JMIR Publications

ABSTRACT

Background:

China’s aging population and high frailty burden make proactive future care preparation urgent, yet few older adults prepare ahead. However, most existing interventions overlook the heterogeneity between pre-frail and frail older adults and lack precision-oriented digital strategies.

Objective:

Building on a series of prior empirical studies, we aimed to develop and pilot-test a digital intervention to support future care preparation among community-dwelling older adults with frailty.

Methods:

We developed the “Yi Yang Plan” WeChat mini-program through a rigorous, multi-phase research process, including a scoping review, a convergent mixed-methods study identifying key determinants of PFC, and a structural equation model informed by triangulated quantitative and qualitative findings. These evidence-informed results guided the design of a differentiated and targeted digital intervention tailored to the distinct needs of pre-frail and frail older adults. An interdisciplinary team conducted iterative, user-centered design. The final intervention comprised four modules: Awareness Enhancement, Care Resources, Care Decision-Making, and Care Planning. A pilot test was conducted with 20 older adults and their family members. Feasibility and acceptability were evaluated using task completion metrics, satisfaction surveys, think-aloud protocols, and semi-structured interviews.

Results:

All participants completed the tasks (mean 20.7±5.2 minutes). Satisfaction ratings (on a 5-point scale) were favorable, highest for ease of use (4.1±0.7) and lowest for content quality (3.7±0.8). Qualitative findings highlighted the usefulness and professional design, while identifying challenges, including varying levels of care preparation and education, limited interactivity, insufficient practical content, and reliance on adult children’s support. Suggestions included personalized recommendations, supportive tools, enhanced usability, involvement of adult children, and integration with offline services.

Conclusions:

The “Yi Yang Plan” demonstrated preliminary feasibility and acceptability as an evidence-based, culturally tailored digital intervention for supporting future care preparation among Chinese older adults with pre-frailty and frailty. By translating prior empirical and theoretical findings into a differentiated, precision-oriented digital strategy, this study advances existing PFC supportive interventions beyond one-size-fits-all approaches. Future iterations should focus on personalization, usability, adult children’s involvement, and linkage with community resources. This digital intervention offers a scalable approach to empower older adults in proactive care planning.