Bridging the Digital Divide for Rural Older Adults by Family Intergenerational Learning: A Classroom Case in a Rural Primary School in China

Rural older adults often feel disconnected from the ever-expanding digital world. To bridge the digital divide, researchers have investigated the effectiveness of formal education and training offered by various social institutions. However, existing research highlights a critical shortcoming in these approaches: a lack of attention paid to rural older adults’ individual needs and interests. Based on the theories of post-metaphorical culture, endogenous development, home-school cooperation, and technology adoption and acceptance, this study implements a family intergenerational learning (FIL) project. FIL characterizes learning between grandparents and grandchildren within the household, suggesting a more practical and individualized strategy to help rural older adults gain digital literacy. By conducting a three-month FIL Project in a rural primary school class in China, the study employs a qualitative method to analyze learning records and interviews from 10 sets of participating grandparents and grandchildren. The analysis renders two critical findings on the effectiveness of the FIL Project for rural older adults. First, FIL can help rural older adults adapt into the digital world by (1) gaining knowledge about digital society, (2) improving their digital skills, (3) changing their lifestyles, and (4) understanding the integration between technology and society. Second, among grandchildren, FIL can cultivate an awareness of lifelong learning and their moral obligations to their grandparents. By illustrating this specific case, this study puts forward a new approach to help the older adults overcome the digital divide in rural areas.

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Bridging the digital divide: Older adults’ engagement with online cinema heritage

Digital Scholarship in the Humanities ◽

10.1093/llc/fqz079 ◽

2019 ◽

Vol 35 (4) ◽

pp. 797-811

Author(s):

Silvia Dibeltulo ◽

Sarah Culhane ◽

Daniela Treveri Gennari

Keyword(s):

Older Adults ◽

Social Media ◽

Cultural Heritage ◽

Digital Divide ◽

Digital Platforms ◽

Film Exhibition ◽

Advantages And Disadvantages ◽

Digital World ◽

Digital Environments ◽

Use Of Social Media

Abstract Is there a way to ensure older adults can bridge the digital divide and engage with online cultural heritage? How can cinema-going memories encourage cross-generational engagement? This article proposes to address these issues by using the Italian Cinema Audiences research project as a case study, and specifically cinema-going memories as intangible cultural heritage (Ercole et al., 2016, Cinema heritage in Europe: preserving and sharing culture by engaging with film exhibition and audiences. Editorial. Alphaville: Journal of Film and Screen Media, 11(Summer): 1–12. Web. ISSN: 2009-4078). It aims to tackle the difficulty of engaging the older generation with the digital world, by proposing and testing new ways to resolve it. Through a mixed-methods ethnographic approach, this article investigates different strategies: the use of social media platforms; a cross-generational activity involving Historypin, a digital, user-generated archive of crowdsourced historical material; an online dedicated archive built in collaboration with the older adults involved in the project. These different solutions aim not only at increasing digital engagement among older adults, but also at furthering younger generations’ involvement in shared cultural heritage in an online context. By focusing on the memories of cinema-going in 1950s Italy, the article explores the implications of the advantages and disadvantages of these different approaches. It also tests Anja K. Leist’s research findings (2013, Social media use of older adults: a mini-review. Gerontology, 59(4): 378–84) on the key role of moderators (the younger generation) to help novice users (the older generation) in the ‘continuous engagement’ in digital environments. We conclude that in order to bridge the digital divide two components are necessary simultaneously: the creation of digital platforms in which the older generations are both curators and users, and the support of and interaction with younger generations.

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Effect of an Integrated Healthcare Program for Korean Rural Older Adults: A Quasi-Experimental Study

Healthcare ◽

10.3390/healthcare8030244 ◽

2020 ◽

Vol 8 (3) ◽

pp. 244

Author(s):

Hyuk Joon Kim ◽

Hye Young Kim ◽

Youngran Yang ◽

Eun Ko

Keyword(s):

Older Adults ◽

Rural Areas ◽

Dynamic Balance ◽

The United States ◽

Control Group ◽

Integrated Healthcare ◽

Healthcare Program ◽

Quasi Experimental ◽

Physical Functions ◽

Rural Older Adults

Studies have been conducted on the development of healthcare programs for older adults in rural areas, not only in Asia but also in Europe and the United States. However, these reports have been limited by largely non-comprehensive results, lack of demand surveys, or programs with no systematic development. The purpose of this study was to develop an integrated healthcare program for rural older adults and investigate the effects of the program. A nonequivalent control group pretest–posttest design was used. Subjects were aged over 65 and lived in the rural community. The integrated healthcare program involved 12 three-hour sessions over 12 weeks. Compared with the control group, the experimental group demonstrated significant differences in both upper extremities strengths (t = 2.74, p = 0.008; t = 2.03, p = 0.047), static balance (z = −2.38, p = 0.017), dynamic balance (t = −4.82, p < 0.001), loneliness (t = −3.02, p = 0.003), and role self-efficacy (t = 2.39, p = 0.020), but no differences for ego integration (t = 1.51, p = 0.137). To improve physical, mental, and social health of the rural older adults, we developed an integrated healthcare program. The program improved physical functions, loneliness, and role self-efficiency of the rural older adults. Therefore, it is recommended that healthcare professionals actively apply this program in primary healthcare institutes and elsewhere.

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Challenges with Pain Treatment for Rural Older Adults: Family Caregivers' Views

Innovation in Aging ◽

10.1093/geroni/igab046.3220 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 893-894

Author(s):

Hyunjin Noh ◽

Cho Rong Won ◽

Zainab Suntai

Keyword(s):

Older Adults ◽

Health Insurance ◽

Family Caregivers ◽

Rural Areas ◽

Pain Treatment ◽

Financial Burden ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Thinking Skills ◽

Rural Older Adults

Abstract Family caregivers face various challenges in assisting older adults experiencing pain and difficult symptoms. Living in rural areas poses additional obstacles to their caregiving. The purpose of this study was to explore family caregivers’ lived experiences in caring for older adults with pain and discomfort in rural communities. A qualitative research design was adopted to capture the common essence of participants’ experiences through a phenomenological method. Purposeful sampling was used, and the participant criteria was: age 18+, have good thinking skills, resident of Alabama, provide unpaid assistance to a family/relative who has chronic/serious health conditions and experienced pain/discomfort in the last 3 months. Ten participants were recruited from rural counties of Alabama. Individual semi-structured interviews were conducted via phone and were recorded and transcribed verbatim. Inductive, thematic analysis of the data revealed themes in five categories: 1) impact of pain (physical and psychological/emotional toll), 2) coping strategies (faith/contentment with life/logistical adaptation), 3) impact of Covid-19 (physical health/social interaction/mental health/added caregiving), 4) challenges in pain treatment (transportation (time/distance/driver/cost) and non-transportation related problems (healthcare provider issues/health insurance/financial burden)), and 5) suggestions (transportation-related (more transportation options/tailored services) and non-transportation-related support (home-based services/better health insurance coverage)). Findings of this study highlight rural family caregivers’ unique experiences in assisting older adults’ access to pain treatment, particularly during the Covid-19 pandemic. Policy- and program-level intervention is called for to increase individualized transportation options, improve health insurance coverage, and expand financial support for rural older adults experiencing pain and their caregivers.

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Environmental Factors Affecting Cognitive Function among Community-Dwelling Older Adults: A Longitudinal Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168528 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8528

Author(s):

Atsushi Motohiro ◽

Takafumi Abe ◽

Kenta Okuyama ◽

Keiichi Onoda ◽

Tomoko Ito ◽

...

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Cognitive Function ◽

Environmental Factors ◽

Cognitive Decline ◽

Rural Areas ◽

Estimating Equation ◽

Community Dwelling ◽

Residential Density ◽

Rural Older Adults

Although neighborhood environmental factors have been found to be associated with cognitive decline, few longitudinal studies have focused on their effect on older adults living in rural areas. This longitudinal study aimed to investigate the role of neighborhood environmental factors in cognitive decline among rural older adults. The data of 485 older adults aged ≥60 years who were living in Unnan City in Japan and had participated in two surveys conducted between 2014 and 2018 were analyzed. Cognitive function was assessed using the Cognitive Assessment for Dementia, iPad version 2. Elevation, hilliness, residential density, and proximity to a community center were determined using geographic information system. We applied a generalized estimating equation with odds ratios (OR) and 95% confidence intervals (CIs) of cognitive decline in the quartiles of neighborhood environmental factors. A total of 56 (11.6%) participants demonstrated a decrease in cognitive function at follow up. Elevation (adjusted OR 2.58, 95% CI (1.39, 4.77) for Q4 vs. Q1) and hilliness (adjusted OR 1.93, 95% CI (1.03, 3.63) for Q4 vs. Q1) were associated with a higher likelihood of cognitive decline. The second quartiles of residential density showed significantly lower likelihoods of cognitive decline compared with the first quartiles (adjusted OR 0.36, 95% CI (0.19, 0.71) for Q2 vs. Q1). Thus, an elevated hilly environment and residential density predicted cognitive decline among rural older adults.

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Neighborhood environment and physical activity among rural Japanese older adults

European Journal of Public Health ◽

10.1093/eurpub/ckz186.254 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

K Okuyama ◽

T Abe ◽

T Nabika

Keyword(s):

Physical Activity ◽

Older Adults ◽

Rural Areas ◽

Population Level ◽

Neighborhood Environment ◽

Exercise Habit ◽

Hilly Area ◽

Significant Difference ◽

Japanese Older Adults ◽

Rural Older Adults

Abstract Background Physical inactivity is one of the global health concerns. Rural populations in general tend to be more physically inactive and have higher risk for chronic conditions. Although numerous studies have assessed the association between neighborhood environment and physical activity to implement population level intervention, most are limited to urban adults. This study investigated potential neighborhood environment associated with physical activity for rural older adults in Japan. Methods The study subjects were from Shimane where is a rural-mountainous region in Japan. Those agreed to participate in the Shimane CoHRE study as of baseline (2010) and followed-up after 5 years were included in the analysis (mean age=71, n = 717). Subjects were asked if they engage in 30 minutes exercise more than twice a week at baseline and follow-up surveys. As a primary exposure, we computed mean land slope within 500 m street network buffer from residential point of each subject by geographic information system. Multiple logistic regression was conducted to estimate the odds of exercise engagement after 5 years by slope categorized in tertile, adjusting for age, BMI, and exercise habit at baseline. Results Significantly higher odds of exercise engagement was observed among those living in the hilly area compared to moderately hilly area after 5 years adjusting for baseline age, BMI, and exercise habit, (Odds ratio (OR): 1.71, 95% Confidence Interval (95%CI): 1.119, 2.616). There was no significant difference of odds between those in flat area and moderately hilly area (OR: 1.137, 95%CI: 0.738, 1.751). Conclusions This finding suggests that people living in hilly neighborhoods are more likely to maintain or start engaging in exercise after 5 years. Considering other potential environmental factors and farming culture within rural areas, future studies should capture various forms of environmental components and physical activity to dissect the mechanism. Key messages There are limited studies focus on rural older adults. Unique geographic feature in rural areas, i.e. hilly neighborhood might be associated with physical activity.

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Rural and Non-Rural Digital Divide Persists in Older Adults: Internet Access, Usage, and Perception

Innovation in Aging ◽

10.1093/geroni/igaa057.1329 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 412-413

Author(s):

Hee Yun Lee ◽

Eun Young Choi ◽

Youngsun Kim ◽

Jessica Neese ◽

Yan Luo

Keyword(s):

Older Adults ◽

Rural Communities ◽

Digital Divide ◽

Rural Areas ◽

Technology Use ◽

Urban Areas ◽

Internet Access ◽

Cross Sectional ◽

Older Americans ◽

Comprehensive Plans

Abstract Despite the overall increase in Internet use among older adults, the digital divide within older Americans remains substantial. This trend is particularly true for older adults living in rural areas. Informed by the Social Determinants of Health Framework, our study aims to examine how one’s residential area relates to (1) Internet Access, (2) subtypes of usage patterns, and (3) perceptions on technology use. Cross-sectional data were drawn from the 2012 Health and Retirement Study (HRS). The sample consisted of 18,196 older adults aged 50 and above (47.6% rural residents). A series of linear and logistic regression analyses were performed. Our models controlled for demographic characteristics, socioeconomic status, and health conditions. Compared to older adults living in urban areas, those residing in rural areas had 29% lower odds of internet access. Living in rural areas predicted lower levels of all sub-types of technology use (communication, financial, health, and media technology). In addition, non-users in rural areas showed more unfavorable perceptions of technology than urban residents. They were more likely to conceive technology as “too complicated”, “too hard to learn”, and “too difficult to keep up with all changes.” Our findings suggest that substantial segments of older adults in rural areas are still behind in accessing and adopting digital technology. Targeted intervention efforts are urgently needed to reduce technology inequality including comprehensive plans to expand broadband access and building mobile technology infrastructure for rural communities.

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Bridging the Digital Divide for Older Adults via Observational Training: Effects of Model Identity from a Generational Perspective

Sustainability ◽

10.3390/su12114555 ◽

2020 ◽

Vol 12 (11) ◽

pp. 4555 ◽

Cited By ~ 2

Author(s):

Qi Ma ◽

Alan H. S. Chan ◽

Pei-Lee Teh

Keyword(s):

Older Adults ◽

Technology Acceptance ◽

Digital Divide ◽

Self Efficacy ◽

Cognitive Theory ◽

Well Being ◽

Community Dwelling ◽

Training Outcomes ◽

Digital World ◽

Wide Range

The proliferation of technology offers potential solutions for enhancing the well-being of older adults. However, older adults often have low digital literacy and are disengaged from the digital world. With age-appropriate training, older adults are expected to acquire a wide range of technological skills and bridge the digital divide. Through the lens of social cognitive theory, this study aims to investigate the effectiveness of observational training through behavior modeling in enhancing technology acceptance in older adults. The moderating effects of model identity on training outcomes from a generational perspective are examined. An empirical training experiment was completed with 59 community-dwelling older adults. Training outcomes were measured using cognitive knowledge, affective variables, and meta-cognition. The results ascertain the effectiveness of observational training in improving their technological knowledge, self-efficacy, outcome expectations, and sense of social connectedness when using technologies. From a generational perspective, the older adult behavior model is more effective than the young or child behavior models in increasing self-efficacy and willingness to use technology. The model identity further enhances the positive outcomes of training. The results of this study contribute to designing educational interventions to bridge the digital divide.

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Neighborhood Environmental Factors and Physical Activity Status among Rural Older Adults in Japan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041450 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1450

Author(s):

Kenta Okuyama ◽

Takafumi Abe ◽

Xinjun Li ◽

Yuta Toyama ◽

Kristina Sundquist ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Environmental Factors ◽

Rural Areas ◽

Self Report ◽

Longitudinal Change ◽

Community Center ◽

The Impact ◽

Physically Inactive ◽

Rural Older Adults

(1) Background: Although several neighborhood environmental factors have been identified to be associated with older adults’ physical activity, little research has been done in rural areas where the population is aging. This study aimed to investigate neighborhood environmental factors and the longitudinal change of physical activity status among rural older adults in Japan. (2) Methods: The study included 2211 older adults, aged over 60 years, residing in three municipalities in Shimane prefecture and participating at least twice in annual health checkups between 2010 and 2019. Physical activity was identified based on self-report. Hilliness, bus stop density, intersection density, residential density, and distance to a community center were calculated for each subject. Hazard ratios for the incidence of physical inactivity were estimated using Cox proportional hazards models. (3) Results: We found that 994 (45%) of the study subjects became physically inactive during the follow-up. Those living far from a community center had a lower risk of becoming physically inactive compared to those living close to a community center. When the analysis was stratified by residential municipality, this association remained in Ohnan town. Those living in hilly areas had a higher risk of becoming physically inactive in Okinoshima town. (4) Conclusions: The impact of neighborhood environmental factors on older adults’ physical activity status might differ by region possibly due to different terrain and local lifestyles.

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Hypertension Prevalence Rates Among Urban and Rural Older Adults of China, 1991–2015: A Standardization and Decomposition Analysis

Frontiers in Public Health ◽

10.3389/fpubh.2021.713730 ◽

2021 ◽

Vol 9 ◽

Author(s):

Qi Yu ◽

Shiqi Lin ◽

Jilei Wu

Keyword(s):

Older Adults ◽

Rural Areas ◽

Decomposition Analysis ◽

Prevalence Rates ◽

Nutrition Survey ◽

Policy Effects ◽

Gender Education ◽

Urban Rural ◽

Urban And Rural Areas ◽

Rural Older Adults

Objectives: The prevalence of hypertension (HTN) among older adults is becoming an important issue in public health in China as it is now stepping into the super-aged society with high pressure of a chronic disease burden. With urban–rural differences in population composition and health facilities, this study aimed to assess the gaps in the prevalence trends of HTN among older adults by considering demographic factors such as age, gender, education level, and regional differences during 1991–2015 in China.Methods: We adopted the consistent sampling design and measure of HTN of the cross-longitudinal surveys of the China Health and Nutrition survey, and we compared the HTN prevalence rates between urban and rural older adults by taking each wave of the survey as a cross-sectional sample of the Chinese population by the following and supplementary samples. The classic standardization and decomposition analysis method was utilized with four factor-specific rates, and contributions were calculated, i.e., age, gender, education, and region, which reflects the aspect of demographic and social development differences between urban and rural areas of China.Results: The prevalence rates of HTN of the whole of older adults were increasing in 1991–2015. However, the gaps of prevalence rates of HTN between urban and rural areas show different trends accompanied by the health policies launched by the government. Namely, the gap was narrowed during 1993–1997 and then enlarged during 1997–2011 and narrowing again. Those trends reflect the policy effects with the health resource allocation and utilization of health services for urban and rural older adults.Conclusions: With the four factors of decomposition analysis, the differences reflect the results of health policy effects, considering the urban–rural discrepancy on older adults with different demographic characteristics. Hence, the differentiated policies should be considered with the urban–rural population, such as HTN prevention and the population health promotion.

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Loneliness and Social Connectedness Among Rural Older Adults Since the COVID-19 Pandemic Onset

Innovation in Aging ◽

10.1093/geroni/igab046.2206 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 579-579

Author(s):

Gabriella Meltzer ◽

Lindsay Kobayashi ◽

Jessica Finlay ◽

Carrie Henning-Smith

Keyword(s):

Older Adults ◽

Social Isolation ◽

Rural Areas ◽

Social Connectedness ◽

Aging In Place ◽

Social Activities ◽

Structural Barriers ◽

Cross Sectional ◽

Targeted Interventions ◽

Rural Older Adults

Abstract Rural areas have a higher proportion of older adults aging in place. Rural areas also face structural barriers to supporting social connectedness among older adults, including transportation barriers, greater geographic distances, and access to technological connectivity. This research aims to discuss rural-specific risks of loneliness and social isolation among older adults, as well as rural/urban differences in loneliness and social isolation among older adults using the national COVID-19 Coping Study. Cross-sectional bivariate analyses highlight rural/urban differences in social activities during the pandemic. For example, rural older adults were more likely to use social media daily, compared with urban older adults (67% vs. 61%, p<0.05), but were less likely to have phone or video calls with others daily (21% vs. 26%, p<0.001). We will also share results of differences within rural older adults in loneliness, isolation, and social activities by socio-demographic characteristics in order to design targeted interventions to improve connectedness.

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