Enhancing technology acceptance in older adults : Persuasion Senior Technology Acceptance Model (PSTAM)

Abstract

Background: Age-related loss of muscle mass and strength poses mobility challenges among older adults and is a significant barrier to achieving healthy aging. Emerging technologies such as wearable robots provide promising potential to assist older adults in overcoming mobility difficulties, yet the acceptance of these technologies remains low. Despite the proliferation of technology acceptance theories and models, it remains unclear and obscure what and how different factors affect wearable robot acceptance.

Objectives: In this thesis, I aim to achieve four research objectives: (1) to examine how message and temporal framing influence wearable robot acceptance among older adults with no or low mobility difficulties in Hong Kong; (2) to explore the effects of national culture and cultural value orientation on wearable robot acceptance among older adults with no or low mobility difficulties in Hong Kong and the United Kingdom; (3) to investigate how different sources of ageism (i.e., self, family and friends, technology developers, and strangers) are associated with wearable robot acceptance among older adults with moderate mobility difficulties in Hong Kong; and (4) to elucidate the real-life challenges in daily activities and to understand how price value and consumption methods are associated with wearable robot acceptance among older adults with high mobility difficulties in Hong Kong.

Methods: This thesis employs a sequential mixed-methods study design with four studies, with each study building on the findings of the previous. Study 1A is a cross-sectional randomized experiment to achieve objective 1. Study 1B replicates Study 1A in the United Kingdom to achieve objective 2. Study 2 is a cross-sectional randomized experiment to achieve objective 3. Finally, Study 3 is a mixed-methods study consisting of shadowing, semi-structured interviews, and surveys to achieve objective 4.

Results: My findings showed that message and temporal framing, particularly proximally/gain-framed messages, significantly influenced the intention to use wearable robots among older adults with no or low mobility difficulties. Moreover, I found that vertical collectivism significantly influences control beliefs, a crucial technology acceptance factor influencing the intention to use wearable robots among older adults. Furthermore, my findings provided evidence of the detrimental effects of ageism from technology developers on the intention to use wearable robots among older adults with moderate mobility difficulties. Also, I unveiled the real-life challenges among older adults with high mobility difficulties in indoor and outdoor settings. Finally, my findings evidenced the anchoring effects of pricing strategies and alternative consumption methods of wearable robots, “rent first, buy later.”

Discussion: The findings from this thesis supported the development of the Persuasion Senior Technology Acceptance Model (PSTAM). It underscores the multidimensional nature of wearable robot acceptance among older adults, encompassing framing strategies, cultural influences, ageism considerations, pricing anchors, and consumption methods. The academic, theoretical, practical, and policy implications provide a comprehensive foundation for advancing research, practice, and policy initiatives to enhance wearable robot acceptance among older adults. I offered a recommendation checklist to promote the ethical applications of the findings from this thesis. Lastly, I provided seven future research directions based on the foundation laid in this thesis.