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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

What would it take to improve the uptake and utilisation of mHealth applications among older Australians? A qualitative study

Tanja Schroeder https://orcid.org/0000-0002-1733-6542 A C * , Karla Seaman https://orcid.org/0000-0003-4611-9616 A , Amy Nguyen https://orcid.org/0000-0003-4603-564X A , Joyce Siette https://orcid.org/0000-0001-9568-5847 B , Heiko Gewald https://orcid.org/0000-0003-2107-2217 C and Andrew Georgiou https://orcid.org/0000-0002-7619-3668 A
+ Author Affiliations
- Author Affiliations

A Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.

B MARCS Institute for Brain, Behaviour and Development, School of Computer, Data and Mathematical Science, Western Sydney University, Westmead, NSW, Australia.

C In­sti­tute for Di­gital In­nov­a­tion (IDI), Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany.

* Correspondence to: tanja.schroeder@mq.edu.au

Australian Health Review 48(1) 28-33 https://doi.org/10.1071/AH23119
Submitted: 13 June 2023  Accepted: 10 January 2024  Published: 25 January 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

Health-related apps on mobile devices (mHealth apps) have become an effective self-management tool and treatment support for patients. There is limited research, however, on how older people (50 and over) perceive the opportunity of using mHealth apps. Our aim was to investigate the perceptions of older people in Australia regarding the opportunity of using prescribed or doctor-recommended mHealth apps and provide insights which can enhance their uptake of mHealth.

Methods

This was a qualitative study using semi-structured interviews involving 21 participants aged 51–82 years. Qualitative thematic analysis was used to categorise the factors that influence the adoption of mHealth apps by older adults.

Results

We show that beyond the prominent influencing factors from technology adoption research (such as performance and effort expectancy, social influence and facilitating conditions), health-specific factors such as a trusting doctor-patient relationship and strong health self-efficacy positively influence the intended adoption of mHealth apps among older adults. In addition, the IT security and accurate interpretation of participants’ input in an mHealth app can present barriers to mHealth app adoption.

Conclusion

Our analyses provide additional insights complementing existing technology adoption research. Their successful adoption and utilisation require further empirical evidence on its effectiveness along with attention to the voices of those who are meant to use them. To address potential barriers, improve the quality and security of mHealth apps, and thus achieve greater patient safety, the involvement of consumers, regulators and health professionals is necessary.

Keywords: aged care, chronic disease management, eHealth, health behaviour, mHealth applications, patient-centred care, technology adoption research.

References

Giansanti D. The Role of the mHealth in the Fight against the Covid-19: Successes and Failures. Healthcare 2021; 9(1): 58.
| Crossref | Google Scholar | PubMed |

Hoque MR, Rahman MS, Nipa NJ, Hasan MR. Mobile health interventions in developing countries: a systematic review. Health Informatics J 2020; 26(4): 2792-810.
| Crossref | Google Scholar | PubMed |

Grand View Research. mHealth Market Size, Share & Trends Analysis Report By Component, By Services (Monitoring Services, Diagnosis Services), By Participants (Mobile Operators, Devices Vendors), By Region, And Segment Forecasts, 2024 - 2030. 2023. p. 118. Available at https://www.grandviewresearch.com/industry-analysis/mhealth-market

European Union. Shaping Europe’s digital future. 2021. Available at https://digital-strategy.ec.europa.eu/en

Baumel A, Muench F, Edan S, Kane JM. Objective User Engagement With Mental Health Apps: Systematic Search and Panel-Based Usage Analysis. J Med Internet Res 2019; 21(9): e14567.
| Crossref | Google Scholar | PubMed |

Cotarelo M, Fayos T, Calderón H, Mollá A. Omni-Channel Intensity and Shopping Value as Key Drivers of Customer Satisfaction and Loyalty. Sustainability 2021; 13(11): 5961.
| Crossref | Google Scholar |

Weichelt B, VanWormer J, Xu Y, Kadolph C, Lin S. Lessons Learned from Development of a Mobile App for Cardiovascular Health Awareness. Sustainability 2021; 13(11): 5985.
| Crossref | Google Scholar |

Federal Institute for Drugs and Medical Devices (BfArM). The Fast-Track Process for Digital Health Applications (DiGA) according to Section 139e SGB V. A Guide for Manufacturers, Service Providers and Users. 2020. pp. 1–128. Available at https://www.bfarm.de/SharedDocs/Downloads/EN/MedicalDevices/DiGA_Guide.html

Fisk M, Livingstone A, Pit SW. Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States. J Med Internet Res 2020; 22(6): e19264.
| Crossref | Google Scholar | PubMed |

10  Nimmanterdwong Z, Boonviriya S, Tangkijvanich P. Human-Centered Design of Mobile Health Apps for Older Adults: Systematic Review and Narrative Synthesis. JMIR Mhealth Uhealth 2022; 10(1): e29512.
| Crossref | Google Scholar | PubMed |

11  Schroeder T, Dodds L, Georgiou A, Gewald H, Siette J. Older Adults and New Technology: Mapping Review of the Factors Associated With Older Adults’ Intention to Adopt Digital Technologies. JMIR Aging 2023; 6: e44564.
| Crossref | Google Scholar | PubMed |

12  Taherdoost H. A review of technology acceptance and adoption models and theories. Procedia Manuf 2018; 22: 960-7.
| Crossref | Google Scholar |

13  Albrecht UV, von Jan U. Safe, sound and desirable: development of mHealth apps under the stress of rapid life cycles. Mhealth 2017; 3: 27.
| Crossref | Google Scholar | PubMed |

14  O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for Reporting Qualitative Research. Acad Med 2014; 89(9): 1245-51.
| Crossref | Google Scholar | PubMed |

15  Lee CC, Czaja SJ, Moxley JH, Sharit J, Boot WR, Charness N, Rogers WA. Attitudes Toward Computers Across Adulthood From 1994 to 2013. Gerontologist 2019; 59(1): 22-33.
| Crossref | Google Scholar | PubMed |

16  Martin LG, Freedman VA, Schoeni RF, Andreski PM. Trends in disability and related chronic conditions among people ages fifty to sixty-four. Health Aff 2010; 29(4): 725-31.
| Crossref | Google Scholar | PubMed |

17  Flick U. An introduction to qualitative research. Sage Publications Limited; 2018.

18  Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3(2): 77-101.
| Crossref | Google Scholar |

19  Li J, Talaei-Khoei A, Seale H, Ray P, MacIntyre CR. Health care provider adoption of eHealth: systematic literature review. Interact J Med Res 2013; 2(1): 2468.
| Crossref | Google Scholar | PubMed |

20  Alalwan AA. Mobile food ordering apps: An empirical study of the factors affecting customer e-satisfaction and continued intention to reuse. Int J Inf Manage 2020; 50: 28-44.
| Crossref | Google Scholar |

21  Alalwan AA, Dwivedi YK, Rana NP. Factors influencing adoption of mobile banking by Jordanian bank customers: Extending UTAUT2 with trust. Int J Inf Manage 2017; 37(3): 99-110.
| Crossref | Google Scholar |

22  Okumus B, Ali F, Bilgihan A, Ozturk AB. Psychological factors influencing customers’ acceptance of smartphone diet apps when ordering food at restaurants. Int J Hosp Manag 2018; 72: 67-77.
| Crossref | Google Scholar |

23  Venkatesh V, Morris MG, Davis GB, Davis FD. User Acceptance of Information Technology: Toward a Unified View. MIS Q 2003; 27(3): 425-78.
| Crossref | Google Scholar |

24  Bandura A. Social cognitive theory: An agentic perspective. Annu Rev Psychol 2001; 52(1): 1-26.
| Crossref | Google Scholar | PubMed |

25  Wu D, Gu H, Gu S, You H. Individual motivation and social influence: a study of telemedicine adoption in China based on social cognitive theory. Health Policy Technol 2021; 10(3): 100525.
| Crossref | Google Scholar |

26  Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice. John Wiley & Sons; 2008.

27  Austin LT, Ahmad F, McNally M-J, Stewart DE. Breast and cervical cancer screening in Hispanic women: a literature review using the health belief model. Womens Health Issues 2002; 12(3): 122-8.
| Crossref | Google Scholar | PubMed |

28  Pywell J, Vijaykumar S, Dodd A, Coventry L. Barriers to older adults’ uptake of mobile-based mental health interventions. Digital Health 2020; 6: 2055207620905422.
| Crossref | Google Scholar | PubMed |

29  Wildenbos GA, Jaspers MWM, Schijven MP, Dusseljee-Peute LW. Mobile health for older adult patients: Using an aging barriers framework to classify usability problems. Int J Med Inform 2019; 124: 68-77.
| Crossref | Google Scholar | PubMed |

30  Vaportzis E, Giatsi Clausen M, Gow AJ. Older adults perceptions of technology and barriers to interacting with tablet computers: a focus group study. Front Psychol 2017; 8: 1687.
| Crossref | Google Scholar | PubMed |

31  Akbar S, Coiera E, Magrabi F. Safety concerns with consumer-facing mobile health applications and their consequences: a scoping review. J Am Med Inform Assoc 2020; 27(2): 330-40.
| Crossref | Google Scholar | PubMed |

32  Kobayashi LC, Wardle J, Wolf MS, von Wagner C. Aging and Functional Health Literacy: A Systematic Review and Meta-Analysis. J Gerontol B Psychol Sci Soc Sci 2016; 71(3): 445-57.
| Crossref | Google Scholar | PubMed |

33  Sofi F, Valecchi D, Bacci D, Abbate R, Gensini GF, Casini A, Macchi C. Physical activity and risk of cognitive decline: a meta-analysis of prospective studies. J Intern Med Suppl 2011; 269(1): 107-17.
| Crossref | Google Scholar | PubMed |

34  Thomas PA. Trajectories of social engagement and limitations in late life. J Health Soc Behav 2011; 52(4): 430-43.
| Crossref | Google Scholar | PubMed |