Perspectives of Older Adults on Digital Health Interventions for Overactive Bladder: A Pre-Implementation Qualitative Interview Study

To examine patient perspectives on the acceptability, perceived usefulness, and implementation expectations of DHIs for OAB management among older adults.

We conducted a pre-implementation qualitative study using 16 in-depth, semi-structured interviews with adults aged 60 and older. The pilot-tested interview guide was informed by an integrated conceptual framework combining the eHealth Literacy Model and the Technology Acceptance Model (TAM). Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis with independent dual coding.

Three main themes were identified. First, perceived usefulness was the primary driver of willingness to adopt DHIs. Their capacity to support symptom and trigger monitoring, provide actionable personalized feedback, and facilitate clinician communication was particularly valuable. Second, willingness to engage depended on low-burden features such as voice input, intuitive interfaces, and flexible monitoring, while cognitively demanding features were identified as barriers to sustained use. Third, trust and acceptance were closely linked to clinician endorsement, trusted institutional affiliation, human connection, confidence in data privacy, with stigma reinforcing the need for discreet design.

Acceptance of DHIs for OAB is shaped by the interplay between perceived usefulness, usability, and trust within the context of unpredictability, embarrassment, and stigma unique to OAB. Successful implementation requires attention to both functional design and contextual factors, including clinician endorsement and data governance. Future research should prospectively evaluate whether interventions designed around these patient-defined priorities improve adherence to behavioral therapy and clinical outcomes.