Health-seeking behavior and its associated technology utilization among community-dwelling older adults in Singapore: Qualitative study.

Abstract

Understanding older people's health-seeking behavior (HSB) is crucial to uncovering their health needs and priorities, as well as developing appropriate policies to address these needs and avert their disease progression. Technologies play an active role in our daily lives, and they have been incorporated into health activities to support the aging population and facilitate their HSB. However, prior research in HSB has mainly focused on behaviors during illness, and there is limited research on how technologies have been utilized in older people's health-seeking activities. This study aimed to investigate the HSB and associated technology utilization among the older population, ultimately proposing implications for practice to address their unmet health needs. This paper presented partial data from a larger qualitative study, which has been approved by the Institutional Review Board and employed a phenomenological approach. Semi-structured interviews were conducted between April 2022 and July 2022, either on Zoom or face-to-face. Inclusion criteria included being aged 50 and above, long-term residing in Singapore, and being able to speak English or Mandarin. The interviews were manually transcribed verbatim, and a thematic analysis was performed with the individual as the unit of analysis to understand group phenomena. Fifteen interviews were conducted to reach thematic saturation. We identified five main consequences of HSB, which were aligned with Poortaghi et al.'s model. Regarding technology utilization in health-seeking, four themes were extracted: 1) the most widely used digital technologies are the mobile health apps and wearable devices with associated wellness programs launched by the government and local companies, and they have the potential to enhance health communication, promote health maintenance, and increase access to health services; 2) information communication technologies and social media, though not primarily designed for health purposes, play a significant role in easing the process of seeking health information and managing symptoms; 3) while the outbreak of the COVID-19 pandemic has resulted in some alterations to older adults' well-being, it has catalyzed the adoption of telehealth as a complement to access healthcare services; and 4) older adults have different considerations when selecting technologies to facilitate their health-seeking and fulfill their health needs. Four archetypes were also proposed based on our findings and the insights gained from our participants' observations in their social networks. These findings led to several implications for practice regarding health communication and promotion, health education, technology design and improvement, telemonitoring service implementation, and solutions to address the needs of each proposed archetype. Unlike the commonly held belief that older adults resist technologies and lack technological proficiency, our findings showed that technologies could play a promising role in facilitating older adults' health-seeking. Our findings have implications for the design and implementation of health services and policies.