Acceptance of digital health technologies in health and aged care: A systematic review and meta-analysis

BACKGROUND: As global populations age, health care systems face mounting pressure to provide accessible, efficient, and patient-centered care. Digital health technologies offer promising solutions for supporting older adults' independence and chronic disease management; however, adoption remains inconsistent due to barriers related to perceived usefulness (PU), perceived ease of use (PEOU), and attitudes toward technology (ATT). PURPOSE: This systematic review and meta-analysis synthesized existing evidence on digital health technology acceptance among older adults, identifying key determinants of behavioral intention (BI) and examining moderating effects of culture, age, and technology type. METHODS: A comprehensive search across PubMed, Scopus, and EBSCOhost identified 59 eligible studies. Of these, 19 studies with quantitative data were included in a meta-analysis using random-effects modeling. Correlation coefficients were converted to standardized path coefficients (β) for comparability. Subgroup and meta-regression analyses assessed heterogeneity and moderator effects across cultural regions, age groups, and technology categories. RESULTS: Perceived usefulness emerged as the strongest predictor of adoption (PU → BI: β = 0.72, 95% CI: .70-.73), followed by attitude (ATT → BI: β = 0.53, 95% CI: .50-.56). Perceived ease of use exerted an indirect influence through usefulness (PEOU → PU: β = 0.60), highlighting the interdependence between usability and perceived benefits. Substantial heterogeneity (I2 = 57.5%-99.7%) reflected genuine contextual diversity. Moderation analyses revealed stronger relationships in Western cultures and among younger-old adults (60-70 years). Technology-specific differences showed that digital health platforms benefited most from usefulness-driven adoption, while assistive technologies depended heavily on usability. CONCLUSIONS: Acceptance of digital health technologies among older adults is shaped by perceived usefulness, ease of use, and contextual moderators such as culture, age, and technology type. The findings underscore that technology adoption in aging populations is not universal but deeply context-dependent. PRACTICAL IMPLICATIONS: Health care administrators and designers should prioritize interventions that enhance perceived usefulness and usability through evidence-based, context-specific strategies such as outcome-driven feedback systems, intuitive interfaces, and culturally tailored digital literacy programs. Policy efforts should support iterative evaluation frameworks that adapt to diverse user needs to ensure equitable and sustainable technology adoption in health and aged care.