Impact of Computer Use on Attitude Toward High Technology Among Community-Dwelling Frail Elders

1. Impact of Computer Use on Attitude Toward High Technology Among Community-Dwelling Frail Elders University at Buffalo Machiko R. Tomita, Ph.D. Kathy Stanton, MS, RN Linda Russ, MS, OTR/L Jun-Yuan Tung, MS, OTR William C. Mann, Ph.D. OTR/L

2. Home-Based Frail Elders Using a PC

3. Introduction • Currently, in the US, there are 35 million older adults aged 65 years and over. • In 2001, 28.4% of them had a computer at home and 12.8% had an Internet connection. • Computer technology with the Internet have a tremendous potential to broaden the lives and increase the independence of people with disabilities (Kaye,2000 USDE)

4. Benefits of Computer UseAmong Older Adults • Provides information about geriatric health information to older adults and their caregivers (Madan & Bodagh, 2002). • Enhances their self-esteem, meets needs for fun and mental stimulation, improves competencies and autonomy, and increases social interaction (Hendrix, 2000) • Decreases level of depression and loneliness, and stress (Billipp, 2001).

5. Barriers to Use of Computers • People with disabilities, those with low income and education, black people with disabilities and the Hispanic population have less chance to access computer w/Internet (Kaye, 2000; Newburger, 2001) . • Web sites are too complex (Vastag 2001).

6. Purpose of this study Most high end communication and health related technology are computer based or require knowledge and skills similar to computer use. Therefore, if elders use a computer, they may be more open to potentially useful high tech devices to maintain their independence. • The aim of this study was to identify impact of computer use on attitude toward high technology among community-dwelling frail elders.

7. Major Research Questions • Does computer use form a positive attitude toward high tech devices: computers, cell phones, smart phones, Personal Digital Assistants (PDA), Personal Emergency Response Systems (PERS), home health monitoring systems and automated houses?

8. Specific Research Questions • What are important predictors of a positive attitude (comfort and willingness to try out) toward the technology among demographic predictors in addition to levels of computer use (nonuse, low and high use)? Do differences exist between computer users and non-users regarding willingness to own and use each high tech device and their perception of benefit from using?

9. Methods - Sampling • A purposive sampling identified 102 community-dwelling elderly with various disabilities among whom 56 were computer users and 46 were non computer users. • Many computer users were study participants in other studies on home monitoring systems in that computers and computer training were previously given.

10. Methods - Procedure • Prior to phone surveys, a 14-page color brochure including photos and descriptions of features of seven types of technology was mailed to study participants. • A phone interview took about 45 minutes, and for persons with mild cognitive impairments, face-to-face interviews were conducted. • The 60-page questionnaire consisted of ten sections that gathered information on background characteristics of participants, seven high tech devices, and wrap-up questions.

11. Methods - Analytical Scheme • To identify important predictors for positive vs. negative attitudes toward high technology in general • Logistic Regression • To discern the attitude for each type of technology • Chi-Squares

12. Background Information Total of 102 participants • 82% Female 18% Male • 81% White 19% Black • 75% Live alone 25% Live with someone • 64% Own house 36% Rent • $1,760 is the mean income • 53% Tire easily that affected activity • 52% Joint problem that affected activity • 42% Back problem that affected activity • 35% Muscular weakness that affect activity

13. Difficulty in Activities • 75% Climbing stairs • 56% Shopping • 54% Walking • 50% Doing housework • 42% Bending, Driving • 41% Getting out of chairs • 22% Writing

14. Computer

15. Computer Use and Nonuse • 55% (n=56) used a computer and 89% of those used computer with internet connection. They value gathering information and social contact most. • 57% experienced discomfort and 54% had difficulties when working for a long period of time. • Main reason for hesitance of more use was lack of knowledge of a computer. • Main reasons of non- use of a computer were lack of need and cost.

16. Cell Phone

17. Cell Phone Use & Nonuse • 29% used a cell phone and 70% of them were very satisfied. 50% used it for emergencies only. • The main reason of hesitance for more use was cost. • The main reason of non use was cost. 29% were interested in owning a cell phone. • The majority of non-users thought it could help security.

18. Smart Phone, PDA and Home Health Monitoring System

19. No One Had: • Smart phones, PDA, and home health monitoring system. • 16% were interested in owning a smart phone and PDA. • 17% were familiar with home health monitoring system. 31% thought it was beneficial and were interested in owning it.

20. Personal Emergency Response System

21. Personal Emergency Response System • 15% used it and the majority used it 1-3 times mainly for falls. • 45% of nonusers were interested in using PERS. The main reason of nonuse was cost. • The majority of users thought it helped security and the majority of nonusers thought it helped security, eased worries and eases family's worries.

22. Home Automation System

23. Home Automation System • 3 people owned it to make lighting and security system automated. They thought it was very important. • 44% of nonusers thought it was beneficial and were interested in owning it but half of nonusers thought cost would be a problem.

24. Overall Perception of New Technology • Close to 60% of elderly people were comfortable with technological devices and 82% wanted to try out new devices. • 70% thought elderly people will benefit from them. The percentage was not much less than that of children, students, and professionals (75%). • 80% think they were accessible to elderly people but 45% think they were not able to get it because of the cost.

25. Results for RQ 1-A • The only important predictors for a positive attitude toward high technology were the level of computer use and hearing ability while other variables such as age, sex, race, education, marital status, income and living arrangement were not associated with a positive attitude. The odds of having a positive attitude were about nineteen times greater for computer users than non users. • The level of computer use alone classified 82.8% of participants accurately between a positive and a negative attitude toward high technology in general.

26. Difference betweencomputer users and nonusers • How comfortable are you with using technological devices? Users Nonusers Very comfortable39%15% Somewhat 48%9% Neither 7% 39% Uncomfortable 5% 20% Very uncomfortable 0 17% Chi-square = 44.176,p<.001

27. Results for RQ 1-B • The only predictor for willingness to try out new technology was a level of computer use (p=.014) . In comparisons with computer non-users, computer users were three times (OR = 3.2) more likely to try out new technology. • The odds of having a positive attitude were about three times greater for computer users than non users

28. Difference betweencomputer users and nonusers • Are you willing to try out new technological devices? Users Nonusers Yes 91% 72% No 9% 28% Chi-square = 6.495,p =.001

29. Results for RQ 2 • Computer use was a predictor for willingness to own and use almost all new high tech devices (cell phone, a smart phone, a PDA and a home health monitoring system). • The only exception was automated housing system.

30. Difference betweencomputer users and nonusers • Who do you think benefits from technology, “Elderly” ? Users Nonusers Yes 84%52% No 16% 48% Chi-square = 12.038,p =.001

31. Conclusion Among community-based frail elders, the levels of computer use were strongly associated with the attitude toward high tech devices. The more they used a computer, the more favorable and interested in high tech devices they were. Although it may be valid to say that those who were interested in technology used a computer more, another probable explanation is that computer use may form a positive attitude toward high tech devices. Computer use may give them a sense of initial mastery of technology that leads to openness to other high tech devices. It is an acquired attitude. This study indicated that frail older adults are strong potential users of high tech devices.