A new study led by Dr Jane Ye In Hwang (School of Population Health, UNSW Sydney) shows that equitable digital health and frailty screening is possible for marginalised older adults, including those with low literacy, cognitive impairment and limited digital experience.
A new study led by Dr Jane Ye In Hwang (School of Population Health, UNSW Sydney) shows that equitable digital health and frailty screening is possible for marginalised older adults, including those with low literacy, cognitive impairment and limited digital experience.
To address barriers that often exclude these groups from traditional and digital screening, the research team developed and user-tested ASCAPE-HS, a tablet-based audio computer-assisted self-interview (ACASI) tool delivering a self-administered Frailty Index and broader ageing screener in under 20 minutes.
The app uses plain-language questions, simple tap-only responses, universal icons and repeatable audio instructions to reduce reliance on written and digital literacy. It is highly acceptable and usable by a diverse range of older adults.
Originally developed within a prison health research program, ASCAPE-HS was intentionally designed so its equity-focused principles can translate to other settings where older adults tend to have complex needs and intersecting disadvantage. The paper offers a purpose-built Frailty Index, as well as a practical checklist to guide collaborative development of accessible digital screening tools across research, clinical and software development teams.
“Older adults who most need early identification of frailty and age-related health issues are often those least well served by existing digital tools,” notes Dr Hwang.
“By centring digital health equity from the outset, our study shows that self-administered, audio-based screening can be both feasible and acceptable across a diverse range of older adults, including those living with cognitive impairment, lower education and complex health histories.”