Acceptance of blind spot monitoring among older drivers: A structural equation modelling study in Hohhot, China

Introduction Rapid population ageing has drawn increasing attention to the relationship between older drivers' well-being and independent driving. Advanced Driver Assistance Systems (ADAS) may help support older drivers, but their benefits depend not only on technical availability but also on user acceptance. This study examines factors associated with older drivers’ acceptance of blind spot monitoring (BSM), a key ADAS function, as reflected in their behavioral intention to use it. Methods A questionnaire-based survey was conducted in Hohhot, China. Drawing on an integrated framework combining the Technology Acceptance Model (TAM) and the Theory of Planned Behavior (TPB), this study incorporated three context-specific constructs: perceived barriers to use, perceived functional decline, and perceived cost. Structural Equation Modelling (SEM) was used to test the proposed relationships. Results The SEM showed good model fit. Perceived usefulness and perceived ease of use were positively associated with behavioral intention to use BSM, with perceived usefulness showing the strongest direct association. Perceived cost was negatively associated with behavioral intention to use BSM. Subjective norms and attitude toward using BSM were positively associated with perceived usefulness and perceived ease of use, while perceived barriers to use were negatively associated with both constructs. Perceived functional decline was positively associated with perceived usefulness. The model accounted for 45.6% of the variance in behavioral intention to use BSM among older drivers. Conclusion These findings provide preliminary implications for improving communication, user guidance, and affordability-related considerations for age-friendly ADAS. In particular, they suggest that clearer communication about BSM functions, targeted user guidance, and attention to cost-related concerns may be relevant to improving older drivers’ self-reported behavioral intention to use BSM.