Mobile Phone, Computer, and Internet Use Among Older Homeless Adults: Results from the HOPE HOME Cohort Study

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: The median age of single homeless adults is approximately 50. Older homeless adults have poor social support and experience a high prevalence of chronic disease, depression and substance use disorders. Access to mobile phones and the Internet could help lower barriers to social support, social services and medical care, yet little is known about access to and use of these by older homeless adults. Objective: We describe access to and use of mobile phones, computers, and the Internet among a cohort of 350 homeless adults over age 50. Methods: We recruited 350 participants who were homeless and >50 in Oakland, CA. We interviewed participants at 6-month intervals about health status, residential history, social support, substance use, depressive symptomology and activities of daily living (ADLs) using validated tools. We performed clinical assessments of cognitive function. During the 6-month follow-up interview, study staff administered questions about Internet and mobile technology use. We assessed participants’ comfort with and use of multiple functions associated with these technologies. Results: Of the 343 participants alive at the 6-month follow-up, 300 (87.5%) completed the mobile phone and Internet questionnaire. The median age of participants was 57.5 (IQR 54-61). Two-hundred and twenty four (74.7%) were male and 243 (81.0%) were Black. Approximately one-quarter (73; 24.3%) of participants had cognitive impairment. Most (217; 72.3%) participants currently owned or had access to a mobile phone. Of those, most had basic, rather than smartphones (89; 32.1%) and did not hold annual contracts (261; 94.2%). Just over half (164; 55%) had ever accessed the Internet. Participants used phones and the Internet to communicate with medical personnel (179; 64.6%), search for housing and employment 85 (85; 30.7%), and to contact family (228; 82.3%). Those with mobile phone access at the time of the interview were significantly more likely to have regained housing (P < .001) and significantly less likely to be cognitively impaired (P-value = .04). Conclusions: Older homeless adults could benefit from portable Internet and phone access, yet participants had a lower prevalence of smartphone and Internet access than adults over 65 in the general public or low-income adults. Participants faced barriers to mobile phone and Internet use, including financial barriers and functional and cognitive impairments. Expanding access to these basic technologies could result in improved outcomes.