Barriers to and Facilitators of Older People’s Engagement With Web-Based Services: Qualitative Study of Adults Aged >75 Years (Preprint)

Abstract

BACKGROUND Background: The COVID-19 pandemic has accelerated the shift towards digital provision of many services, including health and social care, public, financial and leisure services. COVID-19 services (test appointments and results, vaccination appointments etc.) were provided digital-first to the public. Many social, cultural, and economic activities, (appointments, ticket bookings, tax and utility payments, shopping etc.) have transitioned to online platforms. To use digitalised services individuals must be digitally included. This is influenced by three main factors: access, (whether individuals have access to internet); ability, (having requisite skills and confidence to participate online); and affordability, (ability to pay for infrastructure (equipment) and data packages). Many older adults, especially those aged 75+years, are still digitally excluded. OBJECTIVE To explore the views of adults aged 75+ on using digital technologies to access public services. METHODS We conducted semi-structured qualitative interviews with adults aged 75 years and above resident in Greater Manchester. Two distinct groups of older adults were recruited (1) those who were participating (to varying degrees) in digital activities and/or enrolled on a learning and support programme; (2) those who were not engaged digitally. We also interviewed community support workers. Thematic analysis was used to identify the key themes from the data. RESULTS Overall 24 older adults participated (mean age=81, 14 women, 23 White British, 18 digitally engaged) and 2 support workers. Six themes were identified as key in understanding issues around motivation, engagement, and participation; 1) ‘Initial motivation to participate digitally’; e.g. maintaining social connections and gaining skills to be able to connect with family and friends, 2) ‘Public services and freedom of choice’; in particular, little interaction with online public services apart from prescription ordering 3) ‘Narrow use and restriction of activity online’; undertaking limited tasks online and in a modified manner, e.g. checking but never transferring funds during online banking, 4) ‘Impact of digital participation on well-being’; choosing to go to the shops or GP surgery to get out of the house and get some exercise, 5) ‘The last generation?’, respondents feeling there were generational barriers to adapting to new technology and change 6) ‘Making digital accessible’; understanding the support needed to keep those engaged online. CONCLUSIONS The views of older people must be included as we move to greater digitalisation of services if we are not to exclude them from services for which they have great need.