Gluu Essentials Digital Skills Training for Middle-Aged and Older Adults That Makes Skills Stick: Results of a Pre-Post Intervention Study.

BACKGROUND: A number of real-world digital literacy training programs exist to support engagement with mobile devices, but these have been understudied. OBJECTIVE: The purpose of this study was to examine the effectiveness and program acceptability of a digital skills training program among middle-aged and older adults (aged ≥50 years) and to gather participants' recommendations for lifelong digital skills promotion. METHODS: The Gluu Essentials digital skills training program includes learning resources to support tablet use. Through pre-post surveys, this study assessed mobile device proficiency, confidence in going online and in avoiding frauds and scams, the frequency of engaging in online activities, program engagement, acceptability, and suggestions for continued support. RESULTS: A total of 270 middle-aged and older adults completed baseline surveys. Of these 270 participants, 145 (53.7%) completed follow-up surveys. Our findings indicate that mobile device proficiency increased (P<.001), whereas confidence was unchanged. Participants also reported going online more frequently to shop (P=.01) and access government services (P=.02) at follow-up. Program engagement varied considerably, but program acceptability was high. Participants' recommendations included the need for providing ongoing programs for support and training because technology constantly changes, reducing costs for technology and internet access, and keeping learning resources simple and easy to access. CONCLUSIONS: The Gluu Essentials digital skills training program increased mobile device proficiency and frequency of web-based activities (shopping and accessing government services) among middle-aged and older adults.

Virtual Care Prior to and During COVID-19: Cross-sectional Survey of Rural and Urban Adults.

BACKGROUND: To reduce person-to-person contact, the COVID-19 pandemic has driven a massive shift to virtual care. Defined as the use of technology (synchronous or asynchronous) to support communication between health care providers and patients, rural-urban differences in virtual care are relatively unexplored. OBJECTIVE: The 2-fold purpose of this study was to examine rural and urban virtual care access, use, and satisfaction during the pandemic and to identify any unmet needs. METHODS: This study was a cross-sectional online survey exploring virtual care among rural and urban adults in summer 2021 using a combination of fixed and open-ended response options. Quantitative data were analyzed using both descriptive and inferential statistics, and qualitative data were analyzed using inductive thematic content analysis. RESULTS: Overall, 501 (373, 74.4% female; age range 19-86 years; 237, 47.3% rural-living) Western Canadians completed the survey. Virtual care use was high among both rural (171/237, 72.2%) and urban (188/264, 71.2%) participants, with over one-half (279/501, 55.7%) reporting having only started to use virtual care since the pandemic. The self-reported need for mental health programs and services increased during the pandemic, compared with prior for both rural and urban participants. Among virtual care users, interest in its continuation was high. Our analysis also shows that internet quality (all P<.05) and eHealth literacy (all P<.001) were positively associated with participants' perceptions of virtual care usefulness, ease of use, and satisfaction, with no rural-urban differences. Rural participants were less likely to have used video in communicating with doctors or health care providers, compared with urban participants (P<.001). When describing unmet needs, participants described a (1) lack of access to care, (2) limited health promotion and prevention options, and (3) lack of mental health service options. CONCLUSIONS: The increased demand for and use of virtual care may reflect increased availability and a lack of alternatives due to limited in-person services during the COVID-19 pandemic, so a balance between virtual care and in-person care is important to consider postpandemic. Further, ensuring availability of high-speed internet and education to support patients will be important for providing accessible and effective virtual care, especially for rural residents.

Are we failing female and racialized academics? A Canadian national survey examining the impacts of the COVID-19 pandemic on tenure and tenure-track faculty.

The novel coronavirus 2019 (COVID-19) pandemic caused the abrupt curtailment of on-campus research activities that amplified impacts experienced by female and racialized faculty. In this mixed-method study, we systematically and strategically unpack the impact of the shift of academic work environments to remote settings on tenured and tenure-track faculty in Canada. Our quantitative analysis demonstrated that female and racialized faculty experienced higher levels of stress, social isolation and lower well-being. Fewer women faculty felt support for health and wellness. Our qualitative data highlighted substantial gender inequities reported by female faculty such as increased caregiving burden that affected their research productivity. The most pronounced impacts were felt among pre-tenured female faculty. The present study urges university administration to take further action to support female and racialized faculty through substantial organizational change and reform. Given the disproportionate toll that female and racialized faculty experienced, we suggest a novel approach that include three dimensions of change: (1) establishing quantitative metrics to assess and evaluate pandemic-induced impact on research productivity, health and well-being, (2) coordinating collaborative responses with faculty unions across the nation to mitigate systemic inequities, and (3) strategically implementing a storytelling approach to amplify the experiences of marginalized populations such as women or racialized faculty and include those experiences as part of recommendations for change.

Social, political, commercial, and corporate determinants of rural health equity in Canada: an integrated framework.

People in rural and remote areas often experience greater vulnerability and higher health-related risks as a result of complex issues that include limited access to affordable health services and programs. During disruptive events, rural populations face unique barriers and challenges due to their remoteness and limited access to resources, including digital technologies. While social determinants of health have been highlighted as a tool to understand how health is impacted by various social factors, it is crucial to create a holistic framework to fully understand rural health equity. In this commentary, we propose an integrated framework that connects the social determinants of health (SDOH), the political determinants of health (PDOH), the commercial determinants of health (ComDOH), and the corporate determinants of health (CorpDOH) to address health inequity in rural and remote communities in Canada. The goal of this commentary is to situate these four determinants of health as key to inform policy-makers and practitioners for future development of rural health equity policies and programs in Canada.

RéSUMé: Les personnes vivant dans les régions rurales et éloignées sont souvent plus vulnérables et présentent des risques plus élevés pour la santé en raison de plusieurs défis incluant l'accès limité aux services et programmes de santé abordables. Lors des événements perturbateurs, les populations rurales font face à des obstacles et défis uniques en raison de leur éloignement et de leur accès limité aux technologies digitales. Alors que les déterminants sociaux de la santé sont un outil pour comprendre l'effet de divers facteurs sociaux sur la santé, il est crucial de créer un cadre holistique pour bien comprendre l'équité en santé rurale. Dans ce commentaire, nous proposons un cadre intégré qui relie les déterminants sociaux de la santé (SDOH), les déterminants politiques de la santé (PDOH), les déterminants commerciaux de la santé (ComDOH) et les déterminants de la santé des entreprises/corporatifs (CorpDOH) pour lutter contre les inégalités en santé dans les régions rurales et éloignées au Canada. Le but de ce commentaire est de situer les déterminants sociaux, politiques, commerciaux et corporatifs de la santé comme étant essentiels aux responsables de la formulation des politiques publiques ainsi qu'aux clinicien(ne)s dans l'avenir des politiques et programmes d'équité en santé rurale au Canada.