Barriers and facilitators to usability of a smartphone-based digital mental health tool in older adults: Insights from a secondary analysis of mindLAMP.

Background: As demand for mental healthcare access grows among older adult populations, digital mental health tools have emerged as promising tools. However, bridging the digital divide among older technology users remains critical. This post-hoc analysis evaluated potential factors influencing the adoption of a digital mental health tool in older adults.

Methods: We analyzed data from 37 older adults who used a digital phenotyping app (mindLAMP) for 4 weeks to capture passive sensor data and complete nightly surveys. We examined associations between baseline participant features including demographics, cognition, mood, technology attitudes and use, and usability outcomes including app training metrics, adherence, and self-reported usability.

Results: Participants had a mean age of 72, with most identifying as female (68 %), college educated (76 %), retired (81 %), and White (59 %). The app demonstrated high usability, with baseline training averaging 20.2 (±6.5) minutes and 80 % nightly survey completion. At study completion, 30/37 participants reported finding the app easy to use. While not significant after correction, female sex, Black race, and some college education emerged as potentially promising factors associated with better usability outcomes.

Discussion: These findings suggest that with modest training, older adults can engage with digital health tools and report positive usability experiences. Differences in usability outcomes by sex, race, and education point to potential characteristics that may influence engagement. However, given the small, highly educated sample, these findings should be replicated in larger, more diverse cohorts to better understand which factors support the successful use of digital health tools in older adults.