Currently accepted at: JMIR Aging
Date Submitted: Jun 13, 2025
Open Peer Review Period: Jul 4, 2025 - Aug 29, 2025
Date Accepted: Jan 9, 2026
(closed for review but you can still tweet)
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/78913
The final accepted version (not copyedited yet) is in this tab.
Warning: This is an author submission that is not peer-reviewed or edited.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.
Digital and Remote Health Interventions for Older Adults in Rural and Underserved Populations: A Systematic Review
ABSTRACT
Background:
Older adults living in rural and underserved areas face significant barriers to healthcare access, often compounded by limited transportation, geographic isolation, and shortages of healthcare professionals. Digital and remote health interventions may help address these gaps, yet their implementation and effectiveness in these populations remain underexplored.
Objective:
To systematically review the current evidence on the use, effectiveness, and challenges of digital and remote health interventions targeting older adults in rural or underserved populations
Methods:
We conducted a comprehensive literature search in PubMed, Scopus, Web of Science, and Embase for studies published until April 2025. Eligible studies included randomized controlled trials, quasi-experimental studies, and observational designs assessing telehealth, mobile health (mHealth), and other digital interventions among older adults (aged ≥60 years) in rural or underserved settings. Data extraction focused on intervention type, technology used, health outcomes, usability, and implementation barriers.
Results:
A total of 14 studies met the inclusion criteria. Most were conducted in North America and used telemedicine platforms, mobile applications, or remote monitoring tools. Health outcomes targeted included chronic disease management (e.g., diabetes, hypertension), mental health, and fall prevention. While several studies reported improvements in clinical parameters and user satisfaction, common challenges included digital literacy, limited broadband access, and lack of culturally adapted content. Only a minority of studies incorporated formal usability testing or evaluated long-term adherence.
Conclusions:
Digital health interventions offer promising strategies to mitigate health disparities among older adults in rural or underserved areas. However, implementation requires addressing technological, cultural, and infrastructural barriers. Future research should prioritize inclusive design, long-term evaluation, and integration into existing health systems. Clinical Trial: CRD420251066174
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.