Keywords

1 Introduction

Preliminary results [1] indicate the need for social media mobile training among the elderly community to make them engage with technology. However, this research will particularly focus on the mild cognitively-impaired elderly group. Thus, a special training mechanism is needed to meet their cognitive disability. Generally, training plays a significant role in increasing technology awareness, and for the elderly to successfully use mobile social media applications on a regular basis. Therefore, this research investigates a blended training mechanism that can meet the elderly needs, while focusing on elderly with mild cognitive disability. This research will conduct a 3 by 1 experimental study to examine the effects of a blended learning approach to teach elderly with mild cognitive disabilities to successfully use social media mobile apps and be able to retain the information needed after certain period of time. This blended learning mechanism includes classroom training sessions with visual aids, flash cards, and mobile device, as well as a mobile tutoring app with a child narrator that will work as a supportive learning tool to help elderly with mild cognitive issues to retain the information they learned during classes. The mobile tutoring app will help participants during the self-study period particularly – two weeks the researchers will allow between the training phase and the observation phase. The mobile tutoring app will also include a child narrator presenting and singing some information to measure if singing will help participants remember short instructions. Creating an appropriate training mechanism will help elderly to engage with technology, and eventually, will allow them to successfully use social media mobile apps on a regular basis.

The mobile tutoring app will be given to the third group including the embedded child narrator, while the second group will receive the mobile tutoring app as instruction videos with no narration. The first experimental group will solely receive the classroom training includes visual aids, flash cards, and mobile devices but without the mobile tutoring app.

Instead of relying solely on Power Point presentations during classes (passive teaching style), elderly can receive a collection of flash card sets for each social media application addressing the necessary functions/features of a specific social media mobile app. These flash cards contain up-to-date user interface screen shots of app’s main features and written how-to-accomplish-instructions of each task. Flash cards can work as a reference guide for elderly users if they are struggling with a certain functionality or feature, because they tend to be easier to point out information than written notebooks. Added user interface screen shots to the flash card set would be a big plus for elderly to be able to compare what they see in the flash card with what they have on their mobile devices.

Lastly, considering the idea of an app designed particularly to train the elderly how to use social media apps effectively, covering all possible activities a user may need to perform on those platforms. This mobile tutoring app should not terminate the face-to-face training sessions but can be an add-on to serve as a repetitive tool of what might be forgotten to remember in a later time to enhance the memory of mild cognitively-impaired elderly trainees.

2 Literature Review

2.1 Technological Impacts on Elderly

O’Connell [2] found that after participating in an educational computer-skills program, senior participants showed lower levels of physical difficulties, depression, and feelings of loneliness, as reported by several different psychological scales and checklists. They even reported improved life-satisfaction, sense of control, and quality of life. Increased participation in the Internet following a training program also leads to higher computer efficacy, lower levels of computer anxiety, more positive attitudes about aging, higher levels of perceived social support, and higher levels of connectivity with some seniors.

It can be a great motive for elderly who are apart from their children and grandchildren to learn to use social media networks and see their beloved ones every once in a while. There is a successful story of an elderly establishing her own blog to express her feelings and share her experiences; all started by participating in social media networks. Paula Rice said, “I was dying of boredom” after she lost a husband, and while her children and grandchildren are way too far to visit. Yet, she spends around 14 h a day online communicating [3].

Research illustrates that the Internet has become a significant tool to exercise elderly’s brains. Elderly who use social media, Skype, and email on daily basis tend to perform better cognitively and experience enhanced well-being [4]. A cognitive study was carried out in the UK and Italy of 120 elderly (65 years and older) for a duration of two years. Participants were provided with special computer training then were compared against a control group with no training. The results showed mental and physical improvements for those who received the training, while the control group members with no training showed a stable decline. A female participant stated feeling “invigorated” instead of “slipping into a slower pace” and become more concerned about her appearance and wants to lose weight. Overall, sustaining the basic social desires of elderly can have a positive impact on their overall health [4]. To sum up, if eagerness found in elderly to participate in social media, and a proper training mechanism was achieved, there shall be more elderly adults to use social media networking, which will ultimately enhance their well-being.

With the lack of social media network usage among elderly because of computer literacy, and with ascendancy of mobile devices against computers, the purpose of this research is to investigate a training mechanism that overcomes technology literacy among mild cognitively-impaired elderly and add great benefits to their lives. Participating in social media will not only make the elderly feel included within society, but will also improve their well-being and cognitive abilities [5, 6].

2.2 Cognitive Impairment Variations

Cognitive impairment is a syndrome that causes cognitive weakening for older people affecting their memory and education level but not necessarily collide with their activities of daily life. Studies show that between 3% to 19% in adults older than 65 years old experience mild cognitive problems. Some elderly with mild cognitive disability tend to stay stable or even improve over time, but over half worsen to dementia (severe cognitive impairment) within 5 years, which eventually leads to Alzheimer’s disease [7].

Elderly with cognitive issues may suffer from mild to severe cognitive impairment. Mild cognitive disease causes a slight but noticeable and measurable decline in cognitive skills. Such declines are found in memory and thinking skills [8]. On the other hand, severe cognitive impairment can affect a person’s ability to understand the meaning or the importance of objects and may affect the ability to talk or write, which prevents them from living independently [9]. Since this research will focus on mild cognitively-impaired user group, there is a need for a proper definition of cognitive impairments and how it can be measured in elderly in order to select the research experimental groups correctly. Cognitive ability measures will be explained in the next section of this research.

2.3 Cognitive Ability Measures

Cognitive abilities are usually measured using specific tests, in which they produce a score for each certain ability (e.g., numeric, verbal, reasoning), then the resulting scores represent measures of the specific mental abilities. Yet, one final score is also produced to assess the overall cognitive ability. Those tests are now designed as online tools that randomly generate questions include reasoning, perception, memory, verbal, language, mathematics, and problem-solving questions and allow a certain time for applicants to complete the test. Conventionally, the general trait assessed by cognitive ability exams is referred to as “intelligence” or “general mental ability.” Nevertheless, an intelligence test is more of a specific mental abilities test that includes mathematical equations, verbal reasoning, comprehensive reading, number series completion, and spatial relations [10]. Traditional cognitive exams are consistent, include questions that are reliably scored, and can be assigned to large groups of applicants at once. Formats of cognitive ability tests include multiple choice, sentence completion, short answer, or true-false questions, and they are available either commercially or as free online tools. In this research, Wonderlic Test tool, a free online tool, will be used to measure cognitive abilities of potential candidates who will be recruited if eligible to participate in this research experiment.

The Wonderlic test is an intelligence test containing 50 questions designed to be taken in one set for applicants to complete in 12 min. The final score represents the questions that were successfully answered during the given time. The reason for the time restriction during the test is to produce stress among test takers which can help predict how applications perform under a certain amount of pressure. The scoring system of Wonderlic test is similar to the Stanford-Binet test that produce a Bell curve with results placed in the center of the curve [11].

2.4 Teaching Technology to Mild Cognitively-Impaired Elderly

Naumanen and Tukiainen [12] concluded that when elderly receive proper Information and Communication Technology (ICT) training, their ability increases to successfully engage with technology. In order to provide elderly with a proper training approach, we need to know how training can be effective for the elderly? Duay and Bryan [13] answered this question by stating that elderly adults need to feel they matter. They are in need for a recognition of their diverse experience and sociability which should be considered during the learning process. In other words, elderly do not enjoy the passive teaching style, they would rather be involved in a discussion and ask questions when they need to and be in an interactive learning environment. However, elderly’s cognitive abilities can decline because of aging; such noticeable declines in reasoning, discourse comprehension, inference formations, reception of new information and its retrieval from memory [2].

Cognitive abilities are the key factors for fluid intelligence [14]. Successful completion of such a training approach this research is proposing demands for a wide range of perceptual, cognitive, and motor abilities. Similarly, Nair and colleagues [14] studied elderly performance carrying a computer-based study. They concluded that age crystallized intelligence, and fluid intelligence affected elderly early performance, as well as it affected the later performance that involved practice and experience. The impact of age on conceptual and motor abilities shows age-related declines. In addition, many cognitive abilities that are crucial to learning such as working memory, attentional processes, and spatial cognition, are weaken with aging. However, these factors do not necessarily halt elderly from learning a new skill set, even though it may take them longer to adapt to a new technology than younger adults [15]. Therefore, training mild cognitively-impaired elderly can be successful if it is done properly, while taking into account repetition and slow pace progression.

2.5 Child Narrator Impact on Elderly

Instruction videos – such as the mobile tutoring app this research is designing as part of its training mechanism – can increase elderly receptiveness of social media and boost their learning process. Elderly adults tend to accept video tutorials if they had prior background knowledge of contents, thus, the classroom teaching technique was thought of. A human narration incorporation that shows social presence can be highly effective in instruction videos to provide step-by-step details of usage. Existing findings recommend the inclusion of a human narrator in instruction videos as it is preferred by elderly over the ones without [16]. Specifically, elderly adults favored a child narrator in instruction videos over young adults and senior people; a sample of 124 elderly was collected by researchers [16]. Elderly adults are widely accepting a child narrator because they believe it conserves dignity. As elderly adults grow old, they have encountered vast amount of knowledge, therefore, it is hard for them to accept knowledge from others unless they are convinced what other presenting is true [17]. Hence, providing instructions to elderly should not violate dignity values for them to accept, which this research will take into consideration when designing material for the mobile tutoring app presented by a child narrator.

3 Research Questions

Examining such training technique is crucial in defining user engagement, their successful completion of given tasks, and their ability to remember these tasks after training is over. This can be achieved by designing appropriate training mechanism that is not only suitable for elderly but also meets their mild cognitive impairment needs. To address this training mechanism, this research will attempt to answer the following questions:

  • To what extent the blended training approach of classroom and mobile tutoring app with child narrator is successful?

  • Did it help the elderly users to use social media successfully? Are they able to successfully complete tasks after taking these training sessions?

  • Does the designed mobile tutoring app help its users to retain information after certain period of time when completing their training sessions?

  • Does child narrator embedded in the mobile tutoring app design have any effect in the learning process? Does the child singing information make any difference to remember short instructions?

The following research hypothesis will be examined in this study:

H1::

The blended training mechanism used on group 3 (classroom and mobile tutoring app with child narrator) help elderly to successfully complete the given tasks, because it contains three repetitive treatments that work simultaneously.

H2::

The mobile tutoring app helps its users to retain information after certain period of time since users can gain access to it anytime, especially during the self-study period.

H3::

The child narrator included in the mobile tutoring app has a great impact on elderly learning process, as it has been proved by research [16].

H4::

The child narrator songs included in the mobile tutoring app help elderly to remember short instructions.

H5::

Songs are better remembered than words.

4 Experimental Design

The researchers will carry an experimental investigation involving a 3 by 1 design that is also called a between-group design, includes a training phase and an observation phase. During the training phase, the three examined groups will receive training as followed: the first group will receive a classroom training session including visual aids, flash cards, and mobile devices; the second group will receive classroom and mobile tutoring app training but will not experience the child narrator within the mobile tutoring app; the third group will receive a classroom training session and mobile tutoring app training including the child narrator. This will help distinguishing the effects of each method and will allow the researchers to draw a clear conclusion whether the premium treatment used on the third group (classroom, flash cards, mobile device, and mobile tutoring app with child narrator) is successful. 45 participants age between 65 and 80 will be recruited. They will be randomly assigned to one of the groups based on age. Therefore, each group will contain 15 participants of mild cognitively-impaired elderly participants age between 65 and 80 years old, and each class will have an equal distribution of participants’ age range. Participants may have minimal to intermediate experience of social media applications. Additionally, cognitive ability will be measured during the recruiting process using Wonderlic Test; a free intelligent online tool [11]. In addition, other demographic data (e.g. age, sex, experience, etc.) will also be collected. The researchers will base recruiting decisions on candidates’ final score after completing Wonderlic Test. Finally, the researchers will communicate with official institutes such as senior centers located in a Mid-Atlantic State for recruiting and will seek help from assisted living communities around the same location.

The researchers will allow a two-week-self-study period in between training phase and observation phase. Participants will be asked to freely use the course material and apply to a real-life social media mobile app interaction and note down their diaries. For instance, they write down the day and time they use social media and the activities or features they perform. This information will be utilized when running the statistical analysis later. Taking the self-study period into consideration will verify whether a participant performs successfully because of their treatment level or it was the effect of the two-week self-learning period, or both. Therefore, the researchers would not solely base results on participants’ performance during classes but will also take into consideration their practices throughout the experiment including the self-study period.

Two weeks after completing phase one (the training sessions), participants will be called back to attend observation sessions (phase two). The second phase is designed to learn how much participants remember from the first phase and whether they will be able to retain the information and complete all tasks successfully. Participants will be asked to perform the same activities they accomplished during training classes to find out whether they are able to retain information and compare their performance levels within group. The results of each group will be compared to eventually decide which training mechanism works best for mild cognitively-impaired elderly.

The independent variable for this study is the training mechanism that includes the following values:

  • Classroom only includes visual aids, flash cards, and mobile device;

  • Classroom (includes visual aids, flash cards, and mobile device), and mobile tutoring app without narration;

  • Classroom (includes visual aids, flash cards, and mobile device), and mobile tutoring app with the child narrator.

The dependent variables for this study are the effects as a result of the independent variable, such as success rate, task completion, and whether the social media app can be used without personal assistance during the self-study period.

4.1 Data Collection and Analysis

The researchers will run a factorial ANOVA statistical analysis to draw a conclusion of this experimental study. Factorial ANOVA or factorial Analysis of Variance method is used for empirical studies that embrace a between-group design to test two or greater values of an independent variable [18]. First of all, the researchers will conduct a preprocessing segment before analyzing collected data. This includes cleaning up data, which will be a significant step – especially for data recorded manually by participants – to avoid possible errors. This step will avoid negative impacts on results that human error can cause [18]. Next, collected data by the researchers will be coded to be used later by statistical analysis software. For instance, representing categorical variables of participants by codes “0” and “1” in order to be understood and run by the software [18]. The last stage of preprocessing data will be organizing collected data. The researchers will use SAS University Edition statistical analysis software [19] to compare a group of data collected for each group of participants. After initiating and finalizing the preprocessing stage, the researchers will conduct factorial ANOVA statistics.

Three factors that will be taking into consideration when measuring participants performance. These three factors are: successful completion of tasks, retain the information participants learned during the observation meetings, and measure the effect of the mobile tutoring app including the effect of the child narrator if any on mild cognitively-impaired elderly adults. The researchers will study if performance of the second and the third group will be any better than the first group to measure the mobile tutoring app effect, while taking into consideration how well participants practice on their own during the self-study period. Similarly, the researchers will compare performance of the second and the third group throughout, to measure the effect of the child narrator.

4.2 Participants

The researchers will recruit three groups of mild cognitively-impaired elderly adults to participate in two phases of this study. 10 participants for each group is needed. However, the researchers will plan to recruit 15 people for each group in case of drop offs. Therefore, the researchers aim to recruit a total of 45 participants; 15 participants per group.

The participants will be recruited through assisted living homes and Senior Activity Centers in a Mid-Atlantic State. Potential candidates will be asked to take the Wonderlic cognitive test [11] to measure their cognitive ability level. Then, the purpose of the study will be explained to all the potential candidates prior to recruiting. The researchers, if permitted, may use Senior Activity Center’s computer classrooms, or will use the computer labs in the Department of Computer and Information Sciences in a Mid-Atlantic State. The instructor will explain to the participants that being part of the study is voluntary and will inform them of their rights to dismiss class at any point in time they do not feel comfortable completing the study. Then the participants in all three groups will be asked to sign the consent forms. After signing the consent forms a demographic information sheet will be distributed to class before training takes place.

4.3 Training Mechanism

The researchers will conduct a 3 by 1 experimental design consisting of two separate phases and three groups. The first phase will involve various training sessions of three groups of 15 participants each to train mild cognitively-impaired elderly, aging between 65–80 years old, who share similar experience level of social media mobile applications. Participants will then be asked to attend observation meetings (the second phase) after two weeks for the researchers to record how much information can be retained and how successful the participants will be in completing tasks. In addition, participants will be asked to write diaries of their social media activities during the self-study period that will be given between phases. During the second phase, contributors will be asked to repeat the activities were performed in class previously. The instructor will record if people completed tasks successfully as well as the tasks they needed help with, or uncompleted ones. The instructor will collect contributors’ diaries at the beginning of phase two for data analysis later. Training classes and observation sessions will take place simultaneously to save time. This will allow accurate recordings and data analysis of all groups being close in time from each other.

4.4 Classroom Syllabus and Mobile Tutoring App Content

Each group of participants will have a chance to attend two classes for this study, a total of 6 classes for all three groups to cover the two phases. The first phase will be an introductory social media class that will run for 50 min for each group. The instructor will go over the importance of social media using Power Point slides to illustrate. Participants will be taught how to control what they share online so they feel confident to accept to use social media as privacy issues arose in literature. The instructor will go over the basics on how to use Facebook and will ask the participants to perform practically on their mobile devices. Participants will either have their own mobile device (smartphone or tablet) or will receive one from the instructor for the purpose of the study. The training session will be divided into multiple tasks that contributors will perform using their mobile devices. After each task, the instructor will allow some time for discussion. This will be a great opportunity for a collaborative class work where everyone shares their experiences, comments, and socialize.

The exercise will start by teaching participants how to download the Facebook mobile app from the App Store. Then participants will be asked to login or create new accounts if they never had one. Speaking of the third group of participants, the child narrator singing a login instruction will be presented via the mobile tutoring app at this point in time. The instructor will ask participants to help those who are struggling creating new accounts. A brief discussion session will take place to record participants’ experiences with the login/create an account step. The instructor will show participants how to search and add a friend on Facebook and ask participants to invite each other to their friends lists. They will then be asked to post a text on a friend’s timeline. In addition, they will be taught how to send a private message, how to post a picture or video on Facebook, how to like and share photos of others, and how to view friends’ posts. Participants will learn how to read the news and other Facebook services. The last task the instructor will ask participants is to take a selfie using their mobile device front camera and try to include as many people in the photo as possible. They will then be asked to post this photo to their Facebook accounts, and start to tag the people who appear in it. The second and third group of participants will have a chance to review the mobile tutoring app as class progresses. There will be an instruction video of each task that participants will review after the instructor’s explanation, and before they start performing the tasks on their own. The third group particularly will hear the child narrator speaking each activity when reviewing the mobile tutoring app.

Participants will be invited back to class after two weeks to repeat the same previously performed activities. The instructor will record performance as this class will be an observation session. Each group will attend independently, therefore, three observation meetings will take place during this phase. The instructor will videotape participants’ performance to record data. Data collected on both sessions will be combined for later analysis.

Finally, the mobile tutoring app will include instruction videos of the main features that allow the user to successfully use the Facebook mobile app. Written instructions and a child narrator will also help explain each step the mobile tutoring app offers and provide a broad view of features and information of Facebook. The researchers will design two versions of the mobile tutorial app; one includes the child narrator and the other version without. The instructor will manage to present all app’s content during classes to the second and the third group during the training phase. App content will be decided based on multiple interviews of randomly selected mild cognitively-impaired elderly, as well as previous literature review carried by the researchers.

5 Conclusion and Future Work

Preliminary research indicates elderly apprehension of anything new especially when involving new technology. One way to relieve the apprehension of the new technology is through proper training on mobile devices and social media applications [1]. To investigate how to best help the elderly overcome the apprehension, different training approaches are proposed in this research. Existing research recommends classroom training as an effective method that allow elderly to learn new technology, share their experiences, and socialize. However, the researchers are targeting mild cognitively-impaired elderly who may easily forget all the technical detail presented in class. Therefore, the researchers believe the mobile tutoring app that is especially designed with instruction videos and child narration will help boost the memory of elderly with mild cognitive disability, especially when training classes are over. Participants will have the opportunity to access the mobile tutoring app after class whenever they are struggling to perform a certain task.

In order to test the proposed premium training treatment (classroom, mobile tutoring app, and child narration), there is a need to compare the outcomes and performances of two more groups with less training treatment options. Therefore, the researchers decided to include a group of participants who will only receive a class training and mobile tutoring app without narration to measure effectiveness of the child narrator embedded in the app design when compared with the premium training treatment of the third group. In addition, the other group of participants will receive the class training only to measure the overall effectiveness of the mobile tutoring app when compared to the other two groups who will receive the mobile tutoring app as part of their training program.

Running factorial ANOVA statistical analysis will allow to test the three values of the independent variable this research is proposing; classroom only, classroom and mobile tutoring app without narration; and classroom and mobile tutoring app with the child narrator. The end results should draw a clear conclusion of which of these training approaches is the most effective that allow the mild cognitively-impaired elderly to successfully use social media mobile applications on a regular basis.