A User Typology for Digital Health Self-Management Technologies: A Qualitative Study of the Long-term User Experiences of Older Adults with a Digital Self-Management Platform for Multimorbidity (ProACT).

Abstract

Self-management technology to track symptoms, medication, activity and other health goals is being proposed as a solution to the increasing prevalence of multi- morbidity in our ageing populations. Yet, no one-size-fits-all exists for digital self- management. To assure that self-management technologies can provide valuable support in the health management of older people with multimorbidity (PwMs), this paper investigates how and why older PwMs differ in their reaction to the use of self-management technology. An inductive thematic analysis was performed on interviews of 42 PwMs (34 M; 8 F) of 65 years and older in Belgium to explore their emotional and behavioural reaction to the long-term (mean duration = 9 months) use of a digital self-management platform. The analysis resulted in six main themes describing the user experience of older PwMs: emotional reaction to self-monitoring of health, behavioural reaction to self-monitoring of health, involvement from PwMs’ social network in self-monitoring of health, PwMs’ health literacy, PwMs’ self-efficacy in health management, and PwMs’ technology acceptance for self-management. Based on distinctive differences in these themes and the analytical lens of the Causality Orientations Theory, four user types were distinguished: the Indepen- dently Empowered, the Socially Activated, the “Not for me”, and the Ruminator. By exploring these different user types and their needs regarding digital self-management, we have provided a first step for researchers and health practitioners towards enhanced personalised support that enables the optimal self-management journey of older adults with multimorbidity.