Need for and Acceptance of Digital Health Interventions for Self-Management among Older Adults Living Alone: A Mixed-Methods Approach.

Purpose: Although digital solutions could mitigate the challenges faced by older adults living alone (OALA), only a few studies investigated the need for and acceptance of digital health interventions for self-management (DHISMs) among this demographic. Thus, we aim to explore this need and acceptance, along with the contextual factors, among OALA.

Methods: A mixed-methods research approach was adopted. We conducted 1) a quantitative survey (n=191) to investigate the need for and acceptance of DHISMs using a numeric rating scale and 2) a qualitative study (n=24) based on focus group interviews to explore contextual factors related to the quantitative results. Qualitative data were analyzed using thematic analysis.

Results: In the quantitative study, the mean scores for the need for and acceptance of DHISMs were 6.41 and 6.53 out of 10, respectively. Emergency response systems had the highest need and acceptance scores, whereas digital interventions for behavioral change (medication adherence, sleep, stress, and diet management) had relatively lower scores. The qualitative analysis revealed two themes and five subthemes: the need for inclusive support for independent living (environmental safety and diverse self-management challenges with limited support) and multidimensional factors related to DHISM acceptance (personal, technological, and relational barriers and facilitators).

Conclusions: In the future, the unique and multidimensional factors influencing the need for and acceptance of DHISMs among OALA should be carefully considered to support their self-management and independent living. Blended care, which involves integrating age-friendly technology with personalized human interaction, is pivotal for increasing DHISM acceptance in this population.