Investigating Antecedents to Older Adults’ Uptake of Health Information Systems: A Quantitative Case Study of Electronic Personal Health Records

Abstract

Introduction and Aim: older adults are among the primary beneficiaries of health information systems such as electronic Personal Health Records (PHRs), yet they are notably underrepresented in existing research. This study addresses this gap by focusing on this vulnerable group, aiming to enhance their engagement with PHR systems to improve health management. This research seeks to identify the key determinants that influence the intention of older adults to utilize PHR systems, thereby supporting the development of more user-friendly health information technologies for this demographic. Methods: to better understand the functionality of PHR systems and improve user competence, hands-on workshops were conducted for 135 older adults. The workshops aimed to enhance their capability to manage chronic conditions using these systems. Post-training, participants’ intentions to use PHRs were assessed via a survey, applying the Health Belief Model (HBM) as the analytical framework. Data analysis was performed using Partial Least Squares (PLS) path modeling to underscore the robustness of the methodological approach. Findings: the data analysis of the participants’ responses uncovered that seniors’ usage intention toward PHRs is a function of the PHR’s perceived usefulness (p < 0.01, OR = 2.5, 95% CI 1.5–4.1), perceived barriers (p < 0.05, OR = 1.3, 95% CI 0.8–2.1), perceived confidence (p < 0.05, OR = 1.6, 95% CI 1.0–2.5), and cues to action (p < 0.05, OR = 1.8, 95% CI 1.1–2.9). Of these, perceived usefulness was found to be the strongest predictor. The results also indicate that perceived susceptibility and perceived severity did not significantly impact seniors’ intention to use PHRs. Conclusions: according to the findings and based on the HBM literature, if individuals perceive more benefits and fewer barriers to the use of PHRs, greater self-efficacy, and better cues to action, they are more likely to adopt the system.