Telemonitoring Adoption Among Older Adults: Sequential Mixed Methods Study of Message Framing and Structural Influence

Background: Telemonitoring offers solutions for remote health management among older adults; yet, acceptance varies based on individual perceptions and presentation strategies. Objective: This 2-phased sequential mixed methods study examines the role of message framing on telemonitoring adoption among low-income older adults. Methods: Phase 1 involved in-depth interviews with 17 older adults, identifying key facilitators (accessibility, affordability, and health benefits) and barriers (preference for in-person consultations, technological limitations, and information processing difficulties) of telemonitoring. Building on these insights, phase 2 used an experimental study with 120 participants assessing message framing effects (episodic vs thematic) and modalities (video vs photo-text) on telemonitoring adoption. Results: Episodic framing did not produce a significant main effect on attitudes toward telemonitoring; however, its effect was moderated by external locus of control (LOC), with episodic framing associated with more positive attitudes among participants lower in external LOC, and thematic framing more favorable among those higher in external LOC. Conclusions: Convenience, cost, and health benefits emerged as key adoption drivers, while traditional consultation preferences and cognitive processing challenges posed barriers. Theoretical and practical implications were discussed.