Digital technologies have become an essential part of our everyday lives. While they were still a curious novelty in the 1960s and 1970s, they seem to permeate an ever- increasing part of today’s societies (Levin & Mamlok 2021). By now, they are no longer confined to offices, where people need to physically sit in front of computers to use them. Instead, they are ubiquitous, with handheld devices being portable, and wearable technologies frequently even unobtrusive (Delabrida Silva et al. 2018). Augmented Realities blur the lines between technology and reality, while Virtual Realities even place a technological layer over our realities (Arena et al. 2022). Our technologically embedded lives create a myriad of data, which is used for various kinds of communication and as a currency. It is shared on social media for social interaction and to cultivate a personal image (Hall 2018). Moreover, it is routinely shared with companies for marketing and product development, sometimes in exchange for services (Cao et al. 2022). Thus, the datafication of our lives pulls us into a complex network of interactions (...)

Many workers, including older ones, experienced changes at work during the COVID-19 pandemic, among which was a sudden increase in the use of digital technologies. This paper aims at understanding older workers' satisfaction with digital technology-related changes at work during the COVID-19 pandemic in the Nordics. Based on novel survey data collected in Sweden in 2020- 2021, we analyzed the experience with digital technology-related changes at work and modeled the (dis)satisfaction with such changes among older workers (aged 50+). Our findings show that groups of older, less educated, reporting concurrent workload changes and digital technologyrelated difficulties had an increased likelihood of being dissatisfied with digital technology-related changes at work during the COVID-19 pandemic. The results have implications for the theoretical understanding of late working life and for the redefinition of working life policies and age manage- ment strategies in times of work digitalization of work.

Much research is conducted to evaluate digital-based solutions for health-care services, but little is known about how such evaluations acknowledge diversity in later life. This study helps fill this gap and analyses participation in the evaluation of a web-based mobile phone system for monitoring the post-operative progress of patients after day surgery. Participation is conceptualised as resulting from three processes: pre-screening, recruitment and self-selection. Based on field information and survey data, this study models (a) the (non-)participation in a sample of 498 individuals aged 60 and older that includes non-screened, non-recruited, decliners and participants in the evaluation, and (b) the individual decision to participate in a sample of 210 individuals aged 60 and older who were invited to take part in the evaluation. Increasing age enhances the likelihood of not being screened, not being recruited or declining the invitation. Those not recruited were most often ineligible because of technology-related barriers. Decliners and participants differed by age, gender, job, health status, digital skills, but not by social participation. Results suggest that highly specific groups of older people are more likely to be involved than others. Old-age diversity is not properly represented in digital health research, with implications for the inclusivity of new digital health technologies. This has implications for increased risks of old-age exclusion and exacerbation of social and digital inequalities in ageing societies.

The involvement of older people in research on digital technologies is uneven. Some groups of older people, e.g. the older ones, are less likely to participate in research which evaluates new digital technologies, compared to their counterparts. This may bias research results and produce wrong research conclusions. In this work, we aim at understanding whether and how the uneven involvement of older people in research on digital technologies has an impact on the research results. Our example is an intervention study which evaluated a web-based system for monitoring the postoperative progress of individuals after day surgery, i.e. ‘Mobile Phone in Recovery after Ambulatory Surgery’ (MIRAS). We considered a sample of 717 individuals of age 50 years and older (mean age: 65) who underwent a day surgery at one of the MIRAS recruitment sites during the recruitment timeframe. This group included both MIRAS participants and those who were not recruited byMIRAS. Based on information on age, gender, recruitment status, and intervention results, we implemented a weighting procedure to adjust the intervention results for the over-representation and the under-representation of groups of older people in the MIRAS sample by age and gender. We found that weighted and unweighted intervention results differed one another. The unweighted intervention results were over-positive with regards to the efficacy of the intervention due to the under-representation of groups of older people who were older and men. Biased results generate inaccurate conclusions which, in turn, can inform inappropriate digitalisation strategies and policies.

Introduction - Many (older) workers experienced changes in their working life as a result of the COVID-19 pandemic, some of them related to increased use of digital technologies. In this study, we aim at understanding older workers’ degree of affectedness as well as the experience of and satisfaction with technology-related changes at work during the COVID-19pandemic in Sweden.

Methods and Materials - Between June 2020 and December 2021, novel data on work during the COVID-19 pandemic was collected via a four-wave online survey (n=2901). Based on such data, which was collected in the Swedish regionÖstergötland, we modeled (a) the overall affectedness with technology-related changes at work in a sub-sample of workers aged 50 years and older, (b) the experience of specific types of technology-related changes at work in the same sub-sample, and (c) the satisfaction with technology-related changes at work in a sub-sample of 357 workers aged 50 years and older who reported to have experienced such changes.

Results - Our findings show how the experience with technology-related changes is structured along the lines of age, gender, education, occupation, and job status. Also, the satisfaction with technology-related changes proved to be unequally distributed among older workers with differences also between household and family types.

Conclusions - The results have implications for policies and practices to support equal and inclusive late working life in times of digitalisation of work.

Workplace digitalization created a sea change in work practices and it altered the situation of older workers. Digitalization entails the increased use of digital technologies, such as computers and online services. Older workers often possess limited digital skills, which may put their labor market participation at risk. Previous studies began exploring how older workers fare when their workplaces are digitalizing. However, the research field is still emerging and remains fragmented. This article comprises a systematic literature review that takes inventory of what we currently know about older workers in digitalizing workplaces. It demonstrates that older workers experience the digitalization of their workplaces in various areas, reaching from health monitoring to work arrangements. Interestingly, challenges and opportunities emerge in each area affected. This Janus-faced situation underlines the complexity of consequences, and it raises questions about social inequalities in these consequences. The work environment plays a crucial role in shaping how older workers experience workplace digitalization. It shapes which options for adaptation they have, and to which degree they can act on these options. This circumstance makes workplaces an excellent starting point for interventions. Country-characteristics likewise exert an influence. While characteristics such as retirement regulations are purposefully modified for intervention, other characteristics, such as culture, are not. This circumstance limits governmental options for shaping the situation of older workers in digitalizing workplaces. Future research should further explore the situation of older workers in digitalizing workplaces, paying special attention to the theoretical framework and to developments in the wake of the COVID-19 pandemic.

Workplace digitalization created a sea change in work practices and it altered the situation of older workers. Digitalization entails the increased use of digital technologies, such as computers and online services. Older workers often possess limited digital skills, which may put their labor market participation at risk. Previous studies began exploring how older workers fare when their workplaces are digitalizing. However, the research field is still emerging and remains fragmented. This article comprises a systematic literature review that takes inventory of what we currently know about older workers in digitalizing workplaces. It demonstrates that older workers experience the digitalization of their workplaces in various areas, reaching from health monitoring to work arrangements. Interestingly, challenges and opportunities emerge in each area affected. This Janus-faced situation underlines the complexity of consequences, and it raises questions about social inequalities in these consequences. The work environment plays a crucial role in shaping how older workers experience workplace digitalization. It shapes which options for adaptation they have, and to which degree they can act on these options. This circumstance makes workplaces an excellent starting point for interventions. Country-characteristics likewise exert an influence. While characteristics such as retirement regulations are purposefully modified for intervention, other characteristics, such as culture, are not. This circumstance limits governmental options for shaping the situation of older workers in digitalizing workplaces. Future research should further explore the situation of older workers in digitalizing workplaces, paying special attention to the theoretical framework and to developments in the wake of the COVID-19 pandemic.

This thesis aims at contributing to the understanding of digital inequalities among older people, by studying the involvement of older people in research on digital technologies. Some mechanisms driving old age digital inequalities are well known. For instance, people with lower social positions tend to have lower digital skills, to face technology accessibility and affordability issues, and, thus, to engage less with digital technologies compared to their counterparts. However, less attention has been paid to issues related to research and development of digital technologies, such as the involvement of older people in research evaluating new digital technologies. Previous studies indicate that participants and non-participants in research are different one another, with the former being younger, reporting higher educational levels, having better health status than the non-participants. This may bias research outcomes and lead to incorrect conclusions on the utility of digital technologies. The objective of this thesis is to investigate the link between the involvement of older people in digital technology evaluations and the research outcomes. Healthcare is used as exemplifying context in which digital technologies are used. In Study I, participation in digital health research is conceptualised, and a research tool for identifying and measuring selective participation is developed. In Study II and III, factors associated with participation in two digital health intervention studies are analysed. In Study IV, the impact of selective participation on the research outcomes of a digital health study is identified, measured, and corrected. Thesis findings show that participation of older people in digital health research is selective by age, gender, health status, job level, and digital skills, and can indicate a mechanism for digital inequalities. Selective participation biases research outcomes by overemphasising the intervention effects of the over-represented groups over those among the under-represented groups. It can cause an overestimation of the positive effects of digital health technologies due to the under-representation of those groups who do not benefit from the intervention. This promotes digital technologies which increase exclusion risks for some groups of older people and reinforce old age digital and social inequalities. Weighting procedures can be used for mitigating the impact of this mechanism on the research outcomes of intervention studies on digital technologies.

Denna avhandling syftar till att bidra till förståelsen av digital ojämlikhet bland äldre genom att studera äldre människors deltagande i forskning om digital teknik. Vissa mekanismer som driver den digitala ojämlikheten bland äldre är välkända. Till exempel tenderar personer med lägre sociala positioner att ha lägre digitala färdigheter, stöta på problem med tekniktillgänglighet och kostnader, och därmed engagera sig mindre i digital teknik jämfört med personer med högre sociala positioner. Mindre uppmärksamhet har dock ägnats åt frågor som rör forskning och utveckling av digital teknik, t.ex. äldres deltagande i forskning som utvärderar ny digital teknik. Tidigare studier visar att deltagare och icke-deltagare i forskning är olika varandra: deltagarna är yngre, har högre utbildningsnivå och bättre hälsotillstånd än icke-deltagarna. Detta kan snedvrida forskningsresultaten och leda till felaktiga slutsatser om nyttan av digital teknik. Syftet med denna avhandling är att undersöka sambandet mellan äldre människors deltagande i digitala teknikutvärderingar och forskningsresultaten. Hälso-och sjukvård används som exemplifierande sammanhang. I Studie I konceptualiseras deltagandet i digital hälsoforskning och ett forskningsverktyg för att identifiera och mäta selektivt deltagande utvecklas. I Studie II och III analyseras faktorer som är förknippade med deltagande i två digitala hälsointerventionsstudier. I Studie IV identifieras, mäts och korrigeras effekterna av selektivt deltagande på forskningsresultaten från en digital hälsostudie. Avhandlingsresultatet visar att äldre människors deltagande i digital hälsoforskning är selektivt utifrån ålder, kön, hälsotillstånd, arbetsnivå och digitala färdigheter, och kan indikera en mekanism för digital ojämlikhet. Selektivt deltagande snedvrider forskningsresultaten genom att man överbetonar de överrepresenterade gruppernas interventionseffekter jämfört med de underrepresenterade. Det kan leda till en överskattning av de positiva effekterna av digital hälsoteknik på grund av underrepresentationen av de grupper som inte drar nytta av interventionen. Detta främjar därmed digital teknik som ökar risken för utestängning av vissa grupper av äldre och stärker den digitala och sociala ojämlikheten bland äldre. Viktningsförfaranden kan användas för att mildra effekterna av denna mekanism på forskningsresultaten av interventionsstudier på digital teknik.

Questa tesi ha l’obiettivo di contribuire alla comprensione delle disuguaglianze digitali tra gli anziani attraverso lo studio del coinvolgimento degli stessi nella ricerca sulle tecnologie. Alcuni dei meccanismi che generano disuguaglianze digitali in età anziana sono ben noti. Ad esempio, persone con più basse posizioni sociali tendono a mostrare minori capacità digitali, ad riscontrare problemi di accessibilità pratica ed economica e pertanto ad utilizzare meno le tecnologie digitali rispetto alla loro controparte sociale più avvantaggiata. Tuttavia, meno attenzione è stata rivolta a questioni legate alla ricerca e allo sviluppo delle tecnologie digitali e al loro ruolo di queste fasi nel determinare disuguaglianze digitali. Una delle questioni sottoinvestigate è ad esempio il coinvolgimento delle persone anziane nella ricerca che si occupa di valutare nuove tecnologie digitali. Precedenti studi indicano che coloro che partecipano e coloro che non partecipano alla ricerca differiscono tra di loro. I primi sono tipicamente più giovani, riportano livelli più alti di istruzione, mostrano migliori livelli di stato di salute, rispetto ai secondi. Queste discrepanze tra partecipanti e non partecipanti potrebbero generare una distorsione dei risultati della ricerca (bias) e condurre a conclusioni scientifiche errate che si applicherebbero solo a specifici gruppi di anziani. L’obiettivo di questa tesi è di investigare il legame che esiste tra il coinvolgimento delle persone anziane nelle valutazioni di nuove tecnologie digitali e i risultati che si ottengono da quest’ultime. L’ambito sanitario è utilizzato in questa ricerca come contesto esemplificativo in cui vengono impiegate tecnologie digitali. Nello Studio I, viene concetttualizzata la partecipazione alla ricerca sulla salute digitale e viene sviluppato uno strumento di ricerca per l’identificazione e la misurazione della partecipazione selettiva. Nello Studio II e III, vengono analizzati i fattori associati alla partecipazione in due interventi che valutano tecnologie digitali per la salute. Nello Studio IV, viene identificato, misurato e corretto l’impatto della partecipazione selettiva sui risultati di uno studio sulle tecnologie digitali per la salute. I risultati di questa tesi indicano che la partecipazione delle persone anziane alla ricerca sulla salute digitale è selettiva per età, genere, stato di salute, livello lavorativo e competenze digitali, e che può essere un meccanismo che alimenta disuguaglianze digitali. La partecipazione selettiva distorce i risultati delle valutazioni emfatiizzando gli effetti degli interventi tra i gruppi che sono sovrarappresentati e sminuendo gli effetti tra i gruppi sottorappresentati. Questo può causare una sovrastima degli effetti positive delle tecnoloogie digitali per la salute dovuta alla sottorappresentazione di quei gruppi che non traggono benefici dall’intervento. Questo promuove tecnologie digitali che aumentano i rischi di esclusione e le disuguaglianze digitali e sociali. Procedure dette di ‘weighting’ possono essere usate per mitigare l’impatto di questo meccanismo sui risultati delle ricerche sulla salute digitale. 

Much research is conducted for evaluating digital-based solutions for healthcare among older people. However, some older people are less likely to be involved than others. We present an analysis of participation in the evaluation of a mobile-based system for monitoring post-operative progress after a day surgery in Sweden. We explore key factors associated with the unwillingness to participate and discuss the possible role of self-ageism in determining the decision not to participate. Based on field information and survey data, we compared participants and non-participants in a sample of 368 individuals aged 60 and older and modelled the individual decision to participate (or not) in the evaluation. Decliners and those who were willing to participate differ along the lines of (chronological) age, gender, job, health status, and digital skills. Age remains a significant factor explaining individual decision to participate even when controlling for other variables. Overall results indicate that very specific groups of older people are more likely to participate than others in digital health research. Age plays a major role in the decision to participate or not. Negative self-perception of being old with respect to digital health research could contribute to explaining the individual unwillingness to participate.