Session: Examining the Effects of an Intergenerational Mobile Technology and Diabetes Self-Management Training Program (Society for Social Work and Research 22nd Annual Conference - Achieving Equal Opportunity, Equity, and Justice)

Low health literacy and suboptimal self-management skills are associated health communication problems and worse treatment compliance, resulting in poor health outcomes and high healthcare costs. They are potential drivers of health disparities, and its alleviation is central to the values and concerns of the social work profession. Many U.S. adults do not have adequate health literacy and self-management skills to manage their diseases and healthcare needs. The Internet and mobile technology are potentially useful tools to narrow the gaps in self-management and health literacy given the myriads of information, languages, medias, and applications available. However, older adults are less likely to use such technology whereas young adults are often missing advantage of these tools for health promotion.

This symposium will present studies of the Intergenerational Mobile Technology Opportunities Program (IMTOP) designed to motivate and train older adults with diabetes to use mobile technology to improve self-management. The IMTOP curriculum combined training on mobile technology and Internet skills, self-management and health literacy, and patient empowerment and problem-solving. It was delivered in 8 weekly sessions of 2-hour long small group classes. Two innovative components of IMTOP are: 1) using a graphic-interface aging-friendly touchscreen diabetes mobile application (IMTOP app) to engage patients in self-monitoring and behavior change; and 2) deploying college students as volunteer teaching assistants to provide intergenerational and technological support. The latter component also aims to help youth develop health awareness and overcome ageism through contacts and their familiar technology. A wait-list comparison trial with 334 people (156 in immediate intervention group and 178 in waitlist group) age 55 and older with type 2 diabetes was conducted in Taiwan in 2 hospital outpatient settings. College students were recruited from local universities to serve as program volunteers. The students had different academic background, including 40 in health-related fields and 94 in other fields. They received brief trainings on aging experience, older adult technology learning patterns, communication skills with older adults, motivational interviewing, and problem-solving.

Presenters in this symposium will discuss four studies examining the program effects and knowledge gained from the IMTOP. The first study investigated the short-term program effects using differences-in-differences analyses comparing the immediate groups with the training intervention and the waitlist group without it. Given the positive effects of the program intervention, the second study examined whether the IMTOP app usage is a contributing factor to improved self-management behaviors among the older adult participants. The third study analyzed the association between older adults' use of different technologies including computer, tablet, and smartphone at study baseline and family support. The finding shows smartphone usage is not related to family support, unlike the cases of computer and tablet, suggesting a different acceptance pattern of smartphones among older adults. The last presenter will discuss how this intergenerational program affects positive development, health, purpose in life, and usage of the Internet among college students in healthcare-related vs. other majors. The symposium aims to demonstrate evidence, potentials, and limitations of applying modern mobile technology in promoting health literacy and self-management to reduce health disparities.