Attitudes Toward Digital Meal Assistance Services Among Older Adults in China: Cross-Sectional Survey

Digital eldercare services are promoted to address gaps in traditional care provision, yet actual uptake among older adults remains limited. Prior research has largely focused on technological attributes, with less attention to older adults' context-specific behavioral attitudes toward digital services.

This study aimed to identify the multidimensional structure of older adults' behavioral attitudes toward digital meal assistance services and to examine their associations with usage intention and actual use.

A mixed-mode survey was conducted in 2020 among adults aged 60 years or older in a large metropolitan city in China. A total of 1019 valid questionnaires were collected (n=405 online and n=614 offline). Exploratory factor analysis was used to identify attitudinal dimensions, followed by binary logistic regression analyses conducted separately for online and offline samples, controlling for sociodemographic characteristics.

Five attitudinal dimensions were identified, explaining 60.38% of the variance. Regression analyses showed that associations between attitudinal dimensions and service use differed by usage stage and sample type. Digital trust was the most consistent predictor, significantly associated with intention to use in both samples-particularly online (odds ratio [OR] 1.351, 95% CI 1.054-1.732; P=.02)-and with actual use in the offline sample (OR 1.068, 95% CI 1.011-1.128; P=.02), with a marginal association online (OR 1.347, 95% CI 0.986-1.840; P=.06).

Older adults' adoption of digital meal assistance services is shaped by multidimensional and context-dependent attitudes that extend beyond technological considerations. Policy efforts should therefore emphasize trust-building, affordability, and differentiated strategies tailored to diverse groups of older adults.