As healthcare systems increasingly integrate digital technologies, understanding factors influencing older adults' digital health adoption becomes essential for ensuring equitable access. This study examines the relationships among online informal social capital, perceived usefulness, technology attitudes, and health service utilization among Hong Kong older adults.
Drawing on the Technology Acceptance Model and social capital theory, we developed a comprehensive framework to understand digital health adoption pathways. A quantitative telephone survey was conducted with 802 participants aged 55 and above across Hong Kong from July to August 2024. Partial Least Squares Structural Equation Modeling (PLS-SEM) analyzed the complex relationships among variables.
Results revealed that online informal social capital significantly enhances perceived usefulness (β = 0.246, p < .001). Perceived usefulness strongly influences positive attitudes (β = 0.450, p < .001) and reduces negative attitudes (β = -0.348, p < .001). Critically, perceived usefulness does not directly affect health service utilization, challenging traditional Technology Acceptance Model assumptions. Instead, both positive attitudes (β = 0.145, p < .01) and negative attitudes (β = -0.125, p < .05) serve as complete mediators between perceived usefulness and actual service adoption. These findings highlight that recognizing technology's benefits alone is insufficient for older adults' adoption; emotional acceptance through positive attitudes is essential. The study contributes to technology acceptance literature by demonstrating attitude-mediated pathways and provides practical insights for developing age-friendly digital health interventions. Recommendations include leveraging family and community networks as "tech ambassadors" and implementing programs that foster positive technology attitudes rather than solely emphasizing functional benefits.

Authors:
Xin Guan, Hong Kong Baptist University, Hong Kong
Tin Yan Cherry Cheung, Hong Kong Baptist University, Hong Kong
Wan Ping Vincent Lee, Hong Kong Baptist University, Hong Kong

About the Presenter(s)
Ms. Guan is a PhD candidate in Social Work at Hong Kong Baptist University. Her research focuses on mental health, elderly care, digital inclusion, and how technology enhances social work interventions for vulnerable groups.

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