Socioeconomic differences in older adults' intention to use mhealth applications

Older adults with lower socioeconomic status (SES) are most affected by chronic diseases and in need of effective interventions to manage their conditions. Despite the proven benefits of mobile health (mHealth) in chronic disease management, the stimulation of mHealth adoption among people with lower SES is challenging. Such socioeconomic differences have not been investigated among older adults. The aims of this study were to identify factors associated with mHealth acceptance among older adults in the Netherlands with low and non-low SES, and to determine whether the influences of these factors differ between socioeconomic groups.

This cross-sectional study was performed using a questionnaire based on technology acceptance model (TAM) factors. The participants were aged ≥ 65 years, lived independently or in senior living facilities, and had no cognitive impairment. Associations between average TAM factor scores and respondents' intention to use mHealth applications were analyzed separately for low- and non-low-SES groups using controlled multivariable logistic regression. Models including interaction terms were then computed to investigate differences between groups.

The sample comprised 360 respondents (mean age, 74.9 ± 7.0 years). Scores for the eight TAM factors were significantly lower in the low-SES group than in the non-low-SES group, indicating that it is more difficult to motivate the former to use mHealth. All factors except feelings of anxiety and social relationships were associated significantly with the use intention in the low-SES group, and all factors showed significant associations in the non-low SES group. The models including interaction terms showed that perceived usefulness, perceived ease of use, and service availability had significantly stronger relationships with the intention to use mHealth in the non-low SES group than in the low-SES group.

This study revealed differences in the associations of TAM factors with the intention to use mHealth applications between older adults with low and non-low SES. A stronger and more comprehensive approach is needed to stimulate mHealth adoption among low-SES older adults. Policy development with the consideration of specific TAM factors will increase mHealth adoption among older adults. To reduce health disparities, policies should be tailored to older adults' needs.