Older Veteran Digital Disparities: Examining the Potential for Solutions Within Social Networks

Luger, Tana M.; Hogan, Timothy P.; Richardson, Lorilei; Cioffari-Bailiff, Lisa; Harvey, Kimberly; Houston, Thomas K.

doi:10.2196/jmir.6385

Cited by 23 publications

(16 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, among groups with historically less Internet access, the digital divide is shrinking. Whereas 44.0% of a sample of 266 veterans aged 65 years and older reported not having access to the Internet at home, nearly 50% had at least one close social tie whom they could ask to use a device, and 70% had at least one social tie whom they would ask for help accessing the Internet [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Pain Self-Management for Veterans: Development and Pilot Test of a Stage-Based Mobile-Optimized Intervention

Johnson¹,

Levesque²,

Broderick³

et al. 2017

JMIR Med Inform

View full text Add to dashboard Cite

BackgroundChronic pain is a significant public health burden affecting more Americans than cardiovascular disease, diabetes, and cancer combined. Veterans are disproportionately affected by chronic pain. Among previously deployed soldiers and veterans, the prevalence of chronic pain is estimated between 44% and 60%.ObjectiveThe objective of this research was to develop and pilot-test Health eRide: Your Journey to Managing Pain, a mobile pain self-management program for chronic musculoskeletal pain for veterans. Based on the transtheoretical model of behavior change, the intervention is tailored to veterans’ stage of change for adopting healthy strategies for pain self-management and their preferred strategies. It also addresses stress management and healthy sleep, two components of promising integrated treatments for veterans with pain and co-occurring conditions, including posttraumatic stress disorder (PTSD) and traumatic brain injury. In addition, Health eRide leverages gaming principles, text messaging (short message service, SMS), and social networking to increase engagement and retention.MethodsPilot test participants were 69 veterans recruited in-person and by mail at a Veterans Health Administration facility, by community outreach, and by a Web-based survey company. Participants completed a mobile-delivered baseline assessment and Health eRide intervention session. During the next 30 days, they had access to a Personal Activity Center with additional stage-matched activities and information and had the option of receiving tailored text messages. Pre-post assessments, administered at baseline and the 30-day follow-up, included measures of pain, pain impact, use of pain self-management strategies, PTSD, and percentage in the Action or Maintenance stage for adopting pain self-management, managing stress, and practicing healthy sleep habits. Global impressions of change and program acceptability and usability were also assessed at follow-up.ResultsAmong the 44 veterans who completed the 30-day post assessment, there were statistically significant pre-post reductions in pain (P<.001) and pain impact (P<.001); there was some reduction in symptoms of PTSD (P=.05). There were significant pre-post increases in the percentage of participants in the Action or Maintenance stage for adopting pain self-management (P=.01) and for managing stress (P<.001) but not for practicing healthy sleep habits (P=.11). The global impressions of change measure showed that a majority had experienced some level of improvement. User ratings of acceptability were quite high; ratings of usability fell slightly below the mean for digital programs.ConclusionsPreliminary data demonstrate the potential impact of the Health eRide program for chronic musculoskeletal pain for veterans. The results underscore that simultaneously addressing other behaviors may be a promising approach to managing pain and comorbid conditions. Additional formative research is required to complete development of the Health eRide program and to address areas of usabil...

show abstract

Section: Introductionmentioning

confidence: 99%

Pain Self-Management for Veterans: Development and Pilot Test of a Stage-Based Mobile-Optimized Intervention

Johnson¹,

Levesque²,

Broderick³

et al. 2017

JMIR Med Inform

View full text Add to dashboard Cite

show abstract

“…[22][23][24] Yet, little attention has been given to older veterans' attitudes toward technology. Another study 25 found that 17.6% and 56% of older veterans had access to smartphones and home Internet, respectively. 24 However, older veterans had lower rates of smartphone ownership (32% vs 56%) and more difficulties using technology compared with younger veterans.…”

mentioning

confidence: 99%

Technology use and preferences for mental health self‐management interventions among older veterans

Gould

Loup

Kuhn

et al. 2019

Int J Geriat Psychiatry

View full text Add to dashboard Cite

Objectives: The United States Department of Veterans Affairs offers numerous technology-delivered interventions to self-manage mental health problems. It is unknown, however, what barriers older military veterans face to using these technologies and how willing they would be to use technologies for mental health concerns.Methods: Seventy-seven veterans (M age = 69.16 years; SD = 7.10) completed interviews in a concurrent mixed methods study. Interviewers asked about technology ownership and described four modalities of delivering self-management interventions: printed materials, DVDs, Internet, and mobile apps. Interviewers obtained feedback about each modality's benefits, barriers, and facilitators. Participants ranked their self-management modalities preferences alone and compared with counseling.Multivariable adjusted logistic regression and qualitative analyses were conducted to investigate the reasons contributing to preferences.Results: Most reported owning a computer (84.4%), having home Internet (80.5%), and a smartphone (70.1%). Participants preferred printed materials (35.1%) over mobile apps (28.6%), Internet (24.7%), and DVDs (13.0%). Lower computer proficiency was associated with preferring DVDs; higher proficiency was associated with Internet and mobile interventions. Residing in an urban area was associated with mobile apps. When counseling was an option, 66% identified this as their first preference. Qualitative findings showed veterans' desire for information, training, and provider support with technology.Conclusions: Older veterans reported high technology ownership rates but varied preferences for self-management interventions. Notably, two-thirds preferred some form of technology, which points to the importance of ensuring that providers offer existing technology-delivered interventions to older veterans. Veterans' strong preference for counseling emphasizes the need for human support alongside selfmanagement.

show abstract

“…2 Moreover, many older Veterans have chosen telephone visits due to limited access to home internet and/or smartphones. 9 Finally, the substantial increase in encounters done by the primary care team highlight an important role of team-based care. While encounters with the primary care team may not substitute for a visit with a primary care provider, these visits may provide necessary communication to respond to patient questions around the pandemic.…”

Section: Discussionmentioning

confidence: 99%

A rapid mobilization of ‘virtual’ primary care services in response to COVID-19 at Veterans Health Administration

et al. 2020

View full text Add to dashboard Cite

Older Veteran Digital Disparities: Examining the Potential for Solutions Within Social Networks

Cited by 23 publications

References 40 publications

Pain Self-Management for Veterans: Development and Pilot Test of a Stage-Based Mobile-Optimized Intervention

Pain Self-Management for Veterans: Development and Pilot Test of a Stage-Based Mobile-Optimized Intervention

Technology use and preferences for mental health self‐management interventions among older veterans

A rapid mobilization of ‘virtual’ primary care services in response to COVID-19 at Veterans Health Administration

Contact Info

Product

Resources

About