Unveiling Digital Pathways to Active Aging: An Exploratory Mixed Methods Study of Older Adults' Experiences and the Impact of Person-Level Factors on mHealth Intervention Engagement

Abstract

Background. Mobile health (mHealth) interventions hold promise in assisting older adults to meet physical activity (PA) guidelines. Yet, little is known about how older adults perceive using smartphones to enhance their PA. This study explored older adults' experiences with the "My Health Plan" mHealth intervention and examined which person-level factors were associated with adherence. Methods. Forty older adults (52.5% female, mean age: 72.6 years) were instructed to use the My Health Plan application, which provided up to six stretch- and strengthening exercises per day and to wear a Fitbit Charge activity monitor for seven consecutive days. Person-level factors (e.g., gender and age) and psychosocial factors (e.g., intention and motivation) were assessed using a questionnaire. Afterwards, semistructured interviews were conducted to gather participants' experiences with the application and Fitbit. Deductive thematic analysis (qualitative data) and regression analyses (quantitative data) were conducted. Results. Key themes emerging from the interviews were (1) smartphone notifications (including timing and number) and carrying the smartphone throughout the day, (2) suggested stretch- and strengthening exercises, (3) providing feedback, (4) experiences with Fitbit, and (5) overall suggestions for improving the application and mHealth interventions. Overall, participants reported positive experiences with the application and Fitbit. Being male, having higher baseline PA, lower anxiety, and greater ability to participate in social roles and activities were related to increased engagement with the proposed exercises. Conclusions. This study provides valuable insights to optimize future mHealth interventions tailored to older adults' specific needs, aligning with their perceptions of the digital transformation in health promotion.