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Trust Barriers in Older Adults’ Telemedicine Use: A Scoping Review of Vulnerabilities and Design Recommendations
ABSTRACT
Background:
Aging populations worldwide face increasing healthcare demands, particularly for chronic disease management. While telemedicine offers a viable solution to enhance healthcare access, significant trust-related barriers hinder its adoption among older adults, necessitating systematic investigation.
Objective:
This scoping review seeks to enhance telemedicine adoption among older adults by identifying key trust barriers, mapping them to specific vulnerability domains, and proposing evidence-based strategies to address these challenges.
Methods:
We conducted a systematic scoping review in accordance with PRISMA guidelines, analyzing literature from PubMed, Web of Science, and Scopus. Thematic analysis was applied to synthesize findings from 30 included studies.
Results:
Five primary trust barriers were identified: technophobia and technical difficulties, privacy and data security concerns, negative emotional and social impacts, and strong preference for traditional medicine. These barriers mapped onto 4 vulnerability domains: limited telemedicine literacy (particularly low eHealth self-efficacy), declining health status (including sensory and cognitive impairments), psychological and cognitive factors (such as anxiety about losing autonomy), and inadequate social support systems. The review also underscored how rapid technological change amplifies these challenges for older adults.
Conclusions:
Effective telemedicine implementation for older adults requires multipronged interventions, including age-appropriate interface design, targeted digital literacy training, robust privacy protections, and personalized support systems. These approaches address both technological and psychosocial barriers, potentially increasing engagement while mitigating vulnerabilities. Future research should assess the effectiveness of these interventions across diverse older populations.
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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.