Using an mHealth Interactive Platform to Improve Dietary Diversity in the Elderly: An Empirical Study with a Chatbot Example (Preprint)

<sec> <title>BACKGROUND</title> With the advancement of technology and the proliferation of mobile phones, smartphone adoption among the elderly is increasing. Although their usage of social media, such as Line and Facebook, still lags behind the younger generation, scholars have observed a positive correlation between smartphone use and the well-being of older adults. This trend presents an opportunity to leverage mobile health (mHealth) technology to enhance health literacy and status among the elderly. Notably, older adults who frequently use mobile phones for health information exhibit significantly higher health literacy than their less-frequent-using counterparts. Furthermore, data from a major nutritional survey in Taiwan (2017–2020) reveals that the dietary habits of the elderly deviate significantly from national nutritional guidelines, exacerbating the prevalence of chronic diseases and in-creasing the risks associated with an aging society. Extensive national and international studies have confirmed that maintaining dietary diversity is crucial for reducing frailty, mortality, and the risk of cognitive decline. Therefore, promoting dietary diversity among the elderly is a primary objective for geriatric healthcare. </sec> <sec> <title>OBJECTIVE</title> This study attempts to leverage the potential of mHealth to enhance the health literacy of the elderly, specifically focusing on improving their nutritional knowledge. It designs an mHealth function to promote dietary diversity interaction with the elderly. Through this interaction, the study explores the effectiveness of an mHealth mechanism with dietary diversity interaction on the knowledge, attitudes, and behaviours of the elderly regarding dietary diversity. </sec> <sec> <title>METHODS</title> This study utilised an interactive mHealth platform to engage older adults in a six-day, high-frequency interaction based on the Dietary Diversity Score (DDS). The core of this intervention was the dissemination of in-formation related to dietary diversity. The study aimed to explore whether this innovative digital communication method could positively influence the dietary diversity behaviors of the elderly and enhance their aware-ness of its importance. </sec> <sec> <title>RESULTS</title> By collecting interaction data alongside pre-test and post-test evaluations, this study assessed the improvement in dietary diversity and determined the statistical significance of the changes. The results confirm that the application of an innovative technological tool—a dietary diversity chatbot for high frequency interaction with the elderly can effectively improve the dietary patterns and increase dietary diversity among this population. </sec> <sec> <title>CONCLUSIONS</title> This study confirmed that mHealth interactions significantly improved Dietary Diversity Scores (DDS) among elderly participants. These results highlight how tailored mHealth tools can meaningfully influence elderly dietary habits and promote healthier aging. </sec>