Predicting older adults smart healthcare adoption using an extended TAM

This study utilizes the Technology Acceptance Model (TAM) as its theoretical foundation to examine factors influencing the adoption of smart healthcare among community-dwelling older adults. Focusing on elderly residents in Shaoxing, Zhejiang Province, China, the "Smart Healthcare Usage Intention Scale" was developed based on TAM constructs and validated through reliability and validity testing. A total of 403 participants were recruited via convenience sampling between August 2024 and January 2025. Data were analyzed using descriptive statistics, t-tests, Pearson correlation analyses in SPSS 27.0, and structural equation modeling (SEM) in Amos 28.0 for path and mediation analyses. The results indicated a behavioral intention (BI) score of 10.00 ± 3.26. The model exhibited good fit (CMIN/DF = 2.713), revealing that personal tendency, social support, and perceived value had significant positive effects on both perceived usefulness (PU) and perceived ease of use (PEOU). Furthermore, PU and PEOU were found to positively influence BI, and PEOU also had a significant positive effect on PU. Mediation analysis identified six parallel and three serial mediating pathways, underscoring the essential mediating roles of PU and PEOU. These findings provide both theoretical and practical implications for promoting smart healthcare adoption in older adult populations.