Using Internet technologies in rural communities to access services: The views of older people and service providers

Journal of Rural Studies xxx (2016) 1e10

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Journal of Rural Studies journal homepage: www.elsevier.com/locate/jrurstud

Using Internet technologies in rural communities to access services: The views of older people and service providers Heidi Hodge a, *, Doris Carson b, c, e, Dean Carson a, e, f, Lareen Newman d, Jaimee Garrett a a

Mid North Knowledge Partnership, Flinders Rural Health South Australia, Flinders University, Australia Department of Geography and Economic History, Umeå University, Sweden c School of Natural and Built Environments, University of South Australia, Australia d Southgate Institute for Health Society and Equity, School of Medicine, Flinders University, Australia e The Northern Institute, Charles Darwin University, Australia f The Arctic Research Centre, Umeå University, Sweden b

a r t i c l e i n f o

a b s t r a c t

Article history: Received 6 August 2014 Received in revised form 16 June 2016 Accepted 16 June 2016 Available online xxx

Older people in rural communities increasingly rely on the Internet to access essential health, finance, education, and other social services. However, their abilities to participate in the online service system are often undermined by a continuing ‘digital divide’. This divide may be exacerbated by the strategies of service providers who fail to recognise and respond to the needs of older rural clients. This paper is based on a case study in Clare, a small rural town in South Australia, and examines the experiences of older residents and local service providers in trying to engage online for digital service delivery. Drawing on two sets of in-depth interviews, the study uses a mix of thematic content analysis and social network analysis to identify the nature and extent of digital interactions between older people and service providers, and the enablers and challenges for online service engagement. Older participants demonstrated considerable interest in learning how to use the Internet for accessing particular services, with social support networks and third party facilitators being crucial enablers. Service providers’ ambitions to engage with older people online appeared more limited as a result of entrenched stereotypes of older non-users, a lack of internal digital skills, as well as organisational and funding constraints. The case study findings emphasise the importance of balancing the views of older people and service providers in the design of online engagement strategies. These insights are critical for improving online service delivery in rural communities affected by an increasing withdrawal of physical services. © 2016 Elsevier Ltd. All rights reserved.

Keywords: Internet use Older people Digital divide Service providers Rural communities South Australia

1. Introduction Older people are increasingly expected to use online technologies to access important services e including health, finance, education, administration and other social and community services. This is a particular challenge in rural communities which are confronted with both a growing ageing population and the continuing centralisation of services in urban areas (Winterton et al., 2014; Hale et al., 2010). Despite substantial research suggesting that online technologies have the potential to improve service delivery and

* Corresponding author. Mid North Knowledge Partnership, Flinders Rural Health South Australia, Flinders University, PO Box 271, Burra, South Australia, Australia. E-mail addresses: heidi.hodge@flinders.edu.au (H. Hodge), [email protected] (D. Carson), [email protected] (D. Carson), lareen.newman@flinders.edu.au (L. Newman), [email protected] (J. Garrett).

social wellbeing in rural areas, there are still concerns that older people have limited abilities to access and use the Internet, and therefore miss out on the benefits of online services (Newman et al., 2010; Warburton et al., 2014). Such inequalities in Internet usage are commonly described as a ‘digital divide’, suggesting that people with certain demographic and socio-economic characteristics may be more disadvantaged in accessing and using the Internet than others (Cresci and Jarosz, 2010; Townsend et al., 2013). Reasons for a digital divide affecting older people in rural areas are diverse and include limited access to the Internet and to digital technology in rural areas, limited Internet proficiency among older people resulting from lower education and socio-economic backgrounds, as well as differing experiences and preferences in terms of how to use the Internet (Townsend et al., 2013; Newman et al., 2012; Stern et al., 2011). In addition, service providers themselves may face a range of constraints in tailoring their online strategies to the

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Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016

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H. Hodge et al. / Journal of Rural Studies xxx (2016) 1e10

particular information and service delivery needs of older rural clients, thus exacerbating the digital divide experienced by this group (Warburton et al., 2014). Improving online service delivery therefore requires a better understanding of how both groups e service providers and older rural service users perceive their participation and interaction in the online service system, and what challenges they face in this process. This paper explores the digital interactions between older people and organisations providing essential public and community services through a qualitative case study in Clare, a small town in rural South Australia. The research compares the experiences of older people using the Internet for service access with those of service providers seeking to engage with older people online. This comparison reveals the enablers and challenges for online service provision as perceived by both groups, and identifies mismatches between service provider strategies and user behaviour of older people. The paper further proposes a new way of analysing digital service engagement of older people in rural areas by conducting a social network analysis (SNA) that maps out the complex system of Internet mediated interactions between service providers and older service users. This approach is useful to visualise the extent and type of interactions with particular service providers, and to identify apparent engagement weaknesses within the service system. The combined interview and SNA results contribute to a better understanding of the complex mechanisms of digital engagement of older people in rural communities, and the different barriers older people encounter when trying to engage online. 2. Background 2.1. Digital participation of older people and challenges for online service delivery The barriers of older people engaging in digital participation have been a prominent topic of discussion within recent debates around the ‘digital divide’, and the disparities in Internet usage among different social, economic and demographic groups (Cresci and Jarosz, 2010; van Deursen and Helsper, 2015). Older age, along with lower education and income levels, are repeatedly identified as factors that negatively affect Internet usage in a number of developed countries (Calvert et al., 2009; Cresci et al., 2010; Hale et al., 2010). Some groups appear more excluded from using Internet technologies than others, with recent studies suggesting that older women are less likely than older men to use the Internet, ‘older’ old people (e.g. 75 þ years) less likely than ‘younger’ old people (60e75 years), people living alone less likely than those living with their spouses or families, and people with a disability less likely than those without (Berner et al., 2015; Calvert et al., 2009; Cresci et al., 2010; Dane et al., 2013; Lee et al., 2011; Niehaves and Plattfaut, 2010; van Deursen and Helsper, 2015). It has also become clear that the stereotypical image of the older Internet ‘non-user’ is becoming increasingly out-dated as older people become more exposed to Internet technologies and training opportunities, and new generations with more advanced Internet skills continue to enter the older lifecycle stage. This has led to calls for an ongoing re-evaluation of who the ‘pro-nets’ versus the ‘nonets’ are (Cresci et al., 2010), how different groups participate in the digital world, and what barriers keep them from doing so (van Deursen and Helsper, 2015). Recent studies in several developed countries explored the reasons for restricted Internet use among older people in more detail (Cresci et al., 2010; Gatto and Tak, 2008; Gitlow, 2014; Lee et al., 2011; van Deursen and Helsper, 2015; Wagner et al., 2010). The most commonly identified barriers include: a lack of basic computing and Internet literacy skills; a lack of confidence in

people’s own ability to learn those skills; a lack of access to adequate training and learning environments which target the specific needs of older people; fear of fast-changing technologies and the need to constantly re-learn skills; a lack of regular access to computers or the Internet due to prohibitive costs; persistent concerns about online privacy and safety issues; fears about embarrassing oneself in front of others; physical constraints related to mobility, visual impairment, fine motor skills, or mental limitations; and a perceived lack of time. Also a general lack of interest in, and limited recognition of the utility of using the Internet are commonly mentioned as barriers, though it has been acknowledged that such attitudes are gradually changing, with more seniors becoming aware of the potential benefits of Internet technologies and interested in learning how to use them €nen, 2014; Goodwin, 2013). Such learning (Kilpel€ ainen and Seppa efforts can be supported by individualised training (Goodwin, 2013; Berner et al., 2015), the involvement of older people in the design of training (Selwyn, 2004), and the provision of ongoing personal mentoring and social support networks (Cresci and Jarosz, 2010; Niehaves and Plattfaut, 2010; Warburton et al., 2014). In terms of preferred Internet activities, many studies have found that older people use the Internet primarily to communicate with friends and relatives, stay socially connected, access instant information or entertainment, or for daily routine tasks such as shopping, travel and banking (Gatto and Tak, 2008; Sum et al., 2009; Gitlow, 2014). Online engagement with public authorities or civic service providers appears to be comparatively limited (Kilpel€ ainen and Sepp€ anen, 2014; van Deursen and Helsper, 2015). The extent to which this lack of online service engagement is limited to older people only is, however, not clear. Recent research by the UK telecommunications regular Ofcom for example, has shown that using local government websites and online services is generally limited among all Internet users, not just older people (Ofcom, 2015). The reasons for limited online use of services is currently not well understood, and may well differ between older and younger users. Some issues that appear to affect older people in particular are linked to more complex and sensitive information needs arising from the service context, the need for more advanced Internet skills to complete online service tasks, or simply the fact that older people are still used to (or prefer) accessing such services €inen and Sepp€ offline (Kilpela anen, 2014). This points towards a potential functional or opportunity-related digital divide that may affect certain groups of Internet users, whereby differences in digital participation not only arise through different access, technology or skill levels, but through different preferences for using the Internet for particular tasks but not others (Newman et al., 2012; Stern et al., 2011; Wagner et al., 2010). The digital divide affecting older people may further be narrowed or widened by the physical and social contexts of Internet use (Lee et al., 2011). Not all Internet access occurs at home on a privately owned computer by the consumer who is directly seeking the service. People may access the Internet in public settings and/or facilitated through a ‘mediator’ who completes Internet tasks on their behalf (Helsper, 2008). The access setting may also impact on what can be done, either as a result of the capabilities of the actual user, the capabilities of the physical setting (e.g. some public settings may not allow certain types of downloads or be secure for financial transactions), or the social context (e.g. a consumer may not wish to share sensitive information on a public computer or with the person who accesses the Internet on their behalf). Another important concern is that a functional digital divide can form when the views of clients and service providers on how to use the Internet for service delivery differ from one another. This divide may be further exacerbated if service providers are unable to recognise and respond to the specific needs and patterns of

Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016

H. Hodge et al. / Journal of Rural Studies xxx (2016) 1e10

engagement of older people. Service providers themselves may face constraints when it comes to using Internet technologies. One example is the extent to which in-house or out-sourced expertise is available to assist in the design and implementation of Internet services (Lacity et al., 2011; Warburton et al., 2014). Service providers may also be constrained by entrenched stereotyped perceptions of consumers’ capabilities, with some research suggesting that service providers tend to have low expectations of the capabilities of older people and their motivations to use online services (Warburton et al., 2014). Beyond that, service providers may have limited abilities to develop better online engagement strategies for older people due to structural constraints such as funding limitations, internal policies and procedures, and external legislation, which may prevent providers from tailoring digital service strategies to older people’s online engagement needs (Mergel and Bretschneider, 2013). There is a clearly identified need for more research exploring the factors that keep older people from engaging online with the public service system, especially as funding limitations are increasingly prompting service providers (including in the health, social or administrative sectors) to shift their information, communication and service delivery strategies online. A better understanding of older people’s online information and engagement needs is particularly pressing in the Australian context where a recent federal government initiative established a new ‘Digital Transformation Office’, aiming to deliver all government services digitally in their entirety, within the next year (Abbott and Turnbull, 2015). 2.2. Older people and the digital divide in rural areas In general, the system of interactions between consumers and service providers that emerges from this complex set of enablers and constraints has been poorly described, especially in a rural context. Rural areas in many countries, including the UK, US and Australia, have typically been disadvantaged by a digital divide resulting from technological limitations, slower diffusion and restricted monthly allocations of broadband Internet, fewer Internet service providers, and higher costs of Internet usage (Townsend et al., 2013; Basu and Chakraborty, 2011; Salemink et al., 2015; Broadband for the Bush Alliance, 2014). Yet, research has shown that even as broadband access improves in rural areas, adoption rates do not automatically increase to the same extent (Whitacre and Mills, 2007; Townsend et al., 2013). This suggests that the rural digital divide is more deeply rooted in socioeconomic, demographic, ethnic, and knowledge divides that exist between rural and urban areas (Basu and Chakraborty, 2011; Newman et al., 2010; Salemink et al., 2015). There is surprisingly little research on how older people in particular are affected by this rural digital divide, with some studies showing that older people in rural areas are using the Internet less than older people in urban areas (Berner et al., 2015; Calvert et al., 2009; Hale et al., 2010). Perceived higher costs, fewer opportunities to access the Internet in public places, and fewer opportunities to access training and technological support may be among the key challenges faced by older people in rural areas (Warburton et al., 2014; Dane et al., 2013). At the same time, however, older rural people are not a homogenous group, and people with higher incomes and education, as well as those in the ‘younger old’ age brackets, have been shown to be similarly active Internet users as their urban counterparts (Berner et al., 2015). There is also reason to believe that counterurban retirement migration of educated and comparatively wealthy older people from cities to rural communities may have some impact on changing Internet literacy and €inen and activity among older residents in rural areas (Kilpela

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€nen, 2014). Conversely, older residents with limited formal Seppa education, language or cultural differences, or lack of financial resources may experience an even greater ‘divide’ (Haight et al., 2014). This paper examines a case study of older people’s digital interactions with service providers in a rural community in South Australia. As in other countries, household Internet access in Australia clearly differs along socio-economic and geographic dimensions, with Internet access being lower for those in older age groups (65þ), with lower incomes, lower education, and living in rural areas (Australian Bureau of Statistics, 2014a). However, the rural-urban gap in Internet access appears to be slowly closing, as rural areas, and particularly those located in the metropolitan hinterland, have seen substantial improvements in broadband Internet penetration in recent years. According to data from the Australian Bureau of Statistics (2014a), households outside of Australia’s (state) capital cities have demonstrated stronger growth in Internet access (up from 57% in 2006/7 to 79% in 2012/13) than households in capital cities (67% and 85% respectively). Also broadband Internet access has grown more strongly in non-capital city regions, from only 34% in 2006/7 to 72% in 2012/13 (compared with 49% and 79% respectively for capital cities). Data for older Australians in 2012/13 (Australian Bureau of Statistics, 2014a) suggest differences in Internet usage by gender (51% of males were online versus 40% of females), employment status (73% of those still employed were online versus 41% of those not employed); and education level (82% of those with a university degree were online versus 35% of those with a high school degree or below). Older people living outside capital cities recorded a slightly lower proportion of Internet users (43%) than those living in capital cities (47%) in 2012/13. There appeared to be no real differences between urban and non-urban older Internet users in terms of where they accessed the Internet, with the vast majority of users (over 96%) in both types of locations accessing the Internet at home (Australian Bureau of Statistics, 2014a). Other common places of access included the house of family or friends and various public locations. Purchasing goods and services (58%), online banking and bill payments (54%), and access to government services (50%) were among the most common online activities for older people in both capital and non-capital city locations, suggesting that using public services online was more common than other online activities such as social networking (30%), online voice/video calls (30%), watching videos or listening to music online (23%), and educational activities (23%). Interestingly, though, older Internet users living outside capital cities appeared to have a lower rate of using government services online (46% compared with 52% in capital cities), while the use of other online activities was more or less the same between both groups (Australian Bureau of Statistics, 2014a). Again, this raises questions about how rural older people perceive online interactions with public service providers and whether there are potential mismatches in the way services are delivered online to this particular target group. 2.3. The case of Clare in rural South Australia This study was conducted in Clare, a small rural town located about 140 km north of South Australia’s capital city of Adelaide. With a resident population of approximately 3300 people in 2011 (Australian Bureau of Statistics, 2014b), Clare is the main municipal centre of the Clare and Gilbert Valleys local government area (total population 8750). It is a relatively prosperous community with prominent wine-making and tourism sectors, and a growing resident population (þ12% between 2001 and 2011). However, it is experiencing some of the demographic challenges facing other rural communities in Australia and elsewhere, including increased

Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016

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H. Hodge et al. / Journal of Rural Studies xxx (2016) 1e10

rates of youth out-migration and population ageing. At the 2011 Census, the median age of Clare residents was 41 years (compared to 39 for Adelaide), and 20% of Clare residents were aged 65 years or older (up from 15% in 2001), compared with 15% in Adelaide (Australian Bureau of Statistics, 2014b). Consequently, the local government is concerned about providing services for this increasingly ageing population and ensuring that the community continues to be ‘liveable’ for older people. As the main local government centre, Clare has a reasonably well-developed local service infrastructure, including locally-based health services (hospital and general practitioners), welfare services, several banks, and a diverse range of social, community and volunteer organisations. Technological and infrastructure constraints for accessing the Internet no longer present any substantial problems in Clare, as the area has recently been connected to the National Broadband Network e a high speed fibre optic broadband network currently being rolled out across Australia (Martin, 2011). According to the last Census, held in 2011 (Australian Bureau of Statistics, 2014b), the proportion of households with Internet access in the municipality (72%), and more specifically with broadband access (64%), was only slightly below the proportions in Adelaide (75% and 67% respectively). The focus of the research, therefore, was on how the comparative patterns of use by consumers and service providers addressed or exacerbated the digital divide affecting older people. 3. Methods The study conducted in-depth interviews with older residents, and locally-based public and community service providers in Clare. It combined thematic content analysis with a social network analysis (SNA) technique to identify the ways in which residents, service providers, and intermediaries were connected in a system of Internet use for service access. The research was conducted by locally-based researchers from Flinders University between July and December 2013, and supported by the Clare and Gilbert Valleys Council, and the Flinders University Rural Clinical School. Research ethics approval was obtained from Flinders University’s Social and Behavioural Research Ethics Committee prior to study commencement. Targeted resident participants were those aged over 65 years, who were no longer active in the workforce but still living relatively independently in their homes (i.e. not in a nursing home), and who had at least some experience in using the Internet for various tasks. Non-users were excluded, as the focus was on exploring the experiences of older people trying to engage online, and on contrasting their experiences with those of the service providers. To recruit participants, advertisements were placed on several community noticeboards in the Clare area, with six participants eventually volunteering to be interviewed. Participants were therefore self-selected but represented people with mixed levels of Internet activity, allowing for an exploration of different user experiences. The sample size was relatively small due to time and resource constraints for data collection, and the difficulty in identifying and establishing contact with the target group. The low number of

participants likely reflects the self-selection recruitment process used within the guidelines of the research ethics approval for this study, which negated the risk of participants in a small community feeling a sense of coercion to participate. The obvious limitation of this is that interview results are mainly illustrative of the diverse experiences and concerns encountered by older Internet users, but are by no means intended to be representative of all older Internet users in the case study area. The participant characteristics are summarised in Table 1. The sample included four males and two females, all but one of whom had been living in the region for at least ten years and who spoke English as their main language. Living arrangements were a mix of sole residents and people living with partners. One participant selfidentified as an extensive Internet user, three considered themselves as competent Internet users, and two had more limited online participation. Community service providers recruited for the study were those with a physical presence in Clare, in order to obtain insights from providers with local service delivery expertise. Organisations were specifically selected to reflect the range of service providers and community groups that the interviewed residents sought to engage with, and included both government and non-government organisations, but no private commercial enterprises. Subsequent to the resident interviews, ten service providers were invited to participate in the study, and all of them agreed to be interviewed. Service provider participants included agencies in healthcare, financial services, information and education services, local government, sporting and recreational groups, as well as local volunteer organisations (Table 2). These participants all typically engaged in some way with older people, but they were not specifically only targeting older people; instead they were responsible for servicing the local population as a whole, meaning that older people were merely one client group of many. Six of the participants were local service providers while the remaining four were local branches of agencies headquartered in Adelaide. As detailed in the results, their level of service provision using digital platforms varied substantially between agencies. Interviews with both older residents and service providers followed a semi-structured interview topic guide which contained a combination of open-ended and closed questions. In line with previous studies on Internet usage among older people (e.g. Cresci et al., 2010; Gatto and Tak, 2008; Kilpel€ ainen and Sepp€ anen, 2014; van Deursen and Helsper, 2015), the older resident participants were asked to describe all the tasks they performed using the Internet and how they experienced those tasks. In particular, they were asked about their experiences in dealing online with service providers (including healthcare, financial, education, administrative, and community services), and what challenges they encountered in this process. They were also asked about the physical and social settings in which they usually accessed the Internet for such tasks, including where tasks were performed and by whom (e.g. on their own or through a mediator). In contrast, service providers were asked about their current Internet mediated services and their plans for future use of online technologies for service delivery.

Table 1 Characteristics of older Internet user participants in Clare.

Participant Participant Participant Participant Participant Participant

1 2 3 4 5 6

Age

Gender

Household composition

Level of Internet use (self-rated)

Location of Internet access

65e70 65e70 65e70 70e75 60e65 90e95

Male Male Female Male Male Female

Living Living Living Living Living Living

Medium Low Medium-high Medium High Low

At home and public space At home At home Public space At home At home and public space

with spouse with spouse independently with spouse with spouse independently

Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016

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Table 2 Characteristics of service provider participants in Clare.

Service Service Service Service Service Service Service Service Service Service

Provider Provider Provider Provider Provider Provider Provider Provider Provider Provider

1 2 3 4 5 6 7 8 9 10

Sector

Public or community

Base

Health Sports & recreation Volunteer Information and education Arts Local government Volunteer Health and volunteer Information and education Volunteer

Public Community Community Public Community Public Community Community Community Community

Local Local Local Local Local Local Local Local Local Local

They were asked if they had made any efforts or arrangements to specifically engage with older people online, and what challenges they encountered in this process. They were also asked about their views on the Internet capabilities of older clients, and what barriers they saw for increasing the range and effectiveness of Internetmediated services. All interviews were conducted face-to-face by a team of two researchers at a location of the participants’ choice. Interviews typically took up to 60 min to complete. The interviews were not audiotaped; detailed notes, including some word for word extracts of the conversations, were written during the interviews by one of two researchers. This means that the interview findings in this paper are not based upon verbatim quotes but upon summaries and individual short stories that report participants’ experiences. All participants had an opportunity to read the written notes taken during their interview and verify their accuracy. The interview notes were subsequently analysed in two steps. First, a thematic content analysis was conducted to identify common themes and critical issues. For this, the data were manually coded by two researchers who first assigned thematic codes independently from one another, and then compared, merged and refined those codes. Second, the data were analysed using a social network analysis (SNA) to visualise the multiple ways that older residents, service providers, and intermediaries were connected through Internet use. The SNA was constructed using the Gephi open source software (gephi.org), and the network was organised using the Yifan Hu algorithm (Bastian et al., 2009). This algorithm plots the nodes of the network according to the strength of relationships to one another and the similarity of relationships. Nodes which have similar sets of connections are located close together, and important nodes are located toward the centre of the graph. Due to the small sample in this study, it must be emphasised that the SNA is presented as an example and ‘scoping exercise’ of what such a technique can show about these networks of interactions. The SNA graph (Fig. 1) does not attempt to describe the network for this sample in its entirety, but identifies some of the key features of the network that are of particular interest. 4. Findings The following sections present the findings of the case study in three parts. The first section focuses on the experiences and perceptions of the older residents. The second section documents the experiences and perceptions of the service providers, and the third section presents the key outcomes of the SNA. 4.1. Older resident perspectives The older participants in this study used the Internet for a range of activities including: financial management; self-education; purchasing goods online; contracting tradespeople or home

Level of Internet use for service delivery branch of provider provider branch of provider provider branch of provider branch of provider

state provider

a state provider

state provider state provider

High Medium-high Medium High Medium-high High Low-medium Low Medium-high High

services via email; general information sourcing; and maintaining social connections with distant family and friends via email, Skype or Facebook. Making financial transactions online was the most common form of online service engagement. Several participants used online banking services which ranged from paying bills with the assistance of a relative, through to independently managing share portfolios. Payment platforms such as BPay (an electronic bill payment system in Australia) were viewed by some participants as useful alternatives to handling cash, accessing cheque deposits and bill paying facilities where local bank branches had closed. Participant 1, for example, was of the opinion that more public and community service agencies dealing with older people should use the BPay system to avoid cumbersome cash transactions, such as those requiring financial recompense for the provision of in-home trade and domestic services. While some participants acknowledged that they had some initial concerns about the security of online financial transactions, Participant 1 explained that such concerns were quickly reduced with increased frequency and familiarity of use. However, other participants were less willing to make payments for services online. Participant 2, an older married man, explained that walking downtown to the post office to conduct financial transactions fulfilled an important social element in his wife’s life, as it required direct contact with people and also gave her some sense of independence. Replacing the physical interaction with service providers with a simple online transaction would not only take away the value of social involvement, but also the feeling of satisfaction derived from completing an important household task for the family. This example is interesting, in that it emphasises the importance of social contact and physical service interaction for older women, while older men might be less socially affected by a shift from physical to online service interactions. All participants confirmed that healthcare consultations were primarily accessed face-to- face in Clare, although some were required to go to Adelaide to see specialists who were not, or only infrequently, available locally. Those not able to drive to Adelaide themselves had to spend long hours using non-emergency patient transport services. Participant 3, an older woman living on her own, explained that booking such patient transport services could only be done via the telephone and through a health care professional as an intermediary, meaning that the Internet provided few opportunities to access such services online, even though she would have preferred to make such bookings online at her leisure. Only Participant 4 had experience with e-health services, which involved video conferencing with a specialist in Adelaide, while physically being with the local general practitioner in Clare. Even though the online consultation was perceived as quite efficient and satisfying, the participant noted that the payment for the service was duplicated by having to pay for the local consultation, as well as the online specialist consultation. This was viewed as a disincentive for utilising digital e-health services in the future,

Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016

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Fig. 1. Network map of Internet mediated interactions between service providers and older residents.

despite the fact that personal appointments with specialists in the city would mean increased cost and time for travelling. Apart from financial and health-related services, some participants used digital technologies for a range of educational services, including access to courses offered by the University of the Third Age and the local community library. Often this involved teaching staff who were physically present and helped them access online material during classes, but it also involved participants accessing material online on their own, in between classes. Participant 3, who had previously relocated back to Clare from Adelaide, mentioned that she was able to complete high school qualifications locally as a mature-aged student via online participation. The importance of the Internet for teaching and learning purposes was further emphasised by two participants who regularly used online platforms (specifically YouTube) as a self-learning tool to teach themselves specific skills required to carry out simple home maintenance tasks or find instructions for creative hobbies. Participant 3 described the Internet as an absolute necessity to assist older people with such routine activities, particularly in the absence of peers (e.g. partners, family, friends, or instructors) who could help them with those activities otherwise. Self-learning activities involved a continuum of access settings, from independently accessing these platforms on home computers, through to requiring a facilitator to enable them to do so on publicly accessible computers. Participants 1 and 6 had to use the Internet in an external facility where assistance was available, such as the community library or the local bowls club (which had an Internet kiosk), even if they had a functional computer at home. Having access to a facilitator was particularly important for those with limited Internet experience and those without access to extended social or family networks (e.g. children, younger relatives and

friends). Participant 6 described how she struggled to use the Internet at home on her own computer despite having been to computer classes before. She explained how instructions learned in class were difficult to implement at home when there was nobody to practice with or ask for help. In the past, when she was still living in Adelaide, her son used to help her a lot with computer and Internet related questions, but since moving to Clare for retirement she had lost those important support networks and therefore struggled to keep up to date with new online applications. This story also illustrates how the utility of generic Internet training courses, such as the Australian ‘Broadband for Seniors’ program (http://bfseniors.com.au/), was often perceived as quite limited, even though most participants confirmed that they were eager to improve their Internet skills. Some participants described how they experienced computer and Internet training as challenging, noting that contemporary ‘beginner’ courses appeared to expect an advanced level of computing background knowledge. According to Participant 2, such courses were intimidating for real beginners who even struggled with the very basics, such as how to turn on the computer in the first place. Even where computer training for older people was being offered, a lack of easy or free public Internet access was sometimes seen as a barrier to using the Internet more often. Participant 4 described how computers with Internet access at the community library were often booked out, requiring people to wait in line, which was perceived as off-putting. Participant 1 noted that educational services for older people, such as classes offered by the University of the Third Age, were delivered in buildings that had no free public Internet, requiring students to pay extra in order to connect to a mobile wireless Internet router. This created the impression that using the Internet as part of education delivery was not particularly encouraged by the service provider.

Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016

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Another considerable barrier to digital service engagement for older residents was the perceived lack of relevant information content available online. This was particularly the case with local administrative and community service providers, such as the local council and various volunteer or recreational organisations. For example, Participants 3 and 4 complained that it was difficult to find useful and up-to-date information about local community activities and events online, limiting the perceived utility of online technologies as a reliable community information source. Online information search efforts were further compromised by a perception that this would require more advanced computer skills, including the regular use of social media, forums requiring complicated user profiles, and online registrations for newsletters. Participants without those skills felt that they were becoming more distant from the community and common information flows, despite their attempts at basic online participation. 4.2. Service provider perspectives The service providers interviewed for this study were not specifically dealing with older clients only, but were responsible for providing information and services to the wider local population. While the research focused on interactions with older clients, service providers did not indicate that there were different strategies used with other client groups. In general, the use of online technologies to interact with clients (both older and younger) varied substantially across organisations. Many used online technologies at least at some basic level to supplement face-to-face service delivery. For example, some community and volunteer groups reported preferentially mailing hard copy newsletters to members, but tended to interact within the organisation via email and top use online functions such as banking, invoicing and other administrative matters. Other service providers preferred to use online technologies to inform clients of upcoming events or for internal management tasks, such as updating central membership databases and client case management. Many service providers were not convinced that digital technologies offered viable alternatives to physical service provision for older people. Though most participants reported that they were increasingly trying to utilise digital technologies in the last few years, many noted they believed this was more a response to decreasing budgets, agency internal rationalisations, and the need for increased efficiencies rather than a reflection of how clients actually wished to receive information and services. When asked about the benefits of digital technologies for service delivery, several providers actually referred to the advantages that higher online participation among older people would have for their organisations and their own workload rather than for their clients’ wellbeing. Service Providers 4 and 6, for example, mentioned how increased communication by email and online enquiry forms would reduce the time that their staff would have to spend on the phone talking to people, while Service Provider 7 explained that improved dissemination of information through websites and social media sites would save them costs in distributing information through letters and print material. More importantly, there was a widespread perception among both public and community service providers that older users, unlike the younger ‘mainstream’, would generally lack the skills and willingness to shift to increased usage of digital information and service platforms. Only a couple of service providers had opposite views, noting that older clients increasingly expected digital information and service solutions. For example, Service Provider 4 explained that the local community library had started offering digital products such as e-books, and that the majority of those requesting digital formats were older people, thus realising

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the need to train their staff in using such digital formats. Service Provider 10, a local volunteer group, also recognised the demand for increased online participation among older clients and therefore sought to deliver more targeted training opportunities for older people, including an eight-week computer course starting from basic operational instructions, to email setup and social media training. Several participants were able to identify a range of digital applications which had been adopted elsewhere in similar Australian organisations, and which they thought could improve local service delivery to older clients. In the case of community service providers, examples of such suggestions included online volunteer management systems as well as more efficient membership and client interaction functions. In the case of health service providers, suggestions included digital client health and mobility assessments and online passenger transport management systems. In very few instances, however, service providers actively pursued strategies to implement such solutions locally. Their ideas appeared to remain an aspirational vision, often due to the perception that older people would simply not use such online tools and services. Service Provider 2, for example, mentioned that their organisation (a sports and recreational community organisation) had been talking about shifting their entire communication strategies from analogue to digital platforms. However, concerns that older members would not use these channels had largely kept them from doing so. A lack of developed policies to ensure client confidentiality in an increasingly digital environment was another barrier to the expansion of online service engagement. This was a particularly significant concern among participants from the health sector, with Service Providers 1 and 8 noting that their organisations were reluctant to explore new ways of interacting with clients online if it meant that client confidentiality and the security of personal records could be breached. Some participants also acknowledged that better online service engagement was constrained by issues around funding limitations, tight operational budgets, and internal institutional guidelines limiting the shared use of online technologies across different agencies. For example, Participant 1 explained how budget discrepancies between different health and social care providers sometimes meant that new digital technology solutions could be purchased and implemented by one agency, but not used by another, thus limiting the implementation of services such as online diagnostics or home treatment on a wider, crossinstitutional scale. While the above-mentioned limitations to online service engagement appeared to apply to the service population as a whole, and not just older clients, they emphasise that the service providers interviewed during this study had limited flexibility to explore online strategies for specific client sub-groups, such as older people. In particular, local branches of national or state government service agencies faced the challenge that online systems and strategies were most often determined by distant head offices. Such centralised guidelines were sometimes criticised as ‘one size fits all’, offering limited opportunities to tailor online information or consultations to the specific needs of older clients. Service Provider 4, for example, discussed how their local staff members were aware of the fact that Clare’s ageing population would require more personalised and ‘easier to use’ online information and service delivery approaches than the average or younger user. However, the centralised design and management of websites and online communication platforms did not allow for any substantial local modifications. Instead, staff members resorted to traditional faceto- face or phone information exchange and service delivery, which was considered as more flexible and allowed them to respond to the different needs of different client groups more efficiently.

Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016

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Some participants also mentioned limited staff skills and experiences in using digital technologies as reasons compromising more efficient online engagement with older clients. On closer examination, however, most of the service providers were using online technologies quite extensively for a variety of internal management or organisational tasks, including online communication with other service agencies, e-conferencing (e.g. via Skype and online meeting tools), navigating online document management systems, or administering online surveys. This advanced level of online interactions for agency internal tasks was in clear contrast to the more limited online engagement with clients. Hence, issues around limited staff skills were not so much related to the extent to which staff themselves were able to use digital technologies, but the extent to which staff understood how to effectively communicate and engage with older clients online. 5. Social network analysis Fig. 1 shows some key results of the SNA conducted to map out the complex system of Internet mediated interactions reported by participants in this research. The size of the node indicates the number of connections in the network, and the width of connecting lines represents the frequency of use of the Internet for that particular interaction. Thick lines suggest the Internet is very commonly used for interactions. Black lines suggest the connection is always made directly between the resident and the service provider, dark grey lines suggest the connection is sometimes direct and sometimes intermediated by a facilitator, and light grey lines suggest the connection is always intermediated. Noting again that this network map is illustrative of the application of the SNA technique rather than intended as a literal depiction of the network as it existed in Clare, the graph includes annotations of points of interest. Many connections in this example were intermediated by family or friends (‘family’ node), emphasising the importance of social contacts in facilitating digital participation for older people. Fig. 1 also shows different patterns of use for different types of services. Health, home and financial services, and to a lesser extent social services such as recreation and leisure services (‘social’ node), were central to the network map and therefore commonly accessed online by all participants. Education and government services, as well as other services such as emergency, transport and IT, were more peripheral, meaning that they were rarely engaged with. Older adult participants were, with the exception of Participant 4, positioned towards the outside of the graph, meaning that their interactions with services were not as frequent or substantial as the interactions between service providers themselves. This is important insofar as service providers in general appeared to connect online with other service providers quite well, but were less able to do so with the older resident participants. Health and social services were very central to the network, and closely connected to finance and home services, but were only poorly connected to transport and various government services. Excluding Participant 4, there appeared to be two groups of residents. The first group (Participants 2, 5 and 6) had similar patterns of use to one another, including high direct connections with financial and social services. The interactions of Participants 1 and 3 were more limited to intermediated connections with health, financial, and social services, as well as other peripheral services. 6. Discussion This paper explores the digital interactions between older people and service providers in a rural community in South Australia, and identified important enablers and challenges for

online service provision as perceived by both groups. The most common challenges encountered by older resident participants included personal limitations, such as a lack of skills, experience and familiarity in using online technologies; as well as circumstantial constraints, such as issues around ‘easy’ access to the Internet in public places, and the perceived lack of adequate training and support. In addition, limited access to family or social networks that could assist with more complex online service tasks were identified as major challenges. These findings reflect the outcomes of previous studies examining the digital divide experienced by older people in non-rural settings (Cresci et al., 2010; Gatto and Tak, 2008; Gitlow, 2014; van Deursen and Helsper, 2015), suggesting that the identified challenges in this case study may not be specifically ‘rural problems’. Nevertheless, the rural setting may well exacerbate some of the circumstantial and social constraints contributing to the digital divide affecting older people. For example, rural residents have fewer opportunities than urban residents to access the Internet in public places or participate in regular training programs. The small resident sample in this case study did not allow for a more systematic examination of how and why the barriers to Internet usage among older people in rural areas may differ from those in urban areas, suggesting that there is a need for further research to better understand rural-urban differences. Similar to observations by Niehaves and Plattfaut (2010), the outcomes of this case study emphasise that the willingness of older people to use e or learn how to use e the Internet for servicerelated tasks may be considerably underestimated by service providers, due to entrenched stereotypes of older people not being interested in or capable of using online technologies. From this perspective, a digital divide may emerge as a result of service providers’ limited recognition of older peoples’ aspirations and limited motivations to engage with this target group online. While older participants in this case study felt they needed to take responsibility for improving their Internet skills, service providers themselves appeared much less motivated to improve their digital engagement strategies. As suggested in other studies (Warburton et al., 2014; Mergel and Bretschneider, 2013), online engagement efforts among service providers were in some cases constrained by issues such as rigid central agency regulations and funding models, inconsistent usage of technologies across agencies limiting online service coordination, as well as limited staff skills in dealing with older people online. Again, the extent to which these challenges are specific to rural areas is not clear and requires further research. There were suggestions that rural outposts of larger (city-based) service agencies may have little flexibility to adapt digital information and service delivery to the needs of local sub-groups such as older people. This points towards potential mismatches between the experiences of locally based service branches in rural areas and the guidelines provided by centralised service agencies which are less exposed to rural population ageing. In addition, ongoing funding cuts and service rationalisations could mean that the few remaining service providers in rural areas have to respond to the local population as a whole, thus having limited opportunities to differentiate their service strategies based on different demographics. Service providers in this case study primarily saw the benefits of using online technologies in improving internal administrative tasks. This internal focus may lead to providers overlooking opportunities to better meet user needs, such as older people’s demands for more targeted online information, centralised information platforms facilitating easier access to information, or training programs specifically tailored to older clients. A failure to meet these needs may further dis-incentivise the use of online

Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016

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services among older people, especially if clients feel that online technologies do little to improve service outcomes but instead cause increased costs (as in the case of the participant using ehealth services to consult remotely with a specialist). While these shortcomings may not be limited to rural areas, they become certainly more problematic in a rural context. Unlike in urban settings, older people in rural areas rely on a much narrower range of service providers, and are increasingly left without a choice of whether to access services online or face-to-face. Ongoing rural restructuring and centralisation of key services will inevitably continue to complicate face-to-face service delivery in many rural areas. There is therefore a pressing need for service agencies to make sure they invest in the right tools, settings and platforms that can encourage older people in rural areas to use digital services, particularly since new generations of older people no longer seem to fit the stereotyped profile of the reluctant, uninterested Internet non-user (Cresci et al., 2010; van Deursen and Helsper, 2015). An important first step in trying to bridge the functional digital divide within the online service system is recognising older rural people as a particular vulnerable service population that requires more targeted online training and engagement responses. This paper provides a new contribution to this field of research by combining the views of older Internet users and service providers with a novel social network analysis approach. Though the SNA in this case study is only illustrative and based on a small sample, it can be understood as a scoping exercise to demonstrate how this technique can help visualise and analyse the extent, strength and type of digital interactions among different participants and different types of service providers. This approach could be useful in making sense of the complexity of digital service systems and offers potential to be applied in future qualitative and quantitative studies, focusing in particular on comparing different rural contexts, different service sectors, and different groups of service users who might be affected by a digital divide. The SNA in this case study illustrates how substantial complexity can emerge in the digital participation system of older residents and service providers, even for a small sample of participants. Using the Internet to access one type of service may not mean that other services will be accessed online, even when online access is possible. Even amongst the set of services which provide some online connectivity, particular services, health and financial for example, may be more likely than others to be used online. This emphasises the need for future research to distinguish more explicitly between different types of service providers in order to understand the various reasons why older people use the Internet for particular services but not for others. While older people may recognise the benefits of online service participation (such as convenience and immediacy), they sometimes choose to access services face-to-face for simple reasons such as maintaining personal habits and retaining opportunities for social interaction. Increased digital participation in some ways accompanies increased difficulty in knowing when to go online and when to seek physical contact. The example SNA also shows how accessing services online may not always be the result of direct interactions between clients and service providers, but can be a mediated relationship, meaning that the digital competencies of family and friends or other mediators can be as important as the competencies of the residents themselves. Access to such mediators can be more problematic in rural areas than in urban ones, particularly in cases where family members do not live in close proximity to older relatives. Hence, any future strategies aimed at improving online service engagement among older people need to recognise and address the limitations of the social environment accessible to clients. This also raises attention to the importance of the particular demographic

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and migration context of rural areas. Outmigration of younger adults (who are more likely to have IT skills) may reduce the ‘pool’ of skilled Internet mediators in rural areas. Increasing inflows of counterurban retirement migrants from the city could also mean that these new migrants lack the required support network of family and friends in the community. On the other hand, counterurban migration could bring in wealthier and more educated people who are more experienced and confident in using the Internet, and could thus become peer instructors and mediators for other local seniors. In this sense, our observations confirm recommendations from other researchers (e.g. Niehaves and Plattfaut, 2010; Cresci and Jarosz, 2010; Warburton et al., 2014; Salemink et al., 2015) who argued that strategies for enhancing social inclusion and access to stronger social networks are at least as important in the context of addressing the digital divide faced by older people as strategies focused on improving technological capabilities. Realising the opportunities of digital participation in rural communities is therefore likely to be a community exercise, not just an exercise for individuals. As such, local community organisations could more actively facilitate this process by directly providing training and mentoring at their venues, promoting peer-to-peer learning and interactions, as well as involving older people in the design of learning programs (Selwyn, 2004). As argued by Salemink et al. (2015), this case study suggests that there may be substantial value in combining social connectivity research and social inclusion research as part of a more integrated community-based approach to improve our understanding of online engagement in rural areas. 7. Conclusion The focus of the case study on older rural residents with at least some level of existing digital participation revealed some very important considerations for research and practice. The identified opportunities and challenges for digital participation appear to be similar for older people in this rural case study area, as in the mostly urban areas where previous research has been conducted. This may in part be a result of Clare’s proximity to the rural-urban fringe where digital infrastructure is relatively well developed and the socio-economic characteristics of residents are similar to those of city residents. Hence, the digital divide in this case study was not so much a result of unequal access to technology or socio-economic disadvantage, rather than the inability of service providers to adapt their online engagement strategies to the specific needs of older residents. In addition, the need for rurally-based services to expend additional efforts on communication and coordination with their city-based headquarters and service partners could be instrumental in minimising the continuing divide. The extent to which these issues are a specifically ‘rural problem’, or are experienced in urban areas in similar ways, requires some further research. Nevertheless, obvious mismatches between digital service provider strategies and older user behaviour are likely to become more of a problem in rural areas as increasing service restructuring will continue to restrict opportunities for alternative, face-to-face service engagement in the near future. The case study findings in Clare may resonate with the experiences of rural areas in other parts of Australia and the developed world that are characterised by similar spatial, socio-economic, institutional and service infrastructure settings (e.g. located close to urban centres, attractive to counterurban migrants, with good Internet service, and a reasonable physical presence of local service providers). However, researchers should be aware of the diversity and complexity of rural contexts that exist, and resist the temptation to generalise findings from relatively well-serviced rural areas (like Clare) to other types of rural locations, including more isolated

Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016

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and remote areas (Bourke et al., 2012). Remote areas in Australia, as well as in Canada, the US or northern Scandinavia, may include many isolated communities with more limited access to technology and higher degrees of socio-economic disadvantage, and as such they are subject to different barriers to digital participation than the more densely populated and gentrified rural areas closer to the urban fringe. Research should also be cognisant of the diversity of economic, social, cultural, and linguistic backgrounds in rural Australia as elsewhere. While Clare presents a relatively homogenous cultural context (at least amongst older residents), research in other rural parts of Australia, the US and Canada has shown that communities with larger proportions of minorities, such as people from different migrant and language backgrounds or Indigenous people, continue to be substantially disadvantaged in accessing the Internet (Goodall et al., 2014; Newman et al., 2012; Basu and Chakraborty, 2011; Haight et al., 2014). What is needed is a collection of research efforts that sit within and draw from the variety of international rural contexts that exist, in order to improve our understanding of the enablers and challenges for digital participation and online service engagement among older people and other demographic groups. Acknowledgements This research was conducted in collaboration with the Clare and Gilbert Valleys Council as part of the Mid North Knowledge partnership, a research exchange partnership between Flinders University and the local governments of the Mid North in South Australia. The project did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. References Abbott, T., Turnbull, M., 2015. Digital Transformation Office to Deliver 21st Century Government. Joint Media Release, Prime Minister of Australia and Minister for Communications, 23 January. Retrieved from: http://www.malcolmturnbull. com.au/media/digital-transformation-office-to-make-it-easier-to-connect (accessed 29.09.15.). Australian Bureau of Statistics, 2014a. Household Use of Information Technology, Australia, 2012-13. Catalogue No. 8146.0. Commonwealth of Australia, Canberra. Retrieved from: http://www.abs.gov.au/AUSSTATS/[email protected]/Lookup/8146. 0MainþFeatures12012-13?OpenDocument (accessed 05.10.15.). Australian Bureau of Statistics, 2014b. Census Community Profiles 2001, 2006 and 2011. Commonwealth of Australia, Canberra. Retrieved from: http://www.abs. gov.au/websitedbs/censushome.nsf/home/communityprofiles? opendocument&navpos¼230 (accessed 05.10.15.). Bastian, M., Heymann, S., Jacomy, M., 2009. Gephi: an open source software for exploring and manipulating networks. In: Proceedings of the International AAAI Conference on Weblogs and Social Media, 17e20 May, San Jose, USA. Retrieved from: https://gephi.org/publications/gephi-bastian-feb09.pdf (accessed 23.09.15.). Basu, P., Chakraborty, J., 2011. New technologies, old divides: linking Internet access to social and locational characteristics of US farms. GeoJournal 76, 469e481. us, C., Anderberg, P., Sko €ldunger, A., Wahlberg, M., Berner, J., Rennemark, M., Jogre Elmståhl, S., Berglund, J., 2015. Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden. Health Inf. J. 21 (3), 237e249. Bourke, L., Humphreys, J.S., Wakerman, J., Taylor, J., 2012. Understanding rural and remote health: a framework for analysis in Australia. Health Place 18 (3), 496e503. Broadband for the Bush Alliance, 2014. Broadband for the Bush Forum III.  from the Third Broadband for the Bush Forum, Alice Springs, 30 Communique April-1 May. Retrieved from: http://broadbandforthebush.com.au/wp-content/ uploads/2013/05/Broadband-for-the-Bush-Forum-III-COMMUNIQUE-July2014. pdf (accessed 15.09.15.). Calvert Jr., J.F., Kaye, J., Leahy, M., Hexem, K., Carlson, N., 2009. Technology use by rural and urban oldest old. Technol. Health Care 17 (1), 1e11. Cresci, M.K., Jarosz, P.A., 2010. Bridging the digital divide for urban seniors: community partnership. Geriatr. Nurs. 31 (6), 455e463.

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Please cite this article in press as: Hodge, H., et al., Using Internet technologies in rural communities to access services: The views of older people and service providers, Journal of Rural Studies (2016), http://dx.doi.org/10.1016/j.jrurstud.2016.06.016