Building Digital Literacy in Older Adults of Low Socioeconomic Status in Singapore (Project Wire Up): Nonrandomized Controlled Trial

Abstract

Background In a rapidly digitalizing world, the inability of older adults to leverage digital technology has been associated with weaker social connections and poorer health outcomes. Despite the widespread digital adoption in Singapore, older adults, especially those of lower socioeconomic status (SES), still face difficulties in adopting information and communications technology and are typically digitally excluded. Objective We aimed to examine the impact of the volunteer-led, one-on-one, and home-based digital literacy program on digital literacy and health-related outcomes such as self-reported loneliness, social connectedness, quality of life, and well-being for older adults of low SES. Methods A nonrandomized controlled study was carried out in Singapore between July 2020 and November 2021 involving 138 digitally excluded community-dwelling older adults aged ≥55 years and of lower SES. Older adults awaiting participation in the program served as controls. Older adults under the intervention were equipped with a smartphone and cellular data, underwent fortnightly to monthly digital literacy training with volunteers to learn digital skills, and digitally connected to their existing social networks. Primary outcome was the improvement in self-reported digital literacy. Secondary outcomes included improvements in University of California, Los Angeles 3-item loneliness scale, Lubben Social Network Scale-6, EQ-5D-3L and EQ visual analogue scale scores, and Personal Wellbeing Score. Results There were significant improvements in digital literacy scores in the intervention group as compared to controls (mean difference 2.28, 95% CI 1.37-3.20; P<.001). Through multiple linear regression analyses, this difference in digital literacy scores remained independently associated with group membership after adjusting for differences in baseline scores, age, gender, education, living arrangement, housing type, and baseline social connectivity and loneliness status. There was no statistically significant difference in University of California, Los Angeles 3-item loneliness scale, Lubben Social Network Scale-6, Personal Wellbeing Score, or EQ-5D Utility and visual analogue scale score. Conclusions This study adds to the growing research on digital inclusion by showing that a volunteer-led, one-on-one, and home-based digital literacy program contributed to increase digital literacy in older adults of low SES. Future studies should look into developing more older adult–friendly digital spaces and technology design to encourage continued digital adoption in older adults and, eventually, impact health-related outcomes.

Impact of a culturally adapted digital literacy intervention on older people and its relationship with health literacy, quality of life, and well-being

“…7, 81). At the same time, the digitalization of aging societies has generated a digital divide between older people (OP) and other age groups, a phenomenon that has been studied in various studies ( Roque and Boot, 2016 ; Cardozo et al, 2017 ; Pontificia Universidad Católica de Chile y Caja de Compensación Los Andes, 2019 ; Sunkel and Ullmann, 2019 ; Ngiam et al, 2022 ).…”

“…Most studies on DL in OP come from developed countries, showing a preponderance of female participants, ranging in age from 55 to over 70 years, and the number of participants ranging from 39 to more than 100 ( Ferreira et al, 2014 ; Chiu et al, 2016 ; Hasan and Linger, 2016 ; Castilla et al, 2018 ; Jimena, 2020 ; Lee et al, 2022 ; Ngiam et al, 2022 ; Sriwisathiyakun and Dhamanitayakul, 2022 ). Key components for program effectiveness are identified, such as theoretical underpinning, clear and measurable objectives, and preference for multifaceted interventions ( Mirmohammadkhani et al, 2020 ; Pourrazavi et al, 2020 ; Stormacq et al, 2020 ).…”

“…DL sessions range from 6 to 8, with durations of 1 to 2 h, and are held in collective and individual formats. Personalized, volunteer-developed interventions that combine synchronous and asynchronous formats show better results, allowing PMs to progress at their own pace ( Ferreira et al, 2014 ; Jimena, 2020 ; Ghorbanian and Nikou, 2021 ; Arellano-Rojas et al, 2022 ; Ghorbanian et al, 2022 ; Kanakaris and Pavlis, 2022 ; Ngiam et al, 2022 ). Contents include use of social networks, personal development, self-sufficiency, and skills for searching for information and collaborative work online ( Hasan and Linger, 2016 ; Castilla et al, 2018 ; Jimena, 2020 ).…”

“…These DL programs focused on OP make it possible to reduce the digital divide ( Valenzuela et al, 2022 ) as they increase their technological knowledge ( Ma et al, 2020 ), significantly improve digital literacy scores in the intervention group compared to controls ( Ngiam et al, 2022 ), contributing to the digital divide ( Valenzuela et al, 2022 ). with the development of skills and use of devices such as mobile phones ( Lee et al, 2022 ), digital tools for the detection of fake news, and quality information ( Moore and Hancock, 2022 ).…”

“…Considering the definition of subjective well-being as people’s evaluations of their own life, which can be judgments, such as life satisfaction (cognitive), feeling-based evaluations, including moods and emotions (emotional) ( Pavot and Diener, 1993 ; Diener and Suh, 1997 ); regarding these components of psychosocial health of older people, digital skills deficits and poor understanding of health messages are related to adverse effects on well-being ( Stormacq et al, 2020 ). Generally, OP who master new technologies have a good level of psychological well-being due to the feeling generated by being able to achieve it, which helps to improve their position in the eyes of their family and even in society ( Hasan and Linger, 2016 ; Cardozo et al, 2017 ; Shi et al, 2021 ; Sobral and Sobral, 2021 ; Sriwisathiyakun and Dhamanitayakul, 2022 ; Aggar et al, 2023 ), in contrast, the secondary outcomes of Ngiam et al (2022) included improvements, however, they were not statistically significant in the personal well-being score ( Ngiam et al, 2022 ). In turn, Hasan and Linger (2016) report that the increase in digital skills increases social well-being in the dimensions of social participation and involvement, occupation, control over daily life and dignity.…”