Digital Exclusion Research Articles

Student Support for Incarcerated Females in an Open Distance e-Learning Institution

In South Africa, higher education is a constitutionally enshrined basic human right and one of the cornerstones for accomplishing the ideals of offenders’ rehabilitation and preparation for life beyond bars. However, acquiring higher education whilst serving a sentence in a correctional centre is compounded by many institutional challenges especially towards incarcerated female students. Framed by the transactional distance theory (TDT), the qualitative study from which this paper emanates, used purposive and snowball sampling to recruit twenty-nine female distance learning students incarcerated at four female correctional centres across three provinces in South Africa. Based on the thematic content analyses of the data, the findings indicate that there is restricted access to learning resources, and that online participation in both learning and assessment is affected by erratic internet connectivity caused by UNISA-DCS hubs (computer laboratories) due to the security-focused nature of the correctional centres. Furthermore, the lack of direct access to the internet, smartphones, or internet‐enabled devices exacerbates the digital marginalisation and exclusion of incarcerated students which engenders feelings of despondency against a system that is meant to empower them. Thus, owing to these findings, the paper recommends that practitioners, researchers, and policymakers must endeavour to design not only inclusive, but correctional centre-friendly student support. This entails acknowledging that incarcerated students do not have 24/7 access to the internet, the technological gadgets that make online learning possible and some incarcerated students having limited digital literacy. There is a need to design learning policies and strategies that are flexible to enhance the learning experiences and graduateness of incarcerated students.

Towards a Digitalised Criminal Justice System: Lessons from Poland

The Covid-19 pandemic has expedited technological advancements within the Polish criminal justice system, notably through the integration of remote communication tools for legal proceedings. This paper examines the introduction and impact of remote hearings, including those for detention on remand, arguing for the expansion of remote hearings beyond cases where the defendant is in custody. It highlights the existing legal framework's limitations, such as the conditional telephone contact between a defendant and their defense counsel, which infringes on the right to defense due to the lack of confidentiality and effectiveness in legal assistance. Furthermore, the paper discusses the potential benefits of digitizing criminal proceeding files, including improved efficiency, accessibility, and the safeguarding of the fair trial principle. Despite potential drawbacks like digital exclusion and security concerns, the implementation of a unified digital system across all courts is proposed to facilitate data exchange and streamline proceedings. Additionally, the paper addresses the limitations of replacing human interpreters with automated translation software in criminal proceedings, emphasizing the necessity of human oversight to ensure fair trial guarantees. The study suggests a hybrid approach to translation that combines machine translation with human verification, drawing parallels with GDPR provisions for human intervention in automated decision-making processes.

New models of health and social care for people in later life: mapping of innovation in services in two regions of the United Kingdom using a mixed method approach

BackgroundInnovation for reforming health and social care is high on the policy agenda in the United Kingdom in response to the growing needs of an ageing population. However, information about new innovations of care being implemented is sparse.MethodsWe mapped innovations for people in later life in two regions, North East England and South East Scotland. Data collection included discussions with stakeholders (n = 51), semi-structured interviews (n = 14) and website searches that focused on technology, evaluation and health inequalities. We analysed qualitative data using framework and thematic analyses. Quantitative data were analysed descriptively.ResultsOne hundred eleven innovations were identified across the two regions. Interviewees reported a wide range of technologies that had been rapidly introduced during the COVID-19 pandemic and many remained in use. Digital exclusion of certain groups of older people was an ongoing concern. Innovations fell into two groups; system-level ones that aimed to alleviate systems pressures such as preventing hospital (re)admissions, and patient-level ones which sought to enhance health and wellbeing directly. Interviewees were aware of the importance of health inequalities but lacked data to monitor the impact of innovations on these, and evaluation was challenging due to lack of time, training, and support. Quantitative findings revealed that two thirds of innovations (n = 74, 67%) primarily focused on the system level, whilst a third (n = 37, 33%) primarily focused on the patient-level. Overall, over half (n = 65, 59%) of innovations involved technologies although relatively few (n = 12, 11%) utilised advanced technologies. Very few (n = 16, 14%) focused on reducing health inequalities, and only a minority of innovations (n = 43, 39%) had undergone evaluation (most of which were conducted by the service providers themselves).ConclusionsWe found a wide range of innovative care services being developed for people in later life, yet alignment with key policy priorities, such as addressing health inequalities, was limited. There was a strong focus on technology, with little consideration for the potential to widen the health inequality gap. The absence of robust evaluation was also a concern as most innovations were implemented without support to monitor effectiveness and/or without plans for sustainability and spread.

A fissura digital

Jan Van Dijk's The Digital Divide explores the complex dynamics of the digital divide and its profound implications for contemporary society. Van Dijk reveals how digital exclusion exacerbates socioeconomic disparities, making marginalized communities more vulnerable to cybercrime and hindering their access to economic opportunities and social integration. Van Dijk's work underscores the urgent need for concerted efforts by academia, policymakers and practitioners to address the digital divide and promote a more equitable digital future.

The Dual Risks of Digital Exclusion and Unaffordability of Telecommunications in Lower‐Income Australian Households

AbstractWe analyse household telecommunications spending in Australia over the period 2006–2021 using Household Income and Labour Dynamics in Australia (HILDA) survey data. We find the affordability of telecommunications is improving, and that telecommunications spending behaves like other core necessities, such as food. We find households in which members are not employed, have relatively low education, are elderly, Aboriginal or Torres Strait Islanders or immigrants, speak English poorly, reside alone, or have long‐term health conditions are at heightened risk of digital exclusion due to lower spending on telecommunications. Households located in rural areas, with children or with members that work from home are at higher risk of digital exclusion as a consequence of overspending on telecommunications. Overall, the number of people at risk of digital exclusion from inadequate spending or overspending is quite small in Australia. The risks appear to have decreased during COVID‐19. Telecommunications is a core necessity but given the small number of people at risk of exclusion, policies addressing affordability should be highly targeted.

The Double Burden: The Digital Exclusion and Identity Crisis of Elderly Patients in Rural China

The rapid digitalization of China’s healthcare system, a phenomenon that accelerated during the Covid-19 pandemic, had two negative consequences for a significant portion of elderly persons in China. The first is an unfortunate practical outcome: their exclusion from many health services such as online medical appointment platforms, e-prescription requests, obtaining e-referrals, and sharing electronic medical records. The second is an emotionally debilitating identity crisis as elderly persons’ former status as knowledgeable senior mentors was replaced with social perceptions of them as helpless and ignorant souls reliant on more youthful persons for guidance and assistance. This article adopts a grounded theory to explore the phenomenon from the perception of excluded elderly persons using participatory observation and in-depth interviews of 44 elderly clients of a rural hospital in the Shandong province in eastern China. The study shows that the current focus on direct practical aspects of digital exclusion may fail to capture the impact and ancillary consequences such as a painful loss of self-esteem by the digitally excluded. As the study illustrates, the practical aspects can all be overcome through intervention by those who aid the digitally excluded but this help may exacerbate the rarely considered ancillary harms of digital exclusion. Studies of digital exclusion will make more significant contributions to our understanding of the phenomenon if they look beyond the obvious direct consequences of digital exclusion to consider possible ancillary and flow-on effects.

The problem of digital exclusion and the computerization of court proceedings on the example of the institution of consumer bankruptcy

The problem of digital exclusion and the computerization of court proceedings on the example of the institution of consumer bankruptcy

Lessons learned from a multi-site collaborative working toward a digital health use screening tool.

Digital health has the potential to expand health care and improve outcomes for patients-particularly for those with challenges to accessing in-person care. The acceleration of digital health (and particularly telemedicine) prompted by the Coronavirus-19 (COVID-19) pandemic facilitated continuity of care in some settings but left many health systems ill-prepared to address digital uptake among patients from underserved backgrounds, who already experience health disparities. As use of digital health grows and the digital divide threatens to widen, healthcare systems must develop approaches to evaluate patients' needs for digital health inclusion, and consequentially equip patients with the resources needed to access the benefits of digital health. However, this is particularly challenging given the absence of any standardized, validated multilingual screening instrument to assess patients' readiness for digital healthcare that is feasible to administer in already under-resourced health systems. This perspective is structured as follows: (1) the need for digital health exclusion risk screening, (2) our convening as a group of stakeholders, (3) our review of the known digital health screening tools and our assessment, (4) formative work with patients regarding their perceptions on language and concepts in the digital health screening tools, and (5) conclusion with recommendations for digital health advocates generated by this collaborative of digital health researchers and operations leaders. There is a need to develop a brief, effective tool to screen for digital health use that can be widely implemented in diverse populations. We include lessons learned from our experiences in developing and testing risk of digital health exclusion screening questions in our respective health systems (e.g., patient perception of questions and response options). Because we recognize that health systems across the country may be facing similar challenges and questions, this perspective aims to inform ongoing efforts in developing health system digital exclusion screening tools and advocate for their role in advancing digital health equity.

INCREASING OR DECREASING FRUGALITY: THE CONNECTION BETWEEN DIGITALISATION AND FRUGAL INNOVATION

Within wider debates on sustainability and digitalisation, frugal innovation (FI) scholars largely assume that digital technologies are important for FI in realising more sustainable outcomes. However, very few studies interrogate this causality. To tackle this challenge, we connect FI with digitalisation. Thereto, we conceptualise digital technologies as and within FIs and discuss three frugality dimensions to analyse three empirical case studies of digitally-enabled FIs. We use these cases to introduce new nuances on how digitalisation affects frugality and scaling. Our results unveil that digitalisation can increase frugality by enabling more accessible and affordable solutions through new flexible funding schemes and pay-as-you-go models. However, our evidence also implies decreasing frugality by an increase in end-user costs and digital exclusion. Likewise, increasing frugality through complexity reduction seems mainly to benefit intermediaries and frugal innovators themselves, whereas benefits of digitalisation in terms of complexity reduction for end-users seem to be limited. Digitalisation can even increase complexity for end-users, thus suggesting decreasing frugality. Finally, just like with non-digital innovations, scaling of digitally enabled innovations is dependent on the quality of logistical infrastructure and local adaptation practices. Moreover, scaling of digitally-enabled innovations is limited to users in regions with a proper ICT infrastructure.

The perspectives of doing, being, belonging, becoming on older homecare recipients’ use and experiences with technologies in the Assisted Living Project in Norway

ABSTRACT The Assisted Living project (2016-2019) aimed to investigate older adults’ needs for digital technology for daily support and to develop technology solutions in collaboration with the user group. This paper presents data extracted from three sub-studies: Sub-study 1 investigated older homecare recipients’ use of and attitudes towards digital technology, sub-study 2 explored assisted living residents’ needs and requirements for technology, and sub-study 3 explored their experiences with environmental sensor technology to support safety and daily living. The aim was to explore how the occupational science concepts of doing, being, belonging, and becoming can provide a deeper understanding of technology use among participants in the Assisted Living Project. This study demonstrates that for older adults in the Assisted Living project to become technology users required both personal motivation and cognitive capacity for learning to use the device and become familiar with the technology, and access to internet and digital tools. Digitalization in society leads to new challenges for all citizens, especially those who are less familiar with using digital technology. By applying an occupational science perspective to technology use, this paper contributes to creating awareness about digital exclusion and occupational injustice. It provides a deeper understanding of use and non-use and the digital divide, such as the consequences of not having access to digital healthcare services, that may lead to breaches of democratic human rights.

The Capabilities Divide: ICT Adoption and Use among Bedouin in Israel

ABSTRACT The Bedouin community, a subpopulation of the Arab minority in Israel, has been subject to systematic discrimination throughout the state’s history, including in accessibility to digital services. Based on 25 semi-structured, in-depth interviews with Bedouin men and women residing in unrecognised villages – townlets that are not legally designated as municipal entities by the state and therefore lack basic infrastructure – this study asks whether and how the capabilities approach can be used to assess and examine ICT usage among the Bedouin as a marginalised community with distinct needs. The analysis illuminates the tensions and contradictions that characterise their digital experiences and shows that the capabilities approach is particularly apposite for understanding digital exclusion while compensating for the shortcoming of the digital divide framework. The findings uncover the ubiquitous presence of mobile smartphones among Bedouin users as the central enabler of their desired capabilities while pointing out the vital place religion plays in the community members’ decision-making regarding the use of ICTs for the realisation of their desired capabilities.

Teachers' situated knowledge: Addressing digital exclusion in rural contexts

This study delves into the intricate challenges surrounding incorporating information and communication technologies (ICTs) in education, particularly in regions characterized by digital exclusion, such as rural areas. By recognizing the potential of ICTs to support and expand student learning opportunities, this research explores the necessity for effective implementation through tailored professional development aligned with teachers' contextual conditions and needs. In addressing these challenges, the study explores the concept of technological appropriation, underscoring the significance of individual and contextual elements in adapting ICTs to users' specific needs and environments. Through unstructured face-to-face interviews with 21 teachers immersed in a digitally vulnerable rural context, this research unveils insights into how educators’ appropriate technologies to enhance student learning. The findings of this study contribute to the development of educational practices tailored to rural contexts, focusing on providing a meaningful and effective learning experience for students. By shedding light on teachers' strategies for navigating the digital landscape in challenging environments, the research aims to inform policies and practices that bridge the technological gap, ultimately fostering equitable access and enhanced educational outcomes in rural settings.

Challenges Experienced by Saudi Patients With Cancer and Their Family Caregivers in Using Digital Healthcare Technology Platforms in the COVID-19 Pandemic.

COVID-19 has provided a unique boost to the use of digital healthcare technology, putting many vulnerable people at risk of digital exclusion. To promote digital healthcare equity, it is important to identify the challenges that may inhibit cancer patients and family caregivers from benefiting from such technology. This study explored the challenges that cancer patients and family caregivers experience in using digital healthcare technology platforms during the COVID-19 pandemic. A qualitative descriptive study using face-to-face semistructured individual interviews was carried out. A purposive sample of 21 participants was recruited from a public cancer hospital in Saudi Arabia. Qualitative content analysis with an inductive approach was utilized. The factors that challenged the ability of participants to benefit from digital healthcare technology were similar. Four themes related to the challenges the two groups experienced emerged: access to platforms, use of platforms for cancer health-related purposes, attitudes toward these platforms, and individual user preferences. This study identified numerous areas for improvement regarding digital healthcare technology platform implementation, which could increase future benefits and equal use. This study's findings also provide useful information to investigators who intend to create digital nursing interventions for both groups amid COVID-19 and other worldwide health crises.

Frontline Knowledge: Digital Media Literacy of Older Adults in Ukraine

Digital media literacy becomes crucial in modern conflict zones, as conflicts are increasingly digitized and hyperconnected. While a dangerous environment raises the need for orientation, propaganda and fakes discourage audiences’ sense-making efforts. Older adults often experience digital and social exclusion and might be vulnerable to mis- and disinformation. Previous research, focusing mostly on Western Europe, has studied digital media practices of older adults, however, there is very little knowledge on digital media literacy skills and needs of older adults in conflict zones. Drawing on eight focus groups, this article explores Ukrainian older adults’ challenges and compensation strategies during the digitized war. An inductive-qualitative analysis identifies three main factors that shape digital practices and dictate the literacy needs of Ukrainian older adults: (a) (lack of) access, grounded in material infrastructure and social ties; (b) self-(in)efficacy that often stems from pre-convictions about one’s agency and position in society; and (c) resilience that becomes crucial in the situation of continuous exposure to (mediated) violence. This research contributes to the understanding of the media literacy needs of older adults and lays the foundation for developing digital literacy study programs in conflict zones.

Digital Inclusion Through Algorithmic Knowledge: Curated Flows of Civic and Political Information on Instagram

Social media platforms are a critical source of civic and political information. We examine the use of Instagram to acquire news as well as civic and political information using nationally representative survey data gathered in 2019 in the US, the UK, France, and Canada (<em>n</em> = 2,440). We investigate active curation practices (following news organizations, political candidates or parties, and nonprofit organizations or charities) and passive curation practices (liking friends’ political posts and those from parties or politicians and nonprofits or charities). Young adults (18 to 24 years) are far more likely to curate their Instagram feed than older adults in all four countries. We consider two possible explanations for this behavior: political interest and an understanding of how algorithms work. Young adults have more (self-assessed) knowledge of algorithms in all four countries. Algorithmic knowledge relates to curation practices, but there are some cross-national differences. Algorithmic knowledge is theoretically relevant for passive curation practices and the UK sample provides support for the stronger role of algorithmic knowledge in passive than active curation. In all four countries, political interest positively relates to active and passive curation practices. These findings challenge depictions of young adults as news avoiders; instead, they demonstrate that algorithmic knowledge can help curate the flow of information from news organizations as well as civic and political groups on Instagram. While algorithmic knowledge enables youth’s digital inclusion, for older adults, the lack of knowledge may contribute to digital exclusion as they do not know how to curate their information flows.

Levels of Digital Inequality and the Process of Adaptation to Digital Culture

Digital inequality refers to the differences in individuals' access to, use of and benefits from digital technologies. This study aims to explore the effects of demographic differences on digital cultural inclusion and exclusion. The study is designed using a sequential mixed model. The population of the study is consisted of individuals over the age of 18 living in the Sakarya province of Türkiye. The survey form was administered to collect data from 504 participants selected from the population by random sampling. Semi-structured interviews were carried out with 8 participants who are considered capable of providing detailed information on the subject. The survey form contained statements intended to measure the access and benefit levels of the participants. The usage frequency is discussed via questions prepared by the researcher based on the Likert scale, considering the sub-dimensions of digital citizenship introduced by Mike Ribble. According to the results, the participants' access to digital technologies is at high level. Concerning digital technology usage, differences are primarily determined on the basis of the age factor. With regard to the level of benefits, the satisfaction level increased as the education level increased and age decreased. Results obtained through interviews suggested that using digital technologies activated those involved in this digital culture, made their lives easier, and allowed them to engage in popular issues. Finally, the participants thought that the activities in the new media helped them engaging in current events and get important news to cope with recent events and discussions.

EHealth Literacy and the Use of NHS 111 Online Urgent Care Service in England: Cross-Sectional Survey.

Many health care systems have used digital technologies to support care delivery, a trend amplified by the COVID-19 pandemic. "Digital first" may exacerbate health inequalities due to variations in eHealth literacy. The relationship between eHealth literacy and web-based urgent care service use is unknown. This study aims to measure the association between eHealth literacy and the use of NHS (National Health Service) 111 online urgent care service. A cross-sectional sequential convenience sample survey was conducted with 2754 adults (October 2020-July 2021) from primary, urgent, or emergency care; third sector organizations; and the NHS 111 online website. The survey included the eHealth Literacy Questionnaire (eHLQ), questions about use, preferences for using NHS 111 online, and sociodemographic characteristics. Across almost all dimensions of the eHLQ, NHS 111 online users had higher mean digital literacy scores than nonusers (P<.001). Four eHLQ dimensions were significant predictors of use, and the most highly significant dimensions were eHLQ1 (using technology to process health information) and eHLQ3 (ability to actively engage with digital services), with odds ratios (ORs) of 1.86 (95% CI 1.46-2.38) and 1.51 (95% CI 1.22-1.88), respectively. Respondents reporting a long-term health condition had lower eHLQ scores. People younger than 25 years (OR 3.24, 95% CI 1.87-5.62) and those with formal qualifications (OR 0.74, 95% CI 0.55-0.99) were more likely to use NHS 111 online. Users and nonusers were likely to use NHS 111 online for a range of symptoms, including chest pain symptoms (n=1743, 70.4%) or for illness in children (n=1117, 79%). The users of NHS 111 online were more likely to have also used other health services, particularly the 111 telephone service (χ12=138.57; P<.001). These differences in eHealth literacy scores amplify perennial concerns about digital exclusion and access to care for those impacted by intersecting forms of disadvantage, including long-term illness. Although many appear willing to use NHS 111 online for a range of health scenarios, indicating broad acceptability, not all are able or likely to do this. Despite a policy ambition for NHS 111 online to substitute for other services, it appears to be used alongside other urgent care services and thus may not reduce demand.

How did COVID-19 pandemic affect the older adults' needs for robot technologies in Japan?: comparison of participatory design workshops during versus after the COVID-19 pandemic.

Social technology can improve the quality of social lives of older adults (OAs) and mitigate negative mental and physical health outcomes. When people engage with technology, they can do so to stimulate social interaction (stimulation hypothesis) or disengage from their real world (disengagement hypothesis), according to Nowland et al.'s model of the relationship between social Internet use and loneliness. External events, such as large periods of social isolation like during the COVID-19 pandemic, can also affect whether people use technology in line with the stimulation or disengagement hypothesis. We examined how the COVID-19 pandemic affected the social challenges OAs faced and their expectations for robot technology to solve their challenges. We conducted two participatory design (PD) workshops with OAs during and after the COVID-19 pandemic. During the pandemic, OAs' primary concern was distanced communication with family members, with a prevalent desire to assist them through technology. They also wanted to share experiences socially, as such OA's attitude toward technology could be explained mostly by the stimulation hypothesis. However, after COVID-19 the pandemic, their focus shifted towards their own wellbeing. Social isolation and loneliness were already significant issues for OAs, and these were exacerbated by the COVID-19 pandemic. Therefore, such OAs' attitudes toward technology after the pandemic could be explained mostly by the disengagement hypothesis. This clearly reflect the OA's current situation that they have been getting further digitally excluded due to rapid technological development during the pandemic. Both during and after the pandemic, OAs found it important to have technologies that were easy to use, which would reduce their digital exclusion. After the pandemic, we found this especially in relation to newly developed technologies meant to help people keep at a distance. To effectively integrate these technologies and avoid excluding large parts of the population, society must address the social challenges faced by OAs.

A retrospective, comparative analysis of A&E attendance paserns in Irish Traveller versus non-Traveller general practice patients.

Very little is known about Gypsy, Roma, and Traveller health, or access to and utilisation of health care. They are not coded in NHS data systems and there are multiple barriers including illiteracy, digital exclusion, and discrimination. To gain rare insight into Irish Traveller patients' emergency healthcare utilisation and outcomes. A retrospective general practice review of A&E attendances was performed from January to December 2017, comparing Travellers with the rest of the practice patient population. A search was done for all A&E attendance letters and related admissions. Blind review of the diagnosis and management were assessed by two reviewers for appropriateness of attendance at A&E. The frequency and recurrence of A&E attendances, referral pathway toA&E, location of A&E, and age distribution were compared. Traveller patients attending A&E were younger. There were fewer repeat attendances in the travelling community but proportionally more in the Traveller under-20-year-old cohort. Only 38% of A&E attendances in Travellers (56% non-Travellers) were deemed appropriate (χ2 7.16, P = 0.007). Only 20% of Travellers (36% non-Travellers) attending A&E were admitted to hospital (χ2 6.33, P = 0.01). Further, 93% of A&E attendances in Irish Travellers (75% non-Travellers) did not follow initial contact with either a GP or NHS 111 (χ2 9.86, P<0.002). Finally, 51% of Irish Travellers (6% non-Travellers) attended A&E departments distant to their registered GP practice (χ2 89.5, P<0.001). This work throws light on health service utilisation patterns by Irish Travellers. A&E attendances may have been more suited to a non-emergency setting and there may have been missed opportunities for contact with primary care or NHS 111, which may have an impact on continuity, onward referral, and quality of care.

Examining the Interplay of Sociodemographic and Sociotechnical Factors on Users’ Perceived Digital Skills

The rapid pace of technological advancements of the last decades, accelerated during the Covid-19 pandemic, has increased the importance of digital skills for individuals, businesses, and society. However, despite efforts to increase digital ownership and educational initiatives, the digital divide remains a persistent issue and a barrier to social inclusion. Digital exclusion is not limited to access vs. no access but encompasses a spectrum of participation influenced by factors such as geographical location, skills, motivation, and identity. The study explores what sociodemographic and sociotechnical aspects shape users’ digital skills. It is based on an online survey of English internet users aged between 20–55 with school-aged children (&lt;em&gt;N&lt;/em&gt; = 2,004), to measure their digital skills across six dimensions and analyzes the relationship between these skills and sociodemographic and sociotechnical variables. Results show that among the sociodemographic aspects, including gender, age, education level, employment status, income, and residential area, only income significantly contributes to distinguishing groups per level of digital skills. The study also shows that motivation gap, access gap, usage gap, and social support, are all associated with individuals’ digital skills.