Accepted for/Published in: JMIR Aging
Date Submitted: Jun 21, 2025
Open Peer Review Period: Jun 17, 2025 - Aug 12, 2025
Date Accepted: Mar 4, 2026
(closed for review but you can still tweet)
Facilitators and Barriers to Digital Self-Management in Older Adults with Depression: A COM-B and Theoretical Domain Framework Qualitative Study
ABSTRACT
Background:
Depression in older adults presents unique challenges in self-management. Digital tools such as mobile health (mHealth) apps have the potential to support this population. This study explored the facilitators and barriers to digital self-management in older adults with depression to inform the design of effective mHealth applications.
Objective:
To explore facilitators and barriers to digital self-management in older patients with depression with the aim of informing the design and development of mHealth applications for older adults.
Methods:
A purposive sampling method was used to recruit 25 older patients with depression from July to September 2024. Semistructured interviews were conducted to capture real-life experiences. Directed content analysis ensured objective and accurate data interpretation, and the Capability, Opportunity, Motivation, and Behavior (COM-B) model along with the Theoretical Domains Framework (TDF) were applied to identify facilitators and barriers related to behavior.
Results:
Six themes were identified based on the COM-B model and TDF: perception of illness and accumulation of personal experience; dual challenges of cognitive abilities and physical limitations; integration of digital technologies and acceptance differences; social influences and access and utilization of support resources; environmental constraints and accommodations; and intertwined influences of beliefs, emotions, and motivation. A total of 13 barriers and 11 facilitators were identified.
Conclusions:
Digital self-management in older adults with depression is complex and is influenced by multiple interrelated factors. Effective mHealth apps must integrate the cognitive, emotional, and social contexts of patients to provide user-friendly, personalized solutions.
Citation
Per the author's request the PDF is not available.
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.