Older Adults’ User Engagement With Mobile Health: A Systematic Review of Qualitative and Mixed-Methods Studies

Abstract Background and Objectives The aging population places increasing demands on our healthcare system. Mobile health offers the potential to reduce this burden. The aim of this systematic review is to thematically synthesize qualitative evidence of older adults’ user engagement toward mobile health, and to generate relevant recommendations for intervention developers. Research Design and Methods A systematic literature search was performed in Medline, Embase, and Web of Science electronic databases from inception until February 2021. Papers on qualitative and mixed-methods studies that investigated older adults’ user engagement with a mobile health intervention were included. Relevant data were extracted and analyzed using thematic analysis. The Critical Appraisal Skills Program Qualitative Checklist was used to assess the quality of the included studies. Results Thirty-two articles were deemed eligible for inclusion in the review. Three overarching analytical themes emerged from the 25 descriptive themes generated by the line-by-line coding: the limited capabilities, the prerequisite of motivation, and the importance of social support. Discussion and Implications Successful development and implementation of future mobile health intervention for older adults will be challenging given the physical and psychological limitations and motivational barriers that older adults experience. Design adaptations and well-thought-out blended alternatives (i.e., combining mobile health with face-to-face support) might be potential solutions to improve older adults’ user engagement with mobile health interventions.