Motivational factors influencing intention to use mobile health in older adults
: an integrated model of the technology acceptance model and uses and gratifications theory

  • Xiaoxiao Zhang

Student thesis: PhD Thesis


Chinese older adults increasingly turn to mobile health technology for health management and communication. Mobile health, as an attractive solution, offers many advantages for the elderly. Little research, however, has examined their motivations for adopting this advanced technology. The study filled the gap by exploring diversified motivations that influence Chinese older adults’ intention to adopt mobile health technology in their day-to-day lives. The investigation was guided by a proposed research model developed from the original Technology Acceptance Model (TAM) and Uses and Gratifications Theory (U&G). Two independent and interconnected studies (Study 1a&b and Study 2) were conducted using mixed-research methods and quantitative methods respectively. Specifically, study 1 performed a sequential exploratory mixed-method study, combining qualitative (Study 1a) and quantitative analysis (Study 1b) to develop a reliable, empirically derived instrument to measure older adults’ health-related motivations. Study 1a comprised a qualitative stage to generate the primary items of the instrument. This stage provided findings of a qualitative content analysis of 20 in-depth interviews held with Chinese older users. Based on study 1a’s findings, study 1b designed a questionnaire that includes all health-related motives identified from study 1a. The motivations were converted to questionnaire items that asked respondents to rate them on a five-point Likert scale. A self-reported online survey was completed by 433 older mobile health users to investigate the factorial structure of the new-developed instrument. The results disclosed six types of health-related motivations, which are health information need, social support, surveillance needs, technological convenience, social involvement and self-presentation. Study 2 conducted a quantitative analysis to test the predictive and explanatory power of the proposed research model; Specifically, the quantitative phase examined how health-related and technological-oriented motivators and age-specific factors affect older adults’ behavioural intention to use mobile health technology. An online self-reported questionnaire was completed by 586 older users. A variance-based Partial Least Square (PLS) method was used to examine the quality of the structural model and the hypothesised relationship between independent variables and dependent variables. The results showed that eleven independent variables explain 72.68 % of the variance in the behavioural intention, which demonstrates that the proposed research model is a model with good explanatory power. Specifically, perceived usefulness, perceived ease of use, health information need, and social support were the most important motivations in mobile health use. Age-related factors such as self-efficacy, technology trust and technology anxiety significantly affected older users’ behavioural intention, while resistance to change did not show any statistical significance. This study integrated the TAM model and U&G theory with age-related factors to serve as an innovative and integrated research model to examine use of mobile health technology among older Chinese adults. It also provided recommendations on how to leverage mobile health technology to improve older people’s healthcare management and health communication.
Date of AwardNov 2022
Original languageEnglish
Awarding Institution
  • University of Nottingham
SupervisorXiaoge Xu (Supervisor), David Phang (Supervisor) & Jianming Wang (Supervisor)


  • Mobile health technology
  • TAM model
  • U&G theory
  • Motivations
  • China
  • Older adults
  • Age-characteristic factors

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