Telfer School of Management, University of Ottawa, Ottawa, ON, Canada.
Research Chair in Digital Health, HEC Montreal, Montreal, QC, Canada.
JMIR Mhealth Uhealth. 2020 Nov 27;8(11):e24718. doi: 10.2196/24718.
The burden of population aging and chronic conditions has been reported worldwide. Older adults, especially those with high needs, experience social isolation and have high rates of emergency visits and limited satisfaction with the care they receive. Mobile health (mHealth) technologies present opportunities to address these challenges. To date, limited information is available on Canadian older adults' attitudes toward and use of mHealth technologies for self-tracking purposes-an area that is increasingly important and relevant during the COVID-19 era.
This study presents contributions to an underresearched area on older adults and mHealth technology use. The aim of this study was to compare older adults' use of mHealth technologies to that of the general adult population in Canada and to investigate the factors that affect their use.
A cross-sectional survey on mHealth and digital self-tracking was conducted. A web-based questionnaire was administered to a national sample of 4109 Canadian residents who spoke either English or French. The survey instrument consisted of 3 sections assessing the following items: (1) demographic characteristics, health status, and comorbidities; (2) familiarity with and use of mHealth technologies (ie, mobile apps, consumer smart devices/wearables such as vital signs monitors, bathroom scales, fitness trackers, intelligent clothing); and (3) factors influencing the continued use of mHealth technologies.
Significant differences were observed between the older adults and the general adult population in the use of smart technologies and internet (P<.001). Approximately 47.4% (323/682) of the older adults in the community reported using smartphones and 49.8% (340/682) indicated using digital tablets. Only 19.6% (91/463) of the older adults using smartphones/digital tablets reported downloading mobile apps, and 12.3% (47/383) of the older adults who heard of smart devices/wearables indicated using them. The majority of the mobile apps downloaded by older adults was health-related; interestingly, their use was sustained over a longer period of time (P=.007) by the older adults compared to that by the general population. Approximately 62.7% (428/682) of the older adults reported tracking their health measures, but the majority did so manually. Older adults with one or more chronic conditions were mostly nontrackers (odds ratio 0.439 and 0.431 for traditional trackers and digital trackers, respectively). No significant differences were observed between the older adults and the general adult population with regard to satisfaction with mHealth technologies and their intention to continue using them.
Leveraging mHealth technologies in partnership with health care providers and sharing of health/well-being data with health care professionals and family members remain very limited. A culture shift in the provision of care to older adults is deemed necessary to keep up with the development of mHealth technologies and the changing demographics and expectations of patients and their caregivers.
人口老龄化和慢性病的负担在全球范围内都有报道。老年人，尤其是那些高需求的老年人，会经历社会孤立，急诊就诊率高，对所接受的护理满意度有限。移动健康 (mHealth) 技术提供了应对这些挑战的机会。迄今为止，关于加拿大老年人对 mHealth 技术用于自我跟踪的态度和使用情况的信息有限，而在 COVID-19 时代，这一领域越来越重要和相关。
本研究对老年人和 mHealth 技术使用这一研究不足的领域做出了贡献。本研究的目的是比较老年人与加拿大一般成年人群体对 mHealth 技术的使用情况，并探讨影响他们使用的因素。
对 mHealth 和数字自我跟踪进行了横断面调查。对一个全国性的 4109 名说法语或英语的加拿大居民进行了基于网络的问卷调查。调查工具包括 3 个部分，评估以下内容：(1)人口统计学特征、健康状况和合并症；(2)对 mHealth 技术的熟悉程度和使用情况（即移动应用程序、消费者智能设备/可穿戴设备，如生命体征监测器、浴室秤、健身追踪器、智能服装）；(3)影响继续使用 mHealth 技术的因素。
在智能技术和互联网的使用方面，社区中的老年人与一般成年人群体之间存在显著差异（P<.001）。大约 47.4%（323/682）的社区老年人使用智能手机，49.8%（340/682）表示使用数字平板电脑。只有 19.6%（91/463）的使用智能手机/数字平板电脑的老年人报告下载了移动应用程序，而 12.3%（47/383）听说过智能设备/可穿戴设备的老年人表示使用过。老年人下载的大多数移动应用程序都与健康相关；有趣的是，与一般人群相比，他们的使用时间更长（P=.007）。大约 62.7%（428/682）的老年人报告跟踪他们的健康指标，但大多数是手动跟踪。有一个或多个慢性病的老年人大多不跟踪（传统跟踪者和数字跟踪者的比值比分别为 0.439 和 0.431）。老年人与一般成年人群体在对 mHealth 技术的满意度和继续使用的意愿方面没有显著差异。
与医疗保健提供者合作利用 mHealth 技术以及与医疗保健专业人员和家庭成员共享健康/幸福数据仍然非常有限。需要改变为老年人提供护理的方式，以跟上 mHealth 技术的发展以及患者及其护理人员的人口统计学和期望的变化。
