Public defence, Computer Science, MA Maedeh Ghorbanian Zolbin

Title of the thesis: eHealth for Migrant and Native Older Adults: A Qualitative Study on Barriers and Facilitators

Thesis defender: Maedeh Ghorbanian Zolbin 
Opponent: Associate Professor Pernille Scholdan Bertelsen, Aalborg University, Denmark
Custos: Associate Professor Johanna Viitanen, Aalto University School of Science

The number of older adults is increasing worldwide. Some of them face many health issues and are looking for care services. Digital health services can help older adults manage their health, receive care remotely, and live more independently at home. However, not all older adults are able or willing to use these services. Therefore, this thesis studied how the adoption of digital health services could be supported among migrant and native older adults. 

The research brings together three fields of study: eHealth, human-computer interaction, and health literacy. It explored older adults’ perceived challenges towards eHealth services, their needs and expectations, and facilitators that could support older adults’ use of digital health services. 

• The findings showed that older adults face several barriers in the use of digital health services, including limited digital skills, lack of support and access to digital resources, usability problems, health-related challenges, lack of confidence, and negative emotions. The challenges were then connected to basic psychological needs of autonomy, competence, and relatedness to understand the underlying psychological reasons behind them. 
• This thesis identifies migrant and native older adults' needs and expectations towards eHealth services. Then, based on these findings, the thesis proposes potential design guidelines for developing digital health services that better respond to the needs of migrant and native older adults. 
• At the same time, the study identified positive emotions that older adults had towards digital health services, including trust, interest, empowerment, hope, peace of mind, and reduced worry about their health. Knowing about these positive emotions is expected to support older adults’ adoption of eHealth services. 
• Moreover, seven themes were identified for supporting older adults’ motivation to adopt these services: awareness, ease of use, security, self-efficacy, autonomy, relatedness, and access. The thesis also proposes solutions to support the identified motivational themes in practice. When older adults are motivated, nothing can stop them from using digital health services! 
• This thesis studies potential outcomes of eHealth literacy interventions (education) on older adults’ use of eHealth services and presents them in the form of a figure. 

The findings can support healthcare providers, service designers, developers, and policymakers in creating digital health services that are more accessible and inclusive. 

This research highlights that older adults are not a homogeneous group. Their needs and experiences differ depending on their backgrounds and circumstances. So, older adults should be involved in the design of digital health services from the earliest stages, and appropriate support should be available to help them use these services independently. In addition, the use of eHealth services among older adults should remain voluntary, meaning that they should choose to use these services.

Keywords: eHealth services, Older adults, Natives, Migrants, Human-centered design, User experience, Needs and expectations, Health literacy, Motivation.

Thesis available for public display 7 days prior to the defence at Aalto University's public display page.