Design features of interfaces and acceptance of ePHR among elderly individuals in China: Insights from an expanded UTAUT framework

Objective: This study aims to investigate the factors influencing the adoption of electronic Personal Health Records (ePHR) among China's aging "new silver" generation, with a focus on understanding how user interface (UI) design affects older users' adoption intentions. Methods: An extended Unified Theory of Acceptance and Use of Technology (UTAUT) model, incorporating elements from the Technology Acceptance Model (TAM), was used as the analytical framework. The model also includes seven key UI design characteristics. A total of 420 valid responses were collected through online questionnaires and snowball sampling. Structural equation modeling (SEM) was applied to analyze the data. Results: The analysis revealed that behavioral intention (BI) to adopt ePHR was most strongly influenced by perceived ease of use (PEOU; β = 0.218, p = 0.002). Performance expectancy, effort expectancy, perceived usefulness (PU), and self-efficacy were also found to be significant predictors. Among the UI design features, platform features (E1) significantly impacted PEOU, PU, and BI. Additionally, font clarity (E2), color and icon features (E3), operational cognition (E5), and feedback perception (E4) all had significant positive effects on PU, PEOU, and BI. Information retrieval features (E6) influenced PU and PEOU, but had a minor impact on BI. Conclusion: The findings highlight the relevance of the UTAUT model in the context of digital health adoption among older users, emphasizing the importance of user interface design in shaping adoption intentions. The study underscores the need for tailoring ePHR systems to meet the specific needs of older individuals and provides practical recommendations for improving inclusive digital health solutions.