Public library computer training for older adults to access high-quality Internet health information

Abstract

An innovative experiment to develop and evaluate a public library computer training program to teach older adults to access and use high-quality Internet health information involved a productive collaboration among public libraries, the National Institute on Aging and the National Library of Medicine of the National Institutes of Health (NIH), and a Library and Information Science (LIS) academic program at a state university. One hundred and thirty-one older adults aged 54–89 participated in the study between September 2007 and July 2008. Key findings include: a) participants had overwhelmingly positive perceptions of the training program; b) after learning about two NIH websites (http://nihseniorhealth.gov and http://medlineplus.gov) from the training, many participants started using these online resources to find high-quality health and medical information and, further, to guide their decision making regarding a health- or medically-related matter; and c) computer anxiety significantly decreased (p < .001) while computer interest and efficacy significantly increased (p = .001 and p < .001, respectively) from pre- to post-training, suggesting statistically significant improvements in computer attitudes between pre- and post-training. The findings have implications for public libraries, LIS academic programs, and other organizations interested in providing similar programs in their communities.

Introduction

The American population is aging rapidly. By July 2008, approximately 38.7 million Americans were age 65 or older, accounting for 12.7% of the total U.S. population (Central Intelligence Agency, 2008). In 2011, the baby-boom generation will begin to turn 65. It is projected that by 2030, one in five, or 70 million people in the United States will be age 65 or older (U.S. Census Bureau, 2000). The aging of the population presents serious challenges for public libraries, in that older adult patrons tend to have different information needs and preferences than their younger counterparts. In particular, older adults typically have a greater need than younger adults for health and medical information. Yet, older adults' health literacy, or “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (U.S. Department of Health and Human Services, 2000), is also the lowest among all American adult age groups, and only 3% of older adults have proficient health literacy (Kutner, Greenberg, Jin, & Paulsen, 2006).

The Internet holds great potential for helping individuals access health information and services and thus improving health literacy (Fox, 2006). In recent years, as government agencies like the National Institutes of Health (NIH) are increasingly putting health information and services online, the Internet has already become an important source of such information (Bylund et al., 2007, Fox, 2007, Huntington et al., 2007). Unfortunately, older adults are at risk of being left behind, given that their general adoption of the Internet still lags behind other age groups (Fox & Madden, 2005). In particular, while the potential of the Internet in meeting health information needs has begun to be realized by some older adults (Fox, 2005, Fox, 2006, Kaiser Family Foundation, 2005), the overall percentage of older adults taking advantage of the Internet for health-related purposes lags behind younger age groups (Bundorf et al., 2006, Fox, 2006). Even among the small number of older adults who are beginning to use the Internet for health information, the majority lack sophisticated online search skills and strategies that can help them to make maximal use of online resources (Fox, 2006, Xie, 2008). The situation is even worse among older adults who have lower incomes and/or belong to ethnic minority groups, who typically cannot afford to have computer equipment and Internet access at home and lack opportunities to learn to use the technology (Brodie et al., 2000, Carlson et al., 2006, Fox, 2005, Fox, 2006).

For several reasons (Xie & Jaeger, 2008), public libraries have the potential to be an ideal site for providing both Internet access and training for older adults including those who are socially and economically disadvantaged. First, the mission of public libraries is to provide free or low-cost services to meet the information needs of the public. Second, public libraries are typically located in every community and their locations are often accessible using public transportations. And third, the vast majority of American public libraries already have the necessary computer and Internet infrastructure in place (Bertot, Jaeger, McClure, & Ryan, 2006).