Multilevel needs and perceived implementation challenges of mHealth for community frailty management: a qualitative study guided by the Fogg Behavior Model

Background Frailty is an important public health challenge in ageing populations and increasingly requires community-based approaches to prevention and management. Mobile health (mHealth) technologies may support health education, self-management, monitoring, and continuity of care among older adults with pre-frailty or frailty. However, successful implementation depends not only on technological usability but also on behavioral, interpersonal, and health-system factors. Evidence regarding these factors from the perspectives of both older adults and community healthcare professionals remains limited. Objective This study aimed to explore the needs and perceived implementation challenges associated with mHealth for community frailty management from the perspectives of older adults with pre-frailty or frailty and community healthcare professionals, and to interpret these factors using the Fogg Behavior Model (FBM). Methods An exploratory qualitative study was conducted using semi-structured face-to-face interviews with 15 community-dwelling older adults with pre-frailty or frailty and 10 community HCPs. Data were analyzed using a hybrid inductive–deductive thematic analysis approach. Results Seven empirically derived subthemes were developed inductively and subsequently organized into three higher-order interpretive domains corresponding to the FBM dimensions of motivation, ability, and prompts. (1) health-oriented motivation was constrained by limited awareness of frailty and insufficient trust in digital health information; (2) individuals and the primary healthcare system jointly constituted multilevel ability barriers; and (3) mHealth engagement was perceived to depend on complementary action cues and social support. Conclusion Participants perceived the implementation of mHealth in community frailty management as being shaped by interacting factors related to motivation, ability, and prompts. To optimize implementation, attention should be paid to age-friendly design, trustworthy digital health information, frailty and digital health competencies among community HCPs, and coordinated support from family members and healthcare professionals.