Older Adults’ User Engagement With Mobile Health: A Systematic Review of Qualitative and Mixed-Methods Studies

Abstract

Background and Objectives The ageing population places increasing demands on our health care system. Mobile health offers potential to reduce this burden. The aim of this systematic review is to thematically synthesize qualitative evidence of older adults’ user engagement towards mobile health, and to generate relevant recommendations for intervention developers. Research Design and Methods A systematic literature search was performed in Medline, Embase, and Web of Science electronic databases from inception until February 2021. Papers on qualitative and mixed method studies that investigated older adults’ user engagement with a mobile health intervention were included. Relevant data were extracted and analyzed using thematic analysis. The Critical Appraisal Skills Programme Qualitative Checklist was used to assess the quality of the included studies. Results Thirty-two articles were deemed eligible for inclusion in the review. Three overarching analytical themes emerged from the twenty-five descriptive themes generated by the line-by-line coding: the limited capabilities, the prerequisite of motivation, and the importance of social support. Discussion and Implications Successful development and implementation of future mobile health intervention for older adults will be challenging given the physical and psychological limitations and motivational barriers that older adults experience. Design adaptations and well-thought-out blended alternatives (i.e. combining mobile health with face-to-face support) might be potential solutions to improve older adults’ user engagement with mobile health interventions.

Tailored Self-Management App to Support Older Adults With Cancer and Multimorbidity: Development and Usability Testing

“…While other studies detail older adults reporting difficulties with limited functionalities and comprehension of visual health data [ 45 , 53 ], participants in this study emphasized a preference for both text and visual summaries to help them make sense of patterns in the data. Older adults also appreciated and valued different modes to view data trends.…”

Smartphone‐delivered approach bias modification for reducing harmful drinking amongst middle–older age adults: Secondary analyses of a single‐arm pilot study

“…It remains unclear, however, whether greater study engagement is reflective of middle-older adults having more time to complete follow-up, an increased focus on, and desire to, improve health and wellbeing generally at this life-stage, or some combination of factors. With almost one-third of participants noting that inclusion of personally relevant stimuli encouraged consideration of drinking behaviour in the context of personal goals, the unique inclusion of personalisation, as distinct from previous versions of smartphone-delivered ApBM [56,57], may further serve to sustain engagement and adherence in a middle-older adult cohort endorsing high readiness to change [84]. Unlike previous smartphone ApBM studies exploring the effectiveness of training on drinking outcomes amongst younger individuals [54,57] or a diverse age range [58], current analyses are novel in that they are the first to demonstrate that some non-treatment-seeking middle-to-older adults, who may be at particular risk of problematic alcohol consumption and alcohol-related harms, may stand to gain from this non-pharmacological, personalised, mHealth cognitive training approach.…”

“…It remains unclear, however, whether greater study engagement is reflective of middle–older adults having more time to complete follow‐up, an increased focus on, and desire to, improve health and wellbeing generally at this life‐stage, or some combination of factors. With almost one‐third of participants noting that inclusion of personally relevant stimuli encouraged consideration of drinking behaviour in the context of personal goals, the unique inclusion of personalisation , as distinct from previous versions of smartphone‐delivered ApBM [56, 57], may further serve to sustain engagement and adherence in a middle–older adult cohort endorsing high readiness to change [84].…”

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“…Digital cognitive training, especially within a home environment, yields improvements in memory, motivation, and the ability for long-term monitoring [1], [18], [19]. Involving users as co-designers plays a pivotal role in enhancing application design and tailoring it to the needs of specific user groups [20]- [22].…”