{
  "abstract": "Background Digital exclusion is a super social determinant of health as it can affect many areas of life that influence health and wellbeing (e.g. making appointments, banking, contacting family). Older people are especially vulnerable to digital exclusion – it can impact loneliness, poor housing, poor health. Many voluntary and community organisations offer digital support/training, but this is not offered systematically, and does not always reach those who are most in need of support, so exacerbating health inequalities.The INCLUDE study aims to create a robust, replicable method for identifying older people at risk of digital exclusion and to tailor existing digital support to better meet their needs. Here we report on a survey exploring internet use in people aged 65+, conducted as the first part of the study, to estimate the prevalence and predictors of digital exclusion.Methods A bespoke survey included questions about internet use (including 22 different online activities) and potential predictors of exclusion derived from the literature (e.g. age, ethnicity, socioeconomic deprivation). Survey mailouts were generated by two GP practices using patient registers and posted to those aged 65+ living in Bradford District and Craven. Practices linked individual survey IDs to frailty (eFI) scores, enabling the inclusion of frailty as a predictor variable. Postal methods were augmented by telephone follow-up and face-to-face community engagement. Estimates indicated that sending 6,000 surveys was necessary to achieve the required sample size (N≥900).Results 5,982 surveys were posted; 2,932 (49%) were returned and over 350 were completed by telephone and community engagement: a total of 3,300 completed surveys.We defined digital exclusion as respondents not engaging in any online activities by themselves. 17% of the respondents were digitally excluded. A further 30% reported only limited internet use: ‘narrow users.’ Age, frailty, and Asian ethnicity were identified as significant predictors of digital exclusion.34% of the respondents provided free-text responses about their views on the internet at the end of the survey. 10% of these responses included comments about online GP services; the majority reporting difficulties using online health systems or a preference for offline interactions when booking and receiving appointments.Conclusion A predictive model is being developed using survey findings. This model will be implementable in primary care electronic health records, allowing identification of older adults who are more likely to be digitally excluded, to enable the targeting of support. Insights from respondents’ comments will be fed back to GP practices.",
  "authors": [
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"
      ],
      "name": "Caroline Brundle"
    },
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust and University of Leeds, Leeds, UK"
      ],
      "name": "Kate Best"
    },
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust and University of Leeds, Leeds, UK"
      ],
      "name": "Jessica Johansson"
    },
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"
      ],
      "name": "Thomas Atkinson"
    },
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust and University of Leeds, Leeds, UK"
      ],
      "name": "Andrew Clegg"
    },
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust and University of Leeds, Leeds, UK"
      ],
      "name": "Anne Forster"
    },
    {
      "affiliations": [
        "PPI Co-applicant, Hull, UK"
      ],
      "name": "Marilyn Foster"
    },
    {
      "affiliations": [
        "Bradford District and Craven Health and Care Partnership, Bradford, UK"
      ],
      "name": "Sarah Humphrey"
    },
    {
      "affiliations": [
        "North East and Yorkshire Region Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK"
      ],
      "name": "Alison Iliffe"
    },
    {
      "affiliations": [
        "Age UK Leeds, Leeds, UK"
      ],
      "name": "Claire Walker"
    },
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust and University of Leeds, Leeds, UK"
      ],
      "name": "Liz Graham"
    }
  ],
  "title": "P10 Identifying digitally excluded older people: the INCLUDE study",
  "uid": "7dc220a5-2a01-595a-8f44-cf1cc4fe8919"
}