Experiences of Ageism in mHealth App Usage Among Older Adults: Interview Study Among Older Adults Based on Extended Unified Theory of Acceptance and Use of Technology and Risks of Ageism Models

TL;DR

This study explores how ageism affects older adults' use of mHealth apps and identifies key barriers like stereotypes and poor design.

Contribution

The study introduces a novel framework combining ageism models and technology acceptance theory to explore subjective experiences of older adults with mHealth apps.

Findings

Older adults face internalized stereotypes about technology uselessness and learning barriers.

Stereotype threat leads to anxiety and avoidance behaviors in using mHealth apps.

External factors like poor design and lack of support systems hinder app usage among older adults.

Abstract

As the global aging population accelerates, mobile health (mHealth) apps have emerged as critical tools in the health management of older people. However, the promotion of mHealth apps has faced multiple obstacles, including insufficient technological adaptation to aging, digital resistance, and ageism. The impact of ageism on technology usage experiences among older adults is influenced by mechanisms such as stereotypes and biases. Notably, extant research has not adequately explored the subjective experiences of older adults in the context of mHealth app usage scenarios.

The present study was predicated on the extended unified theory of acceptance and use of technology model and the risks of ageism model to systematically explore and understand older adults’ ageism experiences in mHealth app usage. Our objectives were to provide a reference for optimizing age-friendly design and enhancing digital health management capabilities for older adults.

This qualitative study utilized an interpretive phenomenological design and was conducted between February and April 2025. Purposive sampling was employed to select older adults with experience using mHealth apps in a Shanghai community for semistructured interviews. This study used Colaizzi’s phenomenological method to analyze and summarize older adults’ experiences and perceptions of ageism and to extract themes.

The study identified 3 core themes: (1) internalized age stereotypes, which manifest as technological uselessness and learning barriers; (2) anxiety and avoidance behaviors caused by stereotype threat; and (3) external unfair treatment (such as age-friendly design flaws and inadequate support systems), which inhibits usage. These experiences significantly impact older adults’ intention to use mHealth apps.

Ageism profoundly affects the engagement of older adults with mHealth apps. It is advisable to execute systematic interventions to improve digital inclusion and health self-management capabilities, including strategies to challenge age stereotypes, optimize intergenerational support, refine age-friendly design, and establish strong social support networks.

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