Abstract
OBJECTIVES: Lack of familiarity and limited digital literacy frequently limit the ability and willingness of older adults to use digital health tools. This study aimed to investigate the factors influencing the intention to use digital health information and services (DHIAS) and their actual use among indigenous Taiwanese older adults, based on the theory of planned behaviour (TPB) and digital health literacy. DESIGN: Cross-sectional quantitative study using a structured questionnaire. SETTING: Community-based settings at the primary care level; 11 cultural health stations located in Eastern Taiwan. PARTICIPANTS: A total of 170 Indigenous elders aged ≥55 years were recruited. Inclusion criteria included: Indigenous descent, aged ≥55 years, cognitively intact and able to communicate in Mandarin. All participants completed the interview-based survey. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were the intention to use DHIAS and its actual use. Predictors included digital health literacy and TPB constructs. All variables were measured using validated or adapted items within the questionnaire. RESULTS: The mean score for intention to use DHIAS was 1.50 (SD=0.90) and the mean score for actual behaviour was 1.68 (SD=1.14). Hierarchical regression analyses indicated that subjective norms (β=0.270, p<0.001)-a core construct of TPB-and digital health literacy (β=0.603, p<0.001) significantly predicted intention, accounting for 55.7% of the variance. Intention (β=0.732, p<0.001) and digital health literacy (β=0.146, p<0.025) were significant predictors of actual behaviour, accounting for 72.4% of the variance. CONCLUSIONS: Digital health literacy and TPB constructs critically influence digital health engagement among older populations. Interventions aimed at improving digital health engagement among older populations should focus on enhancing digital skills and creating socially supportive environments. Future studies should explore culturally tailored strategies to reduce digital disparities in communities with limited healthcare access.