A Case Study: Growing Community Partnerships with a Service-Learning Intergenerational Computing Course

Jean F Coppola
Pace University,
United States

Abstract

This article presents an interdisciplinary and intergenerational technology research project. Uniquely trained undergraduates enrolled in an Intergenerational Computing service-learning class instruct older adults in geriatric facilities. Geriatric facilities have few staff to work with older adults for technology activities. This model is based on mutually beneficial partnerships. Information on best practices, research instruments, classroom exercises, and lessons learned is presented for replication into the reader’s agency and discipline. A statistically significant change in students’ attitude and advocacy toward older adults was found, as well as a more positive perspective and awareness of careers in the field of aging.

Synopsis

Older adults represent a rapidly increasing percentage of the population, yet limited attention is being given to older persons in terms of Internet access, as well as computer usage, hardware, and software. This article presents an award winning interdisciplinary and innovative intergenerational technology research service-learning project.  In this project, specially trained undergraduate students enrolled in an Intergenerational Computing service-learning class instructed older adults in geriatric facilities.  Geriatric facilities, especially in these difficult economic times, have few staff to work with older adults for technology instruction or related activities.  This model based on mutually beneficial partnerships with geriatric facilities, government agencies, and higher education institutions will be discussed.  Information on best practices, partnerships, pre/post research instruments, classroom exercises, and conclusions will be presented for replication into the reader’s own agency and service-learning ideas transposed to the reader’s discipline. A statistically significant change in students’ attitude and advocacy toward older adults was found, as well as a more positive perspective and awareness of careers in the field of aging after these civic engagement and in-class activities. Moreover, students were willing to continue community service after the conclusion of the course.

Background

This project was developed because of concerns by the county government office in regards to the rapidly growing senior citizen population and the strong desire to provide awareness of career possibilities in the “silver industries” to college students.  At the same time, local higher education institutions wanted to start a service-learning research project and create win-win community partnerships while successfully integrate service-learning in the curriculum.  The higher education institutions agreed to assist the government agency in helping them close the “digital divide” thus addressing the technology needs of the aging population, as well as changing the perception of older adults by college students, while persuading them to work with the older adult population in their career choice.

Introduction

According to the U.S. Census Bureau (2010), by 2030, nearly one in five Americans will be aged 65 and older.  The projections include a rapid escalation in the United States of the over 65 population between the years of 2010 and 2050.  The projection of U. S. residents aged 65 and over is estimated to comprise a population of 88.5 million by 2050, which is more than doubles 2010’s figures.  Simultaneously, the technology explosion is creating a world that depends on technology for everything from purchasing groceries to obtaining directions.  The problem is that older adults, the fastest growing population, often are not comfortable with or can afford connectivity to the Internet.

The perception by some may be that the Internet is well-matched for older adults because of available free time and less physical activity (Norris, 2001). Common elderly impairments, including hearing, vision, or motor skill disabilities, significantly impact computer interaction thus fostering the “grey digital divide” (McGaughey, Downey, 2009).  The digital divide, defined as the gap between new technology and the ability to use (and sometimes, afford) it, is widespread among older adults, and especially those with physical limitationsMany older adults, however, find computers technically intimidating, and are reluctant even to learn how to use them.  For example, in this study some older adults were found to be afraid of breaking the computer if they did something wrong on the screen, thus wanting the college students next to them while working on the computer. The very group that would benefit the most from spending their leisure time emailing friends and family for improved communication, gathering of health and drug information, shopping, and connecting with others in on-line communities, often are not capable.

This case study fosters technology use in the elderly population to stimulate cognitive functioning while improving the overall quality of life socially, emotionally, and practically.  Older adults in an individualized and non-threatening learning environment are assisted by college students to overcome their fear of computers, to learn a new set of communication skills, to be mentally challenged, and to improve their daily life functions and to foster independence.

The literature suggests that the elderly would be less fearful of computers and more apt to adopt the Internet / e-mail if they are delivered in an elderly-friendly way.  The hypothesis is that by college students teaching the elderly computing technology in an intergenerational tutorial setting, the fear most often associated by seniors with computing can be circumvented, and college students will change their attitude and advocacy toward older adults in one semester.

Literature Review

Older adults are making significant gains in Internet use (Fox, 2004) and their use of online communication and entertainment activities have also  increased significantly (Jones & Fox, 2009). Approximately 48% of older adults use the Internet (Zickur, 2010).  Use of social networking sites has quadrupled since 2008, with an increase in use from 4-16%. The fastest growth in the use of social networks has been in the over age 74 group.  Recent surveys show that older adults who use the Internet most frequently use e-mail, searches, and health information (Zickur, 2010). One recent study found that older adults were interested in learning technology that supported activities that they were familiar with (Seals, Clanton, Kelly, et al., 2008). A recent survey of a sample of 216 older adults between the ages of 56- 80 years found that  29% owned a computer, 56% used the computer and 26% used e-mails (Keil, 2005).

The Internet proves essential to the elderly in connecting with family, friends, and lost acquaintances, thus avoiding social isolation.  It also provides valuable health related information and healthcare options (Seals, Clanton, Agarwal, Doswell, & Thomas, 2008).  Research has shown that frequent Internet use by older adults may improve cognition (Seelman, Collins, Bharucha, & Osborn, 2007). Other studies have shown that technology enriches daily functions, increases independence, and improves the overall life quality of older adults (Cresci & Jarosz, 2010; Stark-Wroblewski, Edelbaum, & Ryan, 2007).

The use of technology also has implications in monitoring older adults in their homes and assisting them to remain independent. Home based systems allow healthcare providers to monitor older adults and obtain real-time data in order to inform the senior about their functioning and provide detailed information to the senior so that participate in his/her own care (Kaye, 2011).

Bridging the digital divide by making computers and internet use more accessible to older adults has implications for improved health and quality of life. Despite this, there are many older adults who do not have access to computers and the internet. Older adults are often reluctant to embrace computer technology, and experience fear and anxiety  (Schlag, 2007). Some fear that they will break the computer and therefore area reluctant to use them (Chien, 2008). Many older adults have age related impairments in hearing, vision, and motor skills which make using a computer difficult (Burgstahler, 2002).  Many older adults do not retrieve health information because of a lack of computer literacy or access to computers.  This is particularly true in low income elders who live in vulnerable communities (Mead, et al., 2008). Thus, this aged population that has so much to gain from utilizing a computer are often unwilling or unable to operate a computer (Mann, Belchior, Tomita, & Kemp, 2005).

Lorence and Park (2006) assert that initiatives in the US aimed at reducing the digital divide have not been effective and emphasized that in order for the elderly to experience the benefits of health information technology it is necessary to identify and support policies and interventions aimed at increasing the use and access of computers and the internet by the elderly

Use of Technology as a Catalyst in the Service-Learning Project

The core of this research is based around a unique course entitled, Intergenerational Computing. It is a multi-disciplinary course offering with an innovative approach. In this service-learning course, students learn about both the process of aging, as well as computing technology. The course goes beyond simply having students do community service to help the elderly. The students receive theory and training specifically for teaching technology to the elderly. The students have textbooks and readings for the course in the areas of social gerontology, service-learning, and technology in action.

Students acquire knowledge about the aging process together with applied computing in order to prepare them for structured technology educational activities with their older adult learners. First, students are assigned to teach an intergenerational relative or neighbor computing skills to learn excess “patience” and techniques as they begin to register for the course for about five lessons. Class requirements include essay reflections and blogging of each activity. Role-playing with various props and assistive technology devices allow students to emulate an older adult with visual, hearing, and motor skill disabilities.

Interdisciplinary Focus

Sensitivity Training

Role playing with various props and assistive technology allow students to emulate an older adult with visual, hearing, and motor skill disabilities. As the course developed from a one-day event in 2005, to a semester pilot in 2006, and then progressed to multiple sections over different campuses in the following years, it became evident that a more robust sensitivity training for the undergraduates would improve outcomes over each subsequent semester. Sensitivity training would “soften” the grey digital divide for the enrolled students. With such a gap in their developmental stages the faculty leading the project agreed that it would be helpful if the students could “walk in the shoes” of the elderly. The students needed to see and feel what older adults in their 70s, 80s and 90s may experience.

The original sensitivity training, based on a shoestring budget, began with toothpaste, vaseline, old sunglasses, masking tape, and cotton balls. Old glasses with toothpaste or vaseline rubbed on them were used to simulate different eye impairments and therefore the students could try to see the computer as an older adult with visual impairments.  Simulation glasses are commercially available that simulate impairments such as cataracts, macular degeneration, and glaucoma.   To mimic arthritis of the hand, the students taped two fingers together and tried to type on a keyboard.   Cotton balls were utilized to simulate some loss of hearing.

As resources and grant funding increased, sensitivity included students sitting in a wheelchair, wearing a back brace, and utilizing a cane or walker for mobility.   Lightweight garden gloves are utilized to pick up mediation and deposit pills into weekly medication dispensers.  Popcorn kernels were also provided to students for insertion in their shoes, as well as water wet adult diapers.  Few students, however, accepted the challenge for the wet diaper exercise, but those students that participated, blogged about their experience, which turned into an eye-opening episode.

This sensitivity training has a strong impact on the students as recorded in their blogs shared with classmates and their reflection paper.   Students discussed this memorable event in their blogs and stayed fresh on their minds while instructing the older adults on the computer as confirmed by their weekly blogs.

Understanding Accessibility in Windows Operating Systems

As part of the training process, it is imperative that students understand the vast amount of accessibility options that are available on Windows operating systems. “Accessibility,” as defined by Microsoft, “is about removing barriers…to meet the needs and preferences of a diverse set of individuals that might use the product.” Microsoft has been committed to incorporating accessibility options into its Windows operating systems, mainly through extensive customization options, features, and settings.

Students are trained to learn the most important accessibility customizations for our geriatric patients. Microsoft Windows XP, the still-predominant operating system on most computers  offers an “Accessibility Wizard” which enables our students to easily pick and choose which settings need to be enabled for our geriatric patients. The elderly usually have difficulty with rapid-click motions and small text size.

A common difficulty is seen with the computer mouse.  Users often state it is difficult to “double-click” or “right-click.” As such, the Accessibility Wizard offers the option to increase the detection speed between the double-click function as well as create new functions or patterns for right-click capabilities. “Sticky keys” are also available for combination functions from the keyboard. This option prevents users from having to press multiple keys at once, for example, typing a capital letter by pressing “SHIFT + x.” Sticky keys allow the user to press SHIFT, release the key, and then press the letter without having to press both keys simultaneously.

Another capability that our students learn is how to easily increase the icon size and text size on the screen. By navigating to the Display Properties | Appearance | Effects dialog box from the Control Panel, students can enable “Use large icons” or adjust the font DPI for better-viewing. The Narrator feature, which is “a text-to-speech engine for people who are blind or have low vision” is available for announcing all mouse-clicks, dialog boxes, menu options, or typed text. Playback speed can be selected as well as the preferred playback voice.

Many of our patients prefer to browse the Internet and settings can be customized to adapt to those with disabilities in color recognition. An Accessibility group of options is available by navigating to Internet Options | General | Accessibility from Internet Explorer. Default options can be set to ignore specified colors on a web page or distinct formatting styles for improved clarity. In addition, we explained to our students that a custom cascading-style sheet can be created to override all settings to create a uniform browsing experience.

Since Windows 7 was released on October 22, 2009, all mainstream computer manufacturers are including the operating system pre-installed on new PCs. In addition, corporations are starting to adapt  the new features. The accessibility options are vastly improved in Windows 7, even offering a self-guided tour that our students and geriatric patients are able to utilize together. Windows 7 utilizes the “Ease of Access Center,” which provides quick access to common tools and functions that were somewhat scattered in Windows XP. We also show our students how to use the built-in questionnaire, which features a survey that Windows will use to automatically adjust settings accordingly. The same functionality is available, such as mouse clicking, keyboard adjustments, screen text size, and narration. A series of demonstrations are shown to the elderly to better assist them.

Methodology & Research Questions

Using a one-group pretest and posttest research design, students who participated in the gerontechnology program were interviewed before starting their work with older adults and then after the project was completed (N=165). As shown in Table 1, the average age of the students was 21.8 years, and 52.7% were males with 47.3%  female.

Table 1: Profile of Student Participants (N=165)


Number

Percent

Age at enrollment

     Mean

     Standard Deviation

 

21.78 years

  5.19

 

Gender

     Male

     Female



87

78

 

52.7%

47.3%

Ethnicity

     Hispanic

     African American

     Caucasian

     Asian

     Other



27

15

96

18

9



16.4%

 9.1%

58.2%

 10.9%

5.5%

Year

     Freshman

     Sophomore

     Junior

     Senior

 

12

47

53

53

 

7.3%

28.5%

32.1%

32.1%

Notes:  *Higher scores indicate more positive interest.

Mean scores increased between pre and posttest, with statistical differences in 2 specific action areas.


Students who enrolled in the course had different plans of study, although the majority of students were business majors (59.4%).  Over 90% of the students that responded did not have any previous coursework related to older adults. The hypothesis was that students’ attitudes toward older adults, and their interest in advocating for older adults would improve after the gerontechnology project.  The results shown in Table 2 indicate that between the pretest and the posttest there was a statistically significant mean increase in both attitude scores and students’ interest in advocating for older adults. 

Table 2A: Students’ Interest in Advocating for Older Persons with Specific Action

Action

Pretest

Mean

Posttest

Mean

Discuss aging issues with classmates

3.29

3.38

Encourage others to become involved in aging issues

3.20

3.44*

Work with other college students to form an aging committee

2.70

2.94*

Meet with local congress representative about aging issues

2.51

2.69

Go to Albany and discuss aging issues in NYS

2.12

2.28

Notes:  *Higher scores indicate more positive interest.

Mean scores increased between pre and posttest, with statistical differences in 2 specific action areas.



Table 2B: Students’ Coursework and Volunteer Experience

 

Previous Coursework Related to Older Adults (60+)

 

Response

     No Previous Coursework

93.3

     Previous Coursework

6.6

Volunteer Experience with Older Adults (60+)

 

     Previous Volunteer Experience

34.5

     No Previous Volunteer Experience

61.8



Also, a more positive perspective and awareness of careers in the aging field after these civic engagement and in-class activities prevailed. Moreover, students were willing to continue community service after the conclusion of the course.

Educational Impact & Value of Project for the Educational Institution

Undergraduates thrive on the opportunity to use all of their college-acquired skills on service-learning projects and seeing the projects actually work at making a difference in peoples’ lives. For example, a business student commented he had to learn to work as a team, collaborate with alumni donating computer equipment, understand tax donations, as well as work with community partners for installation and customizations to fit their needs. This student saw the big picture and continued his projects beyond the scope of the course.  Faculty need to provide opportunities to students for enhancing their soft skills, and activity- based learning, while teaching students to become responsible citizens.

This project provided students with a high level of satisfaction. Many students indicated that this Intergenerational Computing class was the best course they have taken during their time in college. As some students self-reported, it changed their lives.

Community Partnerships and Replication of Study

Since October 2005, all partners in this innovative research consortium carefully planned, developed, and implemented the core program component, including curriculum for the service-learning course entitled Intergenerational Computing.

This intergenerational computing program is a best practice model of success for positive partnerships between community organizations that optimally utilizes their assets. A cross section of community organizations formed a consortium including county government, higher education institutions, and a geriatric care organization. This allowed the program to continually add the innovative research findings to refine the curriculum, bring educational skills to teaching the seniors while the eldercare staff advised, assisted and supervised.

Some critical success factors for replication of this study include:

  • Partnering with a health care complex wanting technology infusion and able to provide space and staff support.

  • Health care institution leadership must come from the top.

  • The health care staff must willingly be supportive and encouraged to participate in the development and continuation of a successful program including but not limited to planning, senior selection, anecdotal feedback, and graduation.

  • Partnering with university or other educational institution of higher education that can provide leadership for obtaining donations and maintenance of computer equipment.

  • Resources for installing internet connectivity, software, and furniture either via donations, grants, and/or internal funds.

  • Staff or students willing to assist the seniors between classes (perhaps on a limited schedule)

  • Partnering with faculty that can provide leadership for curriculum development, service learning course development, and willingness to spend additional hours above normal class requirements.

  • Academic institution that supports civic engagement activities and capability to obtain proper enrollment in courses with students willing to teach the elderly.

  • Health care staff willing to remind senior participants to attend sessions where needed and assist those with mobility issues to come to the computer lab.

Findings

Results have shown through observations via the nursing staff, as well as by pre- and post- assessment instrument that the adoption of technology led to an improved quality of life and increased independence.  The older adult participants (average age 77.76) gained a greater sense of well-being and self-worth, a more positive outlook on life, increased cognitive functioning (preliminary results see Table 3), Control Group data is being analyzed, but preliminary results suggests that the significant improvement is not a learning effect.

Table 3: Profile Older Adult Participants

 

Percent

Age of Participants

 

     Mean

77.76 years

     Standard Deviation

10.59

Gender

 

     Male

24.0%

     Female

76.0%

Ethnicity

 

     African American

16.0%

     Hispanic

12.0%

     Caucasian

72.0%

Residence

 

     Nursing Home

24.0%

     Assisted Living

44.0%

     Independent Living

32.0%

Notes:  N=116

 

Table 4: Improvement in Senior MOCA Scores

 

N

Mean

Standard Deviation

Pre MOCA scores – Experimental Group

25

17.76

4.30

Post MOCA scores – Experimental Group

25

20.80

4.16

Notes:  Paired t-tests reveals a significant improvement (p<0.001) in MOCA scores between pre and post test

decreased levels of depression, and reduced social isolation.  This reinforces findings of past research in the literature.  For example, after “graduating” from the course, United XXX (New Rochelle, XXX) nursing staff reported that the older adults felt more purposeful and had increased confidence.  They also were capable of learning something new, developed new relationships, and learned a new means of communication with family and friends.  The senior participants reported that they were more in accord with the world at-large by not being “left behind”, were capable of looking up heath related information, and were mentally challenged by computer activities.

Conclusions

The senior citizen participants were proud of their accomplishments.  The older adults sent and received emails with their families. Moreover, the elderly researched information, such as their own military records, or those of a husband.  Many older adults enjoy working 1-on-1 with the college students week after week, illustrating an additional 2-way social impact.  Students were surprised at the ability of the senior citizens to quickly learn, and enjoy the process.

One unexpected result of this intergenerational endeavor was the special bonds that developed between the elderly and undergraduate students through these meaningful interactions. The benefits were far reaching, and a much valued intergenerational, as well as life changing experience for some. To the undergraduate students, it became clear that senior citizens are capable of learning at any age, were thirsty for acquiring new skills, and greatly respected their young teachers.

The results of this joint venture with higher education, service-learning students, health-care providers, and governmental department of senior programs and services proved successful. The project will continually be expanded during the upcoming semesters.

References

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The Journal of Community Informatics. ISSN: 1712-4441