| Sumario: | Issue Challenges of initial, continuous, and sustained engagement in e-health technology; barriers to and facilitators for digital engagement among elders of Chinese cultural background; culture values and health beliefs and engagement issues in e-health gerontechnology. Content While e-health technologies bring about new promises such as better access and more timely delivery of health services, the e-health technology field also faces a challenge in effectively engaging elderly users. This panel explores innovative ways to enhance engagement with elderly people for health promotion purposes. Based on the collective experience of this panel in working with elderly Chinese to develop innovative health information and communication technologies, we have found that the common barriers to digital engagement in elders include (i) digital literacy, which typically varies in different aging cohorts or sectors; (ii) cultural barriers such as culturally relevant health belief models, illness explanatory model, and their associated general literacy and health literacy levels that tend to inhibit adoption of new e-health technology; and (iii) socio-psychological barriers such as fear of complexity of modern technology. Joint experiences suggest that increasing the level of digital literacy is a necessary condition for digital engagement, but not a sufficient condition for getting elders to engage with health-promoting devices and action. While technological solutions are critical for enhancing engagement, sustained engagement often requires social support to help elderly users remove or reduce barriers. Structure Four paper presentations will be given by investigators from China and the USA, followed by Q&A and a discussion. Dr. An and colleagues will present a study to a local senior day care center in China about the Chinese elders' experiences using a web-based Personal Health Record (PHR) system that can deploy vital signals that are recorded through a portable mobile medical device. They found that some elders did not participate, mainly because they thought the system was hard to use. Dr. Chen and colleagues will present their experience in providing online health education to a low-income caregiver group in Shanghai, and in delivering online telemonitoring support for rural elders in the USA Their findings suggest that what seemed to work in both situations was to attune digital services to the level of users' existing digital capacity, rather than trying to increase their digital literacy or capacity. Dr. Lu and colleagues will present results of a qualitative analysis of the posts from two online communities devoted to dementia care. While both ethnic groups were equally engaged in discussion about topics such as family dynamics and emotional support, Spanish users were more likely to share personal stories, whereas Chinese users tended to share practical caregiving skills or medication management tips. Finally, Fozard and Levkoff will provide a conceptual discussion about cultural influences on acceptance of digital technology. They propose that an older adult's experiences with technology, such as perceived usefulness and perceived ease of use, are best understood when they are viewed as part of the collective experiences of the age cohort as a cultural historical entity. Conclusion We expect to share our insights about common barriers to digital engagement and the strategies for improving e-health engagement among elders. We also hope to raise attention to the complexity of issues related to digital engagement, in efforts to advance the conceptual understanding of the role of culturally relevant health beliefs in e-health engagement.
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