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Digital health and social care delivery: The impact of digital exclusion on older adults in deprived coastal communities


   Faculty of Medicine and Health Science

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  Prof Fiona Poland  No more applications being accepted  Competition Funded PhD Project (UK Students Only)

About the Project

This PhD will provide novel understandings of how older people can address widening disconnections in their care as remote consultations and monitoring and staff recruitment crises dramatically shift post-pandemic health and social care landscapes. The most vulnerable are more likely to become digitally excluded from care in socio-economically disadvantaged coastal communities. Older adults, living with complex co-morbidities or dementia require multiple consultations with health and social care practitioners, scarcer in disadvantaged communities. Reasons for digital health exclusions are diverse and poorly evidenced; but can include culture, poorer support networks, or mental health problems, including fear of using [1, 2], costs linking to digital poverty [3], generating double inequalities for older people in most disadvantaged communities [4]. 

A mixed methods, comparative critical-cases design will inform ethnographic, longitudinal and participative data collection within especially Great Yarmouth, experiencing high digital poverty, and comparator Norfolk coastal communities. Comparing communities, will evidence how communities, people and support networks may affect interactive access to digitally-platformed services. 

The PhD offers excellent training via supervisors’ research expertise and networks in technology-based care, gerontology and community support, to develop skills in social science and care services methodologies to:  Year 1, scope older peoples’ digital exclusion within local and national care systems, linking to SHAPE (Strategic Health Asset Planning and Evaluation) web-based national tool now detailing Great Yarmouth (https://arc-eoe.nihr.ac.uk/bespoke-shape-atlas-arc-east-england); Year 2, compare ethnographic comparative critical case studies of older peoples’ digital poverty, to identify access issues within digital encounters with services. Supervisors and their research teams lead in coproduction methodologies [5] and encourage supervisees to innovate ways to collaborate with older people including, (Year 3), identify digital services practices which can amplify equitable, independent access, and specify the SHAPE tool. Findings will inform a future study to test interventions to inclusively support older people to coproduce mitigating barriers to services. 


Funding Notes

This PhD project is a Faculty of Medicine and Health Sciences competition for funded studentships. The studentships are funded for 3 years and comprise UK tuition fees, an annual stipend of £15,609 (2021/22 rate) and £1,000 per annum to support research training. International applicants (including EU) may apply but are required to fund the difference between UK and International tuition fees (details of tuition fees can be found on our website https://www.uea.ac.uk/study/fees-and-funding/fees).

References

Knowles, B., Hanson, Vl. (2018). The wisdom of older technology (non-) users. Communications of the ACM. 61(3): 72–77
Lariviere, M., Poland, F., Woolham, J. et al. Placing assistive technology and telecare in everyday practices of people with dementia and their caregivers: findings from an embedded ethnography of a national dementia trial. BMC Geriatr 21, 121 (2021). https://doi.org/10.1186/s12877-020-01896-y
Office for National Statistics (2019) Exploring the UK’s digital divide. 4th March 2019
Marmot, M., Allen, J., Boyce, T., Goldblatt, P., Morrison, J., (2020). Health equity in England; The Marmot Review 10 years on. London: Institute of Health Equity
Grotz, J., Ledgard, M. & Poland, F., (2020) Patient and public involvement in health and social care research: an introduction to theory and practice. London: Palgrave Macmillian.
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