ICT-Enabled Community-Based Social Support System Matrix for

Elderly: A Social Support Perspective in Japan

Tingting Huang

School of Business Administration, Women’s University, 6-46 Ikebiraki, Nishinomiya, Hyogo, Japan

Keywords: Social Support Theory, Community, Elderly, Senior, ICT-Enabled Community-Based Social Support System.

Abstract: Japan, as the leading country with the most significant percentage of elderly, has done a great job of improving

the quality of the elderly’ social life. This research adopts a qualitative approach with a multiple case design

and the Social support theory to analyze four cases in Japan that use the deployed ICT to enhance community

and support the elderly' social life. An ICT-enabled community-based social support system matrix is

proposed with four types of elder communities. The findings delight the possibilities and the cautions for

enhancing the elder community with ICT.

1 INTRODUCTION

In 2021, the proportion of people aged 65+ years in

the total population in Japan is more than 28.8%

(Statistics Bureau, 2021). The same survey back in

2009 gave the number as 23%, which already put

Japan on the top of the list of the countries with the

largest percentage of older adults (Muramatsu &

Akiyama, 2011). The projections for 2050 show that

considerable countries will face the similar

population challenge soon (World Health

Organization, 2015).

Today, various assistive technologies have been

adopted to help the elderly improving their living

quality (Khosravi & Ghapanchi, 2016). On the other

hand, how to use assistive technology fulfilling

mental needs of the elderly is another major research

topic (Khosravi, Rezvani, & Wiewiora, 2016). There

was little research focused on how to use the assistive

technologies—appropriate design—effectively to

ease the loneliness and social isolation. As a matter of

fact, the experiences of Japan suggested that one of

the solutions to loneliness and social isolation is to

rebuilding community-based support systems

(Muramatsu & Akiyama, 2011). Nevertheless, only a

limited number of studies (Jia & Noda, 2011a;

Kobayashi & Goto, 2016) in Japan have focused on

this topic from a theoretical perspective, which

https://orcid.org/0000-0001-6105-8554

usually adopted survey methods and concluded from

the users’ perspective.

To address the above research gaps, the author

aims to analyze the representative approaches to

structuring ICT-enabled community-based support

system in Japan. The two main dimensions of the

framework are 1) social integration and 2) system

structure. The author tries to answer the following

question: How do various communities use ICT to

support the social life of the elderly? Why these

approaches to constructing ICT-enabled elderly

support system are functional? By finding answers to

these questions, the author wishes that this research

might be able to prepare the super-aging societies-not

only Japan-for the Future.

1.1 Eldertech and Social Isolation

The term of “eldertech” represents the technology for

the elderly. The elderly are supposed to need the

eldertech the most for remaining independent longer,

but they also are approved to be the most

disadvantaged group for technology adoption

(Niehaves & Plattfaut, 2014). This research has little

interest on physical assistive technology for the

elderly living with chronic illness within the medical

health, nursing, and gerontology literature (Khosravi

& Ghapanchi, 2016; Magnusson, Hanson, & Borg,

2004). In fact, the author is more forcing on the

research theme about the interactions between the

102

Huang, T.

ICT-Enabled Community-Based Social Support System Matrix for Elderly: A Social Support Perspective in Japan.

DOI: 10.5220/0011649400003476

In Proceedings of the 9th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2023), pages 102-109

ISBN: 978-989-758-645-3; ISSN: 2184-4984

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

usage of assistive technology and the mental needs

fulfilling of the elderly (Chen & Schulz, 2016;

Khosravi et al., 2016). Loneliness and social isolation

(Sarason, 2013) is one of the most serious problems

affecting the elderly, which is expressed in little

participation in social activities, dissatisfaction with

social lives, or even no contact with other people at

all (Khosravi et al., 2016). The elderly also have a

tendency to lose sight of their goals and sense of self

(Bobillier Chaumon, Michel, Tarpin Bernard, &

Croisile, 2014). Chen and Schulz (2016) find ICT to

alleviate the elderly’s social isolation through

mechanisms as connecting to the outside world,

gaining social support, engaging in activities of

interests, and boosting self-confidence. According to

the findings of Khosravi et al. (2016), within the

studies on various technologies applied to alleviate

social isolation, the commonly adopted technologies

insist of the general ICT contained the computers and

the internet (Lam & Lee, 2006; Niehaves & Plattfaut,

2014; Martina et al., 2020), social network services

(Coelho & Duarte, 2016; Kim, Lee, & Preis, 2016;

Spagnoletti, Resca, & Sæbø, 2015), robotics (L. M.

Camarinha-Matos & Vieira, 1999; Wu et al., 2016),

telecare systems (Marzano & Lubkina, 2017),

interactive television/games (Silva et al., 2016; Wang

& Sun, 2016), etc. However, the positive effect of

these assistive technology use on social

connectedness and social support seemed to be short-

term and did not last for more than six months after

the intervention (Chen & Schulz, 2016). There are

even negative effects need to be concerned such as

the assistive technology might reduce human contacts

(Wu et al., 2016). All in all, more research is needed

to unlock the relationship between ICT interventions

and social isolation reduction (Chen & Schulz, 2016;

Khosravi et al., 2016).

1.2 ICT-Enabled Community-Based

Social Support System

ICT was found to alleviate the elderly’s social

isolation through four mechanisms: connecting to the

outside world, gaining social support, engaging in

activities of interests, and boosting self-confidence

(Chen & Schulz, 2016). Close-knit community-based

social networks enhanced provision and receipt of

social support (Muramatsu & Akiyama, 2011), which

is fundamental to ease the critical issue—how to

provide appropriate support to the elderly who live

alone (Obi et al., 2013). The pressure due to aging

populations can be alleviated by focusing on

community-based healthcare and empowering people

to proactively manage their own general wellness

(Grace & Gleasure, 2015). By using the internet,

mobile devices, and other technologies have shown

great help on the design and development of virtual

elderly support community environments (L. M.

Camarinha-Matos & Afsarmanesh, 2001; Magnusson

et al., 2004). However, these telehealth and telecare

services are mainly for the elderly and their family

carers for monitoring of some health parameters

motivated by some alarm condition, specific help,

reminding or advising to the elderly person, and

supporting for electronic trading (L. M. Camarinha-

Matos & Afsarmanesh, 2001). Since not all the

elderly have family carers and most of the relatives

with jobs have less flexibility on time and energy, it

is hard to say that the above virtual elderly support

community environments can be adopted practically.

With the proliferation and ubiquity of ICTs, in

recent years, the usage of ICTs in rebuilding

community-based support systems certainly brings

more efficiency and variety (Obi et al., 2013). In

Japan, under the promotion of the Japanese

government, considerable regions have started

various ICT-enabled regional activation projects

(Takata, 2012) which include many community-

based support models for the senior citizens.

However, few of these cases can be found in

academic database. ICT watching systems for the

elderly in Japan (Jia & Noda, 2011b; Kobayashi &

Goto, 2016; Mori et al, 2011; Miyazaki & Shoji,

2017; Naoi & Ogawa, 2015) is one main research

trend which focus on keeping the elderly safe most

and providing some supports in the daily life.

1.3 Theoretical Background: Social

Support Theory

Social support as the most frequently studied

psychosocial topic refers to the availability of

interpersonal resources (Sarason, 2013; Thoits,

1995). The reason for choosing social support theory

as the theoretical lens for this research is because that

social support research has made important advances

(Barrera, 1986) and kept an impressive accumulation

of studies on the relationship between social support

and physical and mental health (Barrera, 1986; Lakey

& Cohen, 2000; Thoits, 1995), especially for the

elderly (Cutrona, Russell, & Rose, 1986). Barrera

(1986) conducts a thorough literature review from the

considered beginning, the seminal works since 1976

(Caplan, 1974; Cobb, 1976), and points out some

consistent criticisms of social support theory such as

broad definitions and diversity of measurement.

Considerable literature reviews of social support have

been conducted (Barrera, 1986; Lakey & Cohen,

ICT-Enabled Community-Based Social Support System Matrix for Elderly: A Social Support Perspective in Japan

103

2000). For instance, Barrera (1986) summarizes

various social support concepts and

operationalizations into three categories, i.e., social

embeddedness, perceived social support, and enacted

support. Lakey and Cohen (2000) resort to the above

three categories into five theoretical perspectives, i.e.,

supportive actions, appraisal, social cognition,

symbolic interactionism, and relationships.

2 RESEARCH METHOD

A qualitative research approach with a multiple-case

design is adopted to search for answers to the research

questions. The case research method is considered to

be suitable for addressing ‘how’ and ‘why’ questions

(Shan L Pan & Tan, 2011). Using multiple cases aims

to 1) seek the relationship between the community

and the most suitable ICT-enabled elderly support

system; 2) make comparisons among various

communities to find the patterns of ICT adoption. The

Social support theory as a theoretical lens guides the

data collection and analysis, which provides three

perspectives, i.e., social embeddedness (network

size), perceived social support (support satisfaction),

and enacted support (helping behavior) (Barrera,

1986).

Four representative cases (Table 1) selected from

fifty ICT-enabled regional activation projects of

Japanese government (Takata, 2012) is studied

mainly through in-depth interviews, observations,

and related documents.

Table 1: Detail information of the four selected cases.

Participants in the study were users and managers

in the four selected cases. Twenty-two individuals

completed the interview. The average age of the

sample was around 70 years (range = 60-88 years),

and 73% of the participants are women. The duration

of each interview is around half an hour. The

observations of the involved organizations and other

secondary data is collected.

Recursively iteration for data analysis between the

relevant literature, the theoretical lens, and the

empirical data is conducted in this research. Because

of a qualitative, inductive, multi-case study seeks to

build abstractions across cases (Merriam & Tisdell,

2015), hypothesis coding is considered to be

appropriate for analytic induction of the qualitative

data set, particularly the search for rules, causes, and

explanations in the data (Saldaña, 2021). This

research adopts the analytical induction method

(Shan L. Pan, Pan, & Leidner, 2012) that has already

been proved to be appropriate for case study in

information systems (IS) field.

3 CASE ANALYSIS

3.1 Case IRO

In Kamikatsu-Cho (the smallest town in Tokushima

Prefecture), the population in 2021 is less than 1500,

and the elderly (over sixty-five years old) take up

fifty-three percent of the local population. The Irodori

business means cultivating, processing, and selling

natural plants that are used as decorations for

Japanese dishes. The plant products vary from

flowers, leaves, and ears of rice to edible potherbs.

Nowadays, with over 140 producers, the earnings of

Irodori have increased to more than 200 million JPY

per year, and seventy percent of the Irodori market

share is kept steadily. Irodori business not only

boosted the regional economy but also generated the

elderly’s passion.

Community Feature. This community in

Kamikatsu-Cho is connected by the transaction in the

Irodori business. The locals who have the land which

produces the Irodori products can join the community

with a small membership fee (only 3000 JPY per

year). In 2021, the community has 150 members, of

which the average age is over seventy, and sixty

percent are women. The ranking of each product’s

sales volume in the town greatly encouraged the

elderly to compete, and the local nursing home closed

because few elderly chose to stay. According to one

government-related staff, the competition strategy

works might because most of the community

members are relatives—they have a long time and

close relationship and know each other very well.

System Structure. IRODORI CO., LTD founded

in 2001 by the local government oversees promoting

the information network of Kamikatsu-Cho. In 2001,

the Ministry of Economy, Trade and Business of

Japan allocated 160 million JPY to help build the

information network of Kamikatsu-Cho. In fact, the

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investment was not enough to build an average

information network. Kamikatsu-Cho chose to make

use of the existing communication line to build the

local area network, and this could largely reduce the

cost of hardware infrastructure. The most important

feature of Kamikatsu-Cho’s system is that the elderly,

even those who have never used computers before,

can accept and use this system. Information on this

system including news and so on is updated every

day, forming users’ habit to use the system every day.

Thirty years later, the producers can afford to buy

their computers and tablets for the business.

Customized software is still operating every day.

Social Integration. Before the thriving of the

Irodori business, most of the elderly were drinking

during the day or chatting to pass the time because of

lacking hope for the future. By providing job

opportunities, the elderly use their mind and their

bodies every day and the feeling of being needed are

keeping them joyful. The staff of IRODORI CO.,

LTD not only teach the elderly how to use computers

in the first place but also hold assemblies to teach

them how to use this system to understand and

analyze transaction data. Solving technical issues in

the community is still the routine of IRODORI CO.,

LTD. Meanwhile, IRODORI CO., LTD offers regular

study tours and classes to the whole world. Many

young urban dwellers are attracted by internships and

learn from the elderly about the Irodori business,

which also makes the elderly more vibrant.

3.2 Case OTS

In the OTS case, social media combined with the

official website intends to draw citizens and travelers

to engage in various events in Otsuki. Seniors in

Otsuki can rent their farmland to visitors, manage it

for them, and post the status of the plants regularly on

the social media. In 2013, Otsuki City was entrusted

with the "Otsuki Wellness Network" project in the

general affairs document "Project to Promote the

Creation of a Super-Aging Society". The “landing-

type tourism product centered on communication”

business using ICT was promoted within Otsuki City.

This project continued as an independent business of

the city after 2014 and ended in 2019.

Community Feature. Otsuki City in Yamanashi

Prefecture is an area blessed with abundant nature,

including the best viewpoint of Mt. Fuji in Japan.

Although the access from Tokyo is less than one hour,

Otsuki City has not been sufficiently recognized as a

tourist destination. On the other hand, the population

has been declining since the 1960s, and the aging of

the population has led to a decline in the state of the

local community and a decline in the vitality of the

area. The population aged 65 and over is the largest

in the Otsuki district with an aging rate of 38.6% (in

2020). Another issue is the increase in idle farmland

due to the declining agricultural population.

System Structure. The system of Otsuki

Wellness Tourism mainly combined the SNS

(Facebook), sensors, and the public cloud. By

installing WIFI network equipment in the field of

"Otsuki Eco-no-Sato" and transmitting the landscape

with a network camera and the temperature and

humidity from the field server installed in the

greenhouse, the situation of the rented farm can be

viewed on time by the city dwellers, and the local

elderly can also interact with them through SNS, such

as posting the status of plants. For the local elderly,

tablets were distributed to active seniors who were

responding to events to share information, and their

health conditions were observed using network-

compatible weight scales, body composition meters,

and pedometers. Meantime, an ICT education course

called "Learning Place" was set up from the

beginning, where the active seniors can experience

step-by-step how to operate tablets and how to use

SNS.

Social Integration. According to the Chairman of

NPO Otsuki Eco Village, the above event was

organized seventy-eight times with around 754

participants from all over Japan; the ICT education

course was organized thirty-one times with about 155

active seniors; more than 350 local elderly

participated in the health measurements. Within the

social activity domain of active seniors, the local

events’ participation and activities of hobby groups

were promoted the most. Active seniors were seen

more actively at the Silver Human Resources Center,

and recreational activities and socializing activities

with neighbors and relatives were rising as well.

3.3 Case TOK

"Tokuta" is a smartphone elderly watching system

based on the side street function of the local shopping

district. It was implemented as "ICT Furusato Genki

Business" by the Ministry of Internal Affairs and

Communications in 2010 and was proposed by the

specified non-profit corporation Tokushima Internet

Citizens' School and developed by the Tokushima

University Regional Creation Center. Although the

project and the application for support were

withdrawn in 2015, the social support network

through Twitter is still in operation.

Community Feature. In Tokushima's local

community, nuclear families have become more

ICT-Enabled Community-Based Social Support System Matrix for Elderly: A Social Support Perspective in Japan

105

common, and the number of elderly living alone has

increased, but the problem was that there was no

mechanism for the local community to share

information about those elderly. Therefore, using the

time of the shop owners to have them watch over the

elderly with ICT is considered to be doable. As of

November 2011(one year after the start), there were

thirty "Watched members" (thirteen men, seventeen

women, average age seventy-three years old) and

forty-two "Watching members" (thirteen men,

nineteen women, average age fifty years old). The

goal is for everyone to tweet about twice a day. The

average number of tweets is 2,917 tweets per month

(July-September 2013), ninety-seven tweets per day

on average, and tweets 1.6 times per person per day.

System Structure. "Tokuta" is a coined word that

combines Tokushima and Twitter. "Tokuta" watches

over the elderly using Twitter and smartphones

(iPhone, Android devices) that send information in

short sentences of 140 characters or less. The rented

iPhone has an iPhone application "Tokuta" installed

exclusively for watching. The system was developed

mainly by students from Tokushima University. With

Tokuta, you can tweet messages such as "I'm full of

energy" and "I'm a little sick" with a simple operation.

On the other hand, the watching team replies, "How

are you feeling today" and "Is it okay?" And interacts

on Twitter. Participants only need to have fun talking

on Twitter for both the "watching party" and the

"watched party", but as a function to support this,

Tokutta analyzes Twitter's remarks with a computer

and analyzes it. A "watching server" that

automatically finds people who are not feeling well is

in operation. The" watching server "extracts the

elderly remarks such as" I'm sick "and contacts the

watching team in charge, asks them to listen to the

situation by e-mail or phone, and visits the house if

necessary.

Social Integration. Tokuta's watching is not a

conventional system for monitoring elderly people

from the outside but is characterized by watching

through daily greetings and conversations. If you say

something trivial around you, someone will reply to

your statement. Since it is only about daily

conversations, the elderly are not managed or tied up

and will enjoy participating. Also, there is almost no

awareness or burden of watching over, and it seems

that they are enjoying participating in the community

purely. Not only the watched side uses Twitter, but

the elderly watching side also uses Twitter to

disseminate information, and the information of the

elderly is shared by the local community. It is a

method of watching over the entire region by creating

a "loose community" through mutual voices through

daily greetings and conversations, rather than just

watching from the outside.

3.4 Case KAT

The new era Katsuragi Creation Promotion Project

creates places and opportunities for self-help and

mutual assistance-type local community regeneration

at community bases such as public halls, and the local

community manages their lives sustainably and

autonomously. In the spring of 2013, it was adopted

by the Ministry of Internal Affairs and

Communications as an ICT town development

promotion project, and the "New Era Katsuragi

Creation Promotion Project" was launched through

industry-government-academia collaboration.

However, this project ended one year later.

Community Feature. Katsuragi City, Nara

Prefecture, is located in the northwestern part of the

prefecture and borders Osaka Prefecture with a

population of about 37,000. The elderly ratio is 25%.

In particular, there are many mountainous areas, and

residents have said that shopping is difficult and that

they are worried about their health. Initially, city hall

staff were promoting a business to visit elderly

people's homes, but it was too costly to continue. In

order to find a business that would sustainably

support living and health at no cost, the wisdom and

power of not only the government but also citizens,

universities, and private companies were gathered.

System Structure. In Katsuragi City, Nara

Prefecture, the local government provided shopping

support and health/life support services for the elderly

using IC cards (NFC standard). Instead of staying at

home, elderly people go to the "Otagaisama Support

House" and access the personal portal by holding an

IC card over the built-in tablet terminal to support

shopping (from purchasing products at online

supermarkets to paying charges) and to access Health

support services (health guidance based on

measured/accumulated blood pressure/body fat

percentage, etc.)

Social Integration. The Otagaisama Support

House utilizes a public hall and is operated by citizen

volunteers, which is a community-based system that

not only reduces the burden on the city but also

encourages the elderly to go out and to communicate

with each other. Citizen volunteers also support the

operation of elderly people who are unfamiliar with

the operation of smartphones and tablets.

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3.5 Cross-Case Analysis

Based on the previous analysis, Table 2 and Table 3

summarize the key features of the four cases. SST

focuses on the ways individuals are embedded in a

social network through social connections, and how

these connections are used to request or offer support

(Maier, Laumer, Eckhardt, & Weitzel, 2015). Social

support refers to the availability of interpersonal

resources (Sarason, 2013). The term social interaction

refers to the frequency and degree of involvement in

social relationships. Social integration is a sense of

belonging to a group of people who share common

interests and recreational activities (Huang, 2018).

Table 2: A Summary of the Different Approaches to

Information Flow Revealed in the Within Case Analyses.

Table 3: The Four Elderly Support Systems.

4 DISCUSSIONS

Based on the results of the case analysis, a 2×2 matrix

with four dimensions: Social embeddedness,

Perceived social support, Enacted social support, and

Support system (Figure 1) is proposed. The first three

dimensions are from the theory lens of Social support

theory. The last dimension represents the physical

structure of the support system. The four directing

arrows with the same pattern that covers from simple

to complex. Four cases in this research are placed in

the matrix as an example for explaining the features

of each type. One of the findings is that Social

embeddedness is positively relevant to the Perceived

social support and the Enacted social support is

positively relevant to the Support system. Four types

of ICT-enabled community-based social support

systems are derived from the cross-case analysis. The

first type is the L4S type, in which “L” is a shortened

form of the word “low” and “4S” represent the four

dimensions above. This type has a relatively simple

system infrastructure, the enacted social support is

limited, and the perceived social support and the

social embeddedness are also limited. In contrast, the

H4S type means “high” in all four dimensions. The

L2S type represents low in the dimensions of Enacted

social support and Support system and high in the

dimensions of Perceived social support and Social

embeddedness. The H2S type represents high in the

dimensions of Enacted social support and Support

system and low in the dimensions of Perceived social

support and Social embeddedness.

Figure 1: ICT-enabled community-based social support

system matrix.

All four types contain a social welfare nature. Besides

the case IRO, all other three cases relate to the ICT

promotion project by the Japanese Ministry of

Internal Affairs and Communications. Multiple

organizations, such as telecommunications

companies, universities, non-profit organizations,

local government, etc., were involved in maintaining

the social support communities. The elderly in the

communities have participated and received supports

for free. The founder of IRODORI CO., LTD was

from Japan Agricultural Cooperatives and the leaf

business has been supported continuing by the local

government from the beginning. All the communities

require ongoing funding support and manpower for

promotion and maintenance.

ICT-Enabled Community-Based Social Support System Matrix for Elderly: A Social Support Perspective in Japan

107

Three differences are observed during the

analysis. First, sufficient input on the support system

and enacted social support rely on stable funding. In

the case IRO, the leaf business has been able to keep

annual sales of 260 million JPY. In the case OTS,

with the withdrawal of the promotion company, the

lack of manpower became apparent, making it

difficult to promote the event. In the case TOK, the

upgrade and maintenance of the application caused

the closure of the project. Because the L2S type and

the L4S type have relatively low costs, the case OTS

and the case TOK all lasted for more than five years.

By contrast, the case KAT as the H2S type only lasts

for one year. Second, the main difference between the

case IRO and the case KAT might be the incentive

mechanism. In the case IRO, the leaf business

provides the elderly with income, famous, self-

affirmation, and common topics. However, in the

case KAT, only self-help living supports, and

communication spots were provided. The main

difference between case TOK and case OTS might be

the same. The case TOK only provides online

communication spots and monitoring services. In the

case OTS, the knowledge of the elderly was utilized,

and the elderly spontaneously tried to learn new

knowledge as same as the case IRO. Third, the

difference between the case TOK and the case KAT

might be the form of the provided communication

spots. In the case KAT, the elderly needed to go to the

community center for accessing support services. The

appearances raised the opportunity for social

interaction. On the other hand, compared to the online

communication spot, the chance of communication is

lower, and the accessible period is shorter. Some of

the elderly in the case TOK are still communicating

with each other on Twitter and helping each other in

real life.

5 CONCLUSIONS

This study adopts a qualitative research approach

with a multiple-case design for constructing an ICT-

enabled community-based social support system

matrix model with three dimensions from the social

support theory and one ICT dimension. Four

representative cases in Japan are chosen and well

analyze within and across all the cases. Findings show

that ICT adoption and community design can solve

the social isolation issues of the elderly, the effects of

which also vary from the deployed system and the

community design. The funding issue is the most

striking issue for keeping the community functional

continually. Incentive mechanism is proven to be

essential for the elderly to get long-term social

support, especially for their mental needs. Four types

of support systems from the proposed matrix model

are considered to be able to cover and explain most of

the current ICT-enabled community-based social

support systems.

ACKNOWLEDGEMENTS

This research is partially supported by the Ministry of

Education, Science, Sports, and Culture, Grant-in-

Aid for Early-Career Scientists, 2019-2022,

19K13933. The author is immensely grateful to the

case members who provide the data for analysis and

participated in this study and to Professor Pan and

others for their comments on the beginning of this

research.

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ICT-Enabled Community-Based Social Support System Matrix for Elderly: A Social Support Perspective in Japan

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