Frequency of Electronic Personal Health Record Use in US Older Adults: Cross-Sectional Study of a National Survey
Background: Electronic Personal Health Records (ePHRs) have significant potential to improve health management for older adults by enhancing access to medical information and communication with healthcare providers. However, usage remains low among individuals aged 65 and older. Existing research points to barriers such as low self-efficacy, digital literacy, and usability challenges, but the specific factors influencing ePHR use among the older adults are not fully understood. Objective: This study integrates the Aging and Technology framework and the Patient Technology Adoption Model to investigate key predictors of ePHR use, including age, education, issue involvement, performance expectancy, effort expectancy, and self-efficacy, while controlling for demographic factors such as gender, race, and income. Methods: This study uses data collected from the Health Information National Trends Survey (HINTS 5 Cycle 3) which includes 532 respondents representing 13,136,180 U.S. adults aged 65 and older when survey weights are utilized. The study uses structural equation modeling to analyze the frequency of ePHR access in the last 12 months. Results: Results show that older adults with higher self-efficacy used ePHRs more frequently, and factors such as issue involvement, performance expectancy, and effort expectancy positively influenced ePHR use. Interestingly, self-efficacy also partially mediates the impact of age on the frequency of ePHR use. Conclusions: These findings suggest that improving self-efficacy, focusing on usability, and enhancing perceived benefits are critical for increasing ePHR usage among the older adults. The study underscores the need for targeted interventions to support older users, to simplify interfaces, and to provide educational resources, ultimately improving health outcomes and quality of life for older adults.
