Social, health and economic impact of COVID-19: Healthy Ageing In Scotland (HAGIS) - a protocol for a mixed-methods study.

INTRODUCTION: Public health responses to the COVID-19 pandemic have reaped adverse physical, psychological, social and economic effects, with older adults disproportionally affected. Psychological consequences of the pandemic include fear, worry and anxiety. COVID-19 fear may impact individuals' mitigation behaviours, influencing their willingness to (re)engage in health, social and economic behaviours. This study seeks (1) to develop a robust and evidence-based questionnaire to measure the prevalence of COVID-19 fear among older adults (aged ≥50) in Scotland and (2) to examine the impact of COVID-19 fear on the willingness of older adults to (re)engage across health, social and economic domains as society adjusts to the 'new normal' and inform policy and practice. METHODS AND ANALYSIS: This mixed-method study includes a large-scale multimodal survey, focus groups and interviews with older adults (aged ≥50) living in Scotland, and an email-based 'e-Delphi' consultation with professionals working with older adults. The COVID-19 fear scale was developed and validated using exploratory and confirmatory factor analyses. Survey data will be analysed using descriptive and inferential statistics. Thematic analysis will be used to analyse qualitative data. Survey and qualitative findings will be triangulated and used as the starting point for an 'e-Delphi' consensus consultation with expert stakeholders. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the University of Stirling for multimodal survey development, fieldwork methodology and data management. Anonymised survey data will be deposited with the UK Data Service, with a link provided via the Gateway to Global Ageing. Qualitative data will be deposited with the University of Stirling online digital repository-DataSTORRE. A dedicated work package will oversee dissemination via a coproduced project website, conference presentations, rapid reports and national and international peer-reviewed journal articles. There is planned engagement with Scottish and UK policy makers to contribute to the UK government's COVID-19 recovery strategy.

Staying Connected during the COVID-19 Pandemic: Experiences of Older People in Mexico and Scotland

During the pandemic older people saw transformations in their social connections due to lockdowns and other restrictions. Technology provided one mechanism for them to stay connected with others, but technology may not be accessible or desirable for everyone. Gender, socioeconomic status, ethnicity, age and other factors enhance or limit engagement with technology. This project explored experiences of older people in Mexico and Scotland during the pandemic and examined the potential of everyday technology to help maintain social connectedness. A mixed methods approach included secondary analysis of large-scale datasets alongside primary data. Online semi-structured interviews and focus groups were carried out with 36 older people in Mexico and 23 older people in Scotland. Sampling was purposeful creating a diverse sample across age, gender, ethnicity and socioeconomic status. The findings demonstrate that advantages and disadvantages accumulated in the life course determine how older people select, optimize and compensate for new ways of staying socially connected during the pandemic in both countries. The use of technologies among older people is further mediated by structural inequalities with differences found between Mexico and Scotland in specific patterns identified. Further, stereotypes about older age and technology use are obstacles to the use of technology, as they affect the perception of self-efficacy by older people. Despite the obstacles, this study has shown that older people have a broad range of resources that have enabled them to cope with the pandemic and utilise technology to maintain social connections. The project offers recommendations to support older people’s human rights.

Using Technology the Right Way to Support Social Connectedness for Older People in the Era of COVID-19.

The restrictions imposed in response to the COVID-19 pandemic pose significant risks to the human rights of older people from limitations in how people are able to engage with their social lives and from increased risk of discrimination linked to conceptualization of COVID-19 as a disease of the old. Further, COVID-19 increases risks of social isolation through public health and societal responses such as lockdowns. These responses have resulted in significant shifts in how citizens and service providers think about technology as a tool to allow people to stay socially connected. However, there are risks to the rights of older people inherent in the use of technology related to their ability to access technology and ageist assumptions that may limit engagement. The 'Technology and Social Connectedness' project was a pre-pandemic mixed-methods study involving evidence review, secondary analyses, and qualitative methods. Cross-dataset analyses led to evidence-based guidance to inform a rights-based approach to using technology. This paper provides analysis from the project that foregrounds a rights-based approach demonstrating how we developed the guidance within this framework and, contextualized within the pandemic response in Scotland, how that guidance can help others to protect and uphold the human rights of older people.