DeLange Martinez Pauline, Tancredi Daniel, Pavel Misha, Garcia Lorena, Young Heather M
Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States.
Department of Pediatrics, University of California, Davis, Sacramento, CA, United States.
JMIR Form Res. 2024 Dec 3;8:e57009. doi: 10.2196/57009.
Self-rated health is associated with information and communications technology (ICT) use among older adults. Non-US born, older Asian American individuals are more inclined to rate their health as fair or poor compared to individuals from other racial and ethnic backgrounds. This population is also less likely to use ICTs as compared to White older Americans. Furthermore, cognitive decline may impact technology acceptance. In a previous adaptation of the technology acceptance model for low-income, Asian American older adults, perceived usefulness (PU), perceived ease of use (PEOU), age, educational attainment, ethnicity, and English proficiency were significant predictors of ICT use. However, the association between health and technology acceptance has not been explored among Asian American older adults.
This study examined the role of self-rated health and subjective cognitive decline in the acceptance and use of ICTs among low-income, Asian American older adults.
This cross-sectional survey included Asian American individuals aged ≥62 years living in affordable housing for older adults (N=392). Using hierarchical multiple regression, we explored the association between self-rated health and ICT use and technology acceptance model mediators (PU and PEOU) while adjusting for demographics, English proficiency, and subjective cognitive decline. Contrast statements were used to estimate contrasts of interest. To further examine the separate and joint association between age and subjective cognitive decline and the dependent variables, we examined scatterplots with locally estimated scatterplot smoothing lines, revealing that the relationship between subjective cognitive decline and ICT use varied in 3 age segments, which led to updating our analysis to estimate differences in ICT use among age categories with and without subjective cognitive decline.
Self-rated health was not significantly associated with ICT use (β=.087; P=.13), PU (β=.106; P=.10), or PEOU (β=.062; P=.31). However, the interaction terms of subjective cognitive decline and age significantly improved the model fit for ICT use (ΔR=0.011; P=.04). In reviewing scatterplots, we determined that, in the youngest age group (62-74 years), ICT use increased with subjective cognitive decline, whereas in the older age groups (75-84 and ≥85 years), ICT use decreased with subjective cognitive decline, more so in the oldest age category. Through regression analysis, among participants with subjective cognitive decline, ICT use significantly decreased in the middle and older age groups as compared to the youngest age group. However, among participants without subjective cognitive decline, the difference in use among age groups was not significant.
This study contributes to the understanding of the complex relationship between health and ICT acceptance among low-income, Asian American older adults and suggests the need for tailored interventions to promote digital engagement and quality of life for this population.
自评健康状况与老年人使用信息通信技术（ICT）相关。与其他种族和族裔背景的个体相比，非美国出生的老年亚裔美国人更倾向于将自己的健康状况评为一般或较差。与美国白人老年人相比，这一群体使用ICT的可能性也较小。此外，认知能力下降可能会影响对技术的接受程度。在之前针对低收入亚裔美国老年人的技术接受模型改编研究中，感知有用性（PU）、感知易用性（PEOU）、年龄、教育程度、种族和英语水平是ICT使用的重要预测因素。然而，尚未在亚裔美国老年人中探讨健康与技术接受之间的关联。
本研究探讨了自评健康状况和主观认知能力下降在低收入亚裔美国老年人对ICT的接受和使用中的作用。
这项横断面调查纳入了居住在老年人经济适用房中的62岁及以上的亚裔美国人（N = 392）。我们使用分层多元回归，在调整人口统计学、英语水平和主观认知能力下降的同时，探讨了自评健康状况与ICT使用以及技术接受模型中介因素（PU和PEOU）之间的关联。使用对比陈述来估计感兴趣的对比。为了进一步研究年龄和主观认知能力下降与因变量之间的单独和联合关联，我们检查了带有局部估计散点图平滑线的散点图，发现主观认知能力下降与ICT使用之间的关系在3个年龄组中有所不同，这促使我们更新分析以估计有和没有主观认知能力下降的年龄组之间ICT使用的差异。
自评健康状况与ICT使用（β = 0.087；P = 0.13）、PU（β = 0.106；P = 0.10）或PEOU（β = 0.062；P = 0.31）均无显著关联。然而，主观认知能力下降与年龄的交互项显著改善了ICT使用的模型拟合度（ΔR = 0.011；P = 0.04）。在查看散点图时，我们确定，在最年轻的年龄组（62 - 74岁）中，ICT使用随着主观认知能力下降而增加，而在较年长的年龄组（75 - 84岁和≥85岁）中，ICT使用随着主观认知能力下降而减少，在最年长的年龄组中减少得更多。通过回归分析，在有主观认知能力下降的参与者中，与最年轻的年龄组相比，中年和老年组的ICT使用显著减少。然而，在没有主观认知能力下降的参与者中，年龄组之间的使用差异不显著。
本研究有助于理解低收入亚裔美国老年人健康与ICT接受之间的复杂关系，并表明需要采取针对性干预措施来促进这一群体的数字参与和生活质量。
