Facilitators and Barriers to Digital Self-Management in Older Adults With Depression: COM-B and Theoretical Domain Framework Qualitative Study

Background: Depression in older adults presents unique challenges in self-management. Digital tools, such as mobile health (mHealth) apps, have the potential to support this population. This study explored the facilitators and barriers to digital self-management in older adults with depression to inform the design of effective mHealth apps. Objective: This study aims to explore the facilitators and barriers to digital self-management in older patients with depression with the aim of informing the design and development of mHealth apps for older adults. Methods: A purposive sampling method was used to recruit 25 older patients with depression from July to September 2024. Semistructured interviews were conducted to capture real-life experiences. Directed content analysis ensured objective and accurate data interpretation, and the Capability, Opportunity, Motivation, and Behavior (COM-B) model and the Theoretical Domains Framework were applied to identify facilitators and barriers related to behavior. Results: Six themes were identified based on the COM-B model and the Theoretical Domains Framework: perception of illness and accumulation of personal experience; dual challenges of cognitive abilities and physical limitations; integration of digital technologies and acceptance differences; social influences and access to and utilization of support resources; environmental constraints and accommodations; and intertwined influences of beliefs, emotions, and motivation. A total of 13 barriers and 11 facilitators were identified. Conclusions: Digital self-management in older adults with depression is complex and influenced by multiple interrelated factors. Effective mHealth apps must integrate the cognitive, emotional, and social contexts of patients to provide user-friendly, personalized solutions.