Monday, 11 March 2013

B4: Meeting the challenge of the digital divide: An example from e-health

Ray Jones

While new ‘digital learnscapes’ may democratise learning opportunity rapid change may widen the digital divide. Future challenges for lifelong learning include equality of access. This presentation will use an example from health to discuss the need to monitor the digital divide in lifelong learning. A measure of e-health readiness and e-health inequality has been developed and validated; the presentation will describe this example of how inequality in lifelong learning may be assessed and addressed.

What are e-health inequalities? In addition to Internet availability and patients’ ability to use it there may be other ‘supply side’ inequalities. For example, some GPs have comprehensive websites allowing patients to re-order prescriptions, access resources to learn how best to maintain or improve health or cope with illness or disability, but other GPs have no website. While recent research has focussed on e-health literacy, help with Internet use and the economics of access are still important, particularly for older people.

This study aimed to develop and validate a self-completed questionnaire and scoring system to assess e-health readiness and e-health inequalities. A model of influences on e-health readiness was developed from review of the literature. A self-completed questionnaire was piloted in three stages followed by a survey of 344 people used to refine the scoring system.
The Plymouth E-health Readiness Questionnaire (PERQ) includes questions used to calculate four sub-scores: (i) patients’ perception of e-health provision, (ii) their personal ability and confidence in using e-health, (iii) their inter-personal support, and (iv) their perception of relative costs. These are combined into an overall ‘readiness’ scale. Reduction in standard deviation of the scores represents reduction in e-health inequalities. Scores produced appear valid and PERQ can measure change.

Various interventions, such as volunteers helping older people get online (eg. Plymouth SeniorNet), or infrastructure changes (eg. Superfast Cornwall) may have different impacts on the digital divide for lifelong learning. Using measures such as PERQ to assess impact will enable policy makers to prioritise interventions that do not widen the digital divide in lifelong learning.

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