Correlates of, and barriers to, Internet use among older adults.

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Correlates of, and Barriers to, Internet Use Among Older Adults a

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Janet Chang , Carolyn McAllister & Rosemary McCaslin a

School of Social Work, California State University, San Bernardino, San Bernardino, California, USA Accepted author version posted online: 18 Jun 2014.Published online: 01 Dec 2014.

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Journal of Gerontological Social Work, 58:66–85, 2015 Copyright © Taylor & Francis Group, LLC ISSN: 0163-4372 print/1540-4048 online DOI: 10.1080/01634372.2014.913754

Correlates of, and Barriers to, Internet Use Among Older Adults JANET CHANG, CAROLYN McALLISTER, and ROSEMARY McCASLIN


School of Social Work, California State University, San Bernardino, San Bernardino, California, USA

Older adults constitute the group with the greatest increase in Internet usage in the past decade; however, usage varies greatly within this population. Services to older adults require a current understanding of Internet-use trends. This study utilized a quantitative survey method to examine correlates of, and barriers to, current Internet use in a demographically diverse county in Southern California. Findings indicate that the presence of a computer at home, a job requiring computer use, age, education, and ethnicity are important factors in predicting Internet use in older adults. Implications for social work practice with older adults is discussed. KEYWORDS Internet use in older adults, social work and Internet advocacy, research on Internet use, quantitative

INTRODUCTION Over the past decade, the use of computers and the Internet among older adults dramatically increased in the United States. For example, the Pew Internet and American Life Project found only 22% of adults aged 65 or older used the Internet in 2004 (Fox, 2004), but as of 2011, the proportion increased to 53% (Zickuhr & Madden, 2012). Older adults, like their younger counterparts, use the Internet for communicating with families and friends via e-mail and video communication programs, shopping online, personal banking, blogging, playing games, or other activities (Hilt & Lipschultz, Received 27 November 2013; revised 7 April 2014; accepted 7 April 2014. Address correspondence to Janet Chang, School of Social Work, California State University, San Bernardino, 5500 University Parkway, San Bernadino, CA 92407, USA. E-mail: [email protected] 66


Internet Use Among Older Adults

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2004; Keenen, 2009; Rosenthal, 2008; US Census Bureau, 2012b; Venkatesh, Morris, Davis, & Davis, 2003). They also use the Internet to access healthrelated information or services, obtain answers to health-related issues, fill and refill medications, and communicate with health care providers (Gatto & Tak, 2008; McMillan & Macias, 2008; Taha, Sharit, & Czaja, 2009; Wagner, Hassanein, & Head, 2010). Numerous studies have reported beneficial effects of Internet use for older adults. Sum, Mathews, Hughes, and Campbell (2008) found that older adults who use the Internet as a communication tool were less likely to feel loneliness. Sum, Mathews, and Hughes (2009) also reported that Internet use significantly predicted a sense of well-being and a sense of community in older adults. Similarly, Gatto and Tak (2008) indicated that older adults were able to experience a sense of connectedness and satisfaction by going online for communication and entertainment purposes. Associations between Internet use and self-efficacy have been found by Erickson and Johnson (2011) and Karavidas, Lim, and Katsikas (2005). A large representative sample from the 2004 Health and Retirement Survey indicated that Internet use was associated with increased contacts with family, friends, and attendance in community organizations (Hogeboom, McDermott, Perrin, Osman, & BellEllison, 2010). Heo, Kim, and Won (2011) indicated that older adults who used the Internet were likely to be satisfied with their leisure pursuits and to experience significantly higher scores than non-users for psychological benefits, educational stimulation, social relationship, and relaxation. Cresci, Yarandi, and Morrell (2010) also reported that computer users had better health and a lower number of hospital days compared to non-users. They also indicated that computer users were more likely to use the library, read, and enjoy learning new things compared to non-users. Training may also assist older adults in accessing accurate, up-to-date health information (Xie & Bugg, 2009). Finally, Shapira, Barak, and Gal (2006) reported that even learning how to use computers and the Internet was positively related to the well-being and empowerment of older adults.

Research Showing No Benefits/Disadvantages to Internet Use Other research points to the potential of there being no benefit or actual disadvantages to older adults using the Internet. For example, Dickinson and Gregor (2006) reviewed literature that reported benefits to wellbeing associated with Internet use. Their interpretation was the that studies in question found wellbeing benefits associated with face-to-face teaching and interaction, rather than benefits associated with Internet use specifically. This outcome was also found by Chen and Persson in 2002. Older adults may also experience increased risk for Internet exploitation, particularly in getting misinformation from Internet sources or incurring security breaches, based on


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their limited understanding of and education on the Internet (Grimes, Hough, Mazur, & Signorella, 2010). Finally, although, generally, Internet use does not appear to decrease face-to-face relationships for older adults, one study that generally found benefits to Internet use found it associated with decreased interaction with extended family (Hogeboom et al., 2010). Despite benefits of Internet use for older adults and its tremendous potential for improving the quality of life of older adults, barriers to utilizing the Internet by some older adults still exist. Within some groups of older adults, the majority do not go online at all. These older adults may lose opportunities to obtain health or social service information or use health management tools that exist online. For example, Cresci et al. (2010) indicated that the Internet could be used as a health-related intervention tool where older adults have access to health information and decision-making tools for managing their chronic health conditions. Thus, it is important to understand critical variables currently associated with Internet use among older adults; particularly, to find out who does not use the Internet, and their reasons for not using it. This study assesses the current status of the rapidly changing phenomena of Internet use in older adults and the impacts of Internet use on services and policies of a local Area Agency on Aging.

Age Studies have consistently shown that age is negatively associated with the Internet use; as age increases, use and attitudes toward computers and the Internet tend to become more negative (e.g., Chen & Persson, 2002). This may be related to age-related changes in cognition, physical, and perceptual abilities, including changes in cognitive processing speed, reducing ability to allocate attention efficiently, decreasing spatial abilities, decreasing visual acuity, decreasing hearing acuity, and decreasing motor skills (Charness & Boot, 2009; Czaja et al., 2006; Czaja & Lee, 2007; Echt & Burridge, 2011; Seals, Clanton, Agarwal, Doswell, & Thomas, 2008; Slegers, Van Boxtel, & Jolles, 2009; Wagner et al., 2010). These mental and physical changes have not been taken into account in most hardware and software design, leaving older adults at a potential disadvantage when using these technologies (Charness & Boot, 2009; Seals et al., 2008). The relation between age and Internet use may be, in part, due to changing generational issues related to technology. Adults in their 60s, particularly baby boomers (those born from 1946 on), were found to show rates of computer and Internet use and activities comparable to their younger counterparts (Gilleard & Higgs, 2008; Rainie, 2009). This may be due to the fact that many boomers currently use computers and the Internet at work or continue to use the computer and Internet skills they learned at work into their retirement and old age.


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Education and Income Education has been found to be associated with Internet use in older adults (ex. Broady, Chen, & Caputi, 2010; Carpenter & Buday, 2007; Chen & Perssons, 2002; Czaja et al., 2006; Echt & Burridge, 2011; Fox, 2004; Werner, Carlson, Jordan-Marsh & Clark, 2011). Older adults with higher levels of education were more likely to use the Internet than those with lower levels of education. Income has also been found to be associated with Internet use among older adults. According to the Pew Internet Project, adults who earned $30,000 or lower were less likely to use the Internet than those who earned more than $30,000 (Zickuhr & Smith, 2012). Cresci et al., (2010) also found in their representative sample of residents in Detroit that non-Internet users tended to have lower levels of income and education, be older, retired, and less active than computer and Internet users. In some studies using regression models, however, income was not significant when controlling for education (Carpenter & Boday, 2007; Czaja et al., 2006; Werner et al., 2011), although other studies have found it to remain an independent factor (e.g., Cutler, Hendricks, & Guyer, 2003).

Ethnicity and Language Research on Internet use has found the digital divide based on reported race/ethnicity to be declining overall (Lopez, Gonzalez-Barrera, & Patten, 2013; US Census Bureau, 2012a). However, differences based on race/ethnicity within the older adult population are still reported. In a number of studies, African American and Hispanic/Latino older adults reported lower use of the Internet (Cutler, Hendricks, & Guyer, 2003; Czaja et al., 2006; Lopez et al., 2013; US Census Bureau, 2012a; Werner et al., 2011). English language proficiency has been found to have a stronger association with Internet use than ethnicity. For example, the use of Spanish as a primary language leads to a significant decrease in Internet use in all age groups, and in older adult groups most of all (Lopez et al., 2013).

Marital Status/Household Arrangements Marital status and living arrangement were found to be related to Internet use in older adults; married older adults and those who are living with someone else were more likely to use the Internet than single older adults, widows, or those living alone (Cutler et al., 2003; Selwyn, Gorad, Furlong, & Madden, 2003; White et al., 2002). A spouse or a family member who uses the Internet is likely to encourage or teach older adults in the household to use it. Adult child(ren) also are apt to teach their parents how to use the Internet.

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Access, Knowledge, and Training A separate factor examined in several studies is access to the Internet. Cutler and colleagues (2003) found that having access to a computer reduced the impact of other demographics associated with lack of Internet use. Many rural areas only offer slow dial-up connections to the Internet, impacting access (Hale, Cotton, Drentia, & Goldner, 2010). Another barrier to the use of Internet among older adults was a lack of training opportunities for learning how to use computers and the Internet in work places (Githens, 2007). Persons in managerial positions often do not see older workers as capable of learning new technologies such as computers and the Internet. After retirement, such workers may lack affinity and motivation to learn how to use computers. Also, human service providers’ negative perceptions and stereotypes about older adults’ use of technology can be a barrier to their Internet use as they may not encourage older adults to learn those skills (Githens, 2007).

Perceived Benefits of Internet Use/Lack of Interest When older adults who have chosen not to use the Internet have been asked about that decision, a primary reason reported is that they do not perceive a benefit to use, or are not interested in use. Melenhorst, Rogers, and Bouwhuis (2006) conducted focus groups with older adults who did and did not use the Internet. Non-Internet users cited a lack of potential benefits from Internet use and the potential challenges of use. Carpenter and Boday (2007) found the majority of non-Internet users had no interest in use. Wagner et al.’s (2010) review of the literature on Internet use in older adults found lack of perceived benefit to be a major factor.

Psychological Barriers Older adults’ frustration, when learning how to use computers and the Internet, have been found to be a barrier to Internet use. Jung et al. (2010) found in their study of minority immigrant elders in Los Angeles that computer anxiety and aging anxiety were strong predictors of the decision not to take a computer training class at senior citizen centers. Gatto and Tak (2008) found that older adults reported barriers such as frustration at the length of time it took to learn computer skills and practice lessons at home to learning how to use computers and the Internet. Other studies that have found psychological barriers such as computer-related anxiety and frustration impacting Internet use include Czaja and colleagues (2006), Chu, Huber, Mastel-Smith, and Cesario (2010), Karavidas and colleagues (2005), and Rosenthal (2008).


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This study, completed within a geographically, ethnically, and economically diverse county in Southern California, provides information on current Internet use and barriers to use in older adults that are 60 years or older. It also provided information to help consider the ways that social workers should be mindful of the impacts of the Internet in working with older adult populations.


METHODS The study collected data from 567 persons, who were aged 60 years or older, residing in a large, diverse county in Southern California. The study employed a survey design using self-administered written questionnaires. As a service learning project, a social work undergraduate class at a public university collaborated with the county Department of Adult and Aging Services to assess the prevalence and predictors of Internet use among older adults. A convenience sample was employed, and Bachelor-level social work students who were taking a research class recruited study participants from various locations including senior citizen centers, community agencies, churches, and supermarkets. Data were collected from April through June, 2012. The study was approved by the Institutional Review Board of the affiliated school.

Instrument Participants were asked about their Internet use, frequency of Internet use, level of comfort in using the Internet, Internet activities, and need for training or assistance on using the Internet. The status of Internet use was measured by asking participants whether they currently use the Internet with a yes or no response. Participants who responded in the affirmative were asked of the frequency of Internet use, with daily, weekly, once a month, a few times a year, and rarely/never responses. These participants were also asked about their comfort level in using the Internet, with response options including very comfortable, comfortable, uncomfortable, and very uncomfortable. Internet activities were measured by asking participants, “For what purposes do you use the Internet?” Response options for the question included e-mail, online banking, online shopping, obtaining health information, making phone calls, obtaining information about services and programs for older adults, playing games, blogging, getting news and weather information, and other. Non-Internet-using participants in the study were asked about their perceived barriers to using the Internet with response options: Do not have access to the Internet, do not know how to use the Internet (lack of knowledge), physical limitations (e.g., disability), mistrust of the Internet due to privacy issues, too addictive, too time consuming, fear of using the Internet,

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language concerns, cannot afford the costs of using the Internet, and other. Participants were also asked whether they needed assistance or training in using the Internet, with yes and no responses. Demographics included gender, age, ethnicity, education, income, and marital status.

Analysis


Descriptive statistics, including frequency distributions, measures of central tendency (i.e., mean), and variability (i.e., standard deviation), were used to summarize and describe the demographic and other variables. Bivariate statistics (i.e., chi-squared tests) were used to assess associations between the status of Internet use and other variables. Logistic regression was used to determine which independent variables were predictors of current Internet use among the participants.

RESULTS Nearly 58% of the participants were women. Their ages ranged from 60 years to 100 years old, with an average age of 69.5 years (SD = 7.8). Over half (56%) of the participants were between the ages of 60 and 69. Over 54% of the participants were White, 28% were Latino, 11% were African American, 3% were Asian Pacific Islander, 3% were Native American, and 4% were of other ethnicities. The gender, age breakdown, and race/ ethnicity of the sample closely approximates the 2010 US Census data for the particular Southern California county (US Census Bureau, 2010). Nearly 46% were married, 24% were widowed, 19% were divorced, 10% were never married, and 2% were in a long-term relationship. Almost half (46%) reported that their family income was between $20,000 and $49,999, with the rest divided between higher and lower income groups. Nearly 28% of the participants completed high school, 30% received some college education, 16% graduated from college, and 12% completed graduate or professional school. Only 14% received less than high school education. (See Table 1.) When participants were asked whether they were currently using the Internet (Table 2), over 58% said yes. However, nearly two- thirds of the participants (64%) indicated that they had access to the Internet at home. Of the Internet users, over two-thirds (67%) stated that they used the Internet daily, 23%, weekly, and the rest (10%), once a month or less. The great majority of the Internet users (82%) reported that they primarily used the Internet at home. The great majority of the Internet users (90%) indicated that they accessed the Internet via computer, with a small number using tablets, smart phones, or other devices. Of the Internet users, over 85% indicated that they were either very comfortable or comfortable using the Internet.

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Internet Use Among Older Adults TABLE 1 Demographic Characteristics of Respondents


Variable Gender Female Male Age 60–69 70–79 80–89 90–99 Ethnicity White African American Latino American Asian Pacific American Other Education Less than high school High school Some college College graduate Graduate or professional school Marital status Never married Married Divorced Widowed In a long-term relationship Income Less than $9.999 $10,000–$19,999 $20,000–$29,999 $30,000–$39,999 $40,000–$49,000 $50,000 or higher

Frequency (n)

Percentage (%)

317 234

57.5 42.5

319 142 70 36

56.3 25.0 12.3 6.3

296 59 155 18 22

53.8 10.7 28.2 3.3 4.0

78 153 162 85 66

14.3 28.1 29.8 15.6 12.1

55 246 99 126 10

10.3 45.9 18.5 23.5 1.9

45 85 84 77 57 125

9.5 18.0 17.8 16.3 12.1 26.4

As expected, there was an association between the frequency of Internet use and a sense of comfort among the participants (x2 = 127.40, df = 12, p = .000). The more frequently participants used the Internet (e.g., daily), the more likely they were to feel comfortable using it. When asked how they learned to use the Internet, over one-third (36%) reported that they they were taught by family members; 25% learned at workplace and another 25% were self-taught. In terms of Internet activities, over 82% used the Internet for e-mail, 61% for communicating with family and friends, 52% for online banking and paying bills, 51% for getting news and weather information, 47% for obtaining health information, 43% for online shopping, 38% for playing games, 29% for entertainment (e.g., watching TV or movies),

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TABLE 2 Respondents’ Internet Use Activities


Variable Do you currently use the Internet? Yes No Frequency of Internet use Daily Weekly Once a month A few times a year Rarely/never Primary place for Internet use Home Work Library Family/friends’ house Level of comfort when using the Internet Very comfortable Comfortable Uncomfortable Very uncomfortable How did you learn to use the Internet? Family members Workplace Self Friends Class Other

Frequency (n)

Percentage (%)

329 236

58.2 41.8

223 76 20 6 7

67.2 22.9 6.0 1.8 2.1

242 24 19 11

81.8 8.1 6.4 3.7

129 154 43 6

38.9 46.4 13.0 1.8

98 68 67 18 15 7

35.9 24.9 24.5 6.6 5.5 2.6

22% for obtaining information about services and programs for older adults, 18% for other purposes, 9% for making phone calls, and 6% for blogging. When the non-Internet users in the study were asked about their perceived barriers to using the Internet (Table 3), nearly 64% indicated that they did not know how to use it. Approximately 49% of the non-Internet users reported that they did not have access to the Internet, followed by mistrust of the Internet (e.g., privacy violations, 25%), cost of using the Internet (24%), fear of using the Internet (15%), physical limitations (e.g., needing adaptive equipment, 13%), too much time consumption (14%), language concerns (e.g., lack of English skills, 11%), and other concerns (10%). However, nearly three-quarters of the non-Internet users (74%) indicated that they did not feel that they missed out on important information by not using the Internet. Similarly, the great majority of the non-Internet users (78%) indicated that they had never felt that an agency or service forced them to have access to the Internet. Overall, 62% of Internet users and 51% of non-Internet users reported that they did not feel they needed training or assistance for the use of computer and Internet.

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Internet Use Among Older Adults TABLE 3 Non-Internet Users’ Perceived Barriers to Internet Use Variable Reasons for not using the Internet Do not know how to use the Internet Do not have access to the Internet Mistrust of the Internet Cannot afford the cost of using the Internet Fear of using the Internet Too time consuming Physical limitation (e.g., needing adaptive equipment) Language concern Other Too addictive (e.g., habit forming)

Frequency (n)

Percentage (%)

145 112 57 55 35 32 29 25 22 16

63.9 49.3 25.1 24.2 15.4 14.1 12.8 11.0 9.7 7.0


Note. N = 227.

Bivariate Analyses Bivariate analyses (Table 4) showed that there was an association between current status of Internet use and age, education, income, marital status, access at home, having a job requiring use, and ethnicity. However, there was no gender difference in Internet use. Internet users were likely to be younger, to have more education, to have higher levels of income, to be married, to have access to the Internet at home, and to have had a job requiring Internet use. There was also a difference in Internet use by ethnicity; only 45.2% of Latinos used the Internet, but 64.5% of the non-Latinos did so.

Logistic Regression A logistic regression analysis (Table 5) was conducted to determine which independent variables were predictors of current Internet use among the participants. Included in the regression were all the variables that were significantly associated with the status of Internet use in the bivariate analyses. The results of the logistic analysis revealed that all of those variables, except income and marital status, were statistically significant in predicting the status of current Internet use. The largest predictor was Internet access at home, rendering participants 20.6 times more likely to use the Internet than those who did not. Those who had had a job requiring Internet use were 6.3 times more likely to use it currently. Participants who were in their 60s were 2.7 times more likely to use the Internet than those who were in their 70s or older, and those with a college education or higher were 2.4 times more likely to be users. Non-Latino participants were 3.1 times more likely to use the Internet than Latino participants.

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TABLE 4 Bivariate Analyses Between Internet Use and Independent Variables Internet Use Yes


Variable Age 60–69 70–79 80–89 90–100 Education Less than high school High school Some college College graduate Graduate or professional school Income Less than $19,999 $20,000–$39,999 $40,000–$49,999 $50,000 or higher Marital status Never married Married Divorced Widowed In a relationship Having had a job requiring Internet use Yes No Access to Internet at home Yes No Ethnicity (Being Latino) Yes No ∗∗∗

No

N

%

225 65 26 13

70.5 45.8 37.1 38.2

94 77 44 21

29.5 54.2 62.9 61.8

15 68 111 70 56

19.2 44.4 68.5 82.4 84.8

63 85 51 15 10

80.3 55.6 31.5 17.6 15.2

50 90 36 106

38.5 55.9 63.2 84.8

80 71 21 19

61.5 44.1 36.8 15.2

23 167 62 58 6

41.8 67.9 62.6 46.0 60.0

32 79 37 68 4

58.2 32.1 37.4 54. 40.0

277 145

87.6 42.5

25 196

12.4 57.5

291 32

82.7 16.4

61 163

17.3 83.6

70 240

45.2 64.5

85 132

54.8 35.5

N

%

Chi-square 49.295∗∗∗

107.712∗∗∗

61.05∗∗∗

24.036∗∗∗

106.916∗∗∗

p < .001.

DISCUSSION Consistent with Internet use in older adults increasing in recent years, this study found that more than a half of participants used the Internet (US Census Bureau, 2012a; Zickuhr & Madden, 2012). The logistic regression results revealed that access to the Internet at home was the most significant predictor of Internet use. It is not surprising to see that non-Internet users also cited the lack of access to the Internet as a frequent barrier to Internet use. The issue of lack of access to the Internet is apt to be the result of an interaction of multiple factors including cost of a computer and

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Internet Use Among Older Adults TABLE 5 Logistic Regression Results on Internet Use Variable Age 60–691 Education College or higher2 In-home computer Presence of computer at home3 Job requiring computer use Job requiring computer use4 Ethnicity Non-Latino5

B

SE

P

Odds Ratio

.980

.278

.000

2.664

.887

.351

.012

2.427

3.025

.292

.000

20.595

1.838

.335

.000

6.285

1.142

.299

.000

3.134


Note. 1 Reference = 70 years or older. 2 Reference = Some college or lower education. 3 Reference = Not having a computer at home. 4 Reference = Job not requiring computer use. 5 Referernce = Latino.

Internet access, lack of interest and motivation in accessing the Internet, lack of previous experience of using the Internet, lack of computer skills, and lack of family members or friends to teach elders how to use the Internet (Cutler et al., 2003). One way of increasing Internet access is to make computers affordable and available to older adults. As Dorin (2007) suggested, government programs, community-based programs, or computer manufacturers need to offer programs of discounts to make the purchase of computers by older adults affordable and convenient. As expected, Internet use was most prevalent among young old adults (persons between aged 60 and 69) and Internet use rates significantly drop with increasing age, consistent with the findings of other previous studies (e.g., US Census Bureau, 2012a; Zickuhr & Madden, 2012). Those young older adults are likely to have held, or currently hold, a job requiring computer and Internet use, which was found to be a significant factor associated with Internet use, also supported by previous research (e.g., Gilleard & Higgs, 2008; Mesch & Talmud, 2011; Wagner et al., 2010). Higher levels of education also predicted Internet use in this study, as supported by past research (Broady et al., 2010; Carpenter & Buday, 2007; Chen & Perssons, 2002; Czaja et al., 2006; Echt & Burridge, 2011; Fox, 2004; Werner et al., 2011). A study by Mesch and Talmud (2011), although not focused specifically on older adults, found an association between education, type of work, and Internet use. Persons with higher levels of education in their study were more likely to work in an environment requiring computer and Internet use. Therefore, it can be expected that participants in this study with lower levels of education are also not as likely to work with computers at work, reducing their chance of using the Internet at home both now and when they retire. This study found that older Latinos were less likely to use the Internet, compared to those of other ethnicities. Reports from the Pew Internet and American Life Project also indicated that Internet use among Latino adults was lower than that of other adult populations and that such a lower level


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of Internet use among Latino adults can be explained by a combination of several factors, including their lower level of education and limited English abilities (Fox & Livingston, 2007; Lopez et al., 2013). It is reasonable to assume that Latino older adults were also less likely to use the Internet, for the same reasons; many older Latinos were Spanish speaking or limited English speaking, received less than a high school education, and were less likely to have held a job requiring computer and Internet use. Thus, when reaching out to involve Latino elders in a computer training, it seems critical to use ethnic-specific recruitment strategies, emphasizing the benefits of getting in touch with family and friends in their native countries, retrieving information on where they originally came from, or getting information on healthy aging and tips on stretching a limited income (Jung et al., 2010). Rodriguez, Gonzalez, Favela, and Santana (2009) designed and implemented a simple Internet-enabled communication system designed to allow older Latinos to send photos and messages to other family members. Most respondents reported learning how to use the Internet from family members. This indicates that older adults’ spouse, child, or other family members play a critical role in motivating and teaching them to use computers and the Internet. This finding is consistent with findings of previous studies that older adults were motivated to learn computer skills by adult children, spouse, friends, or grandchildren (Gatto & Tak, 2008; Keenen, 2009). Having a family member as teacher also can provide the ongoing training and supervision needed to practice computer skills and become confident in these new skills. However, this finding also suggests that older adults who do not have their spouse and family members nearby, or are socially isolated, are likely to lack opportunities to learn computer skills. At the same time, it is very likely that such socially isolated older adults are the ones that could potentially benefit most by going online where they can meet their social and health needs by obtaining social or health related services. The most frequently cited barrier to Internet use by the non-Internet users was lack of knowledge on how to use the Internet, and approximately half of them indicated that they felt they needed training or support. Additionally, the next most frequent barrier cited was mistrust of the Internet. These findings suggest a strong need for making computer training classes or opportunities more available to older non-computer/Internet users to teach computer skills and Internet safety. In fact, prior research on computer training projects finds that older adults have been reported to enjoy and be satisfied with computer learning experiences, were capable of learning in a high tech learning environment and that such on-line educational experiences enhanced older adults’ life satisfaction (Cody, Dunn, Hoppin, & Wendy, 1999; Dorin, 2007 Gatto & Tak, 2008; Hickman, Rogers, & Fisk, 2007; Seals et al., 2008; Xie & Bugg, 2009). At the same time, however, older adults were found to experience some frustration when learning how to use



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computers and the Internet due to their functional limitations. For example, older adults often complained about arthritis, neck pain, hearing and vision problems, numbness, or concentration problem when learning computer skills. They were also often frustrated with the amount of time it took to learn and limited time and opportunities to practice (Gatto & Tak, 2008). Dickinson and Gregor (2006), in their review of prior studies on computer training, found frail elders were typically unable to use the technology or learn Internet skills in a short period of time. Thus, when offering computer classes for older adults, it seems critical to take into consideration their potential functional limitations. One-on-one training, allocating enough time for each task to be learned, and patience with their slow learning process can be effective, feasible strategies for teaching older adults computer skills. Designing materials to boost confidence is important to build self-efficacy. Ensuring that the materials covered are of high interest to the students is essential (Cody et al., 1999; Czaja et al., 2006; Gatto & Tak, 2008; Seals et al., 2008; Xie & Bugg, 2009). Finally, if detailed materials will not always be available to the participants, guided attention training where the point is to help the learner know what to focus on, rather than specifically what to do, is preferable to guided action training (Hickman et al., 2007). Of course, web design suiting the specific needs of the elderly, including large font sizes, high-contrast color combinations for background and text, and readability of web materials, will assist older adults to learn how to navigate the Internet (Charness & Boot, 2009; Czaja & Lee, 2007; Ownby, 2006; Seals et al., 2008). Furthermore, older adults’ psychological barriers, such as computer anxiety, need to be acknowledged and addressed (Chu et al., 2009; Cody et al., 1999; Czaja et al., 2006; Jung et al., 2010). In addition, older adults’ perception that the Internet has no relevancy for their life, also needs to be addressed in a manner that emphasizes concrete benefits such as communicating with their grandchildren or loved ones via Skype, filling medications, or doing grocery shopping online. There was an access gap in Internet use among older adults; nonInternet users are likely to be older adults (70 years or older), to have lower levels of education and income, to live alone, and to be ethnic minority elders with limited English skills. Home-bound elders and older adults with disabilities were also found to have limited access to the Internet. Thus, it is critical for human service professionals to target those older adults at risk to increase training opportunities which may be more realistically provided through ongoing tutoring. Programs of individualized in-home tutoring, such as those pioneered by Pace University, may be most appropriate for isolated elders (Wexler, Coppola, Drury, & Thomas, 2011). At the same time, it is equally important for human service professionals to recognize that there is a portion of elders who do not and, very likely, will not use the Internet. For example, a little more than half (51%)

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of non-Internet users in this study did not want to receive training on how to use the Internet, and almost three-quarters (78%) did not feel any agency was forcing them to use the Internet to receive information. Current practice uses mixed modes of communication to reach all elders. Social Security and Medicare, for example, mail important information to reach the most recipients. Their requests for response emphasize online communication and give clear, detailed instructions for using their sites. However, they also provide telephone and TTY numbers as alternate ways of responding.


Limitations This study had several limitations. It used a nonprobabililty convenience sample, which may compromise the generalizeability of the study findings. Also because no open-ended questions were asked, it was not possible to assess participants’ personal accounts of contexts preventing them from using the Internet, which could have enriched the discussion. It should be noted that data were collected from participants in one county in southern California, who may not be representative of older adults in the United States.

Implications of a Continued Digital Divide The findings of this study, similar to other recent research on the use of the Internet in the older adult population, indicates that the digital divide has diminished but has not disappeared. Although there is Internet use even among the oldest participants, use dips below 50% over the age of 70. As the Baby Boomers retire and become the driving force behind the older adult population, one can expect Internet use to continue to rise; it is also likely there will continue to be a significant population of older adults who do not use the Internet. Many of the individuals who did not use the Internet in this study reported having no interest in learning how to use it, and do not feel agencies have required them to use it to receive services. On the other hand, society is rapidly increasing the use of electronic forms of communication. For example, phone companies are requesting a move away from land lines to wireless or Internet-enabled phone plans (Svensson, 2013). Another recent example is the extensive use of Web sites to disseminate information about the Affordable Care Act (US Department of Health and Human Services, 2013). Although older adults who do not use the Internet do not currently feel they are being pressured to do so in this study, one can expect social services to increasingly move towards the Internet as a primary form of communication. This combination of society’s increasing reliance on the Internet as a primary means of communication coupled with a population of older adults that do not have, and in many cases, do not want, Internet access has significant



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implications for social work practice with older adults. NASW & ASWB Standards for Technology and Social Work Practice (National Association of Social Workers & Association of Social Work Boards [NASW & ASWB], 2005) provide some guidelines. Being prepared to work with diverse populations with various relationships with technology is discussed (NASW & ASWB, 2005). When working with older adults, social service practitioners should be assessing for the ways in which the older adult accesses services. The practitioner may also want to assess whether or not the older adult uses the Internet, their comfort level if they use the Internet, and if they do not use, their potential interest in use. This may assist the practitioner in appropriately giving referrals that match the technology preferences of the older adult. It may also help identify older adults that would like to receive support in learning or enhancing their Internet use. Social workers must also remember the importance of human relationships, and the continued importance of having a voice at the end of the line to communicate with, rather than only using e-mail or web sites to disseminate information. Social work with all clients, and especially older adults, entails far more than supplying factual information. Our skills in enhancing the match between person and environment often requires extensive interaction with the person as a unique individual. Advocacy is another key feature of the Standards for Technology (NASW & ASWB, 2005). The Standards focus on social work advocacy towards increasing Internet access for marginalized populations. Advocating for computer and Internet access is also key in working with older adults, particularly those who face numerous barriers to access. As this study found, lack of access was the strongest predictor of not using the Internet. There are still many communities that have very limited access to wireless services and, at best, only dial-up networks for Internet connections. On the other hand, the continued digital divide should also remind social workers that their core values require them to demand ways for individuals who do not to use the Internet to receive equal access to information and services. Social workers need to monitor proposals such as moving away from phone land lines to ensure that populations marginalized from electronic services do not lose their way of communicating. They also need to be ready to demand, our society moves toward providing information and services on the Internet, that older adults and others who chose not to use the Internet continue to have alternative forms of access.

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Internet use and depression among retired older adults in the United States: a longitudinal analysis.

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Chinese older adults' Internet use for health information.

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Clinical correlates of dental anxiety among older adults.

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