Understanding the use and attitudes of digital technology among ethnic minority elders in Brighton and Hove

Healthwatch Brighton & Hove wanted to understand the digital capabilities amongst ethnic minority elders in Brighton and Hove.  They recruited 22 people for interviews and focus groups from local Indian, Sri Lankan, Black Caribbean, Pakistani, Iranian, Egyptian, White European and Turkish communities.

Overall people's confidence with digital technology averaged at 3.1 out of 5.

Digital skills - Most people, although had a mobile, were using it predominantly to make phone calls or text. There was a particular problem in accessing emails on a mobile, knowing how to file them, send them, and turning off notifications. Other skills such as changing font size or connecting to WiFi were discussed and found to be easier on a laptop compared to a mobile. Some made reference to people in their local community who had far less skills to use digital technology. Also, while some said they intended to raise their confidence with digital technology, others were admittedly trying to avoid it. 

Using digital technology - People used digital technology for a range of different purposes including shopping, banking, comparing deals (e.g. for car insurance), booking holidays and generally searching for information. Keeping contacts with family and friends, often abroad, was a particular benefit. Social media was rarely used, with some describing this as deliberately avoided.

Lowering people’s confidence - Poor reliability due to loss of connection, ‘crashing’ and confusion over passwords dampened people’s confidence. However, the main barrier to using digital technology was centred around distrust. This was particularly the case for unscrupulous emails and financial transactions including banking and making online purchases. This extended to concerns over privacy and sharing data without knowing, with several people having been scammed which only exacerbated these worries. 

Building trust - There were various strategies used to allay the distrust issues. The most common way was to get help from friends or family (usually their children), mostly in knowing how to operate a mobile and access the internet safely. This extended to family or friends making online purchases on their behalf (by settling their friends or family member’s credit card use by cash), and checking emails with others (both receiving and prior to sending). To combat the possibility of being scammed, some suggested having separate accounts for online purchases. Others spoke specifically about only using reputable and wellknown websites even if that was not the cheapest deal. 

Health and GP access – Most people either preferred not to use an online GP booking system (such as e-consult) or had tried with great difficulty. Several shared experiences of people in their community who were greatly disadvantaged by this. Most preferred to make an appointment direct with the surgery (often in person). Once the appointment was in progress, there were also problems in terms of sending photos or videos. Further problems were knowing when a return call from a GP would occur, not using or understanding the NHS App, and not being able to reply to a letter online. Because of the complexities of making an appointment and having to wait, there were instances where people attended the local Emergency Department to get advice. By contrast, some also found remote appointments more convenient, benefitted from online prescriptions, and some mentioned the advantages of Patients Know Best to access results quickly. 

Age-related issues – Most people did not learn about digital technology at the time the internet was first emerging. Families, friends and some professional ‘drop-ins’ have been valuable sources of advice and assistance. Most people were generally interested in attending further training, although others felt it was too late and they were disinterested in learning new skills. For any further support, the language would need to be accessible and the content tailored to specific needs. Above all, people expressed that their age meant any training would have to be step-by-step and not too fast-paced. Also, people spoke about the training focusing on what people ‘need to know and what they don’t need to know’ in preference to a ‘crash course’ that covers everything. The support would need to be informal in order to minimise embarrassment and not create any fear about making mistakes or being 'left behind’. Additional comments suggested the benefits of community-based venues with support led by members of that same community. 

Ethnicity – Although faith or country of origin had no role in shaping experiences, language was considered as a significant obstacle to using digital technology. Being able to read letters, messages, emails and using the NHS App was impossible for those for whom English was not spoken or was their second or third language. Even if a person’s understanding of English was good, understanding test results from the NHS App and My Health and Care Record was problematic. In view of the language, some people mentioned the main obstacle of using digital technology was a combination of ‘language and technology’.‘always on their mobile’. Apart from this general annoyance about being too reliable on digital technology, people also shared how some people within their communities are becoming increasingly disadvantaged by lacking any digital skills and not having the support networks of friends and family. 

As a final point, by the very nature of the research, the people who are more aware of digital technology are more willing to participate in the study compared to those with no experience. The digital skills shown by participants in this study are likely to be overrepresented compared to their peers in the local community.