Doing social and digital inclusion

An aging population and the rapid development of digital citizen services mean that vulnerable people fall outside the digital community. In this article, professor Elin Thygesen from the University of Agder shares several important experiences. Counteracting loneliness and providing older people with basic technological skills are among the goals.

Many people lack digital skills. It makes it challenging to keep up with digitalisation of services in the health sector and in society in general. (Illustration: Colourbox)
Many people lack digital skills. It makes it challenging to keep up with digitalisation of services in the health sector and in society in general. (Illustration: Colourbox)

The public and private sectors offer new digital tools and services at a rapid pace. The online solutions presuppose that the population have access to good mobile broadband and internet services. The internet is a cornerstone that enables digitization and innovation throughout society. The Norwegian e-health strategy aims to use the opportunities inherent in digitalisation and create safe and comprehensive health care services for citizens and health professionals.

Digital transformation also provides new opportunities to go from a "repairing" health service to better coordinated support. The goal is that prevention of illness and social problems, and an active, participating citizen, are given at least as much priority as treatment and rehabilitation.

However, good infrastructure for electronic communication is not enough. Far from everyone is able to log on to digital solutions and electronic patient portals, to find information about their own health and treatment, or book a doctor's appointment.

Professor Elin Thygesen and her colleagues at the Centre for e-health, University of Agder, have been researching the area for several years.

Elin Thygesen, Professor in e-health (Photo: UiA)
Elin Thygesen, Professor in e-health (Photo: UiA)

«Inclusion and co-creation with people is something I care deeply about. In our society, there are more and more elderly people. They need help and social contact, but the oldest are accustomed to mostly using analog technologies. The difficulty of understanding or being able to use digital tools creates a digital divide. This is a big challenge,» says Thygesen.

Youth educated the elderly

After participating in several research projects, Thygesen and her colleagues have gradually built useful knowledge, stone upon stone.

In 2012, they started the Interreg North Sea project iAge. They collaborated with regions in six countries to engage the elderly in activity and participation in working and social life through the use of technology. The pilot project in Agder, Norway, included the municipalities of Vennesla and Lillesand and was named Granma on the Web.

Everyone, young and old, can be a resource to others.
Everyone, young and old, can be a resource to others.

The conclusion was that both the old and the young benefited from participating in the project, which consisted of a two-hour course for six weeks. The pensioners received an introduction to the use of information and communication technologies that could make them more active and independent in everyday life. The schoolchildren learned how to set goals, take responsibility and teach computer skills in an educational way.

Volunteers are a resource

The researchers have also investigated how volunteers can contribute to the health and care sector. In the municipalities, there is a shortage of health workers, at the same time as there are more elderly people with complex needs. Isolation and loneliness characterize the lives of many. They need a helping hand and someone to talk to.

In the In For Care project, Thygesen wanted to make it easier for volunteers to contribute. Vennesla was positive and joined the team again. The researchers also collaborated with Songdalen and Grimstad.

«Volunteering can be so much: from visiting friends to walking groups, prevent harmful substance abuse, eating a meal together, being a conversation partner, doing shopping. Among other things. People are eager to help, they want to use their free time to do good for others.»

The project partners made, among other things, a manual for service design and a status report for volunteering in Europe. A list of success stories showed how municipalities and cities had succeeded in creating positive change in society and in what way they influenced the authorities' priorities and measures. In Norway, they tested a digital coordination tool where the intention was to improve the interaction between the health and care service and the voluntary sector.

Collaboration with the Pensioners' Association

The Norwegian Pensioners' Association has a project where they have recruited older residents to a national technology ambassador corps. Their goal is to recruit over 400 technology ambassadors, with at least one representative in each municipality.

Virtual reality (Photo: Colourbox)
Virtual reality (Photo: Colourbox)

«The ambassadors receive, among other things, information and training on welfare technology and get to test VR technology. Then they will share this knowledge with others in their municipalities. Inclusion and participation are at the center,» says Thygesen.

She points to one main challenge:

«I think it has been demanding to use technology in the homes of the old residents. The responsibility has largely been shifted to patients and relatives, which increases the burden on them. This means we need to explore ideas like digital home help, which can assist when there are problems with the technology. Such things must be in place if it is to work,» says Thygesen.

Quadruple helix innovation

In their work, the researchers have developed a co-creation model for collaboration between academia, business, the public sector and volunteers.

Based on the model, they have created new guidelines and ideas for care, where informal and formal service offerings are combined.

Cooperation is needed between the public sector, business, academia and citizens.
Cooperation is needed between the public sector, business, academia and citizens.

In the In For Care project, they brought together ten actors from several countries - the United Kingdom, the Netherlands, Belgium, Denmark, Sweden and Norway. They were pleased to acquire new and valuable knowledge, based on the quadruple helix model.

They learned several things:

- Involvement across sectors is necessary to be able to solve complex societal challenges

- Involvement must take place through all phases of a project, not just by collecting user insights initially

- All groups can contribute to co-creation, but one must be aware of the involvement of vulnerable people, such as the elderly and people with cognitive impairment

Social activity - important but difficult

A project starting in 2020, From Isolation to Inclusion (I2I), is currently underway. It is an international project with the Centre for e-health, University of Agder as project manager. Twelve partners from seven countries are involved.

Loneliness and isolation can affect everyone. The most vulnerable are immigrants, people with developmental disabilities or physical health problems, and the elderly. Over 75 million Europeans meet family and friends only once a month or less. About 30 million of them often feel lonely.

«We should look at loneliness and isolation as risk factors in line with obesity, smoking and physical inactivity,» says Thygesen.

They work closely with Arendal municipality, and have chosen the elderly who live in the city center as their target group.

«An important question is how we can reduce loneliness by having people participate more in social activities. Experiences with the elderly show that it is often difficult for them to get out and meet others.»

Service design, do-it-yourself, skills development for volunteers.
Service design, do-it-yourself, skills development for volunteers.

She points to three challenges. The information about the different activities is fragmented. Some are on municipal web pages, some in groups on social media. But, not all seniors are online. Another challenge is transportation. Getting from A to B is not always easy. A third challenge is that it can feel scary to go alone and meet strangers. Many do not have a friend or a family member who can accompany them.

«We must think innovatively to find solutions. For example, can activities in an online digital calendar be linked to an offer of transport? So that when you click on the activity, options for mobility services and public transport are displayed.»

Social and digital inclusion can be achieved if all actors, including the end users, work closely together. It is about both physical and mental health. We can do it by using service design, do-it-yourself initiatives, skills development for volunteers, and much more. New digital services must help make people's lives easier and more social - not more difficult.