Accepted for/Published in: JMIR Formative Research
Date Submitted: May 11, 2025
Date Accepted: Oct 20, 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Warning: This is an author submission that is not peer-reviewed or edited.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.
Engagement Beyond Numbers: Unveiling the Power of Teleassistance in Transforming Older Lives
ABSTRACT
Introduction: Population aging poses challenges to healthcare systems, particularly in promoting autonomy and health literacy among older adults. Digital health interventions have shown promise, yet barriers to accessibility and engagement persist. This study evaluates the impact of a multifaceted mobile teleassistance application on health literacy, quality of life, and self-care practices among individuals aged 60 and older, considering both high and low levels of user engagement.
Methods:
A randomized controlled trial was conducted with 21 participants (mean age: 63.9 years; SD = 3.11), divided into high (n = 11) and low-engagement groups (n = 10) based on platform interaction scores. Participants accessed teleconsultations, quizzes, and health-related activities over 14 weeks, with engagement metrics recorded automatically. Data on health literacy (THL-PA), quality of life (SF-36), physical activity (IPAQ), and sedentary behavior were collected pre- and post-intervention. Statistical analyses included generalized linear models (GLMs) and mixed models (GLMMs) to assess group differences and interaction effects over time.
Results:
The high-engagement group demonstrated significant improvements in health literacy (M = 90.1, SD = 13.7; p < 0.001) compared to the low-engagement group (M = 81.6, SD = 12.9). Quality-of-life domains such as vitality (+3.0, p = 0.02), functional capacity (+2.1, p = 0.02), and general health status (+2.8, p = 0.03) also improved significantly in the high-engagement group. Weekly time dedicated to health activities was significantly higher in the high-engagement group (M = 5124 min, SD = 757.9; p < 0.001) compared to the low-engagement group (M = 3120 min, SD = 704.3). However, no significant differences were found in physical activity levels or sedentary behavior (p > 0.05). Discussion: These findings highlight the potential of gamification and tailored digital support in enhancing health literacy and quality of life among older adults. Barriers such as socioeconomic and educational disparities require further exploration. Conclusion: Teleassistance emerges as a promising tool for fostering healthy aging, with significant improvements in health literacy and self-care. Future studies should focus on scalability and long-term impacts to address broader aging challenges.
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