Factors influencing the elderly’s adoption of mHealth: an empirical study using extended UTAUT2 model

Background Despite the high usage of mobile phones in daily life in developing countries like Bangladesh, the adoption and usage of mHealth services have been significantly low among the elderly population. When searching previous studies, the researchers have found that no studies have empirically investigated whether the quality of life and service quality are significant for mHealth adoption by elderlies in Bangladesh. Hence, this study aimed to extend the Unified Theory of Acceptance and Use of Technology by adding service quality and the quality of life to empirically find the key factors that influence elderlies' intention to adopt and use mHealth services in Bangladesh. Methods A face-to-face structured questionnaire survey method was used to collect data from 493 elderlies (aged 60 years and above) in Bangladesh. The data were analyzed with the Structural Equations Modelling (SEM) and Fuzzy Set Qualitative Comparative Analysis (fsQCA). Results SEM results suggested that Social Influence, Hedonic Motivation, Price Value, Habit, and Service Quality had significant impact (p < 0.05) on the elderlies' behavioral intention to adopt mHealth services. Service Quality, Quality of Life, and elderlies' Habit were found significant in explaining the Use Behavior of mHealth services. Quality of Life did not show significant (p > 0.05) effect on Behavioral Intention, which is inconsistent with existing literature. In addition, fsQCA findings suggest how the intensity of the influencers may contribute to high versus low m-health behavioral outcomes. Conclusions The findings have significant implications for theory, practice and future research as explained in the paper. The originality of this study is the integration of quality of life and service quality into UTUAT2 to explain the users' behavioural intention and use behaviour. Overall, the findings may contribute to shaping appropriate policies for designing and implementing mHealth services effectively for elderlies in developing countries. Keywords: mHealth, Elderly, UTAUT2, Quality of life, Service quality, Developing country