The Role of Social Support in Bridging the Digital Divide for Older Veterans

• Published in: Medical care Vol. 63; no. 5; p. 374
• Main Authors: Jacobs, Josephine C, Greene, Liberty, SooHoo, Sonya, Slightam, Cindie, Gujral, Kritee, Zulman, Donna M
• Format: Journal Article
• Language: English
• Published: United States 01.05.2025
• Subjects: Aged; Aged, 80 and over; Cross-Sectional Studies; Digital Divide; Female; Health Services Accessibility; Humans; Male; Social Support; Surveys and Questionnaires; Telemedicine - statistics & numerical data; United States; United States Department of Veterans Affairs; Veterans - psychology; Veterans - statistics & numerical data; United States; COVID-19; social support; age-related digital divide; veterans; video telehealth
• ISSN: 1537-1948
• DOI: 10.1097/MLR.0000000000002131

For nearly a decade, the US Veterans Health Administration (VA) has distributed tablets to Veterans with access barriers who may benefit from video telehealth visits. Older Veterans' lower likelihood of tablet use relative to younger Veterans has prompted interest in factors influencing tablet utilization. We examined whether social support facilitates video telehealth utilization among older Veterans who received VA tablets. We performed a cross-sectional analysis of electronic health record-linked survey data. We used multivariable logistic regression to examine the relationship between social support and telehealth use, controlling for predisposing, enabling, and health factors. Veterans aged ≥65 who received a VA-issued tablet and responded to a national survey (September 2021 to January 2022) (n=859). The outcome measure was any VA video telehealth use in the 6 months post-tablet receipt. Social support measures included tangible support, living with others, and marital status. Fewer than two-thirds of respondents (62.4%) had a video visit in the 6 months post-tablet receipt. In all, 32.2% of respondents noted that the absence of family or friends to help with video visits hindered their use of video telehealth. In multivariable analyses, greater tangible social support was associated with 54.1% (95% CI: 10.1%-116.2%) higher odds of having a video visit. Older adults who receive technological devices to engage in video telehealth benefit from tangible social support from family and friends. Assessing and addressing patients' social and environmental circumstances may help optimize digital divide interventions and ensure that older adults are not excluded from telehealth-related access gains.