Barriers and facilitators to bridging the healthcare digital divide for the older adults: A qualitative research from patients in China.

Abstract

The aim of this study was to explore the barriers and facilitators underlying the healthcare digital divide by using qualitative methodologies, integrated with the Capabilities, Opportunities, Motivations, and Behaviors (COM-B) as well as the Behavior Change Wheel (BCW) theoretical frameworks. To conduct a thorough analysis, semi-structured，in-depth interviews were orchestrated among a cohort of older patients who had experiences with digital healthcare systems. Data were meticulously analyzed via Colaizzi's seven-step methodological procedure. Nine barriers were elucidated, including physical limitation, inadequate training and support, self-imposed denial, failure to rebuild the digital healthcare environment, equipment constraints, deficits in communication and feedback, skepticism regarding data accuracy and validity, sense of social deprivation, and network information boycott. Conversely, eleven facilitators were identified, encompassing peer modeling, availability of training and support, reconstructive efforts toward the digital healthcare environment, mandatory usage, familial influence, media impact, scientific publicity and education, enhancement of self-efficacy, sense of social participation, perceived convenience, and access to healthful information. Based on the COM-B and BCW models, healthcare organizations may be able to improve their digital healthcare support systems (capabilities), technical design, network speed, and equipment configuration (opportunities), as well as focus on "human-computer integration," the parallel existence of digital technology and humanistic care, and taking into account the issues of information security, accuracy, and human rights equality (motivation) while benefiting the patients, in order to bridge the healthcare digital divide for the older adults.