Analysis of Factors Influencing the Willingness of Chinese Older Adults to Use Mobile Health Devices - A Nationwide Cross-Sectional Survey (Preprint)
Authors: Yan Mengyao , Sun Wendi , tan Cheng , Wu Yibo , Liu Yuanli 
Published: October 2024

BACKGROUND

Mobile medical devices have proved to be an effective tool for managing the health of older persons and an important complement to traditional geriatric care services. However, little is known about the willingness of older persons in China to use these devices and the factors that influence their adoption.

OBJECTIVE

This study aims to investigate the determinants of mobile health device usage among older adults in China at individual, social, and familial levels.

METHODS

Utilizing the Andersen Healthcare Utilization Model, this study examines how predisposing characteristics, enabling resources, and need variables impact the willingness of older adults to use mobile health devices. Data for this study were drawn from the Psychology and Behavior Investigation of Chinese Residents survey database, collected between June 20 and August 31, 2022, across 148 cities in China. In order to initially explore the relationship between each potential explanatory variable and the willingness to use mobile health devices among elderly people, therefore, the survey data were subjected to univariate analysis and collinearity diagnosis, followed by the application of a joint model of Binary logistic regression and Chaid decision tree to identity the factors associated with the willingness of elderly people to use mobile health devices. Potential explanatory variables analyzed included gender, ethnicity, educational level, perceived social status, average monthly household income per capita, depression, anxiety, loneliness, social support (measured using the Perceived Social Support Scale), self-efficacy, family health (assessed through the Family Health Short Scale), family communication, health literacy (evaluated by the Short Health Literacy Questionnaire), quality of life, identity bubble, and insurance coverage.

RESULTS

A total of 4085 older adults participated in the survey. The mean score for willingness to use mobile health devices, measured on a scale from 0 to 100, was 63.70±25.11. The results of the binary logistic regression showed that living region (central region:OR=0.793,P=0.028; western region:OR=0.826,P=0.018), whether children living together （Not living with children:OR=1.217,P=0.010),health literacy (high health literacy:OR=1.372,P=0.000),self-efficacy(high self-efficacy:OR=1.182,P=0.050), per capita monthly income of the household (>4000 yuan:OR=1.204,P=0.016), perceived social support (middle perceived social support:OR=1.556,P=0.001; high perceived social support:OR=2.172,P=0.000), family communication (OR=0.979,P=0.002), identity bubble (OR=1.011,P=0.000), quality of life (high quality of life:OR=1.810,P=0.000), chronic disease conditions (Having chronic diseases unrelated to mobile health devices:OR=0.816,P=0.035), loneliness (alone:OR=1.199,P=0.033) and depression severity (mild depression:OR=0.787,P=0.014) were associated with elderly peoples’ willingness to use mobile health devices. And the results of the Chaid decision tree model showed that quality of life (χ2=79.094,P=0.000), identity bubble (χ2=45.850,P=0.000), health literacy (χ2=49.719,P=0.000), living region (χ2=13.967,P=0.001), chronic disease conditions (χ2=14.777,P=0.000), family communication (χ2=13.344,P=0.046) and social status (χ2=19.052,P=0.000) are the main factors influencing mobile health devices willingness among elderly people. The results of the two models can be corroborated with each other to provide a comprehensive and accurate picture of the factors influencing elderly people’s mobile health devices.

CONCLUSIONS

The findings indicate a generally positive attitude toward the use of mobile health devices among older adults in China, with an average willingness score of 63.70 out of 100. Interestingly, positive family communication dynamics were found to reduce the willingness to adopt these devices. This suggests a particular need to focus on isolated and widowed elderly individuals, where the absence of family communication may translate into a higher receptiveness and dependence on mobile health devices. Therefore, policy should prioritize providing free or subsidized health devices to these populations. Moreover, in designing promotional strategies, it is crucial to balance family communication with technology acceptance, while enhancing digital health education within families. This will facilitate the integration of technology in a way that enhances rather than detracts from family health management and emotional bonds, contributing to the closing of gaps in elder care services and improving health management capabilities. Ultimately, this approach aims to achieve a harmonious coexistence of technology and humanistic care.

CLINICALTRIAL

registration no ChiCTR2200061046