Abstract
OBJECTIVE: With the rapid integration of digital technologies into healthcare, technophobia has become a key barrier to digital health adoption, especially among older adults. This study aimed to evaluate technophobia levels and identify associated factors within a multidimensional ecological framework. METHODS: A systematic search was conducted across 10 electronic databases for studies published until April 30, 2025. Meta-analysis was conducted to estimate pooled effect sizes. Technophobia levels were assessed using mean differences (MDs) or standardized mean differences (SMDs), each accompanied by a 95% confidence interval (CI). Summary correlation coefficients (r), with 95% CI, were used to evaluate associated factors based on the health ecological model. RESULTS: Nineteen studies were included. The findings indicate that older adults demonstrated significantly elevated technophobia levels (MD = 39.90, 95% CI: 35.87-43.94) compared to non-older adults, with privacy and security concerns scoring the highest among the three dimensions (MD = 3.29, 95% CI: 2.94-3.64). Additionally, several factors showed significant correlations with technophobia (r = -0.537 to 0.235, P < 0.05), spanning four ecological domains: individual traits (e.g. digital health literacy), behavioral traits (e.g. self-efficacy), interpersonal networks (e.g. social networks), and living environment (e.g. income level). CONCLUSIONS: Technophobia is notably high among older adults in digital health contexts, especially regarding privacy and security concerns. Its roots span individual, social, and systemic dimensions. These findings highlight the need for targeted, multilevel interventions to reduce technophobia and ensure equitable access to digital health technologies.