COVID-19 raises a health and human rights imperative to advance a UN Convention on the Rights of Older Persons
Abstract: The COVID-19 pandemic has revealed the inequitable health harms and human rights violations faced by older persons, raising a need to support healthy ageing policy as a human rights imperative. However, international human rights law has long neglected the health-related human rights of older persons. Drawing from evolving advocacy efforts to advance the rights of older persons through the United Nations (UN), tentative initial steps have been taken at the regional level, with states in the Americas codifying … Show more
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Background Digital technologies facilitate everyday life, social connectedness, aging at home, well-being, and dignified care. However, older adults are disproportionately excluded from these benefits. Equal digital opportunities, access, and meaningful engagement require an understanding of older adults’ experience across different stages of the technological engagement life cycle from nonuse and initial adoption to sustained use, factors influencing their decisions, and how the experience changes over time. Objective Our objectives were to identify the extent and breadth of existing literature on older adults’ perspective on digital engagement and summarize the barriers to and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement. Methods We used the Arksey and O’Malley framework for the scoping review process. We searched MEDLINE, PsycINFO, CINAHL, Web of Science, and ACM digital library for primary studies published between 2005 and 2021. The inclusion and exclusion criteria were developed based on the Joanna Briggs Institute (participants, content, and context) framework. Studies that investigated the digital engagement experience as well as barriers to and facilitators of older adults’ digital technology engagement were included. The characteristics of the study, types of digital technology, and digital engagement levels were analyzed descriptively. Content analysis was used to generate tentative elements using a congruent theme, and barriers and facilitators were mapped over the capability, opportunity, and motivation behavior change model (COM-B) and the theoretical domain framework. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Results In total, 96 publications were eligible for the final charting and synthesis. Most of the studies were published over the past 5 years, investigated the initial adoption stage of digital engagement, and focused on everyday technologies. The most cited barriers and facilitators across the engagement stages from each COM-B component were capability (eg, physical and psychological changes and lack of skill), opportunity (eg, technological features, environmental context, and resources), and motivation (eg, optimism from perceived usefulness and beliefs about capability). Conclusions The COM-B model and theoretical domain framework provide a guide for identifying multiple and intertwined barriers and facilitators at each stage of digital engagement. There are limited studies looking into the whole spectrum of older adults’ digital technology experience; in particular, studies on technological nonuse and sustained use stages are rare. Future research and practice should focus on tailored interventions accounting for the barriers to older adults’ digital engagement and addressing capabilities, motivation, and opportunities; affordable, usable, and useful digital technologies, which address the changes and capability requirements of older adults and are cocreated with a value framework; and lifelong learning and empowerment to develop older adults’ knowledge and skills to cope with digital technology development. International Registered Report Identifier (IRRID) RR2-10.2196/25616
Background Digital technologies facilitate everyday life, social connectedness, aging at home, well-being, and dignified care. However, older adults are disproportionately excluded from these benefits. Equal digital opportunities, access, and meaningful engagement require an understanding of older adults’ experience across different stages of the technological engagement life cycle from nonuse and initial adoption to sustained use, factors influencing their decisions, and how the experience changes over time. Objective Our objectives were to identify the extent and breadth of existing literature on older adults’ perspective on digital engagement and summarize the barriers to and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement. Methods We used the Arksey and O’Malley framework for the scoping review process. We searched MEDLINE, PsycINFO, CINAHL, Web of Science, and ACM digital library for primary studies published between 2005 and 2021. The inclusion and exclusion criteria were developed based on the Joanna Briggs Institute (participants, content, and context) framework. Studies that investigated the digital engagement experience as well as barriers to and facilitators of older adults’ digital technology engagement were included. The characteristics of the study, types of digital technology, and digital engagement levels were analyzed descriptively. Content analysis was used to generate tentative elements using a congruent theme, and barriers and facilitators were mapped over the capability, opportunity, and motivation behavior change model (COM-B) and the theoretical domain framework. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Results In total, 96 publications were eligible for the final charting and synthesis. Most of the studies were published over the past 5 years, investigated the initial adoption stage of digital engagement, and focused on everyday technologies. The most cited barriers and facilitators across the engagement stages from each COM-B component were capability (eg, physical and psychological changes and lack of skill), opportunity (eg, technological features, environmental context, and resources), and motivation (eg, optimism from perceived usefulness and beliefs about capability). Conclusions The COM-B model and theoretical domain framework provide a guide for identifying multiple and intertwined barriers and facilitators at each stage of digital engagement. There are limited studies looking into the whole spectrum of older adults’ digital technology experience; in particular, studies on technological nonuse and sustained use stages are rare. Future research and practice should focus on tailored interventions accounting for the barriers to older adults’ digital engagement and addressing capabilities, motivation, and opportunities; affordable, usable, and useful digital technologies, which address the changes and capability requirements of older adults and are cocreated with a value framework; and lifelong learning and empowerment to develop older adults’ knowledge and skills to cope with digital technology development. International Registered Report Identifier (IRRID) RR2-10.2196/25616
BACKGROUND Digital technologies supports everyday living, wellbeing, advanced and dignified care, and ageing at home. However, the digital divide between ages excludes older people (65 years and above) from these benefits. This divide is a proxy reflection of existing social, cultural, and economic inequalities. The 2021 United Nations (UN) international day of older person underscored equal digital opportunities, access, and meaningful participation for older people with the theme “digital equity for all ages”. OBJECTIVE In this scoping review we aim to a) identify the extent and breadth of existing literature of older people perspective on digital engagement; and b) summarize the barriers and facilitators for technological non-use, initial adoption and sustained digital technology engagement. METHODS We used the Arksey and O’Malley framework for scoping reviews. A combination of search strategy was developed based on Joanna Briggs Institute (JBI) guideline - participant, content, and context. We searched for published primary studies on the major electronic databases including MEDLINE, PsycINFO, CINAHL, Web of Sciences, LISTA, and Association of Computing Machinery (ACM). We conducted a two staged screening (title/abstract and full article) and charted studies that fulfilled the inclusion criteria. The characteristics of the study, types of digital technology under investigation and digital engagement level were analysed using a descriptive analysis. We synthesised the findings from the primary studies qualitatively using the capability, opportunity, and motivation behavioural model (COM-B) and theoretical domain framework (TDF), a structured, systematic, and replicable a priori framework, to ground the barriers to and facilitators of older people digital engagement. RESULTS 96 articles were found eligible for the final charting and analysis. Most of the articles (63.5%) were published over the past five years (2016 onward). Majority of the studies (57/96) investigated the initial adoption stage of the digital engagement, and 54/96 studies were on everyday technology. Information and communication technologies, fall detection devices and remote monitoring technology were the most investigated technologies. Environmental context and resources were the most cited (37 times) barriers and facilitators followed by beliefs about capabilities (29/96) and physical and cognitive related capabilities (26/96). CONCLUSIONS Older people's digital engagement can be conceptualised in a three-staged continuum (non-use, initial adoption and sustained use). Affordable, usable and useful digital technologies, which address the changes and capability requirements of older people and co-created with a value framework, are among the drivers of better engagement. In addition, knowledge and skills to cope with digital technology were important factors. Tailored and comprehensive intervention addressing older people's capabilities, motivation and opportunities is vital in rendering older people digital participation. There is a research gap concerning the barriers and facilitators of older people's technological non-use and sustained digital engagement. Future research and developers may need to look into this process. INTERNATIONAL REGISTERED REPORT RR2-10.2196/25616
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