Health information behavior and related factors among Estonians aged ≥ 50 years during the COVID-19 pandemic
| Date | 15 February 2023 |
| Pages | 1164-1181 |
| DOI | https://doi.org/10.1108/JD-10-2022-0217 |
| Published date | 15 February 2023 |
| Subject Matter | Library & information science,Records management & preservation,Document management,Classification & cataloguing,Information behaviour & retrieval,Collection building & management,Scholarly communications/publishing,Information & knowledge management,Information management & governance,Information management,Information & communications technology,Internet |
| Author | Marianne Paimre,Sirje Virkus,Kairi Osula |
Health information behavior
and related factors among
Estonians aged ≥50 years during
the COVID-19 pandemic
Marianne Paimre
School of Digital Technologies, Tallinn University, Tallinn, Estonia and
Tallinn Health Care College, Tallinn, Estonia, and
Sirje Virkus and Kairi Osula
School of Digital Technologies, Tallinn University, Tallinn, Estonia
Abstract
Purpose –The purpose of the article is to introduce the outcomes of a study analyzing the relationships
between willingness to use technology for health purposes, health information behavior (HIB), health behavior
(HB) choices, readiness for COVID-19 vaccination, socioeconomic indicators and self-reported health among
older adults aged 550 years living in Estonia.
Design/methodology/approach –A cross-sectional survey was conducted among 501 people aged 550
in Estonia in 2020, a month after the end of lockdown.
Findings –The results of the study indicate that the more recurrent the need for HI was (rho 50.11, p< 0.05)
and the more regularly one searched for it (rho 50.14, p< 0.01), the more willing a person was to get
vaccinated. Also, interest in digital applications corresponded to vaccination readiness (rho 50.25, p< 0.001).
However, this relationship did not emerge in the case of other HBs such as healthy eating and exercise.
Differences in HIB should be taken into account when developing effective means of health communication
designed especially for crisis situations.
Originality/value –Estonia is known as one of the digital front runners in the world. However, social welfare
and the well-being of disadvantaged groups among the population (e.g. older people) have not yet caught up
with the more developed Western countries. Thus, learning more about the health-related information behavior
of older adults, e.g. the kind of health information they are seeking and using in Estonia, allows policymakers,
health information providers and libraries in Estonia to plan and carry out more effective interventions and
help them to improve the existing systems so as to furnish older adults with relevant information.
Keywords Older adults, Technology acceptance, Health information behavior, Health behavior,
COVID-19 pandemic, Vaccination
Paper type Research paper
Introduction
The aging of society places a significant burden on the health and welfare systems of most
countries (EC, 2021;WHO, 2015). At the same time, digitalization is creating favorable
conditions for independent and healthy aging (Ihm and Lee, 2021;Weil et al., 2021;
Nimrod, 2020). Various digital health applications and services have been developed for older
adults in advanced countries aimed at monitoring one’s health and allowing them to cope
with minor health issues on their own (Arthanat, 2021;Chu et al., 2021). Computers and smart
devices also facilitate access to health information (HI) sources and help raise health
awareness (Pourrazavi et al., 2021;Turner et al., 2018;Chaudhuri et al., 2013). Although older
people’s adoption rate of smart devices is growing faster than ever, many of them do not use
new technology at all or encounter several problems while attempting it (Age UK, 2021;
Li et al., 2021). At the same time, a vast number of them have long been familiar withthe new
JD
79,5
1164
This study was supported by Tallinn University Research Fund Grant TF3320 “Surveying the health
information behavior among Estonians aged fifty and older in the online environment”.
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/0022-0418.htm
Received 13 October 2022
Revised 20 January 2023
Accepted 26 January 2023
Journal of Documentation
Vol. 79 No. 5, 2023
pp. 1164-1181
© Emerald Publishing Limited
0022-0418
DOI 10.1108/JD-10-2022-0217
technology and use it almost as often and skillfully as young people (Oh et al., 2021;
Mestheneos and Gheno, 2019;Heart, 2013;P
alsd
ottir, 2008).
Estonia is known as one of the digital front runners in the world. According to the United
Nations E-Government Survey 2020 rating 193 United Nations (UN) Member States in terms
of digital government, Estonia ranks among the top three most digitally advanced countries
together with Denmark and the Republic of Korea (UN, 2020, p. xxv). The UN survey notes:
“The citizens in Estonia can do basically anything online except for a very few things like
getting married or divorced and selling or buying real estate. The X-road, a multi-channel
communication protocol developed for the entire online service provision, secures functions
such as digital identity, e-voting, e-taxation, and e-businesses, to name a few. Eesti.ee is the
one-stop-shop to government information and e-services”(UN, 2020, p. 52). In the 2020
e-Participation Index, Estonia is ranked 1st in the world, ahead of South Korea and the United
States (UN, 2020, p. 120). In the 2021 edition of the European Commission’s Digital Economy
and Society Index (DESI) Estonia ranks 7th out of the 28 EU Member States (EC, 2021, p. 19).
With regard to digital public services, Estonia is the top performer in the EU courtesy of well-
developed e-government and e-health systems with the central government as well as
municipalities providing their services online (EC, 2021, p. 18). However, social welfare and
the well-being of disadvantaged groups among the population (e.g. older people) have not yet
caught up with the more developed Western countries (Leppiman et al., 2021).
Although the health of older people has significantly improved together with life
expectancy and Estonian pensioners tend to work longer and are better educated than their
counterparts in many other European countries, they face the most significant poverty risk in
the entire European Union (EU) (Unt et al., 2020;EC, 2014). Within the EU, 16.8% of people in
the age of 65 years and over were at risk of poverty in 2021 while the corresponding figure for
Estonia was 40.6% (Eurostat, 2023). This percentage has increased dramatically since 2011,
when it was just 13.1% (Tkacz, 2021). In Estonian healthcare, more emphasis has been
recently placed on digital services (Haigekassa, 2022;Laanepere, 2021;E-Estonia, n.d.), and
all citizens, regardless of age, should be ready to use them. According to Eurostat (2023), the
percentage of individuals using the Internet for health-related information in Estonia was
62.0% in 2021. However, according to the European Social Survey (ESS) in 2022, 6% of the
Estonian 50–64-year-olds and 34% of the 65–74-year-olds had never used the Internet
(European, 2022). In the 75þage group the corresponding figure was 66% (European, 2022).
At this point, it is necessary to specify who fall under older adults. Views and definitions of
this age rangevary by source. For example,according to the UnitedNations (UNHCR, n.d)and
for statistical and public administrative purposes, older adults are often defined as persons over
60 years of age (Britannica, 2022). However, the National Institute on Aging’s guide (NIH, 2022)
as well as the International Organization for Standardization (ISO,n.d) classifies people ag ed 65
and overas older adults. Amongthe 65þgroup, persons between 65 and 74 are often regarded
as the youngest, those between 75 and 84 as middle-olds and those over 85 the oldest olds
(Alterovitz and Mendelsohn, 2013). The biological age alone does not often correspond to the
perceived age or “social age”. As people today live and work longer, many elderly people do not
regard themselves as old. Depending on health and other cir cumstances, some “oldest-olds”may
feel much younger than they actually are and vice versa (APA,n.d;Williamson an d Asla, 2009).
In Baltes’model, aging is subjective and unique, and a person can remain mentally strong
despite disabilities or frailty and adapt to limitations as they age (Donnellan and O’Neill, 2014;
Baltes et al., 2006). To encompass the entire age spectrum of Estonian older adults and also
younger ones for comparison, this study focuses on Estonian seniors in their fifties and above to
analyze their willingness to use technology for health purposes, health information behavior
(HIB), and factors related to themduring the COVID-19 pandemic.
Learning more about the health-related information behavior of older adults, e.g. the kind
of HI they are seeking and using in Estonia, allows policymakers, HI providers and libraries in
Health
information
behavior
1165
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