1 INTRODUCTION

In 2019, hearing loss was estimated to affect approximately 1.5 billion people globally, with 62.1% of those affected being above 50 years.¹ The Australian hearing loss prevalence data in 2017 suggests that more than three million 60 years and older adults have a hearing loss in their better ear.² Untreated hearing loss increases the risk of social isolation,³ loneliness^{3, 4} and depression.⁵ During the Covid-19 pandemic, mental and psychosocial well-being worsened in older adult populations in Australia.⁶ This was likely due to the social isolation policies introduced, which temporarily removed in-person communication (the primary form of social and family engagement) for many older adults.

Online communication has been proposed to decrease loneliness and social isolation in older populations⁷ and would be effective in situations where in-person contact is not possible. Social isolation is a quantifiable variable referring to a limited number of social connections.⁸ In contrast, loneliness refers to the subjective feeling of being lonely,⁸ which could be either social loneliness resulting from the perception of a small social network or emotional loneliness resulting from the perception of a lack of emotional support.⁹ Community groups using social media (Facebook, WhatsApp, Instagram, etc.) for those with similar experiences (i.e., hearing loss) could increase social engagement and networking and meaningful relationships where members can sympathize with some of the experiences of other users. This could help address the social and emotional loneliness experienced by a subset of older adults with hearing loss.

With this in mind, we conducted a community conversation to identify the community's views on creating an online community specifically for hearing-impaired older adults to support their psychosocial well-being. Facebook was chosen as, in Australia, 55% of older adults used social media apps in 2020, with 97% of them using Facebook for their online social networking.¹⁰ The online community/Facebook group aimed to reduce social isolation and loneliness through increased community engagement with others with hearing loss.

2 METHODS

Participants were divided into eight groups of five participants and given 15–20 minutes to think about the questions and write down their answers. Three experienced researchers (Audiology, Psychology and Ageing) facilitated discussions in each group. All written responses were collated and tabled (Table 1). After the table feedback, the facilitators worked together to determine the key pieces of information identified across the tables. The thematic analysis method was used to identify the common themes across the participant groups. This project was approved by the University of Western Australia Human Research Ethics committee (2021/ET000487).

3 RESULTS

The main feedback from our participants was that they did not use Facebook as a social media platform, were unlikely to use it in the future, and were not interested in creating a Facebook account specifically to join an online community. They did not see the value of using Facebook for social connection, preferring to contact their family and friends by phone. Many community conversation contributors perceived social media negatively. They also expressed a lack of confidence in using social media and a lack of understanding of navigating it safely and securely.

4 DISCUSSION

Findings of this community conversation revealed that many older adults are disinterested in using Facebook/social networking sites to promote social communication.

These findings align with other research - despite older adults' increased internet and social media uptake, they maintain an ambivalent or negative attitude towards it.¹² The main barriers to older adults using social media for communication seem to be: concerns about privacy issues, fear of inappropriate content, lack of understanding regarding the purpose and benefits of social networking sites, a perceived lack of social conduct in online communities, a lack of comfort with online self-disclosure, a perceived lack of personal relevance (e.g., if friends/family were not already participating), and a perceived lack of control.^{13, 14}

Due to COVID-19-related restrictions, older adults may have encountered extended periods of social isolation, loneliness and mental health distress; hence, addressing these psychosocial outcomes is crucial.⁶ Even though many older adults perceive social media for communication negatively, some evidence suggests that the relationship between social media communication and loneliness is mediated by perceived social support and social contact.²⁰ These findings indicate that some older adults could still benefit from social media communication to reduce social isolation and loneliness.

While our community conversation got helpful feedback from participants for the questions asked, the consensus and opinions among participants on the undesirability of using digital technology, getting or using Facebook for a community group provided us with several areas of interest for further research and community involvement in social networking sites usage/interventions among older adults experiencing loneliness, (i) determining what social media platforms/networking sites (Facebook, WhatsApp, etc.) are desirable for older adults as a potential tool to improve their well-being, (ii) determining how these social media platforms/networking sites could be better constructed for their needs, and (iii) ways of addressing their concerns where possible (e.g., increasing technical literacy and confidence, privacy concerns).

5 CONCLUSIONS

It is essential to accept that online social networking is not for everyone and may not add value to the lives of every person; however, it is helpful for those interested in learning new technologies, building online social connections and also receiving social support through online social media/networking sites.

CONFLICTS OF INTEREST

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article. However, Prof Leon Flicker is an Editorial Board member of the Australasian Journal on Ageing.