Relationship between perceived risks of using mhealth applications and the intention to use them among older adults in the netherlands: Cross-sectional study

Nicky Sabine Klaver, Joris Van de Klundert, Roy Johannes Gerardus Maria Van den Broek, Marjan Askari

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Background: Considering the increasing demand for health services by older people and the ongoing COVID-19 pandemic, digital health is commonly viewed to offer a pathway to provide safe and affordable health services for older adults, thus enabling self-management of their health while health care systems are struggling. However, several factors cause older people to be particularly reluctant to adopt digital health technologies such as mobile health (mHealth) tools. In addition to previously studied technology acceptance factors, those related to perceived risks of mHealth use (eg, leakage of sensitive information or receiving incorrect health recommendations) may further diminish mHealth adoption by older adults. Objective: The aim of this study was to explore the relationship between perceived risks of using mHealth applications and the intention to use these applications among older adults. Methods: We designed a cross-sectional study wherein a questionnaire was used to collect data from participants aged 65 years and older in the Netherlands. Perceived risk was divided into four constructs: Privacy risk, performance risk, legal concern, and trust. Linear regression analyses were performed to determine the associations between these perceived risk constructs and the intention to use mHealth applications. Results: Linear regression per perceived risk factor showed that each of the four constructs is significantly associated with the intention to use mobile medical applications among older adults (adjusted for age, sex, education, and health status). Performance risk (β=-.266; P=<.001), legal concern (β=-.125; P=.007), and privacy risk (β=-.100; P=.03) were found to be negatively correlated to intention to use mHealth applications, whereas trust (β=.352; P=<.001) was found to be positively correlated to the intention to use mHealth applications. Conclusions: Performance risk, legal concern, and privacy risk as perceived by older adults may substantially and significantly decrease their intention to use mHealth applications. Trust may significantly and positively affect this intention. Health care professionals, designers of mHealth applications, and policy makers can use these findings to diminish performance risks, and tailor campaigns and applications to address legal and privacy concerns and promote mHealth uptake and health care access for older adults, especially during the COVID-19 pandemic.

Original languageEnglish
Article numbere26845
JournalJMIR mHealth and uHealth
Issue number8
StatePublished - Aug 2021
Externally publishedYes


  • Adoption
  • Covid-19
  • Digital health
  • Intention to use
  • Older adults
  • Perceived risks
  • mHealth


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