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Select one of the two assigned chapter readings from our text for focus. (Elderly or Healthcare). As a team, discuss the following questions as it relates to your selected chapter:

1. Top two favorite topics from the chapter (each team member)

2. Integrate your thoughts from the supplemental government web-site link below @ elderly and telehealth.

3. What ideas for org change would YOU add to the chapter if the authors asked for you to participate?

4. Does this relate to your selected organization? (explain).

do not use the Internet is because it is not experienced as useful from their own
perspective. The ‘beginner Internet learning classes’ are described as a sociotechnical system of elderly people, incorporating varied worldviews [6] that exists
within the system and factors influencing perceived usefulness of solutions. The
author then outlines two different types of users (Internet and non Internet-users),
which determine purposes, and perception of the benefits and drawbacks of Internet
usage.
2 Background
A selected number of topics have been chosen to investigate ‘the perception of the
benefits and drawbacks of Internet usage by elderly people’. Initially the term
‘elderly’ is defined in the context of the study. However different countries around
the world had different perception in defining the term elderly. Therefore the study
was aimed based on a generation, called the ‘silent generation’ (born in the mid
1920s to the early 1940s) as majority of the authors from the literature defined
elderly within this category. Key elements of the Internet usage will be outlined to
explain the benefits and barriers the elderly encounter. The literature review consisted of exploring barriers relating to Internet adoption such as age related disabilities, expenditure and affordability, privacy, security, trust relations and risks
elderly people encounter whilst adopting the Internet. Research was also carried out
on the accessibility, usability and design of the webpages and how that affects the
elderly’s interaction with the Internet. Other research was conducted on how the
elderly retrieve valuable training and support in using the Internet, for example if
the participants are achieving some level of experience by attending the Internet
tutorial classes.
3 Research Method
Throughout the investigation of the topic, primary and secondary research has been
conducted by adhering to the Triangulation research methodology. The primary
research consisted of two research tools, including observations and
structured/semi-structured interviews, which provided a mixture of quantitative and
qualitative data. The scope of the project included investigating the perception of
the benefits and drawbacks of Internet usage by the elderly people (silent generation). The selection of participants was restricted to Portsmouth (Hampshire) and
Swindon (Wiltshire). Furthermore observations were conducted by attending local
community centres and libraries, which provided training courses for the beginner
elderly Internet/computer users. In total 8 different beginner training classes were
attended in order to observe how elderly users interacted with the Internet.
Moreover in depth interviews were conducted with 14 participants, 6 being Internet
The Perception of the Benefits and Drawbacks … 201
users and 8 being non-Internet users, as this provided the perception of both users.
Electronic survey was considered, however this method was not undertaken as it
could lead to the results being biased because not all users have access to or uses the
Internet [7]. For this study the research methodology was inspired by the
Triangulation Methodology illustrated in Fig. 1.
Triangulation is a method used to analyse the data collected in a study by using
multiple methods to collect data on the same topic [9]. The method assured validity
of the research by using variety of approaches to collect data on the same subject.
There are four types of triangulation methods [10], such as Data Triangulation. This
is when data is gathered through different sampling strategies where parts of the
data are collected during different time periods and social situations and on a variety
of people. Investigator Triangulation is when more than one researcher is involved
in the research to gather and analyse the data. Theoretical Triangulation is when
more than one theoretical position is used in interpreting data and Methodological
Triangulation is when more than one method is used to gather primary data by the
researcher. After considering all four methods the Data Triangulation and
Methodological Triangulation was adhered. This is because the data was gathered
from two different sources by multiple methods and increased the validity of the
data [10]. Additionally data triangulation provides an advantage in social research,
as it provides confidence in the collected data, with clear and deeper understanding
of the phenomena [11]. The Triangulation Methodology provided additional
sources of information and often gave more insight into the selected topic. The
methodology was also beneficial when inadequacies found in one-source data is
minimised when multiple sources confirmed the same or similar data. For example
multiple sources provided verification, assurance and validity while complementing
similar data [11]. Moreover the data and information is supported in multiple types
of research, which provided ease to analyse data to draw conclusions.
Fig. 1 Triangulation
methodology (Adapted from
[8])
202 D. Hussain et al.
Initially the focus was on planning and designing the research tools and strategy,
for the interview questions and the structured template to record the results of the
observation. The interview questions were identified based on the secondary literature research and was piloted and evaluated further. While testing the data
collection form, feasible amendments and improvements were made. For example
reflecting on the way the questions were asked during the interviews to reduce the
bias by listening to or revising the previous interview scripts/recordings.
The review of the academic research materials has been used to develop foundations of knowledge of elderly people’s perception on the Internet technology
usage. For example how they believe the Internet will be useful and the benefits and
barriers they encounter whilst interacting with the Internet. The observation study
template (Fig. 2) monitors the difficulties the users encountered whilst using the
Internet. The common barriers identified were accessibility, usability and design
issues as well as experiencing difficulties logging-in i.e. emails. The research data
was analysed using social-technical framework of reference to systemically comprehend the complexity of the topic [6, 12]. Figure 2 illustrates 75 participants have
been observed in total of 8 different observations classes, as the participants
required assistance/help 211 times. Out of the 75 participants 70 believed they
achieved some level of experience by attending the tutorial class. Taking notes by
pen and paper was common (31 users) as it helped the participants learn and
remember the tasks and procedures.
4 Data Analysis
The interviews gathered a large amount of qualitative data, which enabled the
researcher to gain a deeper insight and understanding of the topic. The results of the
interviews were used to compare the findings with the observation results. Whilst
conducting the interviews two different templates were used, one for Internet users
and the other for non-Internet users. The templates consists of pre-defined questions, however as the interviews were structured and semi-structured the questions
varied depending on how the interviewees answered the questions [13, 14].
Textual analysis coding method was used in order to analyse the interview
results by highlighting the key themes and categorising the responses into
Total Participants: 75 (Total Number of Organisations: 8) 120 minutes
Number of times seeking assistant: 211 Trainee’s experienced level of achievement: 70
Keyboard
Typing
Mouse
Usability
Display Step-by-step
note taking
Accessibility
Issues
Trouble
Logging-in
44 40 25 31 34 24
Fig. 2 Observation results/template
The Perception of the Benefits and Drawbacks … 203
appropriate groups [13, 14]. Below illustrates a number of examples of the interview responses being analysed by highlighting the most frequent and repetitive
responses. For example Table 1 illustrates the analysis of Internet users, where 6
participants stated the Internet could be used to improve knowledge and skills.
Analysis Internet Users (Table 2)
Analysis Non-Internet Users (Table 3)
Table 1 Types of benefits
users think they can gain by
using the internet
Data item—categories Number of
occurrences
Total
Research purposes ✗✗ 2
Improve knowledge and
skills
✗✗✗✗✗✗ 6
Solving problems ✗✗✗ 3
Hobby ✗✗✗✗ 4
Perform tasks in own comfort ✗✗✗✗ 4
Socialise and network ✗✗ 2
Save money ✗ 1
Table 3 Reason for not
using the internet
Data item—categories Number of occurrences Total
No knowledge ✗✗✗✗✗✗ 6
Don’t require it ✗✗✗✗✗ 5
No access ✗✗ 2
Complicated and confusing ✗✗✗✗✗✗ 6
Disability ✗✗ 2
Expenditure ✗✗ 2
Don’t feel safe ✗✗✗ 3
Table 2 Types of problems
encountered accessing the
internet
Data item—categories Number of occurrences Total
Connection failure ✗✗✗ 3
Slow connection ✗✗ 2
Resolving technical issues ✗✗✗ 3
Pop-ups ✗✗✗✗ 4
Usability issues ✗✗✗ 3
204 D. Hussain et al.
5 Research Topic
5.1 Generation
Firstly the underlying worries were defining the term “who are the elderly?” This is
because after carrying out the literature search (secondary research), it appeared that
different countries around the world had different perceptions when defining the
term “elderly”. This has led the researcher to come to a conclusion and conduct the
primary research based on a generation. The generation that was chosen was the
“silent generation”, where people were born in the mid 1920s to the early 1940s [7].
The generation “baby boomer” was considered (born between 1946 and 1964) [7].
However the “silent generation” was selected because the majority of authors in the
literature defined elderly within this category.
5.2 Benefits of Internet
After interviewing two groups of participants; Internet users and non-Internet users,
the researcher intended to discover what benefits elderly people think they can gain
by using the Internet or if they were to use the Internet. The interview results
suggest that all participants believed the Internet could be a useful tool for
improving general knowledge and skills, whereas 50% of the non-Internet users had
the same perception. In addition 65% of elderly participants who use the Internet
mentioned, the Internet could be used for hobby purposes and 57% of participants
stated it could also be useful for performing tasks in your own time and comfort.
However there does not seem to be enough evidence from the literature review that
suggests the perception of elderly people regarding why they believe the Internet
can be a useful tool. On the other hand the findings have agreed with Eastman’s
[15] and Castells [16] study, where both Internet users and non-Internet users
thought the Internet could be useful for communicating [2] and networking with
families and friends around the world. In addition participants believed it can save
money, i.e. you do not have to use your landline to communicate with people in
different countries.
The interview results attempts (Internet users) to answer the first research
question ‘Do elderly people gain benefits accessing the Internet?’ After interviewing users that practice using the Internet, 80% of the respondents mentioned
they gain benefit by searching health related information. This shows positive
correlation with the literature review where Robertson-Lang et al. [17] research also
discovered the Internet was a significant resource for searching health related
information. This topic is the most common searched field the elderly perform
online [8]. It was also found in the secondary and primary research that elderly
people generally used the Internet for searching holidays, travel information and
checking the weather online [3, 18]. Fifty percent of the participants used the
The Perception of the Benefits and Drawbacks … 205
Internet for communication purposes, such as emailing and social networking. Once
again the primary research was consistent with the secondary research, as emailing
was one of the most common activities on the Internet the elderly performed [15].
However participants that did not use the Internet for emailing was because they
experienced problem-remembering their login details i.e. username and password.
The primary research discovered, a participant found the Internet beneficial by
using the ‘click and collect’ facility. This has found to show some level of similarities with the secondary research, as the literature review suggests elderly people
adopt the Internet for various reasons such as online shopping [19]. On the other
hand the primary research indicates 65% of the participants used the Internet for
watching and reading the news and 50% used the Internet to listen to music and
watch videos. However the researcher did not come across any research where
elderly people tend to use the Internet to listen to music and watch videos. This was
an unexpected surprise, as the researcher was not expecting elderly people to watch
videos and listen to music online. An assumption was made beforehand that elderly
people would prefer to watch videos on TV or listen to music from a tape recorder
or radio.
5.3 Reasons for not Using the Internet
‘What are some of the reasons for not using the Internet?’ was the second research
question the researcher intended to retrieve answers from by interviewing
non-Internet users. Seventy-five percent of the participants mentioned they do not
use the Internet because they do not have enough knowledge about the technology
and did not know how to use a computer. These findings were also supported by
Jokisuu’s [20] study. Further research by Ogozalek’s [21] study discovered that
elderly people who did not use the computer mentioned they do not require a
computer at all, hence why they don’t use the technology. This was found to be
partially accurate in the primary research, as 63% of the non-Internet users commented they do not require using the technology. Where one participant stated “I
don’t require using it for any sort of reason”. Six out of eight non-Internet users
seemed to be finding the technology complicated and confusing, hence the reason
for not adopting the Internet. Olphert et al. [22] describes the cost of accessing the
Internet can also be an important factor. Where 15.4% of Lee’s [23] participants
stated, “It cost too much to purchase Internet access”. These findings show to be
similar with the primary research, where 25% of the interviewees found expenditure
as a barrier for not using the Internet.
206 D. Hussain et al.
5.4 Internet Security
Another barrier for not using the Internet is because not all users felt it was safe
[24]. A study by Lee [23] justifies the perception and the barriers of Internet
security which elderly people encountered. The secondary findings suggest elderly
people avoid tasks on the Internet, which involve providing financial information
[25]. This was because of fearing their personal information may be at risk as
elderly users were concerned about security issues [24]. These findings were found
to be accurate by the primary research, where 82% of Internet users and 86% of
non-Internet users felt anxious and worried about Internet security, especially
regarding financial information. Despite the fact there are security features available
to protect users from theft and fraud [24], the majority of the participants preferred
not to carry out tasks involving personal data. This explains why one of the par-
ticipants in the primary research claimed they had been victimised in the past.
A participant also mentioned when they are browsing on the web and carry on
the search, the next day the same search is displayed on the screen. This made the
user anxious thinking they are being followed or watched. However this was
relating to “cookies” as the participant was not educated in this area. This finding
was unexpected and turned out to be important, which was not identified in the
secondary research. The study has taught the researcher it is important that users are
educated about Internet security in order to make them feel a little more confident
when using the technology.
5.5 Usability Issues
The researcher conducted interviews and observations to examine the types of
problems elderly people encounter whilst accessing the Internet (research question
3). According to the interview (Internet users), 66% of participants explained they
encountered usability issues, such as finding pop-ups as a big frustration and
problematic. These findings were supported by Gatto and Tak’s [26] study, which
suggest positive correlation, where participants experienced spam and pop-ups to be
the biggest cause of frustration, which potentially leads to viruses. In addition
interview results suggests 50% of the participants found connection failure and
resolving technical issues challenging, which led the participants to not use the
system. These findings turned out to be critical, which was not discovered in the
secondary research.
As participants experienced usability issues, they decided to keep a list of
step-by-step instructions of how to use the website they frequently visit [27]. These
findings are supported by the observation results, as 45% of the beginner Internet
learners took step-by-step notes whilst attending the tutorial sessions. An Internet
user also commented the step-by-step notes could become invalid as the
design/layout of websites can occasionally change. This was also echoed by
The Perception of the Benefits and Drawbacks … 207
Nielsen [27], as the author’s study explains the notes can become irrelevant when
the design of the website changes. This led to further challenges as users had to
re-learn and understand the new design and take new notes. The observation result
also suggests 58% faced problems using the keyboard. For example participants
were confused when using specific symbols and functions. Another usability issue
identified during the observation was the difficulty in using the mouse. Users were
occasionally confused between the right and left mouse click. These findings are
also supported by Gatto and Tak’s [26] research, whose findings showed similarities with regards to usability issues.
5.6 Accessibility Issues
Good et al. [18] study discovers participants faced accessibility issues whilst using
the Internet, which was generally caused by visual impairments [28]. Visual
impairments led to participants having difficulties to read written instructions and
manuals from the display screen [29]. This behaviour was also observed during the
observation as 45% of participants encountered accessibility issues, such as eyesight problems. In addition the findings show correlation with the interview results,
as 25% of the elderly Internet users and all the non-Internet users explained they
experience eyesight problems. Therefore showing positive correlation between the
primary and secondary findings as users with visual impairment experienced difficulties to see written content on the display screen. This implies that not all elderly
users are aware of the ‘font enlargement’ feature or possibly the websites are not
applying to the W3C standards and regulations [30].
The analysis of Internet users and non-Internet users discovered participants
having ‘shaky hands’, which led to difficulties in using the mouse and keyboard.
However during the observation it was identified those participants were using
special keyboards and ergonomic mouse in order to assist them to use the Internet.
This is described by Mitzner et al. [31] study, as the author states there are adaptive
features and hardware available to support users with accessibiliy issues.
5.7 Internet or Manual Transactions
The fourth research question focussed on “if elderly people preferred to use the
Internet or manual transactions to complete tasks”. For example if the participants
preferred to use the Internet or preferred face-to-face interaction, i.e. physically
going out to shop instead of online shopping, going to the bank instead of online
banking. The primary results indicate 67% of the silent generation preferred
face-to-face interaction. This was found to be accurate with Beneke et al. [4]
research. The author highlights, participants preferred face-to-face communication
instead of using the Internet. However on the other hand 16% mentioned they do
208 D. Hussain et al.
prefer to use the Internet or it may depend on the situation. Moreover 2 users stated
they do prefer online shopping as it allows more comfort and avoids queuing up
and carrying shopping bags. This research showed consistency with Sum et al. [19]
study where using the Internet for online shopping provided an advantage, as
shoppers do not have to carry shopping bags home. It can be agreed online
shopping can be advantageous, however there are disadvantages as 66% of elderly
people disliked online shopping because they did not feel secure and confident
providing their financial information [25].
5.8 E-Government
Both Internet and non-Internet users were interviewed to get their perception on the
governmental services going online (E-Government). The majority of the Internet
users believed the service could be beneficial as the process could be quicker and
efficient. This shows similarities with the secondary research as the elderly Internet
participants used the Internet for governmental services, such as paying bills and
taxing their vehicles [4, 32]. However the Internet users argued the service should
be optional by having both facilities available, as not everyone knows how to use a
computer and the Internet. Moreover 50% of the interviewees mentioned they do
prefer pen and paper applications, where the other 50% did not mind using either
facility. The non-Internet participants were not pleased about e-government service
as they claimed they “don’t like technology”. All the non-Internet participants
argued that there should be alternative methods available. Despite the fact governmental services are going online, it still does not encourage all elderly participants to adopt the Internet. Participants believed they can discover alternative
methods i.e. getting their family members to complete tasks.
5.9 Computer Training
The primary research has discovered 37% of non-Internet users are aware of the free
public computer training sessions for elderly people. This shows similarities with the
secondary research, as there are public libraries that provide both Internet access and
training for elderly beginner users [33]. Therefore this leads 63% of non-Internet users
not being aware of the free computer training sessions. This suggests that perhaps the
classes are not being advertised appropriately as the majority of the elderly people
were not aware of the facility. Fifty percent of the participants mentioned they would
consider attending the free classes. The other 50% stated they would not attend the
class because they did not feel the need to use the Internet as they have managed
without it throughout their career. Eighty-seven percent of the participants that do not
The Perception of the Benefits and Drawbacks … 209
use the Internet tend to seek assistance from other members if a task requires using the
Internet. This information was interesting, as the researcher did not manage to find any
similarities during the secondary research.
6 Conclusion
The project emphasised the perception of the benefits and drawbacks of Internet
usage by the elderly people (silent generation). However after completing the study,
it can be perceived that the drawbacks of Internet usage are being commonly
discussed, while the benefits are being overlooked. Despite the challenges of using
the Internet, It can be suggested those elderly people who have adopted the Internet
do benefit from the technology. While the non-Internet participants who have no
experience of using the technology had a negative perception and did not show
much interest.
Although the use of the Internet can be beneficial for the silent generation and in
some situations has a positive impact in their life style, it can also come across
equally having several drawbacks. Overall, the research suggests those elderly
people that have adopted the Internet and attended the socio-technical environment
[11] to learn to use the Internet seemed to gain some level of benefit by using the
technology. Elderly people with negative perceptions of the technology, result in
lack of motivation [17, 34] and determination to learn to use the Internet.
Non-Internet users believed they managed without the technology throughout their
career; therefore they can carry on without it. One of the key underlying reasons for
not using the Internet is because a number of participants were not willing to learn
to use the technology. This can be due to the socio-technical environment as not all
participants found the beginner learning classes convenient i.e. location [35].
However those who are practicing to use the Internet did seem to find the tech-
nology challenging and complicated. This suggests, perhaps web developers should
consider making web pages more user friendly in order for it to be accessible,
usable and less complex [6] for all types of users, enabling simpler interaction
between people and technology.
Expenditure and affordability was identified as a barrier, as not everyone
believed it was worth paying for the technology if they were not going to make
good use of it. The cause of Internet security threats and online hacking has also
made elderly people anxious in using the technology. A number of participants felt
worried and insecure when it relates providing financial and personal information;
therefore the generation prefers face-to-face interaction [36] like the “old fashioned” way.
Numerous participants did not provide the researcher consent to carry out the
observation study, which was a limitation. This was because a number of users felt
uncomfortable and anxious learning, whilst being observed by an external
researcher [11]. The barriers and challenges stated as the limitations of the research
could be seen as potential future recommendations. One of the recommendations
210 D. Hussain et al.
for future research will be to conduct both electronic and paper based surveys. The
electronic survey was not carried out on its own because it may provide biased
results, as responses from non-Internet users will not be achieved.
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