scholarly journals CATCH-ON Connect: A Program to Increase Technology Access Among Older Adults During COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 267-268
Author(s):  
Erin Emery-Tiburcio ◽  
Robyn Golden ◽  
Salvador Castaneda ◽  
Michelle Newman ◽  
Janis Sayer
Keyword(s):  
Older Adults ◽  
Health Professionals ◽  
Digital Literacy ◽  
Technical Assistance ◽  
The Internet ◽  
Technology Access ◽  
Primary Care Clinics ◽  
High Satisfaction ◽  
Quantitative Results ◽  
Project Partner

Abstract During the COVID-19 pandemic, technology became an essential tool to maintain connections to social support, health professionals, and services. However, many older adults do not have access to technology or do not feel comfortable using it. CATCH-ON Connect provides cellular-enabled tablets and individual, personalized technical assistance to older adults. Adults age 65+ in project partner primary care clinics who do not have an internet-ready device or who lack digital literacy are eligible to participate. Older adults learn how to access their electronic health record portal, use pre-installed apps (e.g., Lyft, Zoom), and receive education about COVID-19 and the 4Ms. Of the 40 participants enrolled to date, 46% have never accessed the internet with a tablet or smartphone. Initial qualitative outcomes indicate high satisfaction and increased electronic socialization. Quantitative results of participant technology challenges, loneliness, and utilization of telehealth services will be discussed.

scholarly journals Evaluating the Need to Address Digital Literacy Among Hospitalized Patients: Cross-Sectional Observational Study (Preprint)

2019 ◽  
Author(s):  
Hanna Vollbrecht ◽  
Vineet Arora ◽  
Sebastian Otero ◽  
Kyle Carey ◽  
David Meltzer ◽  
...  
Keyword(s):  
Health Literacy ◽  
Digital Literacy ◽  
Hospitalized Patients ◽  
The Internet ◽  
Technology Access ◽  
Adequate Health Literacy ◽  
Gender And Education ◽  
Low Health Literacy ◽  
Health Literacy Level ◽  
Literacy Level

BACKGROUND Technology is a potentially powerful tool to assist patients with transitions of care during and after hospitalization. Patients with low health literacy who are predisposed to poor health outcomes are particularly poised to benefit from such interventions. However, this population may lack the ability to effectively engage with technology. Although prior research studied the role of health literacy in technology access/use among outpatients, hospitalized patient populations have not been investigated in this context. Further, with the rapid uptake of technology, access may no longer be pertinent, and differences in technological capabilities may drive the current digital divide. Thus, characterizing the digital literacy of hospitalized patients across health literacy levels is paramount. OBJECTIVE We sought to determine the relationship between health literacy level and technological access, use, and capability among hospitalized patients. METHODS Adult inpatients completed a technology survey that asked about technology access/use and online capabilities as part of an ongoing quality of care study. Participants’ health literacy level was assessed utilizing the 3-question Brief Health Literacy Screen. Descriptive statistics, bivariate chi-squared analyses, and multivariate logistic regression analyses (adjusting for age, race, gender, and education level) were performed. Using Bonferroni correction for the 18 tests, the threshold <i>P</i> value for significance was &lt;.003. RESULTS Among 502 enrolled participants, the mean age was 51 years, 71.3% (358/502) were African American, half (265/502, 52.8%) were female, and half (253/502, 50.4%) had at least some college education. Over one-third (191/502, 38.0%) of participants had low health literacy. The majority of participants owned devices (owned a smartphone: 116/173, 67.1% low health literacy versus 235/300, 78.3% adequate health literacy, <i>P</i>=.007) and had used the Internet previously (143/189, 75.7% low health literacy versus 281/309, 90.9% adequate health literacy, <i>P</i>&lt;.001). Participants with low health literacy were more likely to report needing help performing online tasks (133/189, 70.4% low health literacy versus 135/303, 44.6% adequate health literacy, <i>P</i>&lt;.001). In the multivariate analysis, when adjusting for age, race, gender, and education level, we found that low health literacy was not significantly associated with a lower likelihood of owning smartphones (OR: 0.8, 95% CI 0.5-1.4; <i>P</i>=.52) or using the internet ever (OR: 0.5, 95% CI 0.2-0.9; <i>P</i>=.02). However, low health literacy remained significantly associated with a higher likelihood of needing help performing any online task (OR: 2.2, 95% CI 1.3-3.6; <i>P</i>=.002). CONCLUSIONS The majority of participants with low health literacy had access to technological devices and had used the internet previously, but they were unable to perform online tasks without assistance. The barriers patients face in using online health information and other health information technology may be more related to online capabilities rather than to technology access. When designing and implementing technological tools for hospitalized patients, it is important to ensure that patients across digital literacy levels can both understand and use them.

scholarly journals Equity in telemedicine for older adults during the COVID-19 pandemic

2021 ◽  
Author(s):  
Weihong Kuang ◽  
Guojun Zeng ◽  
Yunbo Nie ◽  
Yan Cai ◽  
Jin Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Professionals ◽  
Paradigm Shift ◽  
Drug Prescription ◽  
The Internet ◽  
Careful Attention ◽  
The West ◽  
West China Hospital ◽  
West China ◽  
Online Treatment

Abstract The coronavirus disease 2019 (COVID-19) pandemic has spurred an unprecedented paradigm shift to telemedicine across healthcare fields in order to limit exposure to the virus. At the West China Hospital of Sichuan University, telemedicine has been used to perform COVID-19-related tele-education to health professionals and the general population, as well as tele-diagnosis, online treatment and internet-based drug prescription and delivery. However, many older adults could not make appointments with doctors due to difficulty using the internet-based platform. Careful attention needs to be paid by future researchers and policymakers in order to mitigate barriers older adults face when using telemedicine.

scholarly journals Evaluating the Need to Address Digital Literacy Among Hospitalized Patients: Cross-Sectional Observational Study

10.2196/17519 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e17519 ◽  
Author(s):  
Hanna Vollbrecht ◽  
Vineet Arora ◽  
Sebastian Otero ◽  
Kyle Carey ◽  
David Meltzer ◽  
...  
Keyword(s):  
Health Literacy ◽  
Digital Literacy ◽  
Hospitalized Patients ◽  
The Internet ◽  
Technology Access ◽  
Adequate Health Literacy ◽  
Gender And Education ◽  
Low Health Literacy ◽  
Health Literacy Level ◽  
Literacy Level

Background Technology is a potentially powerful tool to assist patients with transitions of care during and after hospitalization. Patients with low health literacy who are predisposed to poor health outcomes are particularly poised to benefit from such interventions. However, this population may lack the ability to effectively engage with technology. Although prior research studied the role of health literacy in technology access/use among outpatients, hospitalized patient populations have not been investigated in this context. Further, with the rapid uptake of technology, access may no longer be pertinent, and differences in technological capabilities may drive the current digital divide. Thus, characterizing the digital literacy of hospitalized patients across health literacy levels is paramount. Objective We sought to determine the relationship between health literacy level and technological access, use, and capability among hospitalized patients. Methods Adult inpatients completed a technology survey that asked about technology access/use and online capabilities as part of an ongoing quality of care study. Participants’ health literacy level was assessed utilizing the 3-question Brief Health Literacy Screen. Descriptive statistics, bivariate chi-squared analyses, and multivariate logistic regression analyses (adjusting for age, race, gender, and education level) were performed. Using Bonferroni correction for the 18 tests, the threshold P value for significance was <.003. Results Among 502 enrolled participants, the mean age was 51 years, 71.3% (358/502) were African American, half (265/502, 52.8%) were female, and half (253/502, 50.4%) had at least some college education. Over one-third (191/502, 38.0%) of participants had low health literacy. The majority of participants owned devices (owned a smartphone: 116/173, 67.1% low health literacy versus 235/300, 78.3% adequate health literacy, P=.007) and had used the Internet previously (143/189, 75.7% low health literacy versus 281/309, 90.9% adequate health literacy, P<.001). Participants with low health literacy were more likely to report needing help performing online tasks (133/189, 70.4% low health literacy versus 135/303, 44.6% adequate health literacy, P<.001). In the multivariate analysis, when adjusting for age, race, gender, and education level, we found that low health literacy was not significantly associated with a lower likelihood of owning smartphones (OR: 0.8, 95% CI 0.5-1.4; P=.52) or using the internet ever (OR: 0.5, 95% CI 0.2-0.9; P=.02). However, low health literacy remained significantly associated with a higher likelihood of needing help performing any online task (OR: 2.2, 95% CI 1.3-3.6; P=.002). Conclusions The majority of participants with low health literacy had access to technological devices and had used the internet previously, but they were unable to perform online tasks without assistance. The barriers patients face in using online health information and other health information technology may be more related to online capabilities rather than to technology access. When designing and implementing technological tools for hospitalized patients, it is important to ensure that patients across digital literacy levels can both understand and use them.

Executive Dysfunction Mediates the Association Between Older Age and Online Health Information Search Performance

2020 ◽  
Author(s):  
Victoria Kordovski ◽  
Savanna M. Tierney ◽  
Samina Rahman ◽  
Luis D. Medina ◽  
Michelle A. Babicz ◽  
...  
Keyword(s):  
Older Adults ◽  
Executive Functions ◽  
Information Search ◽  
Search Task ◽  
Executive Dysfunction ◽  
Older Age ◽  
The Internet ◽  
Younger Adults ◽  
Related Information ◽  
Health Related

Objective: Searching the Internet for health-related information is a complex and dynamic goal-oriented process that places demands on executive functions, which are higher-order cognitive abilities that are known to deteriorate with older age. This study aimed to examine the effects of older age on electronic health (eHealth) search behavior, and to determine whether executive functions played a mediating role in that regard. Method: Fifty younger adults (≤ 35 years) and 41 older adults (≥50 years) completed naturalistic eHealth search tasks involving fact-finding (Fact Search) and symptom diagnosis (Symptom Search), a neurocognitive battery, and a series of questionnaires. Results: Multiple regression models with relevant covariates revealed that older adults were slower and less accurate than younger adults on the eHealth Fact Search task, but not on the eHealth Symptom Search task. Nevertheless, executive functions mediated the relationship between older age and eHealth Fact Search and Symptom Search accuracy. Conclusions: Older adults can experience difficulty searching the Internet for some health-related information, which is at least partly attributable to executive dysfunction. Future studies are needed to determine the benefits of training in the organizational and strategic aspects of Internet search for older adults and whether these findings are applicable to clinical populations with executive dysfunction.

scholarly journals Comparison of the caregivers’ and community health professionals’ views on home health care services for disabled older adults: a cross-sectional study in Beijing, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojingyuan Xu ◽  
Chunyan Zhao ◽  
Meirong Wang ◽  
Xiaolei Chen ◽  
Shuang Shao ◽  
...  
Keyword(s):  
Older Adults ◽  
Community Health ◽  
Home Health Care ◽  
Health Professionals ◽  
Home Nursing ◽  
Cross Sectional ◽  
Guidance Services ◽  
Nursing Services ◽  
Beijing China ◽  
Health Guidance

Abstract Background In an era of an increasingly ageing society, part of healthcare for older adults can be provided in patients’ homes, and the need for home health care services (HHCSs) is increasing. This study sought to determine whether a gap exists between the views of community health professionals and the caregivers of disabled older adults towards HHCSs in Beijing, China. Methods A cross-sectional study with two comparative questionnaire surveys was conducted in Beijing, China. One survey was administered to the caregivers of disabled older adults, and the other was administered to health professionals in community health service institutions (CHSIs). T-tests and Wilcoxon signed-rank tests were used to explore potential differences between the views of caregivers and community health professionals towards HHCSs. Results We received 370 valid questionnaires from caregivers and 224 questionnaires from health professionals. Of the 370 caregivers, 314 (84.9%) were willing to apply for HHCSs for the older adults, but only 20.5% (N = 76) received HHCSs. Over 80% of the caregivers accepted out-of-pocket costs less than 100 yuan per visit. Caregivers’ demands on home nursing services were significantly higher than those of health guidance services (Z = − 7.725, P < 0.001). Most of the 224 health professionals chose “health professionals’ personal safety cannot be guaranteed” as a problem limiting the provision of HHCSs (N = 151, 40.8%). The health professionals’ attitudes towards home nursing services were significantly less positive than those towards health guidance services (Z = − 10.081, P < 0.001). For home nursing services, health professionals’ attitude scores were lower than the caregivers’ demand scores (Z = − 4.960, P < 0.001), while for health guidance services, health professionals’ attitude scores were higher than the caregivers’ demand scores (Z = − 8.373, P < 0.001). Conclusions Gaps exist between the views of caregivers and health professionals on HHCSs. Compared to health professionals with a higher willingness to provide health guidance services, caregivers need home nursing services. Feasible policies should be implemented to safeguard the rights and interests of health professionals, and qualified health professionals should be trained for HHCSs.

scholarly journals Internet users’ utopian/dystopian imaginaries of society in the digital age: Theorizing critical digital literacy and civic engagement

2021 ◽  
pp. 146144482110186
Author(s):  
Gianfranco Polizzi
Keyword(s):  
Civic Engagement ◽  
Media Literacy ◽  
Digital Literacy ◽  
Digital Age ◽  
The Internet ◽  
Online Engagement ◽  
Internet Users ◽  
Utopian Studies ◽  
Utopian Thinking ◽  
Literacy Research

This article proposes a theoretical framework for how critical digital literacy, conceptualized as incorporating Internet users’ utopian/dystopian imaginaries of society in the digital age, facilitates civic engagement. To do so, after reviewing media literacy research, it draws on utopian studies and political theory to frame utopian thinking as relying dialectically on utopianism and dystopianism. Conceptualizing critical digital literacy as incorporating utopianism/dystopianism prescribes that constructing and deploying an understanding of the Internet’s civic potentials and limitations is crucial to pursuing civic opportunities. The framework proposed, which has implications for media literacy research and practice, allows us to (1) disentangle users’ imaginaries of civic life from their imaginaries of the Internet, (2) resist the collapse of critical digital literacy into civic engagement that is understood as inherently progressive, and (3) problematize polarizing conclusions about users’ interpretations of the Internet as either crucial or detrimental to their online engagement.

scholarly journals Innovative Partnership Between Primary Care, AAA, and Academia Connects 4Ms and Social Determinants of Health

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 107-107
Author(s):  
Suzanne Leahy ◽  
Katie Ehlman ◽  
Lisa Maish ◽  
Brad Conrad ◽  
Jillian Hall ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health System ◽  
Preliminary Evaluation ◽  
Language And Literacy ◽  
Community Based ◽  
Primary Care Clinics ◽  
College Of Nursing ◽  
Value Based Care ◽  
The University

Abstract Nationally, there is a growing focus on addressing geriatric care in primary care settings. HRSA’s Geriatric Workforce Enhancement Program (GWEP) has called for academic and health system partners to develop a reciprocal, innovative, cross-sector partnership that includes primary care sites and community-based agencies serving older adults. Through the University of Southern Indiana’s GWEP, the College of Nursing and Health Professions, the Deaconess Health System, three primary care clinics, and two Area Agencies on Aging (AAA) have joined to transform the healthcare of older adults regionally, including rural residents in the 12-county area. Core to the project is a value-based care model that “embeds” AAA care managers in primary care clinics. Preliminary evaluation indicates early success in improving the healthcare of older adults at one primary clinic, where clinical teams have referred 64 older adult patients to the AAA care manager. Among these 64 patients, 80% were connected to supplemental, community-based health services; 22% to programs addressing housing and transportation; and, nearly 10% to a range of other services (e.g., job training; language and literacy; and technology). In addition to presenting limited data on referred patients and referral outcomes, the presentation will share copies of the AAA referral log, to illustrate how resources were categorized by SDOH and added to support integration of the 4Ms.

scholarly journals Elders’ Life Stories: Impact on the Next Generation of Health Professionals

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Tracy Chippendale
Keyword(s):  
Health Professionals ◽  
Life Stories ◽  
Life Story ◽  
Descriptive Analysis ◽  
Life Review ◽  
Mixed Methods Design ◽  
Intergenerational Exchange ◽  
Negative Images ◽  
Images Of Aging ◽  
Quantitative Results

The purpose of this study was to pilot an enhanced version of the “Share your Life Story” life review writing workshop. The enhanced version included the addition of an intergenerational exchange, based on the content of seniors’ writings, with students planning careers in the health sciences. The researcher employed a mixed methods design. Preliminary results using descriptive analysis revealed an increase in positive images of aging and a decrease in negative images of aging among the five student participants. Qualitative results revealed six themes that illuminate the hows and whys of the quantitative results as well as additional program benefits. Feedback from students and seniors helped to refine the intergenerational protocol for a larger scale study.

Telemedicine Preparedness Among Older Adults with Chronic Illness (Preprint)

2021 ◽  
Author(s):  
Kelsey Ufholz ◽  
Amy Sheon ◽  
Daksh Bhargava ◽  
Goutham Rao
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Quality Improvement ◽  
Chronic Illness ◽  
Primary Care Providers ◽  
The Internet ◽  
Care Providers ◽  
Research Assistant ◽  
Term Care ◽  
Video Calling

BACKGROUND Since the COVID-19 pandemic, telemedicine appointments have replaced many in-person healthcare visits [1 2]. However, older people are less likely to participate in telemedicine, preferring either in-person care or foregoing care altogether [3-6]. With a high prevalence of chronic conditions and vulnerability to COVID-19 morbidity and mortality through exposure to others in health care environments, (1-4), promoting telemedicine use should be a high priority for seniors. Seniors face significant barriers to participation in telemedicine, including lower internet and device access and skills, and visual, auditory, and tactile difficulties with telemedicine. OBJECTIVE Hoping to offer training to increase telemedicine use, we undertook a quality improvement survey to identify barriers to, and facilitators of telemedicine among seniors presenting to an outpatient family medicine teaching clinic which serves predominantly African American, economically disadvantaged adults with chronic illness in Cleveland, Ohio. METHODS Our survey, designated by the IRB as quality improvement, was designed based on a review of the literature, and input from our primary care providers and a digital equity expert (Figure 1). To minimize patient burden, the survey was limited to 10 questions. Because we were interested in technology barriers, data were collected on paper rather than a tablet or computer, with a research assistant available to read the survey questions. Patients presenting with needs that could be accomplished remotely were approached by a research assistant to complete the survey starting February 2021 until we reached the pre-determined sample size (N=30) in June 2021. Patients with known dementia, those who normally resident in a long-term care facility, and those presenting with an acute condition (e.g. fall or COPD exacerbation) were ineligible. Because of the small number of respondents, only univariate and bivariate tabulations were performed, in Excel. RESULTS 83% of respondents said they had devices that could be used for a telemedicine visit and that they went on the internet, but just 23% had had telemedicine visits. Few patients had advanced devices (iPhones, desktops, laptops or tablets); 46% had only a single device that was not IOS based mobile (Table 1). All participants with devices said they used them for “messaging on the internet,” but this was the only function used by 40%. No one used the internet for banking, shopping, and few used internet functions commonly needed for telemedicine (23.3% had email; 30% did video calling) (Table 1). 23.3% of respondents had had a telemedicine appointment. Many reported a loss of connection to their doctor as a concern. Participants who owned a computer or iPhone used their devices for a broader range of tasks, (Table 2 and 3), were aged 65-70 (Table 4), and were more likely to have had a telemedicine visit and to have more favorable views of telemedicine (Table 2). Respondents who had not had a telemedicine appointment endorsed a greater number of telemedicine disadvantages and endorsed less interest in future appointments (Table 2). Respondents who did not own an internet-capable device did not report using any internet functions and none had had a telemedicine appointment (Table 2). CONCLUSIONS This small survey revealed significant gaps in telemedicine readiness among seniors who said they had devices that could be used for telemedicine and that they went online themselves. No patients used key internet functions needed for staying safe during COVID, and few used internet applications that required skills needed for telemedicine. Few patients had devices that are optimal for seniors using telemedicine. Patients with more advanced devices used more internet functions and had more telemedicine experience and more favorable attitudes than others. Our results confirm previous studies [7-9] showing generally lower technological proficiency among older adults and some concerns about participating in telemedicine. However, our study is novel in pointing to subtle dimensions of telemedicine readiness that warrant further study—device capacity and use of internet in ways that build skills needed for telemedicine such as email and video calling. Before training seniors to use telemedicine, it’s important to ensure that they have the devices, basic digital skills and connectivity needed for telemedicine. Larger studies are needed to confirm our results and apply multivariate analysis to understand the relationships among age, device quality, internet skills and telemedicine attitudes. Development of validated scales of telemedicine readiness and telemedicine training to complement in-person care can help health systems offer precision-matched interventions to address barriers, facilitate increased adoption, and generally improve patients’ overall access to primary care and engagement with their primary care provider.

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