Projects

ICT, THE DIGITAL DIVIDE AND HABITUS IN SELF-MANAGEMENT OF HEART CONDITIONS

Summary

In this project, we seek evidence rigorous enough to provide a critical test of a key aspect of the concept of e-Society, and also broad enough data to evaluate the success or failure of that test, so that further work can pick up where we leave off.

E-Society is expected to offset social exclusion and empower individuals who might otherwise be unable to manage their own lives, in the following ways: It might facilitate exchange over the web between people in similar situations, who would not meet face to face. It might provide access to information that people need, but could not get by other means. Use of the web promotes interactive learning and so might be more effective than other forms of learning.

Access becomes ever cheaper and may soon be practical over widespread digital TV. On the other hand, the web is vast, ever expanding and uneven in quality. To navigate it successfully calls for more than economic capital and practical training. It also requires discrimination about sources, self-confidence and a balance of trust in and wariness about virtual encounters: that is, cultural and social capital. The habitus (habitual pre-dispositions and cultural pathways) of relatively deprived people may disable them from taking the benefits e-Society seems to hold out.

Aims

Can a 'virtual community' of similarly deprived people provide an interface to facilitate any learning that is necessary and so help overcome their social exclusion?

Middle aged men and women with heart disease who live in a deprived inner city area are our focus. This group of people is at high risk of heart disease and likely to be further excluded by their condition. On the other hand, people diagnosed with heart disease tend to be receptive to health promotion messages. If they could not be reached as we propose, the promise of e-Society would be hollow.

Methods

The rigorous evidence for this critical test comes from a randomized control trial. A total of 540 men and women aged 50-74 in deprived inner city wards and drawn from general practice CHD registers, who give informed consent and meet the criteria for inclusion, will be split into three at random: 180 of them will be assigned a PC, printer and ISP subscription at home, then have training together in groups of 15; a further 180 will be controls; while the remaining 180 will be in reserve as replacements for drop-outs. The experimental group's use of the web in managing their heart disease will take place through a dedicated portal and be monitored for 12 months in all. During the first half, the research team will facilitate their use of the web and train at least one person in each group of 15 to continue as a facilitator, and, during the second, the group will be put to the test as a self-sustaining virtual community. The 180 will provide a wider frame of reference for each individual. Message boards will be set up at both a small and large group level. Users will be asked to relay their discoveries from the web to their local groups and thereby (if they fly) to the message board, where everyone will contribute to a decision about the quality of the discovery and whether it should become a permanent link on the dedicated web portal. At the beginning, the end and in the middle of the intervention period, both the experimental subjects and the controls will be surveyed - repeatedly about their (maybe changing) health and lifestyles, and at the beginning about their history and habitus. Experimental subjects' hits on the web, and their message-board postings will be used along with each small group's retrospective account of the experience of the RCT, to provide 'process' data that will enable the success or indeed failure of the trial to be evaluated.

Keywords

Digital Divide, Heart Disease, Self Care, Interactive Learning, Peer Support, Virtual Community

Conference Presentations

Bellaby P, Lindsay S, & Smith S. (2005). Enabling Healthy Choices: Is ICT the Highway to Health Improvement?, British Sociology Association, Medical Sociology Group, York.

Lindsay, S., Smith, S., Bell , F. & Bellaby, P. (2006). “Tackling the Digital Divide: Exploring the Impact of ICT on managing heart conditions among deprived men and women.” Internet & Society, Wessex Institute of Technology, Southampton UK , June 12-14.

Lindsay S, S Smith & P. Bellaby. (2007) “Can informal e-learning and peer support help bridge the digital divide?” British Sociology Association London, UK April 12-14.

Bellaby P, S Lindsay & S Smith. (2007) “What can be learned about the prospects for and the drivers of rapid innovation by comparing what has happened with the Internet and what must happen with sustainable energy?” British Sociology Association London UK April 12-14.

Bellaby, P, S Smith, S Lindsay and F Bell (2007) The ethical aspects of online research. E-Society Online Research Methods Colloquium London UK, March 28-29.

Lindsay S, P Bellaby et al. (2007) “Using the Internet to help manage heart conditions.” ESRC Symposium: The Impact of Self Care Initiatives on Patients Salford UK January 26.

Bell F, S Smith, S Lindsay and P Bellaby (2006) “Approaches to learning in the ‘Hearts of Salford’ project.” Understanding and Responding to Digital and Social Exclusion Workshop. London School of Economics, UK: December 12.

Smith, S, S. Lindsay & P. Bellaby. (2006). “Community computing interventions in multiply deprived urban areas: an effective vehicle for health promotion?” International Conference on Urban Health Amsterdam October 25-28 2006

Bellaby P, S Lindsay & S Smith. (2006). “Can ICT empower the multiply deprived?” Association of Internet Researchers Brisbane, Australia: Sept. 27-30.

Lindsay, S, S Smith & P Bellaby. (2006) “Tackling the digital divide: Exploring the impact of ICT on managing heart conditions.” International Symposium on Information, Communication and Society York UK: Sept. 20-22.

Lindsay, S, S Smith, P Bellaby & S Kay. (2006) “Non-use of ICT among a deprived elderly sample.” E-Society Program Meeting York, UK: Sept. 18-19.

Bellaby, P., S. Lindsay and S. Smith. (2005). “Enabling healthy choices: Is ICT the highway to health improvement?” British Medical Sociology Group Conference. University of York, United Kingdom. September 15-17.

Publications relating to this research

Lindsay S, S. Smith, F. Bell & P. Bellaby. (2007) “Tackling the digital divide: exploring the impact of ICT on managing heart conditions.” Journal of Information, Communication & Society 10(1): 1-20.