Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey Study

BackgroundThe aging population and the accompanying rise in chronic diseases have intensified the need to study the adoption of telehealth services. However, the success of telehealth services depends not only on their ease and usefulness but also on addressing broader concer...

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Main Authors: Siow-Hooi Tan, Yee-Yann Yap, Siow-Kian Tan, Chee-Kuan Wong
Format: Article
Language:English
Published: JMIR Publications 2025-03-01
Series:JMIR Aging
Online Access:https://aging.jmir.org/2025/1/e60936
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author Siow-Hooi Tan
Yee-Yann Yap
Siow-Kian Tan
Chee-Kuan Wong
author_facet Siow-Hooi Tan
Yee-Yann Yap
Siow-Kian Tan
Chee-Kuan Wong
author_sort Siow-Hooi Tan
collection DOAJ
description BackgroundThe aging population and the accompanying rise in chronic diseases have intensified the need to study the adoption of telehealth services. However, the success of telehealth services depends not only on their ease and usefulness but also on addressing broader concerns. Despite being a substantial user group in traditional health services, older adults may encounter barriers to adopting telehealth services. Increasing the adoption of telehealth among the older adult population is crucial for enhancing their access to care and managing the challenges of aging effectively. ObjectiveWe aimed to explore factors influencing the adoption of telehealth services among older adults in Malaysia, going beyond the conventional framework by incorporating transition cost and subjective well-being as additional constructs. MethodsA cross-sectional survey was conducted among 119 adults aged ≥60 years in Malaysia, using 39 survey items adapted from existing studies. Data analysis was performed using partial least squares structural equation modeling, with both the measurement model and structural model being evaluated. To determine the predictive relevance of the model, PLSpredict was applied. In addition, importance-performance map analysis was conducted to further expand on the structural model results by assessing the performance of each variable. ResultsOf the 119 participants, 52 (43.7%) were women and 67 (56.3%) were men. The study found that subjective well-being (β=0.448; P<.001) was the most significant factor, followed by attitude (β=0.242; P<.001), transition cost (β=−0.163; P<.001), and perceived usefulness (β=0.100, P=.02) in influencing telehealth service intention. Furthermore, perceived ease of use (β=0.271; P<.001), availability (β=0.323; P<.001), subjective well-being (β=0.261; P<.001), and trust (β=0.156, P=.004) positively influenced perceived usefulness, while inertia (β=0.024, P=.22) did not. In addition, availability (β=0.420; P<.001) and subjective well-being (β=0.260; P<.001) were positively related to perceived ease of use, with inertia (β=−0.246; P<.001) having a negative impact. The importance-performance map analysis results showed that subjective well-being (importance=0.532) was the most crucial factor for older adult users, while availability (importance=70.735) had the highest performance in telehealth services. ConclusionsThis research underscores the importance of catering to the subjective well-being of older adults and optimizing the availability of telehealth services to encourage adoption, ultimately advancing health care accessibility and quality for this vulnerable demographic.
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spelling doaj-art-fb233b09cd8942268b92ebaa01506e4f2025-08-20T03:41:57ZengJMIR PublicationsJMIR Aging2561-76052025-03-018e6093610.2196/60936Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey StudySiow-Hooi Tanhttps://orcid.org/0000-0001-6366-5606Yee-Yann Yaphttps://orcid.org/0000-0003-0348-4998Siow-Kian Tanhttps://orcid.org/0000-0001-8858-5493Chee-Kuan Wonghttps://orcid.org/0000-0002-8678-4664 BackgroundThe aging population and the accompanying rise in chronic diseases have intensified the need to study the adoption of telehealth services. However, the success of telehealth services depends not only on their ease and usefulness but also on addressing broader concerns. Despite being a substantial user group in traditional health services, older adults may encounter barriers to adopting telehealth services. Increasing the adoption of telehealth among the older adult population is crucial for enhancing their access to care and managing the challenges of aging effectively. ObjectiveWe aimed to explore factors influencing the adoption of telehealth services among older adults in Malaysia, going beyond the conventional framework by incorporating transition cost and subjective well-being as additional constructs. MethodsA cross-sectional survey was conducted among 119 adults aged ≥60 years in Malaysia, using 39 survey items adapted from existing studies. Data analysis was performed using partial least squares structural equation modeling, with both the measurement model and structural model being evaluated. To determine the predictive relevance of the model, PLSpredict was applied. In addition, importance-performance map analysis was conducted to further expand on the structural model results by assessing the performance of each variable. ResultsOf the 119 participants, 52 (43.7%) were women and 67 (56.3%) were men. The study found that subjective well-being (β=0.448; P<.001) was the most significant factor, followed by attitude (β=0.242; P<.001), transition cost (β=−0.163; P<.001), and perceived usefulness (β=0.100, P=.02) in influencing telehealth service intention. Furthermore, perceived ease of use (β=0.271; P<.001), availability (β=0.323; P<.001), subjective well-being (β=0.261; P<.001), and trust (β=0.156, P=.004) positively influenced perceived usefulness, while inertia (β=0.024, P=.22) did not. In addition, availability (β=0.420; P<.001) and subjective well-being (β=0.260; P<.001) were positively related to perceived ease of use, with inertia (β=−0.246; P<.001) having a negative impact. The importance-performance map analysis results showed that subjective well-being (importance=0.532) was the most crucial factor for older adult users, while availability (importance=70.735) had the highest performance in telehealth services. ConclusionsThis research underscores the importance of catering to the subjective well-being of older adults and optimizing the availability of telehealth services to encourage adoption, ultimately advancing health care accessibility and quality for this vulnerable demographic.https://aging.jmir.org/2025/1/e60936
spellingShingle Siow-Hooi Tan
Yee-Yann Yap
Siow-Kian Tan
Chee-Kuan Wong
Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey Study
JMIR Aging
title Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey Study
title_full Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey Study
title_fullStr Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey Study
title_full_unstemmed Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey Study
title_short Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey Study
title_sort determinants of telehealth adoption among older adults cross sectional survey study
url https://aging.jmir.org/2025/1/e60936
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