A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> VII. SOCIO-EMOTIONAL HEALTH <s> This study examined whether training provided to adults age 60+ would increase the use of information and communication technologies (ICTs), such as email and the Internet, and influence participants’ social support and mental health. Participants were randomly assigned to an experimental (n = 45) or a control group (n = 38). The experimental group participated in a six-month training program. Data were collected before, during, and after training on outcomes related to computer use, social support, and mental health. Mixed regression models were used for multivariate analyses. Compared to the control group, the experimental group reported greater self-efficacy in executing computer-related tasks and used more ICTs, perceived greater social support from friends, and reported significantly higher quality of life. Computer self-efficacy had both a direct and indirect effect on ICT use, but not on other variables. With appropriate training, older adults want to and can learn the skills needed to use ICTs. Older adults with ICT skills can access online sources of information regarding Medicare Part D options and utilize patient portals associated with electronic medical records. Agencies may develop services that build upon this technology sophistication, but policies also will need to address issues of access to equipment and high-speed Internet service. <s> BIB001 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> VII. SOCIO-EMOTIONAL HEALTH <s> Background: Older adults are at increased risk of experiencing loneliness and depression, particularly as they move into different types of care communities. Information and communication technology (ICT) usage may help older adults to maintain contact with social ties. However, prior research is not consistent about whether ICT use increases or decreases isolation and loneliness among older adults. Objective: The purpose of this study was to examine how Internet use affects perceived social isolation and loneliness of older adults in assisted and independent living communities. We also examined the perceptions of how Internet use affects communication and social interaction. Methods: One wave of data from an ongoing study of ICT usage among older adults in assisted and independent living communities in Alabama was used. Regression analysis was used to determine the relationship between frequency of going online and isolation and loneliness (n=205) and perceptions of the effects of Internet use on communication and social interaction (n=60). Results: After controlling for the number of friends and family, physical/emotional social limitations, age, and study arm, a 1-point increase in the frequency of going online was associated with a 0.147-point decrease in loneliness scores ( P =.005). Going online was not associated with perceived social isolation ( P =.14). Among the measures of perception of the social effects of the Internet, each 1-point increase in the frequency of going online was associated with an increase in agreement that using the Internet had: (1) made it easier to reach people ( b =0.508, P <.001), (2) contributed to the ability to stay in touch ( b =0.516, P <.001), (3) made it easier to meet new people ( b =0.297, P =.01, (4) increased the quantity of communication with others ( b =0.306, P =.01), (5) made the respondent feel less isolated ( b =0.491, P <.001), (6) helped the respondent feel more connected to friends and family ( b =0.392, P =.001), and (7) increased the quality of communication with others ( b =0.289, P =.01). Conclusions: Using the Internet may be beneficial for decreasing loneliness and increasing social contact among older adults in assisted and independent living communities. [J Med Internet Res 2013;15(2):e39] <s> BIB002 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> VII. SOCIO-EMOTIONAL HEALTH <s> Older adults are normally characterized as consumers, rather than producers, of digital content. Current research concerning the design of technologies for older adults typically focuses on providing access to digital resources. Access is important, but is often insufficient, especially when establishing new social relationships. This paper investigates the nature and role of digital content that has been created by older adults, for the purpose of forging new relationships. We present a unique field study in which seven older adults (aged 71-92 years), who did not know each other, used a prototype iPad application (Enmesh) to create and share photographs and messages. The findings demonstrate that older adults, even those in the \'1c"oldest old\'1d" age group, embraced opportunities to express themselves creatively through digital content production. We show that self-expression and social engagement with peers can be realized when socio-technical systems are suitably designed to allow older adults to create and share their own digital content. <s> BIB003 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> VII. SOCIO-EMOTIONAL HEALTH <s> Although research has shown that loneliness in adolescents leads to higher rates of depressive symptoms, the presumed protective factor of social connectedness has not been studied in conjunction with these two constructs. The aim of the present study was to determine if social connectedness would predict lower loneliness and depressive symptoms over time in a large sample of adolescents. A large sample of adolescents (N = 1774; 9-16 years at Time 1) were surveyed three times, separated by one year each, with self-report measures of social connectedness, loneliness, and depressive symptoms obtained. As expected, social connectedness was negatively associated with loneliness and depressive symptoms concurrently and longitudinally. Contrary to prediction, social connectedness did not function as a buffer between loneliness and depressive symptoms over time. However, consistent with prediction, a significant longitudinal mediation pattern was obtained over the three years: the effect of social connectedness on depressive symptoms was mediated by loneliness. Social connectedness at T1 predicted a reduction in loneliness at T2, which in turn predicted a reduction in depressive symptoms at T3. Moderation analyses of this mediation pattern suggested that this obtained mediation result was obtained for males, but not females, and obtained for older adolescents, but not for younger adolescents. The results are congruent with the view that social connectedness exerts an effective protective influence on adolescents against loneliness and depressive symptoms. <s> BIB004 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> VII. SOCIO-EMOTIONAL HEALTH <s> The aging population (seniors) maintains a strong desire to remain independent as long as possible while maintaining their physical health and emotional well-being. We have witnessed a growth in technological solutions delivered as Apps on mobile devices for health and wellness. However, several challenges remain in their application to assist seniors in the dimensions of health and wellness. They fail to provide sufficient connectivity and a level of usability that is appropriate for seniors. To that end, we are developing a tablet-based application, eSeniorCare, to integrate various components of health and wellbeing targeting successful aging. Our design and development followed an iterative process involving feedback from the participants. We conducted a 31-week study of the application with 16 participants at an independent facility in collaboration with Memorial Hospital of South Bend. Our study found that through the use of the application, participants demonstrated improved technological health management skills and decreased risk for depression, suggesting that eSeniorCare represents an important step toward improving senior care and quality of life. <s> BIB005 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> VII. SOCIO-EMOTIONAL HEALTH <s> ObjectivesResearch suggests that older adults who remain socially active and cognitively engaged have better cognitive function than those who are isolated and disengaged. This study examined the efficacy of learning and using an online social networking website, Facebook.com, as an intervention to maintain or enhance cognitive function in older adults.MethodForty-one older adults were assigned to learn and use Facebook (n = 14) or an online diary website (active control, n = 13) for 8 weeks or placed on a waitlist (n = 14). Outcome measures included neuropsychological tests of executive functions, memory, and processing speed and self-report questionnaires about social engagement.ResultsThe Facebook group showed a significant increase in a composite measure of updating, an executive function factor associated with complex working memory tasks, compared to no significant change in the control groups. Other measures of cognitive function and social support showed no differential improvement in the Facebook group.DiscussionLearning and using an online social networking site may provide specific benefits for complex working memory in a group of healthy older adults. This may reflect the particular cognitive demands associated with online social networking and/or the benefits of social engagement more generally. <s> BIB006
In old age, social connectedness and support play an important role in reducing loneliness and depression BIB004 . Yet, older adults are often socially isolated due to their physical limitations and/or life circumstances (e.g. death of a spouse, and preference for living independently). Fortunately, over the past decade, numerous information communication technologies (ICT) have been developed that can have a direct influence on individual's socio-emotional health. For example, emails and social networking websites like chatrooms, discussion groups and support groups facilitate social inclusion and relationship maintenance through back-andforth messaging. The audiovisual tools can boost the experience of these online interactions by adding voice and video dimensions to them. Studies show that ICT is effective in helping older adults develop and sustain new friendships, and experience a sense of community and belonging BIB002 . However, there has been some speculation around their impact on older adults' perception about their level of social support. Myhre et al. (we have described their study in Cognitive Health section) reported that participants in their study did not experience an improvement in their perception of social support BIB006 . The researchers had hypothesized that back-and-forth online dialogue on Facebook would increase social support variables in older adults but their study suggested to the contrary. It is possible that the study design which restricted participants' contact to study participants only (not the social media) is responsible for this outcome. Therefore, further research in understanding the impact of social media use on social support of older adults is needed. Woodward et al. tried to address this question in their study using online communication tools but their results also suggest that ICT may not be effective in expanding older adults' social networks BIB001 . Essentially, the researchers collaborated with an older-adult-service-providing community agency to assess the effect of ICT use on socio-emotional health of older adults. Forty-five older adults used Internetbased applications such as Skype and email to connect with friends and family for six months. Thirty older adults who were not expected to do anything acted as control. Both groups were assessed for mental health and social support measures at the baseline, three months after the study, at the end of the study and three months post-study. The experimental group experienced an increased perception of support, particularly from their friends, and an improved quality of life compared to the control group. However, the experimental group did not report any statistically significant improvement in other measures of social support (i.e. number of people in the network and frequency of contact) or in loneliness and depression. This shows that ICT tools are effective in supporting existing relationships but not necessary in helping build new ones. Meanwhile, other innovative applications have been evaluated for their ability to help older adults build new social connections. Engagement for Media Sharing (ENMESH) is a particularly important example in this area BIB003 . It is a tablet-based application consisting of a shared display where photographs and messages of all the connected users are visible in a cascading fashion. A user can move objects around and change their sizes using fingers, and other users can witness these interactions in real-time. Seven older adults (85 years and older) who did not know each other used Enmesh to share photographs and messages with each other for ten weeks. The analysis of shared content showed that producing digital content provided older adults with important opportunities for self-expression, creativity and social engagement. Sneak-peeking into their peers' lives and witnessing their peers' tablet interactions helped individuals connect with each other and find common interests. These promising findings behoove us to explore what other kinds of digital content production would appeal to older adults, and what type of media would be suitable for promoting different social relationship (such as inter-generational relationships, peer communication etc). Apart from using tablet applications, older adults' interest in and desire to learn tablet skills can also reduce social isolation. Most studies report providing tablet training to participants in a group setting. Although older adults benefit most from personalized, one-on-one instruction, training with others provides an opportunity to connect and learn from 9012 VOLUME 4, 2016 peers. However, we did not find any research that specifically measured the impact of group training classes on social support measures for older adults. A study by Dasgupta et al. reports change and decrease in depression risk for 12 out of 16 participants BIB005 . The participants attended group-based tablet training classes for eleven weeks and used a tablet application for 31 weeks. Due to the limitations of their study methods, it is not possible to attribute decrease in depression to group-based tablet workshops. However, based on their empirical observations of increased participant contact both during and after workshops for the purposes of learning and teaching the tablet, the researchers suggest that participant's social support was greatly improved, explaining the decrease in depression risk. Tablet learning has also been effective in improving social networks of older adults by enriching it with multi-generational dimension. Since the younger generation has grown up in the age of computers and technologies, they demonstrate greater comfort with these tools. As a result, teens can become effective mentors for older adults. A national volunteer-based program called Cyber-Seniors pairs older adults who want to learn to use computers and the Internet with teenagers who are willing to teach these skills. We did not find any study that reports social, emotional and physical benefits of inter-generational relationships, based on technology mentoring, on older adults. However, personal and social development benefits of these workshops on teens have been vastly documented.