WhatsApp Intervention for Seniors' Digital and Cognitive Management (WISDOM)

Promoting lifelong learning and digital usage are forms of cognitive stimulation that foster cognitive flexibility and connectivity with information and social networks. Functional imaging research has shown that older adults who were previously internet naïve demonstrated increased brain neural activity after learning to search online. Other studies reported that older adults who underwent in-person digital literacy programs involving internet searches, messaging, photography, and mobile application use showed improvements in overall cognition, episodic memory, and processing speed. Knowledge and skills gained through learning also promoted empowerment, psychosocial well-being, and improved quality of life.

In Singapore, formal and non-formal learning among older adults remains low, with only 13.2% participating, and those who do often have higher socioeconomic status. Socially disadvantaged older adults rarely take part, even though learning engagement has been found to improve subjective well-being more strongly in this group. Volunteer-led, one-to-one digital literacy programs for older adults with low socioeconomic status have shown promise but were resource-intensive. Thus, innovative, accessible, and affordable approaches are needed.

Chat-based applications offer a potential platform for informal learning among older adults, as they support multimedia attachments, real-time messaging, and videoconferencing. WhatsApp is a common chat-based application widely used by older adults in Singapore. Previous studies have reported positive health and behavioral outcomes of chat-based interventions in areas such as smoking cessation, diabetes, breastfeeding, and depression. However, evidence for digital health literacy interventions using mobile-based chat-based platform to promote digital health literacy skills among older adults.

This study will pilot WISDOM (WhatsApp Intervention for Seniors' Digital and cOgnitive Management) to assess feasibility and explore its potential benefits among socially disadvantaged older adults. A mixed methods design will be adopted. Four active ageing centres will be randomized into two WISDOM and two control groups. About 140 older adults with low socioeconomic status will be recruited.

The WISDOM program will last 6 weeks and include face-to-face sessions and WhatsApp-based learning. Weekly topics include, but not limited, to basics of operating search engines, websites, and mobile applications, searching online health information using Google and YouTube, evaluating the reliability of health information and applying online health information.

Participants in the WISDOM group may receive additional support where needed. A subset of participants will join qualitative interviews to share their experiences and provide feedback.

Data will be collected at three timepoints: baseline (pre-test), post-test 1 (week 7), and post-test 2 (3 months after completion) to monitor changes in digital health literacy and cognitive outcomes. Quantitative analyses will include repeated measures approaches, and qualitative data will be analyzed thematically.

This pilot study will provide insights into feasibility, acceptability, and preliminary effectiveness of WISDOM as a potentially scalable, low-resource intervention to improve digital health literacy and cognition among socially disadvantaged older adults in the community.

• Perceived usefulness of online health information [Time frame: Baseline, week 7 (post-test 1), and 3 months after intervention (post-test 2).]
• Perceived ease of using online health information [Time frame: Baseline, week 7 (post-test 1), and 3 months after intervention (post-test 2).]
• Attitudes towards online health information [Time frame: Baseline, week 7 (post-test 1), and 3 months after intervention (post-test 2).]
• Use of online health information [Time frame: Baseline, week 7 (post-test 1), and 3 months after intervention (post-test 2).]
• Changes in health behaviour and decision-making using internet-based health information [Time frame: Baseline, week 7 (post-test 1), and 3 months after intervention (post-test 2).]
• Cognitive function [Time frame: Baseline, week 7 (post-test 1), and 3 months after intervention (post-test 2).]
• Cognitive domains (working memory, executive function, visuospatial coordination, psychomotor speed, attention) [Time frame: Baseline, week 7 (post-test 1), and 3 months after intervention (post-test 2).]
• Social support networks [Time frame: Baseline, week 7 (post-test 1), and 3 months after intervention (post-test 2).]