Expecting attrition

As with any other intervention or training activities, technology interventions are susceptible to high attrition rates, or an elevated level of dropouts. Any intervention involving older adults is particularly susceptible to increased attrition rates due to a number of factors; a review of longitudinal studies conducted by Bhamra and colleagues (Bhamra et al., 2008) found that being older, being more cognitively impaired, having less education, having a lower socioeconomic status, being less socially active, and having worse health are all risk factors for attrition in older adult populations. In our study, we experienced firsthand the difficulties associated with dropouts. Although we were able to initially recruit 324 participants for the study (314 of which passed our cognitive screening instrument), only 256 participants completed the preintervention and postintervention assessment, and only 208 completed all follow-up assessments (as a reminder, our study went on for a full year after the interventions were completed). For our study, the most cited reasons for participant dropout were health concerns, lack of participation, relocation, loss of interest, and death.

Unfortunately, training personnel may not be able to address all the particular reasons why an older adult in a CCRC chooses to withdraw from a technology class. Little can be done if a participant becomes sick and cannot attend technology class or if a participant decides to move away from the CCRC. But although the technology trainers may not be able to account for all possible reasons for attrition, some—like loss of interest—can be prevented by keeping the technology interventions interactive and enjoyable and by keeping the participants engaged throughout. We found that our participants tended to remain interested in the classes if they found the lessons to be applicable to their wants and needs; as an example, our original training plan included equal time spent on teaching email and social media, but as the study progressed and we found participants were much more interested in email than social media, we increased the time spent teaching email and reduced the hours spent on teaching about sites like Facebook and Twitter.

Participants remained more engaged when they were asked to participate in the lesson as well; as an example, when teaching the participants about searching for information online, we would ask the class for suggestions on "what to Google." Something as simple as asking for a search topic can go a long way in keeping the participants engaged with the instructors and engaged with the material (and when asking the class for topics to search, you can get varied responses that may inject a bit of humor into the proceedings). Finally, keeping things light and fun also assisted in battling disinterest; as an example, when teaching participants how to open email attachments, we would send them emails with either humorous pictures with animals or pictures of local landmarks to open.

Battling disinterest can be an adaptive process for the instructors. As previously mentioned, we adapted our classes to include more email-focused sessions once we learned that the participants preferred to learn about that topic. Adaptations like this happened frequently, with us expanding some lessons and condensing or even cutting others. Unfortunately, not every class environment will be the same, and so instructors may be left with making quite a few judgment calls on which topics to cover and which to gloss over. For our project, having optional office hours (where participants could receive one-on-one instruction beyond the normal class sessions) allowed participants to learn about topics that were not covered in the class and thus any topic that was condensed or cut could still be taught to the participants. However, not every CCRC setting may be equipped to have office hours sessions like we did, and so instructors must be mindful about creating and adapting a class schedule that remains fun and engaging while also not ignoring topics CCRC residents may want covered.

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