Understanding the psychosocial drivers of adoption and use of mobile mental health interventions among older adults

Pywell, Jake Thomas (2021) Understanding the psychosocial drivers of adoption and use of mobile mental health interventions among older adults. Doctoral thesis, Northumbria University.

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Abstract

Depression is a major mental health problem in the UK and is particularly problematic within older adults. In addition, tackling the symptoms of depression in older adults is hindered by specific barriers that older adults face in the access of mental health care. Mobile mental health interventions (MMHIs) provide a number of benefits for the delivery of mental health interventions due to their accessibility and thus, are able to overcome a number of barriers to mental health treatment. Existing research has explored ways in which use of MMHIs can be encouraged among a wide variety of demographic groups, including students, adolescents and adults, along with the psychological determinants of future use of MMHIs. However, older adults are seldom included in such research, despite being an age group that could benefit from MMHIs. This thesis aimed to address these gaps by investigating factors which may hinder older adults’ access to such interventions and explore how older adults’ perceptions of MMHIs may be improved. These research objectives were explored using a mixed methods approach.

First, this thesis qualitatively explored the psychological barriers that older adults who use technology may experience in the uptake and use of MMHIs. These findings laid the foundation for a series of three quantitative, survey-based studies. The second study took a quantitative approach in investigating the influence of these barriers on their attitudes towards MMHIs, and identified perception of data security, perceived effort expectancy and awareness of mobile mental health as key determinants of attitudes. Next, the Technology Acceptance Model (TAM) was applied to the three identified determinants of attitudes to present an adapted Technology Acceptance Model. In this adapted model, perception of data security was a valuable addition and showed significant associations to attitudes and intention to use MMHIs for older adults. Finally, an experimental study was conducted to compare the effects of different types of information about data security practices on improving older adult’s intentions to use MMHIs, and their attitudes towards them.

This thesis has resulted in new knowledge about factors which are important for older adults in the uptake of MMHIs and highlights the role that perceptions of data security, expected effort requirement and awareness of current interventions might play in shaping their uptake by older adults. These findings are discussed in the context of existing literature and the implications for theory, current mental health care delivery and design of MMHIs.

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