JMIR Publications

ABSTRACT

Background:

Against the backdrop of an increasingly aging population, promoting physical health among older adults through scientifically guided exercise is an important strategy for actively addressing population aging. The promotion of physical health among older adults encompasses multiple stages, including monitoring, early warning, intervention, and feedback. However, current services continue to face challenges such as insufficiently precise identification of individual needs, inadequate coordination across service delivery processes, and inefficient collaboration among available resources. Advances in digital technology have created new opportunities to address these challenges.

Objective:

To integrate evidence on the service needs of older adults with different health and functional statuses with evidence from community service contexts, identify platform design requirements and differentiated service pathways, and develop a conceptual framework for a digital health platform aimed at promoting physical health among community-dwelling older adults.

Methods:

This study employed a mixed-methods design. Quantitative data were collected from a service needs survey conducted in Shanghai, Zhengzhou, and Chengdu from May to September 2025. A total of 1,688 adults aged 60 years and older were included, comprising 608 general older adults, 992 older adults with chronic diseases, and 88 older adults with disabilities. Qualitative data were collected concurrently in Shanghai, Zhejiang, Jiangsu, Henan, and Sichuan through field observations and semistructured interviews to examine the organization of existing community-based services and identify their major challenges. Quantitative findings were used to determine the priority of service needs among the 3 groups of older adults, while qualitative data were synthesized using framework analysis. The 2 types of evidence were integrated through joint displays, following a structured pathway of “needs evidence–service context–integrated interpretation–design response” to derive platform design requirements, stratified service pathways, and a conceptual framework.

Results:

The 3 groups of older adults reported relatively high needs for health records, routine physical fitness assessments, personalized exercise prescriptions, and regular evaluations, although the priority of these needs varied across groups. General older adults primarily prioritized physical fitness monitoring and exercise guidance, whereas older adults with chronic diseases placed greater emphasis on scientifically guided exercise and risk management. Among older adults with disabilities, medical and nursing support and family involvement were relatively higher priorities. Qualitative findings indicated several major challenges in current community-based services, including inadequate linkage between classification results and service allocation, a lack of continuity across service stages, limited access to cross-sector resources, and insufficient use of existing data. By integrating the 2 types of evidence, 4 platform design requirements were identified: stratified service allocation, continuity across service delivery, cross-sector collaboration, and continuous data use. Based on these requirements, differentiated service pathways were developed for the 3 groups of older adults. The platform incorporates core functions including stratified service matching, continuous monitoring and follow-up, cross-setting service coordination, and dynamic assessment and adjustment, integrating physical fitness monitoring, risk assessment, exercise intervention, professional referral, and outcome evaluation into a continuous service process.

Conclusions:

Drawing on evidence regarding the service needs of older adults and the community service context, this study developed a conceptual framework for a digital health platform aimed at promoting physical health among community-dwelling older adults and specified differentiated service pathways and key platform functions for older adults with different health and functional statuses. The framework provides a design foundation for subsequent platform prototype development and implementation in community settings. Clinical Trial: This study adhered to the principles of the Declaration of Helsinki and was approved by the Biomedical Ethics Committee of Shanghai University of Sport (Approval No. 102772020RT133). All questionnaire and interview participants voluntarily participated in the study after providing informed consent. All research data were de-identified before analysis.