Perception and Initial Adoption of Mobile Health Services of Older Adults in London: Mixed Methods Investigation

Abstract

Background Advances in mobile technology and public needs have resulted in the emergence of mobile health (mHealth) services. Despite the potential benefits of mHealth apps, older adults face challenges and barriers in adopting them. Objective The aims of this study are to understand older adults’ perception of mHealth services and to discover the barriers that older adults face in the initial adoption of mHealth apps. Methods This paper systematically analyzed main determinants related to mHealth services and investigated them through questionnaires, interviews, and a workshop. Two studies were carried out in London. In study 1, the questionnaires with follow-up interviews were conducted based on the literature review to uncover older adults’ perception (including perceived usefulness, perceived ease of use, and perceived behavioral control) of mHealth services. Study 2 was a workshop helping older adults to trial selected mHealth apps. The workshop was conducted by the first author (JP) with assistance from 5 research students. The barriers that older adults faced in the initial adoption period were observed. The interviews and workshop were audiotaped and transcribed. Descriptive statistics and the thematic analysis technique were used for data analysis. Results In total, 30 older adults in London completed the questionnaires and interviews in study 1. The results of study 1 show that the lack of obvious advantage, low reliability, scary information, and the risk of privacy leakage would decrease older adults’ perceived usefulness of mHealth services; the design of app interface would directly affect the perceived ease of use; and aging factors, especially the generation gap, would create barriers for older users. In total, 12 participants took part in the workshop of study 2, including 8 who took part in study 1. The results of study 2 identified that access to technology, the way of interaction, the risk of money loss, heavy workload of using an mHealth app, and different lifestyle are influential factors to older adults’ adoption of mHealth services. Conclusions The perceptions of mHealth services of older adults were investigated; the barriers that older adults may face in the initial adoption stage were identified. On the basis of the synthesis of these results, design suggestions were proposed, including technical improvement, free trial, information clarification, and participatory design. They will help inform the design of mHealth services to benefit older adults.

What are the determinants of older people adopting communicative e-health services: A meta-ethnography

“…Moreover, the older adults who participated in the 10 studies (many of whom had more complex needs) discussed their limited digital literacy as being a barrier to using these services, along with a lack of knowledge of online security (13,32,42,44) and complicated interfaces reinforcing the limited usage of communicative e-health services (13,34,42,44). Furthermore, limited access to, or having out-of-date digital devices and the internet proved to hinder their ability to utilise communicative e-health services (13,41,46,47). Older adults' lack of awareness of what services are available to them adds to their limited usage.…”

“…However, some ndings suggest that even when older adults had equity of access to technology for communicative e-health services, this did not equate to the successful use of applications (34). In addition, some older adults experienced not having enough space on their phones to download the communicative e-health application (13) and reported uncertainty when deleting applications on their phones to make room for new communicative e-health applications (13).…”

“…Older adults expressed concerns about their online privacy and the lack of trust they have in communicative e-health services, (13,42,44). Additionally, the risk of privacy leakage decreases their perception of the usefulness of communicative e-health services (13).…”

“…Findings suggest some older adults have issues when accessing devices and the internet (46) and this means they are unable to take advantage of any communicative e-health services and are limited to traditional methods. Some older adults, on the other hand, may have a device but poor internet speed (13) which can make using communicative e-health services frustrating due to the slow response from the technology and may discourage them from using services due to an initial negative experience. However, some ndings suggest that even when older adults had equity of access to technology for communicative e-health services, this did not equate to the successful use of applications (34).…”

“…Over the years, there has been a growing body of literature focusing on e-health services and older adults (8-10). There are several common barriers and facilitators to e-health services that have been identi ed and these include but are not limited to: poorly designed interface (11)(12)(13), high cost of technology (14), privacy and security issues (8, 13,15,16), chronic illness (17)(18)(19) and lack of digital skills (9,16,(19)(20)(21).…”