Empowering Digital Inclusion through Meals and Friendship: Learning from the United States Michigan ‘Virtual Connections’ and Singapore ‘Community Fridge’

Myat Yadana Kyaw, Thet Htoo Pan, Paul P. Freddolino, Elizabeth Teo, Myo Nyein Aung and Rohit Prasad

Report in Japanese  Report in Thai  Report in Spanish  Report in Vietnamese 

Digitally Inclusive Healthy Ageing Communities (DIHAC) is a cross-cultural study primarily based in Japan, Republic of Korea, Singapore and Thailand and now extending to India and Malaysia through interested networks and collaborations. As a part of the project, we organize bi-monthly cross-cultural meetings to showcase innovations as well as local practices in healthy ageing and digital inclusion from different parts of the world. In this 27th DIHAC cross-cultural meeting, we invited speakers from Michigan State University, United States and Singapore University of Social Science to discuss how community social ties are empowering older adults to be digitally and socially included based on community meal or food programs. It was organized on 20th February 2025.

Associate Professor Dr. Myo Nyein Aung, PI of the DIHAC study, began the meeting by welcoming the participants and socializing. The meeting was then handed over to the chair, Mr. Rohit Prasad, CEO of HelpAge India. Both Dr. Myo and Mr. Prasad contributed to UNESCAP meetings in China and Bali, Indonesia last year Mr. Prasad is a renowned executive with years of management experience in social work and business. He is currently a key player in HelpAge India in improving health and well-being of older adults. The meeting was attended by over 40 participants from Japan, ROK, Singapore, Thailand, Malaysia, Laos, China, Hongkong, India, Belgium, Ukraine, Europe and the United States including public and private stakeholders, UNESCAP and World Bank officials, medical doctors, healthy ageing experts, researchers and graduate students in the fields of global health, public health, social gerontology and gerontechnology.

As a welcome remark from the Chair, Mr. Prasad mentioned the DIHAC research meeting as a collaborative effort of ageing researchers and experts across time zones and geography. Mr. Prasad then briefly explained that HelpAge India works for the socio-economically vulnerable older population from community level services to research and advocacy with the aim of promoting healthy ageing in India. Later, he highlighted the current digitization in India, urban-rural digital divide and its impact on older adults. He called for minimizing digital ageism and promoting user-friendly design and privacy as crucial issues to be addressed in the era when health and digital technology mingle. It is an important message for the healthy ageing decade.

Figure: Chairperson Mr. Rohit Prasad, speakers, international audience and DIHAC study team at the 27th DIHAC meeting

Presentation 1: Virtual Connections: Three Strategies for Enhancing Digital Literacy of Hard-to-Reach older adults

The first speaker was Dr. Paul P. Freddolino, Ph.D., Professor, School of Social Work, College of Social Science, Michigan State University, United States. Dr. Freddolino introduced three strategies of digital empowerment programmes implemented in communities in the state of Michigan where 19.3% of the population is over 65 and 16 area agencies work to support older adults. In the snowy region of Michigan, Home-delivered meals (Meals on Wheels) initiatives enhance older adults living alone to meet their basic needs [1]. Digital empowerment programs launched since 2021, are based on the ideas that technology can reduce social isolation and that older adults can overcome barriers to digital technology uptake with the help of close and trusted people, known as warm experts [2]. Three projects are detailed below.

In Project 1, called ‘Virtual Table’ Model, trusted home-delivered meal (HDM) drivers (warm experts) engaged in digital literacy training programmes for HDM recipients. Coloured printed materials and tablets with internet access were distributed to the participants. An 8-12-week core ICT skills course covered basic device use, social communication and topics of participants’ choice. This was followed by a 6-8 week telehealth course. Additionally, a weekly chat with a volunteer and a social meet-up via Zoom every two months are included in the programme.

In terms of evaluative findings, there was a significant increase in the number and frequency of participants’ use of various digital technologies at the mid-point and sustained to the post-test.  He explained that changes in computer self-efficacy, loneliness and other psychological parameters are expected to be observed with further intensity of training, and skills are expected to increase over time. Trusted relationships are found to be effective for recruitment, retention and satisfaction with digital literacy programmes. In addition to digital literacy, older adults benefit from forming social bonds with coaches. Challenges such as human resources for coaches, volunteers, and economically sustainable plans need to be considered for future implementation.

As a continuation, ‘Virtual Table II’ was implemented among congregate meal recipients (group meals) at senior centres in the Detroit area. The participants were low-income older adults in need of support and services who owned smartphones. Mobile phone-based telehealth content was developed in a participatory approach with Virtual Tables graduates. Digital literacy training was delivered in group settings.

In Project 3, ‘Virtual Connections’, in addition to training HDM recipients, and congregate meal recipients, a new strategy of ‘caregiver training’ is being implemented. All three models are implemented simultaneously in six different counties in Michigan to learn which strategies work in which situation. Digital literacy training programmes are expected to increase the use of telehealth among older adults and connect care agencies with virtual care providers. Despite the technological and human resource challenges, digital literacy programmes are connecting families, reducing loneliness and social isolation, and improving quality of life for older adults. Future plans include providing digital literacy training by partnering with community-focused businesses to increase accessibility, reaching out to minority and hard-to-reach populations, and scaling up to other counties.

• Trusted relationships can encourage older adults to engage in digital literacy programmes.
• Different digital empowerment strategies can be implemented, tailored to community contexts and mobilizing community resources.

After Dr. Freddolino’s presentation, the Chair, Mr. Rohid appraised the Community-Based Social Innovation (CBSI) programmes that are delivered in different settings. He also highlighted the importance of identifying the appropriate setting for scaling up. Regarding the selection of participants,  the recruited participants were initially not tech-savvy and participated through the information they received from their HDM drivers. The social relationships developed through coaching may have facilitated participants’ retention in the programme. In terms of family support for digital literacy training, the speaker mentioned that family concerns about fraud and scam inhibited some older adults from participating in the programmes, while some families saw the value of older adults adopting digital technology. In response to questions about assessing the level of digital skills, the speaker explained that basic operational skills such as g-mail and photos were tested after each session, and the content was repeated at the next session when needed.

Presentation 2: Community Empowerment to Support an Ageing Population in a Northeast Township in Singapore

The second speaker was Ms. Elizabeth Teo, M.Sc., Project Manager, Singapore University of Social Science (SUSS), District Councilor, Northeast Community Development Council, Singapore, and Community Gerontologist, from Singapore. Ms. Elizabeth is motivated to build capacity training, pioneering with Prof Carol Ma, Co-PI of the DIHAC study in Singapore. Together with her husband, she established the ongoing project. The community empowerment project is based in a township of the Northeast Community Development Council of Singapore. Singapore is a multiracial country and each block of flats has different racial groups. Before the pandemics, Ms. Elizabeth and volunteers from the community organized activities to help older adults, low-income households and nursing homes with food, utilities as community empowerment programmes. During the pandemics, all activities went online. Physical contact was reduced, leading to social isolation. To prevent this, groceries and living essentials were delivered to older people’s homes on a weekly basis to check on their health.

However, when pandemic restrictions are lifted, it is important to reintegrate older adults into their social lives and keep them connected for active ageing.  Therefore, ‘community fridge’ programme was set up to provide ongoing social support to older people and to help them rebuild their social connections. The community fridge has been installed in living blocks where people over 65 reside. Rescued food and vegetables from supermarkets and shops, along with products from community gardens, are collected and made available in the fridge for anyone in need. Because the fridge with food and vegetables is placed in the living block of older adults, they feel a sense of responsibility and empowerment to take care of it. Together with volunteers, older adults take part in repacking, storing food and maintaining the community fridge. Every Saturday, older adults gather at the fridge not only to take food, but also to socialize with their friends and neighbors. In some living blocks, older adults organize meals using food from the fridge, which they then share with others. The speaker mentioned that the success of this programme includes supportive leadership, community collaboration, funding and sustained contributions from volunteers. Older adults feel more empowered and recognized when their efforts are publicly shared through the media, resulting in a greater impact.

• The Community Fridge programme provides an opportunity for older adults to make social connections, develop a sense of ownership and create a purpose for participating in community activities.
• Collateral benefits from the fridge program include the use of social media ‘WhatsApp’ to connect and communicate about community activities, which may enhance older adults’ use of digital technologies.

The speaker invited questions and addressed the main issues highlighted during the meeting. Regarding formal digital literacy training programmes to prevent fraud and scams, the Singapore Information Media and Digital Authority (IMDA) trains ‘Digital Ambassadors’ to help older people with their digital devices’ problems at the community level. The Community Fridge serves as an opportunity for peer participants to share information through the ‘digital ambassadors’. In terms of food hygiene and safety when preparing meals, older adults follow local rules, and food is served at tables and not taken away. Cultural and religious factors are taken into consideration when preparing meals. Social media such as WhatsApp are used to share information about the programme and to plan events. One of the participants suggested that evaluation could be done through empowerment evaluation and documenting their success stories.

As the ending remark, the Chair summarised that food and meals are unique dimensions that connect older adults trespassing race, ethnicity and generations. First, it is important to address the voices and choices of older adults. Second, social health, such as social connectedness and reducing loneliness, is as important for older adults as their physical and mental health. Finally, evaluating change and measuring the benefits of interventions may need multidimensional approaches. The meeting finished successfully with the announcement of the upcoming 28th DIHAC meeting in April.

References

1. Services, Michigan Department of Health & Human Services., Home-Delivered Meals (Wheels on Meals).
2. Hänninen, R., S. Taipale, and R. Luostari, Exploring heterogeneous ICT use among older adults: The warm experts’ perspective. New Media & Society, 2021. 23(6): p. 1584-1601.

Authors

Myat Yanada Kyaw, M.D., is Ph.D. student at the Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan

Thet Htoo Pan, M.D., is Ph.D. student at the Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan

Paul P. Freddolino, Ph.D., is Professor at School of Social Work, College of Social Science, Michigan State University, United States

Elizabeth Teo, M.Sc., is Programme Project Manager at Singapore University of Social Sciences (SUSS), District Councilor (Northeast Community Development Council, Singapore) and Community Gerontologist, Singapore

Myo Nyein Aung, M.D., M.Sc., Ph.D., is Associate Professor at the Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan

Rohit Prasad, MBA., is CEO of HelpAge India