Table 2.

Overview of findings

Factor	Category	Barrier	Facilitator
Individual	Intrinsic	Ageing limitations: reduction of hearing, sight, memory, and fine motor control [34, 36–39]. Perceived self-efficacy [35, 38, 40, 41]. Lacking confidence in e-health [42]. Fear and dislike of technology [37]. No interest in learning [37, 42].	Desire to learn [34, 36–38, 41]. Motivation to make a lifestyle change [19, 43]. Altruism: wanting to contribute to scientific progress [19, 41, 43].
	Extrinsic	Lack of experience/skills with e-health [35, 37] or technology [36, 38, 41]. Lack of knowledge of e-health [34, 35]. Previous negative experience [40]. Unmet expectations [37]. Lack of need to change [34, 36, 37, 39]. Fear that traditional services my perish [37]. Disbelief in efficacy of e-health [37, 39, 42]. Lack of external accountability [44, 45]. Inability to incorporate into routine [44]. Required effort [35, 38]. Cultural limitations such as language barriers and e-health detracting from time with family [38].	Belief that e-health services are of benefit [19, 34, 37, 40]. Convenience of e-health [45]. Ability to incorporate into current routine [40, 44, 46]. Previous experience and skills [19, 35, 36, 40]. Previous experience with e-health and required skills [19, 35, 36, 40]. Positive experience with technology generally [37]. Opportunity to learn new information [43].
Technological	Functional	Small screen and text [44]. Small icons, lack of colour contrast [36]. Complex functionality [42]. Poor functionality [35, 37, 41].	Ease of use such as audio feedback, and large and clear visual display [35, 36, 40, 41].
	Content	Lack of alerts [41]. Alert fatigue: reminders/emails/texts [46]. Condescending and impersonalized communication, inability to respond to reminders [46]. Overwhelming and difficult to understand content [35, 38]. Too much content on one page [44]	Personalized content [37, 44–46]. Use of reminders/alerts [41, 44, 46]. Use of images [46].
	Availability	Lack of access to electronic equipment [38] Cost of electronic equipment and internet service [34, 36].	Free or low-cost electronic equipment [36].
Relational	Technological Support	No training/support to learn [36, 38]. No one to help troubleshoot issues [41]. Reliance on family for guidance, and lack of family’s patience and understanding while learning [38].	Training/support to learn [36–39, 41]. Dedicated coach for training and continued support [41]. Peer-to-peer platform to share experiences [44]. Option for family/carer to provide support [34].
	Social Support	Lack of social interaction [37, 45]. Absence of interpersonal communication [35]. Communication through technology considered an ‘inauthentic experience’ [35].	Socially inclusive and community-based information [38].
Environmental	Location	Poor/unreliable internet [45].	Availability to rural/remote populations [45].
Organizational	Privacy	Health information concerns [35, 42, 46].
	Trust	Unknown accuracy of information [37, 38, 42]. Not knowing who people are communicating with [35]. Concern over management of emergency situations [37]. Concern over Western Medicine’s prioritization of medication [38].	Recommandation from physician [36, 43]. Content designed by experts in the field [45]. Access to specialists through platform [34]. Authenticity: platform with clear credentials [35].
	Data sharing	Lack of communication between health platforms [37].	Sharing of health information between health care providers [39, 44, 46].

Note. Individual = persons’ individual attributes including physicality, cognition, experience, skills, and knowledge; technological = the use of the technology, including device functionality, content, and availability; relational = person-to-person engagement and support; environmental = location context and characteristics; organizational = structure, capabilities, and development of the service