Older Adults' Reasons for Participating in an eHealth Prevention Trial: A Cross-Country, Mixed-Methods Comparison

J Am Med Dir Assoc. 2019 Jul;20(7):843-849.e5. doi: 10.1016/j.jamda.2018.10.019. Epub 2018 Dec 9.


Objectives: To explore older adults' reasons for participating in a multinational eHealth prevention trial, and compare motivations between countries.

Design: Cross-sectional mixed methods research using quantitative and qualitative approaches (the ACCEPT-HATICE study).

Setting and participants: Substudy conducted during the recruitment phase of an 18-month RCT testing the efficacy of an eHealth intervention for self-management of risk factors for cardiovascular disease (CVD) and cognitive decline in older adults in Finland, France, and the Netherlands. Participants were 343 dementia-free community dwellers aged 65+ with basic computer literacy and either ≥2 cardiovascular risk factors or a history of CVD/diabetes.

Measures: Online questionnaire (quantitative data) and semistructured interviews (qualitative data).

Results: Contributing to scientific progress, wanting to improve one's lifestyle, and benefiting from additional medical monitoring were the predominant reasons for participating. Altruistic reasons were particularly relevant among the French, whereas Finnish and Dutch participants mainly emphasized the benefits of lifestyle changes and regular medical checkups. During interviews, preventing functional dependency emerged as a key underlying motivation. Although some trial design features influenced the decision to participate, the use of an eHealth intervention was not an important motivator in this population.

Conclusions/implications: Altruism and personal benefits motivated older adults to participate in the trial; emphasizing such aspects could facilitate recruitment in future RCTs. Additional medical monitoring may be particularly appealing when access to public health care is considered limited. Furthermore, maintaining autonomy and preventing functional dependency emerged as a key concern in this population of young older adults.

Keywords: Patient recruitment; autonomy; motivation; randomized controlled trial; telemedicine.

MeSH terms

  • Aged
  • Altruism
  • Attitude to Health*
  • Cardiovascular Diseases / prevention & control
  • Cognitive Dysfunction / prevention & control
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Motivation*
  • Randomized Controlled Trials as Topic*
  • Research Subjects*
  • Risk Factors
  • Self-Management
  • Telemedicine