Abstract
This study aimed to assess the impact of a virtual intergenerational service-learning project on undergraduate students’ ageism attitude toward older adults and on older adults’ social competence. Students were randomly assigned to two groups: the service-learning group and the non-service-learning group (spring 2021 semester). Service-learning students (n = 20) were paired with older adults for a weekly virtual conversation of at least 30 min per week for 8 weeks. Pretest and posttest surveys were used to assess the change in students’ ageist attitudes toward older adults. Paired samples t-test was used to assess the change in older adults’ social competence levels. Our findings suggest that compared with the students in the non-service-learning group, students in the service-learning group experienced a greater decrease in ageism score after project completion. Service-learning modestly but significantly increased older adults’ social competence level (p = .041).
Introduction
The US Census Bureau reported that the overall US population is aging, mostly due to increased life expectancy over the last four decades. By 2060, nearly 25% of the US population will be 65 years or older, compared with 15% in 2016, the number of older adults ages 85+ years will triple, and an additional half-million individuals will be centenarians (Bureau, 2020). As people live longer, they are more likely to need frequent visits to health care providers to treat their multiple comorbidities (Bishop et al., 2022; Kadambi et al., 2020).
Furthermore, as people age, they may have reduced or limited social activities and social connections due to loss of mobility, and/or loss of loved ones and friends, which may lead to social isolation (an objective measure of social connections) and/or loneliness (“a subjective feeling of being alone”; Li et al., 2023). Social isolation and loneliness have been reported as a global pandemic among older adults and found to be associated with adverse physical and mental health outcomes, lower quality of life, high rate of emergency visits, high primary mortality (Barnes et al., 2022; Li et al., 2023; Park et al., 2020; Sneegas, 1985), and depleted perceived social skills or social competence, which is defined as “confidence in social abilities in a given situation”(Li et al., 2023; Sneegas, 1985), page 16. More precisely, social competence refers to a person’s capacity to engage in fulfilling social interactions and relationships (Özdoğan et al., 2023).
Social competence empowers individuals to obtain social support and increase social networks (Özdoğan et al., 2023). As such, individuals with a high level of social competence are more likely to be able to build strong social networks and they are less likely to experience loneliness (Özdoğan et al., 2023). Social isolation and loneliness were more prevalent during the COVID-19 pandemic due to several months of mandatory confinement and quarantine (Cocuzzo et al., 2022; Li et al., 2023; Smith et al., 2020), and older adults were the most affected population (Dahlberg, 2021; Hwang et al., 2020).
Another issue associated with aging is ageism, defined as “a stereotype, prejudice, and discrimination based on age” (Levy et al., 2022). According to this definition, everyone can be a victim of ageism, regardless of age, but older adults are more prone to experience ageism and the COVID-19 pandemic has played a major factor to the increasing ageism trend worldwide (Levy et al., 2022; Lytle & Apriceno, 2023; Sutter et al., 2022).
Since an aging population will impose additional need for healthcare services, healthcare providers and administrators need to be culturally competent regarding their interactions with the older adult population to avoid ageism bias. Therefore, an adequate awareness of ageism bias through training that involves intergenerational interaction between the younger generations of future health administrators and older adults is crucial. A pedagogical tool that enables this intergenerational-based education is service-learning.
The purpose of this study is to build on prior studies on intergenerational service-learning (Augustin & Freshman, 2016; Bartlett et al., 2021; Bowling et al., 2022; June & Andreoletti, 2020; Parkinson & Turner, 2019; Ruiz-Montero et al., 2020; Yamashita et al., 2013; Yoelin, 2022) by assessing the effectiveness of an intergenerational virtual service-learning intervention on undergraduate students’ ageist attitude toward older adults and its impact on older adults’ social competence during the COVID-19 pandemic using a pre-post design.
Literature Review
Service-Learning
Service-learning is defined as “an experiential learning, which integrates community service activities into academic curricula” (Tambaum, 2022) page 10. Service-learning has been found to be an effective pedagogical tool that provides real-life/experiential education with respect to community/civic engagement and social issues. As such, service-learning has been used to simultaneously educate students about social issues such ageism, racism, social isolation, loneliness, poverty, incarceration, and mental health, among others. Service-learning helps the individuals impacted by these social issues, and solve these issues (Bringle & Hatcher, 1995; Warren, 2012).
In addition to the immersive learning experience offered in service-learning-based education, students engaged in service-learning activities are also required to write a diary and a personal reflection of their experience to reinforce learning (Bringle & Hatcher, 1999). These two aspects of service-learning (experiential learning and diary/reflection writing) differentiate it from just lecture-based traditional education.
Extant literature has demonstrated the effectiveness service-learning on both students and the service-learning recipients with respects to several social issues (Salam et al., 2019). With respect to students, studies have demonstrated that students have a better understanding and assimilation of study materials because they are able to apply what they learned in the classroom in a real-life experience (Simons & Cleary, 2006). Also, students exhibited better awareness and attitudes toward those social issues after service-learning completion (Cline & Bain, 2022; Salam et al., 2019; Simons & Cleary, 2006; Tambaum, 2022; Yoelin, 2022). With respect to service-learning recipients, positive outcomes have been found in terms of free consultations, trainings, mentoring, nutrition guidance, medical check-ups and medicine, natural resources conservation, improved social welfare, as well as decreased social issues (Salam et al., 2019).
The real-life and immersive learning experience used in service-learning pedagogy was traditionally conducted in a face-to-face environment where students are physically present at the service-learning site. However, the mandatory confinement and quarantine measures to contain the COVD-19 pandemic have made this immersive training difficult to administer. Some instructors have converted in-the-field, real-life, service-learnings into virtual service-learnings (Bartlett & Scholl, 2024; Meuser et al., 2022).
Intergenerational Service-Learning
Several studies have demonstrated the effectiveness of intergenerational service-learning to educate the younger generations (high-school and college students) in addressing the issues associated with aging, such as ageism and other negative stereotypes, as well as providing some social support for the older adult population (Chen, 2018; Counts et al., 2022; Horan & Perkinson, 2019; June & Andreoletti, 2020; Moinolmolki & Broughton, 2022; Parkinson & Turner, 2019; Ruiz-Montero et al., 2020; Underwood & Dorfman, 2006; Yoelin, 2022).
Methods
This intergenerational service-learning study was administered during the Spring 2021 semester. This study attempted to assess the effectiveness of intergenerational service-learning on undergraduate students’ ageism bias toward older adults and on older adults’ social competence using an experimental and control group design on older adults’ feelings of social competence (as measured by the validated Short Forms of the Texas Social Behavior Inventory (TSBI; Helmreich & Stapp, 1974a) and students’ ageism bias toward older adults using the validated Aging Semantic Differential Scale (ASD; Gluth et al., 2010; Rosencranz & McNevin, 1969), the validated Ambivalent Ageism scale (AAS; Cary et al., 2017), and a two-items scale created by the authors to measure student’s comfort and confidence interacting with older adults. A copy of these survey instruments is posted in the Appendix 1. This was approved by the Institutional Review Board of the Texas State University IRB protocol #7046.
The primary hypotheses from this study consisted of: (1) student-older adult interactions will have a positive impact on student perceptions of older adults (as reflected in significant changes in their semantic differential ratings of older adults); (2) that student-older adult interactions will decrease student ageism scores (compared to pretest scores) and; (3) students who interact with older adults will report more comfort and confidence in working with older adults than the students who completed a more traditional research paper on aging.
During the prior Spring 2021 semester, undergraduate students majoring in healthcare administration in an academic institution in Texas were randomly assigned to a service-learning group (treatment group) and a non-service-learning group (control group) with the main objective of reducing student’s ageist attitudes toward older adults. The students assigned to the service-learning group were paired with older adults for a weekly virtual conversation. Non-service-learning students were assigned a more traditional research paper on ageism. Both the service-learning and non-service-learning groups were asked to fill out an online survey to measure their levels of ageist attitudes toward older adults (Aging Semantic Differential Scale, Ambivalent Ageism scale, and a two-item experimenter created scale of comfort and confidence in working with older adults) at both the pretest and posttest intervals.
Study Participants
College Students
Undergraduate students enrolled in a course on healthcare history, language, and culture, offered by the Bachelor of Healthcare Administration program, during the Spring 2021 semester, were randomly assigned to the service-learning project (n = 20) and the non-service-learning project (n = 41). Students assigned to the service-learning project were paired with older adults residing in the community. Students were required to engage in a weekly virtual conversation with their older adult partners for at least 30 min, for a total of 8 weeks. Older adults were allowed to choose the modality of the conversation either via Zoom, text message, or telephone. Students were given some ice-breaking interview guidance (list of potential questions) for the first conversation, then students and older adults were granted the freedom to choose the conversation topics for subsequent weeks. As part of every service-learning project, students were asked to write a half-page diary of each virtual encounter and a one-page reflection of what they learned after four virtual conversations, for a total of two reflections. Non-service-learning students were asked to write an individual traditional term paper on ageism manifestation in different countries.
Older Adults
Convenience sampling was used to recruit the older adults who were ≥65 years old to participate in this study. They were recruited from the neighborhood churches and senior living facilities using phone calls and/or emails. Twenty older adults accepted to participate in the service-learning project. Of these participants, 17 (85%) were female. Participants’ ages ranged between 65 and 84 years old. They retired from diverse careers such as schoolteacher, college professor, registered nurse, flight attendant, university employee, hospital custodian, pastor, oil company employee, Internal Revenue Service officer, and State Board appraiser.
Measures
Pretest and Posttest Surveys for Students
Three measures were employed with students in a pre-post method in this study. The Aging Semantic Differential Scale (ASD; Gluth et al., 2010; Rosencranz & McNevin, 1969), the Cary’s Ambivalent Ageism Scale (AAS; Cary et al., 2017), and a two-item researcher generated Likert-rating of Comfort and Confidence in interacting with older adults based on a 10-point scale (1 = not at all comfortable/confident to 10 = very comfortable/confident). The ASD has been found to have high levels of reliability and validity (Cary et al., 2017). This differential scale, provides an attitudinal dimension (such as Progressive 1-----2-----3-----4-----5-----6-----7 Old Fashioned) that are considered to be opposites (Gluth et al., 2010; Rosencranz & McNevin, 1969). Students’ pretest and posttest surveys were virtually administered on Qualtrics. All students were given an informed consent approved by the IRB of the academic institution of the authors during the administration of the pre- and post-surveys
Pretest and Posttest Surveys for Older Adults
Older adults completed a 16-item social competence/self-esteem measure based on the Short Forms of Texas Social Behavior Inventory (TSBI), which is a validated objective measure of self-esteem or social competence (Helmreich & Stapp, 1974a). The pretest posttest surveys for the older adults were paper based. The older adults participating in this study were given an informed consent approved by the IRB of the academic institution of the authors during the administration of the pre- and post-surveys.
Cronbach alpha was computed for each of the questionnaires given. The Texas Social Behavior Inventory has been shown, historically, to have a Cronbach alpha between .85 and .86 (Helmreich & Stapp, 1974b). The Cronbach alpha for the TSBI in the current study was .78. For the Aging Semantic Differential Scale, a typical Cronbach Alpha score has been reported to be .86. For the current study, the Cronbach alpha for the ASD scale was .82. Historically, the Ambivalent Ageism Scale has a Cronbach alpha of .91 (Cary et al., 2017). For the current study, Cronbach alpha score was .80. Though these Cronbach alpha scores are lower than those noted in past research, they fall within what is considered to be a reasonable score for 30 participants (between .7 and .8).
Data Analysis
The aggregated mean scores of the ASD scale, AAS scale, and the two-items scale created by the authors were used for the pretest and posttest student surveys to assess students’ change in ageism attitude toward older adults. In the same vein, the aggregated pretest and posttest mean scores of TSBI scale were used to assess older adult participants’ social competence level. The data of the older adults’ survey allowed us to conduct a paired-sample t-test. IBM® SPSS® Statistics software Version 28 was used for data analysis.
Results
Participant Attrition and Missing Data
Only a small number of participants completed both the pretest and the posttest. Because of this low number, we could only make a comparison between the pretest and posttest scores by group. More precisely, some participants completed a pretest and failed to complete the posttest, and others did not complete the pretest but completed the posttest. Since we were aggregating the data and not trying to make pretest-posttest comparisons for any particular student or any particular older adult participant, we only eliminated from analyses those who did not complete both pretest and posttest surveys. In other words, pretest analyses for older adults and students represent the data for all students or all older adults that completed a pretest (the average of their scores on each measure) and the posttest analyses included those who completed posttest measures independent on whether they completed a pretest. Again, this comparison seems justifiable because we were not trying to draw comparisons between any particular student’s or older adult’s within subject scores but to compare between groups at pretest and between groups at posttest.
For missing data, a 5% level was used. If a participant had 5% or less of the data missing, they were included in the analyses by using the mean score on that item to replace the missing data point. If the participant had more than 5% data missing, they were excluded from analyses. As a result, 9 of the 61 students (85% response rate) were eliminated from the pretest analyses and 28 students were eliminated from the posttest analyses (54% response rate). For the older adults, four (out of 20) older adults (80% response rate) were eliminated from pretest analyses and four were eliminated from the posttest analyses.
As can be seen from Table 1, older adults reported moderate self-esteem/social competency levels at both pretest and posttest (the highest possible score is 80). Nonetheless, there is a modest change in TSBI scores when comparing pretest and posttest averages using a paired samples t-test.
Older Adult Pretest and Posttest TSBI Average – Paired Samples Statistics.
Statistically significant at p ≤ .05.
Outcomes of Intergenerational Virtual Service-Learning on Students
All measures for students (ASD, AAS, and Comfort/Competence interacting with Older Adults) were administered both pre and post interactions with older adults. Additionally, some students (21) assigned to the service-learning group interacted with older adults while the remaining students assigned to the non-service-learning group (41) completed a more traditional research project on ageism manifestation in different countries rather than interacted with older adults. The basic results for the pretest and posttest measures for students are summarized in Tables 2 to 4.
Pretest and Posttest Results for Students in the Non-Service-Learning Group (Control Group).
Statistically significant at p ≤ .05.
Pretest and Posttest Results for Students in the Service-Learning Group (Experimental Group).
Statistically significant at p ≤ .05.
Combined Pretest and Posttest Results for Students in the Non-Service-Learning and Service-Learning Groups.
Note. NSL = non-service-learning group; SL = service-learning group.
Statistically significant at p ≤ .05.
Tables 2 and 3 summarize the data from pretest and posttest for both the service learning and non-service-learning groups. The pattern of means shows that interacting with older adults and completing a more traditional paper on ageism has an impact on students’ attitude regarding ageism, their perceived ability to work with older adults and their semantic differential ratings of older adults. We have highlighted with p values those mean comparisons that demonstrated significant change from pretest to posttest scores.
Pretest Results for Students
As can be seen in Table 4, the two groups service-learning (SL) and non-service-learning (NSL) do NOT differ significantly on any of the variables at the beginning of the project (Pretest data). This means that the random assignment of the students to the service-learning project and the more traditional research project does not appear to be driven by major differences in attitudes about older adults or ageistic attitudes; sampling bias does not seem to be an issue. Of course, the question of interest (and our hypotheses center on this) is whether there are differences in the posttest results after the service-learning students spent a minimum of 4 hrs, in total, interacting (virtually) with their assigned older adult partners in comparison to the non-service-learning students who completed a more traditional research paper on ageism in different countries.
Posttest Results for Students
As can be seen in Table 4, both groups showed a decrease in their ASD scores from pre to posttest, but the scores for service-learning students were significantly lower at the posttest than those for the non-service-learning group, t (1,31) = 2.041, p = .05. Scores on the ageism scale (AAS) decreased from pre to posttest for both groups but were not significantly different from each other on either the pretest or posttest survey. It appears that interacting with older adults and completing the more traditional research paper on ageism improved students’ ageism scores. For example, service-learning students showed a decrease in those AAS scores from 44.75 at the pretest to 36.77 at the posttest, and non-service-learning students showed a decrease from 42.00 at the pretest to 37.70 at the posttest (see Table 2).
Regarding the experimenter generated two-item measure of comfort and confidence in interacting with older adults, virtually no change occurred in either group. Both groups averaged almost 17 out of 20, on the pretest and posttest data, on this self-rating with higher scores reflecting more comfort and confidence.
Outcome of Virtual Intergenerational Service-Learning on Older Adults
In this study, 16 older adults filled out the paper-based pretest and posttest surveys. The older adults’ mean score of the TSBI at the pretest was 53.13 (higher scores reflect more self-assessed social competence and self-esteem) while the older adults’ mean score on the posttest was 53.88. This difference is modestly significant at p = .041, with a standard deviation of 1.34 and a standard mean error of 0.36.
Discussion
This study attempted to assess the effectiveness of virtual intergenerational service-learning in decreasing students’ ageistic attitude. The researchers recognized that a paired test was not conducted due to data limitation. Therefore, the determinations as to whether the virtual interactions between students and seniors (Intergenerational interactions) had a significant impact on AAS and ASD scores could not be made. However, the changes in the average from pretest to posttest for the experimental (Table 3) and control groups (Table 2) certainly do conform to that assumption.
The reader will note that, contrary to what was hypothesized, the control group showed a decrease (in average) on the Ambivalent Aging Scale. In fact, both groups’ scores dropped dramatically on this scale. The reader is reminded that the “control” group completed a more traditional project – researching and writing about a topic related to aging – so it is likely that the assignment had a similar effect on these scores that the intergenerational interactions had. The fact that the scores on the other measures did differ, still suggests that intergenerational interactions could be a more effective method for decreasing ageistic attitudes than traditional projects and papers.
The changes in the scores of the two-item measures to assess students competencies/comfort interacting with senor adults are not significant. Prior to enrolling in the service-learning course, students may already have had some meaningful interactions or relationships with older adults like their great grandparents, grandparents, and other older relatives or neighbors. As a result, a 30-min virtual interaction with an older adult individual for over 6 or 8 weeks is no longer impactful in enhancing students’ competencies/comfort interacting with older adults.
With respect to the older adults, virtual intergenerational service-learning significantly increased their social competence score by 0.75 points. This finding indicates that virtual intergenerational service-learning is an efficient and effective way to increase older adults’ social competence. Therefore, engaging in virtual interaction with other people may be one of the solutions to keep older adults socially active, especially when confinement due to a pandemic prevents a face-to-face or a physical interaction with others.
Our intergenerational service-learning project was conducted virtually, due to the COVID-19 pandemic. While we found some decreases in students’ ageism scores, the effect sizes were not highly substantial. We expect these decreases to be greater if college students and their older adult counterparts were able to meet physically. In the same vein, while our study slightly increased older adults’ social competence, a face-to-face interaction with college students could have a greater effect on their social competence scores. Also, there may have been some potential limitations to the virtual intergenerational service-learning in terms of loss of Internet connection.
Study Implications
The findings from our study have some implications for the use of service-learning. Service-learning is a double-edged sword that may positively affect the service-learner (college students) and the recipients of the service (older adults or other vulnerable populations). The findings from this study indicate that intergenerational service-learning can positively impact both students (decreased ageism score) and older adults (increased social competence). The worldwide population is rapidly aging. The United Nations predict that the number individuals aged 65 or older is projected to reach 1.5 billion by 2050, meaning that 1 in 6 people will be older than 65. In the same vein, the number of people aged ≥80 will triple within the next 30 years (Desa, 2019) . Therefore, it is important that the society starts to prepare the younger generations to be comfortable interacting with older adults, who are at risk of social isolation and in need of greater social support/interactions and more healthcare services. Intergenerational service-learning is one of the cost-effective tools that educational institutions can use to train the younger generation (college students) to be more comfortable interacting with older adults and more empathetic toward them, while alleviating the burden of social isolation and loneliness that may lead to social incompetence and other illnesses among older adults.
Our study was conducted during the COVID-19 pandemic when social distancing was the norm and yet we capitalized on technology to enable our students to reach-out to the older adults in the community. Therefore, service-learning is a versatile tool that can be used on a face-to-face basis or virtually. Educators can also be creative choosing the type of service-learning activity for their students such as games, reading, watching a movie together, and discussions, among others.
Limitations
This study has some limitations. First, since all the measures used to measure ageism and social competence were self-administered surveys, we could not eliminate social-desirability biases that might have influenced the participants. Second, our IRB prevented us from giving incentives to students and older adults to fill out the surveys. Therefore, not all participants filled out the surveys and there was a decline in the number of completed surveys from the pretest to posttest survey among students, resulting in a smaller sample size. That decline in the number of students who completed the posttest survey prevented us from using paired-sample t-tests. However, we were able to use a paired-sample t-test from the sample of senior adults. Third, we were not able to limit the social interactions of older adults only to the required weekly virtual meeting with college students. Some social interactions beyond the virtual service-learning allocated time might have influenced older adults’ social competence level. Nonetheless, the lock-down during COVID-19 pandemic might have restricted such additional social interactions.
In addition, the reaction of the society to COVID-19 pandemic might have indirectly impacted our study. Some studies found that COVID-19 triggered some positive and negative impacts on senior adults. On the one hand, the society demonstrated empathy toward older adults due to their higher risk of mortality and complications compared to the younger population. For example, they were offered special senior shopping hours and some people initiated pen pal programs. On the other hand, some older adults experienced neglect and ageism, neglect, abuse, and discrimination such as “# BoomerRemover.” Nevertheless, the extra precautions (extreme social distancing) to protect older adults from contracting COVID-19 resulted in increased loneliness and ultimately decreased social competence (Freitas et al., 2020). Therefore, these positive and negative effects of COVID-19 on social competence and ageism could indirectly impacted the findings of our study.
Conclusions
We examined the impact of a virtual intergenerational service-learning on undergraduate students’ ageistic attitude and on older adults’ social competence. We found that the intergenerational service-learning mostly benefited the students as they exhibited a decrease in ageism score after service-learning completion based on the ASD scale. As such, this finding highlights the usefulness and effectiveness of virtual service-learning as it pertains to giving students the opportunity to engage in immersive learning when on-site or face-to-face interaction is not allowed or not possible. With respect to older adults, virtual intergenerational service-learning marginally increased their social competence level. We call for future studies to validate the use of intergenerational virtual service-learning for online courses.
Footnotes
Appendix 1
Acknowledgements
The authors express their heartfelt gratitude to Ms. Diane Osborne for her valuable effort recruiting the older adults who participated in this study.
Ethical Considerations
This study was approved by Texas State University IRB protocol #7046.
Consent to Participate
Informed consents approved by Texas State University IRB protocol # 7046 were given to the students and older adults who participated in this study.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
The survey data collected for this study are not publicly available due to IRB protocol restriction.
