Knowledge, attitudes, and factors associated with mobile health application use among middle-aged and older adults: quantitative survey (Preprint)
BACKGROUND Despite the great benefits of mobile health applications (mHAs) in managing non-communicable diseases (NCDs) internationally, studies have documented general challenges to broad adoption of mHAs among middle to older age groups. By focusing on broad adoption, these studies have been limited in their evaluation of patients who can benefit the most from the functionalities provided by mHAs. OBJECTIVE This study aims to evaluate the knowledge, self-confidence, perceived benefits, and barriers of using mHAs depending on experience with mHAs among the middle-aged and older adults. Furthermore, we aim to identify the factors associated with the actual use of mHAs. METHODS We conducted a cross-sectional survey at a single tertiary hospital in Seoul, Korea, between May 1 and May 31, 2018. Of the 625 patients who were contacted, 323 participants were granted full inclusion to the study. We compared demographics, knowledge, self-confidence, and perceived benefits and barriers by experience with using mHAs, then performed logistic regression to identify the factors associated with mHA use. RESULTS Among the participants, 64.1% (N = 207) had experience using mHAs. Those in the experienced group were more likely to have more than college education (55.1% vs. 27.5%, P < 0.001) and to report a higher monthly income (≥ $7,000, 22.7% vs. 18.1%, P = 0.05) than their less-experienced counterparts. Although the experienced group was more likely to have higher self-confidence in using mHAs, about half of the study participants, including people with experience using mHAs, did not have appropriate knowledge of mobile technology. With adjusted logistic model, higher educated (adjusted PR (aPR) = 1.53, 95% CI, 1.26–1.80), higher perceived benefits of mHAs (aPR = 1.43, 95% CI, 1.04–1.83), and higher self-confidence using mHAs (aPR = 1.41, 95% CI, 1.12–1.70) were significant factors associated with mHA use. CONCLUSIONS The use of mHAs among middle-aged and older adults is becoming more common globally; nevertheless, there are still people unable to use mHAs properly because of lack of experience and knowledge. Strategies are needed to encourage the reliable usage of mHAs among those who may need it the most by improving self-confidence and better articulating benefits.