Perceptions of Adults Aged 50 Years and Older Regarding the Use of Wearable mHealth Technologies to Promote Physical Activity: Systematic Review and Meta-Ethnography

Clinical Snapshot

Key Findings

• Effect Size: Not applicable (qualitative meta-ethnography; no quantitative effect size calculable)

• Primary Outcome: Synthesis of perceptions of adults aged ≥50 years regarding wearable mHealth technologies for physical activity promotion, yielding three meta-ethnographic themes: barriers, facilitators, and areas for improvement

• Nnt Or Sensitivity: Not applicable; key qualitative findings: personal barriers include physical limitations and negative technology perceptions; technological barriers include poor functionality, design, and accessibility; facilitators include perceived health benefit, social and healthcare professional support; areas for improvement centre on user-centred, age-friendly interface design and continuous professional support integration

• Confidence Interval: Not applicable (qualitative synthesis; GRADE-CERQual confidence assessment not reported in abstract)

Clinical Application

Implementation of wearable mHealth technologies in clinical practice is feasible but requires structured support frameworks. Key feasibility considerations include: (1) healthcare professional training to support technology onboarding and troubleshooting; (2) co-design processes involving older adults in device and app development; (3) addressing accessibility needs (font size, interface simplicity, alarm customisation); (4) accounting for seasonal and environmental factors affecting device use. Cost and digital literacy remain significant implementation barriers. In Australia, wearable mHealth technologies for physical activity are not currently listed on the Pharmaceutical Benefits Scheme (PBS) and are not subject to specific TGA therapeutic device regulation unless they make therapeutic claims. The RACGP's 'Green Book' (Guidelines for Preventive Activities in General Practice) and the 2024 Australian Physical Activity and Sedentary Behaviour Guidelines support physical activity promotion in older adults, creating a policy environment receptive to these findings. The Australian Digital Health Agency's national digital health strategy (2023–2028) explicitly prioritises consumer-centred digital health tools, aligning with this review's recommendation for user-centred design. Medicare Benefits Schedule (MBS) telehealth items may support healthcare professional-led monitoring of wearable device data in chronic disease management contexts. The My Aged Care framework and Primary Health Networks (PHNs) represent potential implementation pathways. Australia's culturally and linguistically diverse (CALD) older adult population underscores the review's call for intersectional demographic consideration, as digital health equity is a recognised priority in the National Preventive Health Strategy 2021–2030. Community-dwelling adults aged 50 years and older, particularly those with chronic conditions where physical activity promotion is a clinical priority (e.g., cardiovascular disease, type 2 diabetes, osteoarthritis, obesity, depression). Findings are most directly applicable to relatively healthy, community-dwelling older adults; generalisability to frail, cognitively impaired, or institutionalised populations is uncertain.

Abstract

BACKGROUND: Despite advances in wearable mobile health (mHealth) technologies and their associated apps designed to promote physical activity, and the importance of adapting them to users, little is known about older adults' perceptions of these technologies. OBJECTIVE: This review aimed to synthesize and analyze qualitative evidence exploring the perceptions of adults aged 50 years and older regarding areas to improve, barriers to, and facilitators of wearable mHealth technologies (activity trackers and companion apps) to promote physical activity. METHODS: A qualitative systematic review and meta-ethnography was conducted. Comprehensive searches were performed across 8 databases (MEDLINE, Scopus, Web of Science, CINAHL, The Cochrane Library Plus, PsycINFO, ProQuest, and ÍnDICEs-CSIC) for articles published in English or Spanish between January 2013 and January 2024. The synthesis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines. RESULTS: Ten articles met the inclusion criteria and were synthesized using meta-ethnography. Three main themes emerged: (1) barriers to promoting physical activity caused by wearable mHealth technologies: personal barriers (physical aspects, perceptions about technology, and personal preferences), technological barriers (functionality, content, design, alarms, availability, and accessibility), and environmental barriers (season of the year); (2) personal facilitators (consideration that these apps improve health, perceptions about technology, and personal preferences), technological facilitators (functionality, content, and design), relational facilitators (technological and social support), environmental facilitators (seasonal variations), and health care professionals (support and monitoring by health care services); and (3) personal areas (perceptions about technology and personal preferences), technological areas (functionality, content, and design), and relational areas (technological support). CONCLUSIONS: Although older adults acknowledge the potential of wearable mHealth technologies to promote physical activity, their effective engagement is hindered by distinct personal, technological, and environmental barriers. Bridging the digital divide requires designers to prioritize user-centered, age-friendly interfaces that are integrated with continuous support from health care professionals. To promote genuine health equity, future research must rigorously report intersectional demographics to ensure that mHealth interventions mitigate, rather than inadvertently exacerbate, existing disparities.

References

1. 1.Rodríguez-Martín, B., González-Arroyo, D., Priego-Jiménez, S., Lopez-González, M., Medrano-Echeverría, M., Ruiz-Grao, M. C., & Álvarez-Bueno, C. (2026). Perceptions of adults aged 50 years and older regarding the use of wearable mHealth technologies to promote physical activity: Systematic review and meta-ethnography. JMIR mHealth and uHealth. https://doi.org/10.2196/67157