Health-Seeking Behavior and Its Associated Technology Use: Interview Study Among Community-Dwelling Older Adults (Preprint)

Abstract

BACKGROUND Population aging is a global phenomenon, and older people may have a possible increase in seeking health services. Digital technologies such as smartwatches, mobile apps, exergames, and telemedicine, have progressively permeated our life and have become increasingly popular in supporting the aging population and facilitating healthy aging. Understanding older people’s health-seeking behavior is crucial to uncover their health needs and priorities, as well as developing appropriate policies to address these needs and avert their disease progression. However, research on health-seeking behavior in literature largely focused on behavior during illness episodes, and there is a scarcity of studies on how digital technologies were utilized in older adults’ health-seeking behavior. OBJECTIVE Following Chin and Kramer’s definition and Pootaghi et al.’s defining attributes, health-seeking behavior in our study is a multi-faceted concept encompassing 1) day-to-day efforts to maintain their physical, mental, and social well-being, 2) responses to symptoms, 3) access to the health system, and 4) health information-seeking. Our study aimed to investigate how community-dwelling older adults in Singapore utilized digital technologies in their health-seeking behavior. METHODS This study has been approved by the Institutional Review Board. A semi-structured interview approach was used in this qualitative study that spanned April 2022 to July 2022, either on Zoom or in person. Inclusion criteria included being aged 50 and above, long-term residing in Singapore, and being able to speak English or Mandarin. Community outreach and social media recruitment strategies were adopted for participant recruitment. The interviews were manually transcribed verbatim anonymously, and a thematic analysis was performed. RESULTS A total of 15 interviews were conducted at thematic saturation. Digital technologies have been playing a substantial role in all aspects of our participants’ HSB, and almost everyone had consciously or subconsciously used some form of digital technologies to facilitate their self-monitoring, manage medical appointments and review test results, improve access to healthcare services, and seek and share health information. We also identified five different factors affecting the participants’ preference and judgment for health education (i.e., the professionalism of the instructor, the language used by the instructor, the usefulness and relevance of the content, cost, and personal interest) and eight considerations when selecting mobile health applications (i.e., perceived usefulness, the comprehensiveness of features, perceived ease of use, performance and quality, recommendations by the social network, cost, rewards, and reliability). CONCLUSIONS The results of our study counter the stereotype that older adults reject technologies and are technologically disadvantaged. Our findings also have implications for policies and healthcare models to view the different dimensions of HSB holistically to better understand and address the unmet health needs of community-dwelling older adults.