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Soundararajan A, Lim JX, Ngiam NHW, Tey AJY, Tang AKW, Lim HA, Yow KS, Cheng LJ, Ho J, Nigel Teo QX, Yee WQ, Yoon S, Low LL, Ng KYY. Smartphone ownership, digital literacy, and the mediating role of social connectedness and loneliness in improving the wellbeing of community-dwelling older adults of low socio-economic status in Singapore. PLoS One 2023; 18:e0290557. [PMID: 37647263 PMCID: PMC10468072 DOI: 10.1371/journal.pone.0290557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, safe-distancing measures resulted in many community-dwelling older adults being socially isolated and lonely, with its attending negative impact on wellbeing and quality of life. While digital technology may have mitigated this, older adults of low socioeconomic status (SES) are more likely to be digitally excluded and hence susceptible to the adverse effects of social isolation and loneliness. This study aims to understand the factors that affect digital literacy, smartphone ownership, and willingness to participate in a digital literacy program (DLP), and to test the hypothesized relations between digital literacy, social connectedness, loneliness, wellbeing, and quality of life amongst community dwelling older adults of low SES. MATERIALS AND METHODS A questionnaire assessing digital literacy, social connectedness, wellbeing and quality of life was administered. Socio-demographic variables, pre-existing internet-enabled, and willingness to participate in a home-based DLP was also collected. Logistic regression was used to identify demographic factors associated with digital literacy, smartphone ownership, and willingness to enroll in a DLP. Serial mediation analysis was also performed using a structural equation model framework. RESULTS A total of 302 participants were recruited. Female gender, older age, lower education levels were associated with lower digital literacy. Those who owned a smartphone tended to be younger and better educated. Older adults who were better educated, of Chinese descent (the ethnic majority in Singapore), and who had lower digital literacy, were most willing to enroll in the digital literacy education program. Social-use digital literacy had a positive indirect effect on well-being ([Formula: see text]) and Quality of life ([Formula: see text]), mediated by social connectedness and loneliness. In contrast, instrumental-use digital literacy had a negative indirect effect on well-being ([Formula: see text]) and Quality of life ([Formula: see text]), mediated by social connectedness and loneliness. DISCUSSION The results suggest there are demographic barriers to participation in DLPs and highlight the benefit of focusing on enhancing social-use digital literacy. Further study is needed to evaluate how well specific interventions to improve social-use digital literacy help to reduce social isolation and loneliness, and ultimately improve wellbeing and quality of life.
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Affiliation(s)
- Amrish Soundararajan
- TriGen, Singapore, Singapore
- Department of Family Medicine, National University Health System (NUHS), Singapore, Singapore
| | - Jie Xin Lim
- TriGen, Singapore, Singapore
- Wee Kim Kee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
| | - Nerice Heng Wen Ngiam
- TriGen, Singapore, Singapore
- Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Angeline Jie-Yin Tey
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Department of Respiratory Care & Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Aaron Kai Wen Tang
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Haikel A. Lim
- TriGen, Singapore, Singapore
- Department of Psychiatry, National Health Group, Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Ka Shing Yow
- TriGen, Singapore, Singapore
- Department of Internal Medicine, National University Health System, Singapore, Singapore
| | - Ling Jie Cheng
- TriGen, Singapore, Singapore
- Health Systems and Behavioral Sciences Domain, Saw See Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jess Ho
- NTUC Health Co-operative Ltd, Singapore, Singapore
| | - Qun Xuan Nigel Teo
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Wan Qi Yee
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Lian Leng Low
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Kennedy Yao Yi Ng
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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Lim HA, Lee JSW, Lim MH, Teo LPZ, Sin NSW, Lim RW, Chua SM, Yeo JQ, Ngiam NHW, Tey AJY, Tham CYX, Ng KYY, Low LL, Tang KWA. Bridging Connectivity Issues in Digital Access and Literacy: Reflections in Empowering Vulnerable Older Adults in Singapore (Preprint). JMIR Aging 2021; 5:e34764. [PMID: 35503520 PMCID: PMC9115659 DOI: 10.2196/34764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Haikel A Lim
- Department of Psychiatry, National Healthcare Group, Singapore, Singapore
- TriGen, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Joanne Sze Win Lee
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | | | - Lynn Pei Zhen Teo
- TriGen, Singapore, Singapore
- National University of Singapore, Singapore, Singapore
| | | | - Rou Wei Lim
- TriGen, Singapore, Singapore
- Division of Pharmacy, Singapore General Hospital, Singapore, Singapore
| | - Si Min Chua
- TriGen, Singapore, Singapore
- Punggol Polyclinic, Singapore Health Services, Singapore, Singapore
| | - Jia Qi Yeo
- TriGen, Singapore, Singapore
- National Healthcare Group Pharmacy, Singapore, Singapore
| | - Nerice Heng Wen Ngiam
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Department of Respiratory Medicine, Singapore General Hospital, Singapore, Singapore
| | - Angeline Jie-Yin Tey
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Celine Yi Xin Tham
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Kennedy Yao Yi Ng
- TriGen, Singapore, Singapore
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Lian Leng Low
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Singapore
| | - Kai Wen Aaron Tang
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Department of Psychiatry, Singapore General Hospital, Singapore, Singapore
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Ng KYY, Leung GYC, Tey AJY, Chaung JQ, Lee SM, Soundararajan A, Yow KS, Ngiam NHW, Lau TC, Wong SF, Wong CH, Koh GCH. Bridging the intergenerational gap: the outcomes of a student-initiated, longitudinal, inter-professional, inter-generational home visit program. BMC Med Educ 2020; 20:148. [PMID: 32393249 PMCID: PMC7216381 DOI: 10.1186/s12909-020-02064-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Older persons consume disproportionately more healthcare resources than younger persons. Tri-Generational HomeCare (TriGen), a service-learning program, aims to reduce hospital admission rates amongst older patients with frequent admissions. The authors evaluated the educational and patient outcomes of TriGen. METHODS Teams consisting of healthcare undergraduates and secondary school (SS) students - performed fortnightly home visits to patients over 6 months. Self-administered scales were used to evaluate the educational outcomes in knowledge and attitudes towards the older people and nine domains of soft skills pre- and post-intervention. Patients' reported satisfaction and clinical outcomes were also assessed. RESULTS Two hundred twenty-six healthcare undergraduates and 359 SS students participated in the program from 2015 to 2018. Response rates were 80.1 and 62.4% respectively. One hundred six patients participated in TriGen. There was a significant increase in Kogan's Attitudes towards Old People Scale (KOP) scores for healthcare undergraduates and SS students with a mean increase of 12.8 (95%CI: 9.5-16.2, p < 0.001) and 8.3 (95%CI: 6.2-10.3, p < 0.001) respectively. There was a significant increase in Palmore Facts on Aging Quiz (PFAQ) score for SS students but not for healthcare undergraduates. Most volunteers reported that TriGen was beneficial across all nine domains assessed. There was also a significant decrease in hospital admission rates (p = 0.006) and emergency department visits (p = 0.004) during the 6-month period before and after the program. Fifty-one patients answered the patient feedback survey. Of this, more than 80% reported feeling less lonely and happier. CONCLUSION TriGen, a student-initiated, longitudinal, inter-generational service-learning program consisting of SS students and healthcare undergraduates can reduce ageism, develop soft skills, inculcate values amongst SS students and healthcare undergraduates. In addition, TriGen potentially reduces hospital admissions and emergency department visits, and loneliness amongst frequently admitted older patients.
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Affiliation(s)
- Kennedy Yao Yi Ng
- Department of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Angeline Jie-Yin Tey
- Department of Intensive Care Medicine, Sengkang General Hospital, Singapore, Singapore
| | - Jia Quan Chaung
- Changi Naval Base, Singapore Armed Forces, Singapore, Singapore
| | - Si Min Lee
- Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Ka Shing Yow
- Department of General Surgery, Changi General Hospital, Singapore, Singapore
| | | | - Tang Ching Lau
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Hospital, Singapore, Singapore
| | - Sweet Fun Wong
- Populational Health and Community Transformation, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Chek Hooi Wong
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Gerald Choon-Huat Koh
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 117549, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore.
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