line questionnaire (N = 136) investigating social support in the computer-mediated environment. Satisfaction with Internet providers of social support was significantly higher for high Internet users than for low Internet users whereas low Internet users were more satisfied with their non-Internet support networks than high Internet users. Internet companionship network size was significantly larger than Internet social support network size. Greater involvement with the on-line community was predictive of lower perceived life stress. Social support and companionship satisfaction were not related to the types of coping strategies used; however, the results indicate that direct action was the most common coping strategy for the sample.
347 citations
TL;DR: Low levels of social and emotional loneliness were both associated with high degrees of face-to-face networks of friends, while high levels of Internet use were associated with low levels of Social and Emotional Loneliness.
Abstract: The association between Robert Weiss's bimodal theory of loneliness and Internet use was examined. The degree of social and emotional loneliness was assessed using the Social and Emotional Loneliness scale. This was compared with self-report measures of Internet use and the breadth of one's network of friends, both online and on a face-to-face basis. Low levels of social and emotional loneliness were both associated with high degrees of face-to-face networks of friends, while high levels of Internet use were associated with low levels of social loneliness and high levels of emotional loneliness. This supports recent research that has found that the Internet can decrease social well-being, even though it is often used as a communication tool.
311 citations
"Computer, Internet, and E-mail Use ..." refers background in this paper
...Unlike younger users though (Moody, 2001), older adults do not take time away from face-to-face interactions with others....
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TL;DR: This paper found a negative impact of Internet use on psychological well-being of young adults, which conflicted with the emerging literature on Internet use among older adults, finding that older adults are more likely to use the Internet more frequently than younger adults.
Abstract: Past research found a negative impact of Internet use on psychological well-being of young adults. This finding conflicted with the emerging literature on Internet use among older adults, which usu...
166 citations
"Computer, Internet, and E-mail Use ..." refers background in this paper
...Computer and Internet users are younger (Chen & Persson, 2002; Fox, 2004; Lieb, 2005; Rideout, Neuman, Kitchman, & Brodie, 2005; Address correspondence to Susan L. Gatto, Department of Nursing, University of Central Arkansas, Little Rock, AR 72035....
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