Perceived benefits of digital health and social services among older adults: A population-based cross-sectional survey.
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ABSTRACT: Objective
The aim of this study was to describe the benefits of digital health and social services perceived by older adults and to examine factors associated with perceiving these benefits. Several factors related to (a) sociodemographic characteristics, (b) area of residence, (c) physical, cognitive, psychological, and social functioning, and (d) Internet use, were examined.Methods
The present sample included 8019 respondents aged between 75 and 99 years. The inverse probability weighting method was used to correct for bias. Linear regression analyses were used to examine the associations.Results
The ease of use of the services regardless of the time and location was perceived as the most beneficial. Convenient distance to local health or social services (parameter estimate = 0.15 [0.08-0.23]), good functional ability (PE = 0.08 [0.01-0.14]), good vision (PE = 0.15 [0.04-0.25]), ability to learn (PE = 0.05 [0.01-0.10]) and living with someone (PE = 0.08 [95% CI 0.04-0.13]) were associated with perceiving more benefits. In addition, access to the Internet (PE = 0.12 [0.06-0.19]) and independent use of the Internet (PE = 0.23 [0.17-0.29]) were associated with perceiving more benefits.Conclusions
Older adults who are healthier, have a social relationship in their everyday life or have easier access to traditional services seem to perceive more benefits from digital health and social services. Digital services should be developed to correspond with special needs caused by disadvantages in health and the social environment. To facilitate the use of digital health and social services, more efforts should be made to enhance older adults' perceptions of their benefits.
SUBMITTER: Kainiemi E
PROVIDER: S-EPMC10259144 | biostudies-literature | 2023 Jan-Dec
REPOSITORIES: biostudies-literature
Publications
Perceived benefits of digital health and social services among older adults: A population-based cross-sectional survey.
Kainiemi Emma E Saukkonen Petra P Virtanen Lotta L Vehko Tuulikki T Kyytsönen Maiju M Aaltonen Mari M Heponiemi Tarja T
Digital health 20230101
<h4>Objective</h4>The aim of this study was to describe the benefits of digital health and social services perceived by older adults and to examine factors associated with perceiving these benefits. Several factors related to (a) sociodemographic characteristics, (b) area of residence, (c) physical, cognitive, psychological, and social functioning, and (d) Internet use, were examined.<h4>Methods</h4>The present sample included 8019 respondents aged between 75 and 99 years. The inverse probabilit ...[more]
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Project description:BackgroundThe number of online services in health care is increasing rapidly in developed countries. Users are expected to take a more skilled and active role in taking care of their health and prevention of ill health. This induces risks that users (especially those who need the services the most) will drop out of digital services, resulting in a digital divide or exclusion. To ensure wide and equal use of online services, all users must experience them as beneficial.ObjectiveThis study aimed to examine associations of (1) demographics (age, gender, and degree of urbanization), (2) self-rated health, (3) socioeconomic position (education, experienced financial hardship, labor market position, and living alone), (4) social participation (voting, satisfaction with relationships, and keeping in touch with friends and family members), and (5) access, skills, and extent of use of information and communication technologies (ICT) with perceived benefits of online health care and social welfare services. Associations were examined separately for perceived health, economic, and collaboration benefits.MethodsWe used a large random sample representative of the Finnish population including 4495 (56.77% women) respondents aged between 20 and 97 years. Analyses of covariance were used to examine the associations of independent variables with perceived benefits.ResultsAccess to online services, ICT skills, and extent of use were associated with all examined benefits of online services. ICT skills seemed to be the most important factor. Poor self-rated health was also consistently associated with lower levels of perceived benefits. Similarly, those who were keeping in touch with their friends and relatives at least once a week perceived online services more often beneficial in all the examined dimensions. Those who had experienced financial hardship perceived fewer health and economic benefits than others. Those who were satisfied with their relationships reported higher levels of health and collaboration benefits compared with their counterparts. Also age, education, and degree of urbanization had some statistically significant associations with benefits but they seemed to be at least partly explained by differences in access, skills, and extent of use of online services.ConclusionsAccording to our results, providing health care services online has the potential to reinforce existing social and health inequalities. Our findings suggest that access to online services, skills to use them, and extent of use play crucial roles in perceiving them as beneficial. Moreover, there is a risk of digital exclusion among those who are socioeconomically disadvantaged, in poor health, or socially isolated. In times when health and social services are increasingly offered online, this digital divide may predispose people with high needs for services to exclusion from them.
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Project description:BACKGROUND:Research suggests that digital recovery support services (D-RSSs) may help support individual recovery and augment the availability of in-person supports. Previous studies highlight the use of D-RSSs in supporting individuals in recovery from substance use but have yet to examine the use of D-RSSs in supporting a combination of behavioral health disorders, including substance use, mental health, and trauma. Similarly, few studies on D-RSSs have evaluated gender-specific supports or integrated communities, which may be helpful to women and individuals recovering from behavioral health disorders. OBJECTIVE:The goal of this study was to evaluate the SHE RECOVERS (SR) recovery community, with the following 3 aims: (1) to characterize the women who engage in SR (including demographics and recovery-related characteristics), (2) describe the ways and frequency in which participants engage with SR, and (3) examine the perception of benefit derived from engagement with SR. METHODS:This study used a cross-sectional survey to examine the characteristics of SR participants. Analysis of variance and chi-square tests, as well as univariate logistic regressions, were used to explore each aim. RESULTS:Participants (N=729, mean age 46.83 years; 685/729, 94% Caucasian) reported being in recovery from a variety of conditions, although the most frequent nonexclusive disorder was substance use (86.40%, n=630). Participants had an average length in recovery (LIR) of 6.14 years (SD 7.87), with most having between 1 and 5 years (n=300). The most frequently reported recovery pathway was abstinence-based 12-step mutual aid (38.40%). Participants reported positive perceptions of benefit from SR participation, which did not vary by LIR or recovery pathway. Participants also had high rates of agreement, with SR having a positive impact on their lives, although this too did vary by recovery length and recovery pathway. Participants with 1 to 5 years of recovery used SR to connect with other women in recovery at higher rates, whereas those with less than 1 year used SR to ask for resources at higher rates, and those with 5 or more years used SR to provide support at higher rates. Lifetime engagement with specific supports of SR was also associated with LIR and recovery pathway. CONCLUSIONS:Gender-specific and integrated D-RSSs are feasible and beneficial from the perspective of participants. D-RSSs also appear to provide support to a range of recovery typologies and pathways in an effective manner and may be a vital tool for expanding recovery supports for those lacking in access and availability because of geography, social determinants, or other barriers.
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Project description:BackgroundInterest in and funding for digital health interventions have rapidly grown in recent years. Despite the increasing familiarity with mobile health from regulatory bodies, providers, and patients, overarching research on digital health adoption has been primarily limited to morbidity-specific and non-US samples. Consequently, there is a limited understanding of what personal factors hold statistically significant relationships with digital health uptake. Moreover, this limits digital health communities' knowledge of equity along digital health use patterns.ObjectiveThis study aims to identify the social determinants of digital health tool adoption in Georgia.MethodsWeb-based survey respondents in Georgia 18 years or older were recruited from mTurk to answer primarily closed-ended questions within the following domains: participant demographics and health consumption background, telehealth, digital health education, prescription management tools, digital mental health services, and doctor finder tools. Participants spent around 15 to 20 minutes on a survey to provide demographic and personal health care consumption data. This data was analyzed with multivariate linear and logistic regressions to identify which of these determinants, if any, held statistically significant relationships with the total number of digital health tool categories adopted and which of these determinants had absolute relationships with specific categories.ResultsA total of 362 respondents completed the survey. Private insurance, residence in an urban area, having a primary care provider, fewer urgent emergency room (ER) visits, more ER visits leading to inpatient stays, and chronic condition presence were significantly associated with the number of digital health tool categories adopted. The separate logistic regressions exhibited substantial variability, with 3.5 statistically significant predictors per model, on average. Age, federal poverty level, number of primary care provider visits in the past 12 months, number of nonurgent ER visits in the past 12 months, number of urgent ER visits in the past 12 months, number of ER visits leading to inpatient stays in the past 12 months, race, gender, ethnicity, insurance, education, residential area, access to the internet, difficulty accessing health care, usual source of care, status of primary care provider, and status of chronic condition all had at least one statistically significant relationship with the use of a specific digital health category.ConclusionsThe results demonstrate that persons who are socioeconomically disadvantaged may not adopt digital health tools at disproportionately higher rates. Instead, digital health tools may be adopted along social determinants of health, providing strong evidence for the digital health divide. The variability of digital health adoption necessitates investing in and building a common framework to increase mobile health access. With a common framework and a paradigm shift in the design, evaluation, and implementation strategies around digital health, disparities can be further mitigated and addressed. This likely will begin with a coordinated effort to determine barriers to adopting digital health solutions.
| S-EPMC9768657 | biostudies-literature
Project description:BackgroundTackling physical inactivity represents a key global public health challenge. Strategies to increase physical activity (PA) are therefore warranted. Despite the rising availability of digital interventions (DIs), which offer tremendous potential for PA promotion, there has been inadequate attention to the special needs of older adults.ObjectiveThe aim was to investigate community-dwelling older adults' needs, requirements, and preferences toward DIs to promote PA.MethodsThe target population of this cross-sectional study was community-dwelling older adults (≥60 years old) within German-speaking Switzerland. Potential respondents were informed about the study and sent a link to a self-developed and self-administered online survey by our cooperating institutions.ResultsOverall, 922 respondents who completed the online survey were included in the final analysis. The mean age of the sample was 72 years (SD 6.4, range 60-98). The preferred delivery mode of DIs to promote PA was a website (428/922, 46.4%) and 80.3% (740/922) preferred video-based structures. Most respondents expressed the need for personal access, personal goals, personal messages, and a personal contact in case of problems or questions (585/817, 71.6%; 546/811, 67.3%; 536/822, 65.2%; 536/822, 65.2%). Memory training, psychological wellbeing, and nutrition were mainly rated as relevant additional content of DIs to promote PA (690/849, 81.2%; 661/845, 78.2%, 619/849, 72.9%).ConclusionCommunity-dwelling older adults may be willing to use DIs to promote PA in the long term, but this study identified particular needs and requirements in terms of design, technological realization, delivery mode, support, and individualization/personalization among the sample. Our results can inform future developments of DIs to promote PA specifically tailored to older adults. However, caution is warranted in interpreting the findings due to the sample's high PA and education levels.
| S-EPMC10548814 | biostudies-literature
Project description:ObjectivesDigital support services may provide informal caregivers with remote access to information and training about care issues. However, there is limited specific data on how factors such as demographics, socioeconomic resources and the caregiving context may influence caregivers' use of digital support services. The aim of this study is to identify associations between informal caregiver's characteristics and the use of the internet to access digital support services in two countries: Italy and Sweden.Setting and participantsA sample of 663 respondents who have access to the internet participated in a cross-sectional survey by completing the online questionnaire. Respondents were recruited by the Italian National Institute of Health and Science on Ageing and the Swedish Family Care Competence Centre.Primary and secondary outcome measuresLogistic regression analyses were performed to assess predictors of caregivers' frequent use of the internet to access digital support services.ResultsEducational attainment (OR 3.649, 95% CI 1.424 to 9.350, p=0.007), hours per week spent caring (OR 2.928, 95% CI 1.481 to 5.791, p=0.002), total household income (OR 0.378, 95% CI 0.149 to 0.957, p=0.040), care recipient relationship to the caregiver (OR 2.895, 95% CI 1.037 to 8.083, p=0.042) and gender of care recipient (OR 0.575, 95% CI 0.356 to 0.928, p=0.023) were significant predictors in the multivariate analysis for the Italian caregivers group. Hours per week spent caring (OR 2.401, 95% CI 1.105 to 5.218, p=0.027) and age of caregiver (OR 2.237, 95% CI 1.150 to 4.352, p=0.018) were significant predictors in the multivariate analysis for the Swedish caregivers group.ConclusionsDigital support services could be important tools to empower informal caregivers. When it comes to policy and practice in relation to caregivers, similarly to other broad vulnerable groups, there is no 'one-size-fits-all' approach, and it is therefore important to consider the specific characteristics and needs of both caregivers and care recipients.
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Project description:BackgroundHealth inequalities among older adults become increasingly pronounced as aging progresses. In the digital era, some researchers argue that access to and use of digital technologies may contribute to or exacerbate these existing health inequalities. Conversely, other researchers believe that digital technologies can help mitigate these disparities.ObjectiveThis study aimed to investigate the relationship between the digital divide and health inequality among older adults and to offer recommendations for promoting health equity.MethodsData were obtained from the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study. Physical, mental, and subjective health were assessed using the Activities of Daily Living (ADL) scale, the Instrumental Activities of Daily Living scale, the Mini-Mental State Examination scale, and a 5-point self-rated health scale, respectively. The chi-square and rank sum tests were used to explore whether internet use and access were associated with health inequality status. After controlling for confounders, multiple linear regression models were used to further determine this association. Sensitivity analysis was conducted using propensity score matching, and heterogeneity was analyzed for different influencing factors.ResultsThe 2018 analysis highlighted widening health disparities among older adults due to internet access and use, with statistically significant increases in inequalities in self-rated health (3.9%), ADL score (5.8%), and cognition (7.5%). Similarly, internet use widened gaps in self-rated health (7.5%) and cognition (7.6%). Conversely, the 2020 analysis demonstrated that internet access improved health disparities among older adults, reducing gaps in self-rated health (3.8%), ADL score (2.1%), instrumental ADL score (3.5%), and cognition (7.5%), with significant results, except for ADL. Internet use also narrowed disparities, with significant effects on self-rated health (4.8%) and cognition (12.8%). The robustness of the results was confirmed through propensity score-matching paired tests. In addition, the study found heterogeneity in the effects of internet access and use on health inequalities among older adults, depending on sex, age, education, and region.ConclusionsThe impact of internet access and use on health inequalities among older adults showed different trends in 2018 and 2020. These findings underscore the importance of addressing the challenges and barriers to internet use among older adults, particularly during the early stages of digital adoption. It is recommended to promote equitable access to the health benefits of the internet through policy interventions, social support, and technological advancements.
| S-EPMC11780301 | biostudies-literature
Project description:BackgroundSocial exclusion has far-reaching consequences that extend beyond regular activities and access to resources and knowledge; social exclusion is a major social determinant of health. However, there is a lack of evidence on social exclusion and health outcomes among India's older adults. Thus, the current study investigates the association of social exclusion with depressive symptoms among Indian older adults.MethodsThis study used information on 30,366 older adults from Longitudinal Ageing Study in India (LASI) wave-1, 2017-2018. Social exclusion scores were calculated, and two broad domains of social exclusion, i.e., exclusion from civic activity & social relations and exclusion from services, were considered in the study. The depressive symptom was calculated using the CES-D score. Using logistic regression models, the average marginal effects of selected covariates and domains of social exclusion on depressive symptoms were estimated to assess the links between social exclusion and depressive symptoms.ResultsWith the increase in the social exclusion score in the selected domains, the prevalence of depressive symptoms among older also increased. Elderly persons who do not vote or live alone in the domain of being excluded from civic & social activities and older adults excluded from services were observed to have a higher prevalence of depressive symptoms. Adjusting for sociodemographic factors, the average marginal effects suggested that older with four scores of civic activity & social relation exclusion, two scores of service exclusion and four scores of overall social exclusion were estimated to have a higher prevalence of depressive symptoms, respectively.ConclusionsThis study's findings shed light on social exclusion and its relationship to depressive symptoms among older Indians. Older health care services should be expanded in breadth while also addressing social exclusion, resulting in considerable improvements in older individuals' mental health.
| S-EPMC9206346 | biostudies-literature
Project description:BackgroundAdolescents may forego needed sexual and reproductive health (SRH) services due to a variety of concerns and barriers. The purpose of this study is to compare adolescents' perceptions of these barriers by participant characteristics including race/ethnicity, gender, sexual orientation, housing situation, and sexual experience.MethodsAdolescents in a California-wide sexual health education program completed an anonymous survey at baseline (N = 10,015) about perceived barriers to using SRH services. Logistic regression analyses that accounted for the clustered data structure assessed differences by gender, age, sexual orientation, race/ethnicity, living situation, and sexual experience.ResultsThe majority of participants were Hispanic/Latino (76.4%) with an average age of 14.9 years, and 28.8% had sexual experience. Half of the youth reported concerns about test results (52.7%), cost of services (52.0%), and confidentiality of services (49.8%). When controlling for other characteristics, youth identifying as transgender/non-binary/multiple genders had the highest odds of perceiving cost (odds ratio (OR) 1.89) and confidentiality (OR 1.51) as barriers. Increasing age was associated with decreasing odds of all barriers. Sexual orientation was a consistent predictor, with LGBQ+ youth having higher odds of perceiving test results (OR 1.21), cost (OR 1.36), and confidentiality (OR 1.24) as barriers. Asian or Pacific Islander/Native Hawaiian youth had higher odds of perceiving test results (OR 1.68) and cost (OR 1.37) as barriers. In contrast, Black youth had lower odds of reporting cost (OR 0.65) and confidentiality (OR 0.77) as barriers. Younger respondents and youth who identified as female, transgender/non-binary/multiple genders, LGBQ+, and Asian or Pacific Islander/Native Hawaiian had higher odds of reporting five or more barriers compared to reference groups.ConclusionsThe majority of adolescents face barriers to accessing appropriate SRH services, with females, gender-minority youth, younger adolescents, LGBQ+ youth, and Asian and Pacific Islander/Native Hawaiian youth more likely than others to report barriers. Access to SRH services can be improved through strengthening linkages between clinics and SRH education programs, providing youth-friendly clinical services, and ensuring youth have sufficient information, skills, and support to access care.Trial registrationApproved by California Health and Human Services Agency's Committee for the Protection of Human Subjects [12-08-0658, 11/30/2017].
| S-EPMC8609799 | biostudies-literature
Project description:ObjectiveOnline health and social care services are getting widespread which increases the risk that less advantaged groups may not be able to access these services resulting in digital exclusion. We examined the combined effects of age and digital competence on the use of online health and social care services.MethodsWe used a large representative population-based sample of 4495 respondents from Finland. Paper-based self-assessment questionnaire with an online response option was mailed to participants. The associations were analyzed using survey weighted logistic regression, exploring potential non-linear effects of age and controlling for potential sex differences.ResultsHigher age, starting from around the age of 60 was associated with a lower likelihood of using online services for receiving test results, renewing prescriptions and scheduling appointments. Good digital competence was able to hinder the age-related decline in online services use, but only up to around the age of 80.ConclusionsOur results suggest that older adults are at risk of digital exclusion, and not even good digital competence alleviates this risk among the oldest. We suggest that health and social care providers should consider older users' needs and abilities more thoroughly and offer easy to use online services. More digital support and training possibilities should be provided for older people. It is equally important that face-to-face and telephone services will be continued to be provided for those older people who are not able to use online services even when supported.
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Project description:ObjectiveThis study describes cardiometabolic diseases and related risk factors in vulnerable older adults residing in social housing, aiming to inform primary care initiatives to reduce health inequities. Associations between sociodemographic variables, modifiable risk factors (clinical and behavioural), health-related quality of life and self-reported cardiometabolic diseases were investigated.Design, setting, and participantsThis was a cross-sectional study with an interviewer-administered questionnaire. Data was collected from residents aged 55 years and older residing in 30 social housing apartment buildings in five regions in Ontario, Canada.Outcome measuresThe proportion of cardiometabolic diseases and modifiable risk factors (e.g., clinical, behavioural, health status) in this population was calculated.ResultsQuestionnaires were completed with 1065 residents: mean age 72.4 years (SD = 8.87), 77.3% were female, 87.2% were white; 48.2% had less than high school education; 22.70% self-reported cardiovascular disease (CVD), 10.54% diabetes, 59.12% hypertension, 43.59% high cholesterol. These proportions were higher than the general population. Greater age was associated with overweight, high cholesterol, high blood pressure and CVD. Poor health-related quality of life was associated with self-reported CVD and diabetes.ConclusionsOlder adults residing in social housing in Ontario have higher proportion of cardiovascular disease and modifiable risk factors compared to the general population. This vulnerable population should be considered at high risk of cardiometabolic disease. Primary care interventions appropriate for this population should be implemented to reduce individual and societal burdens of cardiometabolic disease.
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