Exploring Digital Literacy Among Community-Dwelling Older Adults

Background: Digital literacy is becoming increasingly important for older adults as more services and information transition online. Having strong digital skills can help seniors stay connected to family and friends, manage their health, and access important resources . Objective: This study aimed to explore digital literacy among community-dwelling older adults. Setting: The study was conducted at two older adult clubs, namely : AL Wafa Club , and AL Hayaht and AL Amal Club in Alexandria , Egypt . Design and Sample: A descriptive research design was used. A convenience sample of ninety older adults were included in the study . Tools: Four tools were used by the researchers . Results: The study findings indicate 44.4% of the study subjects possess a high level of digital literacy , a significant relations were found between digital literacy and levels of education, the residential area , living conditions, occupation before retirement , type of digital communication technology devices used, the starting time of using digital devices , the rate of utilizing these devices, and the availability of internet connection.. Whereas , there is no statically significant relation was found between digital literacy and gender , age , marital status, current work status, sufficiency of income , and the presence of chronic diseases. Conclusion: Less than half of the study subjects demonstrated a high level of digital literacy, particularly in areas such as performing basic device functions, engaging in entertainment activities, utilizing the internet, troubleshooting technical issues, managing software, and maintaining privacy. Recommendations: There is a need for targeted interventions and educational programs to address these areas of low digital literacy in older adults and improve overall proficiency.


Introduction
The utilization of technology is increasingly recognized as a prerequisite for successful aging.As such, older adults must continuously acquire digital skills to keep pace with the evolution and rapid expansion of information and communication technologies (ICTs) .ICTs have come to refer to a broad range of these technologies, which include smartphones, specialised apps, web-based sites with health and other information, social media, and a variety of other applications (Fingerman et al., 2020).
According to Goodfellow (2011) defined digital literacy (DL) as the ability to be aware, behave, and use digital technology.Recently , DL is defined by Okan et al. 2021 as the ability to use information and ICTs to locate, evaluate, use and create information.Spires et al. ( 2019), identified key skills for digital literacy, including operational, formal, cognitive, social-emotional, communication, creative, and research skills.These skills include technical knowledge, problem-solving, online identity management, communication across digital platforms, and the ability to create multimedia content.
Gaining DL is crucial for older populations as it helps maintain independence, supports health management, offers lifelong learning opportunities, promotes cognitive health, provides access to online entertainment, and fosters intergenerational connections by enabling easy communication between seniors and distant family members ( Okan et al. 2021).
DL tends to be negatively associated with age, leading to the marginalization of older individuals concerning digital participation.Notwithstanding, older adults often face challenges in acquiring digital literacy, as they typically experience poorer memory and lower levels of self-efficacy, and require more time to learn new skills (Tsai et al., 2017).
Gerontological nurses play a crucial role in supporting older adults in the adoption and utilization of communication and information technologies.By gaining a better understanding of technology usage among older adults, gerontological nurses can design and implement effective interventions aimed at enhancing older adults' digital literacy and subsequently their well-being and quality of life .
Moreover, there is a paucity of research investigating digital literacy among older adults.Acknowledging the intricate nature of this issue, the data generated from this study will offer valuable insights into the utilization of digital communication technologies by older adults in their everyday activities.

Aim of the study:
This study aimed to explore digital literacy among community-dwelling older adults.

Research questions:
1. What is the current level of digital literacy among community-dwelling older adults?2. How do socioeconomic factors, such as income and education level, influence digital literacy levels in older adults?

Materials
Design: A descriptive research design was used to carry out this study.
Setting and subjects:  0) Not at all to nearly every day (3).The PHQ-2 was translated into the Arabic language and approved to be valid and reliable by Hafez et al., 2020 (reliability coefficient 0.965).
A PHQ-2 score ranges from zero to six (0-6).A score of 3 is the optimal cut point when using the PHQ-2 to screen for depression.If the score was 3 or greater, major depressive disorder is likely.).This tool assesses the ability of older adults to perform various operations on a digital communication device.It includes questions related to older adults' proficiency in performing the fundamental device functions as functions as turning the device on and off, proficiency in performing communication tasks as opening emails, proficiency of data and file storage tasks , and uutilizing the internet as transferring files such as (photos)from portable device to the computer.Additionally, questions related to efficiency in utilizing calendar software as adding events into a calendar, engagement in entertainment activities watching movies and videos, and maintaining privacy as setting up a password to lock/unlock the device.

Tool (III): Older
Responses to the questions: Yes, No and Never tried.Yes takes a score of one (1), No, and Never tried take a score of zero (0).The higher the scores on this tool, the greater the level of digital literacy of the respondents.Scoring system of the tool was as follow: • A low level of DL is indicated by a score of < 33.33%.2. Each study subject was interviewed individually by the researchers.3. To motivate older adults to attend the clubs, the researchers conducted workshops and measured their blood pressures and random blood sugar levels.4. The researchers conducted interviews with 5 to 10 elderly individuals daily, the duration of each interview varied between 20 and 40 minutes.

Data collection commenced on mid
April 2023 and ended in mid July 2023.
Ethical considerations: An informed written consent from all participants, who were informed of the study's purpose, voluntary participation, and the right to withdraw at any time.

Statistical analysis of the data:
The data was collected, revised, coded, and analyzed using IBM SPSS version 25.Reliability was determined using Cronbach's alpha.Quantitative data was summarized using mean, standard deviation, and mean score.Statistical analysis used two-tailed tests with an alpha error of 0.05.Inferential statistical analysis used Mann Whitney and Kruskal Wallis tests.median.

:
Table 1 illustrates that 51.1% of participants are male, with 80% aged 60-70.The mean age of the study population is 66.37±6.00years .Additionally, 64.5% are married, 46.7% have secondary education, 68.9% not having a current work and 45.6% of the study subjects were employees.84.4% of the study subjects reported to have enough income and 66.7% of the study subjects live with their spouses .Mobile phones are used by all participants, with 81.2% using digital communication technologies for over three years.Chronic diseases affect 68.9% of participants, and 36.7% face health problems affecting digital communication, with visual impairments being the most prevalent.Table 3 revealed that a significant relation was found between DL and levels of education, occupation before retirement, the residential area, living conditions, digital communication technology devices used, the starting time of using digital devices , the rate of utilizing these devices, and the availability of internet connection (P <0.001,<0.001,<0.001, 0.039, <0.001, 0.026, 0.031, <0.001) respectively .Whereas , no statically significant relations were found between DL and gender , age , marital status, current work status, sufficiency of income , and the presence of chronic diseases.(P=0.403,0.455, 0.210, 0.793, 0.169, 0.469).

Discussion:
The main findings of the current study revealed that less than half of the study subjects have a high level of DL , with respect to the categories of DL, the study subjects demonstrated a high level of DL in performing fundamental device functions, engaging in entertainment activities, utilizing the internet and troubleshooting , software management and maintaining privacy.Conversely, the subjects exhibited a low level of DL in effectively utilizing calendar software.To the best of the authors' knowledge, no studies have been conducted specifically examining the levels of DL among older adults.
This study revealed that participants with post-graduate education , subjects from urban areas, and those who lived with their spouses displayed a higher level of DL .These results may be due to the fact that subjects with higher education demonstrate self-confidence and interest in using digital technologies.Into the bargain , people in rural areas have low income and limited access to the interne, consequently, they cannot afford the cost of digital devices or access to the internet.Furthermore , couples encourage each other to use digital technology, additionally they help each other when any problem facing them which improve their digital skills.
These findings are in line with Leukel et al., 2023 revealed that older adults were more likely to utilize the digital technologies in later life if they had higher educational status in their younger years.additionally , Wang et al., 2020 who revealed that rural regions have a higher level of digital isolation since their percentage of DL is lower than that of urban areas.Moreover, Lee et al., 2021 revealed that the mutual assistance between couples is satisfying for them and improve their digital knowledge.
With respect to the occupation before retirement, the study find out that the subjects who were health care providers as pharmacists , doctors and nurses exhibited a higher level of DL.This result can be justified by the fact that health care professionals typically receive extensive training and education in their field, which includes exposure to digital technologies and their applications in healthcare settings.This training equips them with the necessary knowledge and skills to navigate and utilize digital tools and platforms effectively.
As for the type of digital communication technology device used, it was observed that subjects who used a computer showed a higher level of digital literacy , with statistically significant correlation .Computers offer a wide range of functionalities and capabilities compared to other digital communication technology devices such as smartphones or tablets.They provide larger screens, more processing power, and a full keyboard, allowing users to perform complex tasks, access a broader range of applications and software.
This study revealed that subjects who use digital communication technologies for more than three years , subjects who used digital communication technologies on a daily basis and those who have an available internet connection exhibited higher levels of DL, with statistically significant correlations.This may be related to that over time, individuals tend to become more familiar and comfortable with digital tools, which can contribute to the development of their DL.Furthermore , with an internet connection, individuals can explore a wide range of digital content, educational materials, online tutorials, and interactive platforms.Access to these resources enables individuals to acquire new knowledge, learn digital skills, and enhance their DL.These findings in accordance with Quatro, 2020 who revealed that increasing rate of technology use is associated with feeling of confidence and self-efficiency .Moreover, this study revealed that , there is no statically significant relation were found between digital literacy and gender , age , marital status, current work status, sufficiency of income , and the presence of chronic diseases.

Conclusion:
According to the findings of this study, less than half of the study subjects demonstrated a high level of digital literacy, particularly in areas such as performing basic device functions, engaging in entertainment activities, utilizing the internet, troubleshooting technical issues, managing software, and maintaining privacy.
Additionally , in this study, it was found that various sociodemographic and clinical factors significantly impact DL among the study participants.These factors include the older adult's level of education, residential area, living conditions, occupation prior to retirement, the type of digital communication technology devices used, the duration of using digital devices, the frequency of utilizing these devices, and the availability of internet connection.

Recommendations:
In line with the study findings, it is recommended to provide digital literacy training programs for older adults that address their needs, to raise awareness about the importance of digital literacy , and to provide access to resources such as computer labs, internet connectivity in older adults clubs and in the assisted living facilitates This tool was developed by the researchers based on the review of relevant literature, it consists of two parts as follows:-1.Part I: Socio-demographic data of the older adults such as age, gender, marital status, levels of education, type of digital communication device the older adult had, current work status , and monthly income.2. Part II: Clinical data of the older adults such as diagnosis, medical health history including the presence of health problems impede the use of digital communication technologies.Tool (IV): Older Adults' digital literacy structured interview schedule: This tool was developed by the researchers based on the review of relevant literature to evaluate the digital literacy of older adults ( Amin et al., 2021; Spires et al., 2019

Table ( 1): Percent distribution of the study subjects according to their Socio-demographic and clinical data.
# More than one answer

557) Types of health problems impede the use of digital technologies (n = 33) #
U: Mann Whitney test H: H for Kruskal Wallis test # More than one answer Significance p<0.05