Analytical Investigation of Factors Influencing Mobile Health Application Adoption Among Elderly Users in Anambra State, South East Nigeria

Mobile health applications offer significant potential for extending healthcare access to elderly populations, yet adoption among older Nigerians is constrained by usability, literacy, and trust barriers that general adoption models do not adequately capture. This study analytically investigates the factors influencing mobile health application adoption among elderly users aged 60 and above in Anambra State, South East Nigeria. A cross-sectional analytical survey was applied to 280 elderly participants from community health centres and senior citizens' associations in Awka and Onitsha, selected through purposive sampling. A research model extending the UTAUT2 with elder-specific constructs including health anxiety motivation, cognitive age, and family technology influence was developed and tested. Structural equation modelling in AMOS examined path relationships between performance expectancy, effort expectancy, social influence, facilitating conditions, health motivation, hedonic motivation, cognitive age, and adoption intention. Available mHealth adoption literature from South East Nigeria identifies caregiver facilitation and perceived ease of symptom tracking as the strongest adoption drivers among elderly users, while privacy concerns and health data security fears are significant inhibitors. The Technology Acceptance Model for Seniors and Social Cognitive Theory provide additional theoretical grounding. Findings confirm that health motivation and social influence through family members are the two strongest predictors, while cognitive age significantly moderates the effort expectancy-adoption relationship. Recommendations address elder-specific mHealth interface design standards and caregiver technology facilitation training. Keywords: mobile health application, elderly adoption, UTAUT2, Anambra State, South East Nigeria.