Table 2.

Potential strategies to increase airway-specific mHealth use in older adults.

Main qualitative findings	Strategies to leverage or overcome findingsa
Limited awareness of full mHealth options	Outreach from health care practitioners and institutions should inform older adults of validated and safe mHealth options (eg, web-based catalogues, educational materials, recruiting local opinion leaders and champions, academic partnerships)
Use of mHealth principally confined to preinstalled smartphone or tablet apps	Develop mHealth interventions that leverage mobile technology already being used by older adults (eg, spirometry from smartphone microphones [38]) to enhance uptake and adherence
Minimal concern for privacy of health data with mHealth use	Ensuring data security and privacy of mHealth are essential, but focusing on these details may not strongly encourage older adults use (compared to younger adults, among whom privacy concerns are more frequently raised [20,39])
Appreciated convenience and accessibility of mHealth	Convenience, accessibility, and portability of mHealth should be emphasized for older adults through patient outreach, training, and educational materials
Use of mHealth primarily for self-monitoring purposes	Self-monitoring capabilities of mHealth should be emphasized for older adults (adapting implementation to older adults needs or preferences)
No use of mHealth for self-management purposes (ie, action plans, inhaler adherence, environmental controls)	If the patient has a low level of self-management, explore barriers and propose mHealth as a potential solution if appropriate (engaging patients as active participants)
Facilitation of active and informed participation in care with mHealth	Explore desire for more active and informed involvement in care and propose mHealth as a means of patient empowerment
Perception of mHealth as useful only for managing active respiratory disease	Patient education addressing illness perception should be provided, particularly among older adults where health literacy level is lower [14,36]
Resistance to changing established health care routines or habits with mHealth and learning new technology	If possible, introduce mHealth solutions early after disease diagnosis Tailor implementation to older adults by providing older adults with clear information about the expected benefits of changing current habits with mHealth if appropriate [40] Training and educational resources specifically designed to facilitate mHealth use among older adults
Concern that mHealth would replace in-person visits	Focus on mHealth solutions that are designed to enhance and not replace in-person care for older adults [33] (tailoring implementation) Emphasize that in-person care options are always available when using mHealth
Fear and anxiety of constant reminders of poor health with mHealth or of misusing mobile technology	Facilitate structured and ongoing training opportunities for older adults to practice with mHealth interventions and troubleshoot usability barriers [40] Provide clear guidance around appropriate monitoring frequency and how to respond to and interpret mHealth data generated (and how or when to relay data to providers)
Reluctant to engage with mHealth if not recommended from a trusted health care source	Health care practitioners should discuss validated mHealth options with older adults Promotion of objective and transparent criteria for mHealth evaluation (eg, validated checklists) Professional respiratory societies and patient groups should provide guidance around safe and validated mHealth options, with specific outreach targeted to older adults

^aIt is important to recognize that some older adults may not want to incorporate mHealth into their care routines. In these cases, care gaps should be approached in line with patient preferences.