Use and Acceptance of Digital Communication Technology by Older Adults for Social Connectedness During the COVID-19 Pandemic: Mixed Methods Study

Abstract

Background Older adults are at higher risk for health issues, including mental health problems. This was especially apparent during the COVID-19 pandemic, where older adults were simultaneously more vulnerable to the disease and the mental health concerns created by social distancing. Subsequently, the use of digital communication technology (DCT) became a critical option for maintaining social connectedness in older adults. Prior to the pandemic, the low uptake and use of technology by older adults was an established problem, known as the digital divide. However, not much is known about how this may have changed as a result of the pandemic. Objective This study aims to explore how older adults maintained social connectedness through DCT during the pandemic and to understand factors influencing the use and acceptance of DCT. Methods A mixed methods explorative field study was set up, involving surveys and interviews of 25 community-dwelling older adults (65-88 years old) living in the United Kingdom. The surveys included the internet acceptance questionnaire (based on the Technology Acceptance Model [TAM]); COVID-19 dysfunctional anxiety was captured using the COVID-19 Anxiety Scale (CAS). Background information (demographics, use of technology) was gathered before conducting semistructured interviews. We hypothesized that CAS would affect constructs of TAM and that predictive constructs of TAM would have remained valid during the pandemic. We also posited that there would be unidentified themes outside TAM that impacted the acceptance and use of DCT. We used the quantitative data to guide the semistructured interviews, which were then analyzed through thematic analysis to identify additional themes. Results Correlational analysis showed that CAS influences all constructs of TAM. We also saw that the predictive constructs of TAM, especially the perceived ease of use (PEU) and perceived usefulness (PU), remained valid during the pandemic. Common acceptance-influencing themes were encountered in both quantitative and qualitative analyses, with 3 matching the known constructs of TAM (PU, PEU, and behavioral intention). We identified 2 additional themes affecting acceptance, namely influence of the pandemic (situational context) and privacy and security concerns. DCT use (especially email and videoconferencing use) increased during the pandemic, but the results related to social networking sites were mixed. Conclusions The COVID-19 pandemic impacted technology acceptance and use by older adults, encouraging their use of certain DCT apps (email and videoconferencing apps, such as WhatsApp). These apps helped insulate them from adverse effects (social isolation and loneliness). Other social networking apps, however, exerted a negative influence, increasing anxiety and a general feeling of negativity. Future studies should maximize older adult agency related to design, privacy, security, and user requirements for development. We also recommend that when studying DCT acceptance for older adults, our additional identified themes should be considered alongside the existing TAM constructs.

Application and Challenges of the Technology Acceptance Model in Elderly Healthcare: Insights from ChatGPT

“…Evaluating the acceptance of mobile health applications tailored for elderly users, considering factors like user-friendliness, perceived usefulness, and ease of navigation. [4,5,15,19,24,28,47,48] Health Information Systems:…”

“…Elderly individuals may harbor reservations about the confidentiality of their health information when using digital platforms, leading to hesitancy in embracing healthcare technologies. [8,15,24,35] Resistance to Change:…”

“…Of the core components of TAM in elderly healthcare, Perceived Usefulness (PU) becomes paramount, reflecting the extent to which the elderly believed that a given technology would enhance their healthcare experience. This involved considerations such as improvements in health monitoring, access to medical information, or assistance with daily living [8,[14][15][16]24,25,[81][82][83][84].…”

“…Parallelly, Perceived Ease of Use (PEOU) assumes significance, gauging the elderly individuals' belief in the technology being user-friendly and effortlessly navigable [8,[14][15][16]24,25,[81][82][83][84]. Attitude Toward Using (ATU) encapsulates their overall evaluation of adopting specific healthcare technologies, where positive attitudes significantly influence acceptance [1,5,7,16,[25][26][27][28][29][30].…”

“…The TAM has served as a valuable framework for assessing the elderly's perception and acceptance of various healthcare technologies. In the realm of telehealth, TAM can be employed to gauge how elderly individuals perceive and embrace remote consultations, monitoring, and virtual care technologies [24,28,34,[37][38][39][40][41][42][43][44][81][82][83][84]. Furthermore, TAM has been proven useful in understanding the factors influencing the adoption of wearable health devices among the elderly, including smartwatches and fitness trackers designed to monitor vital signs and activity levels [28,45,46].…”