Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 29, 2025
Date Accepted: Sep 18, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Impact of a mobile health application on digital transformation: a randomized clinical trial on strengthening digital skills in older women
ABSTRACT
Background:
Digital technology advanced rapidly following the COVID-19 pandemic; however, older adults continue to face significant challenges in adopting and effectively using these technologies. Mobile health applications offer a promising strategy to enhance digital competencies and promote digital inclusion among this population.
Objective:
This study aimed to evaluate the impact of a lifestyle-oriented mobile health application on improving digital skills, as well as to assess its usability and the level of user satisfaction among older women.
Methods:
A 14-week randomized clinical trial was conducted in Ribeirão Preto, São Paulo, Brazil. Forty elderly women were randomized into an intervention group (n = 21), who used the mobile application, and a control group (n = 19). Digital competencies were measured before and after the intervention using a semi-structured questionnaire based on the MCDMSenior framework, covering six domains: basic technology use, internet navigation, mobile application use, online research, digital communication, and utilization of digital resources. Additionally, satisfaction with the educational content was evaluated using the Suitability Assessment of Materials (SAM) and system usability was assessed using the System Usability Scale (SUS). Qualitative data regarding participant experiences were also collected.
Results:
Post-intervention analyses revealed significant differences in specific digital competencies. The intervention group demonstrated a moderate improvement in internet navigation skills (Cohen’s d = 0.634), while gains in basic technology use and digital communication were minimal. Conversely, the control group exhibited moderate improvement in basic technology skills (Cohen’s d = 0.521) and lower effects in online research and digital communication. Overall, satisfaction with the educational content was low (average SAM = 35%), and usability was rated as average (SUS = 71.5 points). Qualitative feedback underscored persistent age-related fears and insecurities in the use of digital technologies.
Conclusions:
Mobile health applications can effectively enhance certain digital competencies in older women, particularly internet navigation, but improvements in content suitability and usability are needed. Refinements in application design and tailored user support are essential to overcome age-related barriers and foster digital inclusion among older populations. Clinical Trial: Brazilian Registry of Clinical Trials (ReBEC), Registration No. RBR-6wgkzs8.
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