Abstract
BACKGROUND: Thailand has aged fast, becoming a superaging society. Simultaneously, ongoing rapid digital transformation puts older people at risk of being left behind. Research assessing the digital skills of older people and their application of digital technology for health is a literature gap. METHOD: This study is an explanatory-sequential design mixed-method study. Community survey of 500 community older adults in Northern Thailand applied London School of Economics and Political Science (LSE) digital skills instrument to measure "operational internet skills," "information navigation skills," "social skills," "creative skills," and "mobile skills" and perceived health and technology use for health promotion. Quantitatively, Kruskal-Wallis and Mann-Whitney U tests identified differences in the digital skills across sociodemographic and internet use characteristics, while multivariable ordinal logistic regressions analyzed types of digital skills associated with health outcomes. Qualitatively, thematic analyses explained the quantitative findings in detail. RESULTS: The mean age of the participants was 68.36 years, of which 69% were female. Ordinal logistic regression identified that higher "social skills" positively influenced self-rated health (β = 0.32, 95% CI = 0.11-0.52), while 'Information navigation skills' affected internet use to access healthcare (β = 0.20, 95% CI = 0.04-0.36). Older adults with higher levels of 'operational skills' and 'social skills' positively associated with application of technology for health promotion in terms of improving eating habits ('operational skills', β = 0.54, 95% CI = 0.28-0.79; 'social skills', β = 0.64, 95% CI = 0.45-0.83); accessing healthcare ('operational skills,' β = 0.49, 95% CI = 0.23-0.75 'social skills' β = 0.74, 95% CI = 0.55-0.93) and accessing long-term care services ('operational internet skills,' β = 0.47, 95% CI = 0.21-0.73; 'social skills' β = 0.66, 95% CI = 0.47-0.85). Multiple focus-group interviews of older persons revealed how smart phone apps enabled them to stay connected, seek care and help others. CONCLUSION: Therefore, it is urgent to enhance digital skills and internet use among older populations to promote healthy aging.