JMIR Publications

ABSTRACT

Background:

eHealth and Telehealth play a crucial role in assisting older adults who visit hospitals frequently or who live in nursing homes and can benefit from staying at home while being cared for. Adapting to new technologies can be difficult for older people. Thus, to better apply these technologies to older adults’ lives, many studies have analyzed acceptance factors for this particular population. However, there is not yet a consensual framework to be used in further development and the search for solutions.

Objective:

This paper presents an Integrated Acceptance Framework (IAF) for the older user’s acceptance of eHealth, based on 43 studies selected through a systematic review.

Methods:

We conducted a four-step study. First, through a systematic review from 2010 to 2020 in the field of eHealth, the acceptance factors and basic data for analysis were extracted. Second, we carried out a thematic analysis to group the factors into themes to propose and integrated framework for acceptance. Third, we defined a metric to evaluate the impact of the factors addressed in the studies. Last, the differences amongst the important IAF factors were analyzed, according to the participants’ health conditions, verification time, and year.

Results:

Through the systematic review, 731 studies were founded in 5 major databases, resulting in 43 selected studies using the PRISMA methodology. First, the research methods and the acceptance factors for eHealth were compared and analyzed, extracting a total of 105 acceptance factors, which were grouped later, resulting in the Integrated Acceptance Framework. Five dimensions (i.e., personal, user-technology relational, technological, service-related, environmental) emerged with a total of 23 factors. Also, we assessed the quality of the evidence. And then, we conducted a stratification analysis to reveal the more appropriate factors depending on the health condition and the assessment time. Finally, we assess which are the factors and dimensions that are recently becoming more important.

Conclusions:

The result of this investigation is a framework for conducting research on eHealth acceptance. To elaborately analyze the impact of the factors of the proposed framework, the criteria for evaluating the evidence from the studies that have extracted factors are presented. Through this process, the impact of each factor in the IAF has been presented, in addition to the framework proposal. Moreover, a meta-analysis of the current status of research is presented, highlighting the areas where specific measures are needed to facilitate e-Health acceptance.