Background Although digital health technologies (DHTs) help many people maintain a healthy life, including those of advanced age, these technologies are of little use to older adult populations if they are not being adopted in daily life. Thus, it is critical to identify ways to help older adults recognize and try new technologies and maintain their use of them to maximize the benefits of these technologies in a digital-based society. Objective Our study aimed (1) to assess the current usage of DHT among older adults in Hong Kong and (2) to examine how high and low levels of eHealth literacy in this group affects the relationship between the Technology Readiness and Acceptance Model (TRAM) and attitudes and intention toward DHT. Methods A total of 306 adults over 60 years of age in Hong Kong participated in this study. After conducting confirmatory factor analysis to validate the measurement model, the hypothesized model was tested using structural equation modeling. Results Optimism was significantly related to perceived usefulness, while optimism, innovativeness, and discomfort were significantly associated with perceived ease of use. Both perceived usefulness and perceived ease of use were significantly linked to attitude toward the use of DHTs. Meanwhile, attitude significantly predicted usage intention. Additionally, the results revealed the differences in the relationships of the TRAM between participants with high and low levels of eHealth literacy. The influence of optimism and innovativeness on perceived ease of use was stronger for the higher-level group than for the lower-level group, and the influence of discomfort for the higher-level group was much weaker. Conclusions The findings provided partial support for the impact of eHealth literacy on encouraging older adults to use DHT and obtain health benefits from it. This study also suggests providing assistance and guidelines for older adults to narrow the aging-related technology gap and to further explore the associations of eHealth literacy, the TRAM, and actual behaviors.

BACKGROUND Although digital health technologies help people maintain a healthy life, these technologies are purposeless unless elderly people use them. Thus, it is critical to identify ways to help elderly people recognize and try new technologies and maintain their use of these technologies in order to benefit the most from these technologies in a digital-based society. OBJECTIVE Our study aimed a) to assess the current usage of digital health technology (DHT) among elderly people in Hong Kong and b) to examine how the eHealth literacy of elderly people affects the relationship between the technology readiness and acceptance model (TRAM) and attitudes and intention toward DHT between high and low levels of eHealth literacy. METHODS 306 elderly individuals over 60 years old in Hong Kong participated in this study. After conducting confirmatory factor analysis to validate the measurement model, the hypothesized model was tested by using the structural equation model. RESULTS Optimism was significantly related to perceived usefulness (PU), while optimism, innovativeness, and discomfort were significantly associated with perceived ease to use (PEU). Both PU and PEU were significantly linked to attitude toward the use of DHT (ATDHT). Meanwhile, ATDHT significantly predicted the usage intention. Additionally, the results revealed the differences in the relationships of the TRAM between participants with adequate and inadequate eHealth literacy. The influence of optimism and innovativeness on PEU was stronger for the adequate group compared to the inadequate one, and the influence of discomfort for the adequate group was much weaker. CONCLUSIONS The findings provided partial support for the impact of eHealth literacy on encouraging elderly people to use DHT and obtain health benefits from it. This study also suggests to provide assistance and guidelines for elderly people to narrow the aging-related technology gap and to further explore the associations of eHealth literacy, the TRAM, and actual behaviors.