From Social Capital to Health Services: Examining Attitude-Mediated Digital Health Adoption Among Hong Kong Older Adults

As healthcare systems increasingly integrate digitaltechnologies, understanding factors influencing older adults’ digital healthadoption becomes essential for ensuring equitable access. This study examinesthe relationships among online informal social capital, perceived usefulness,technology attitudes, and health service utilization among Hong Kong olderadults. Drawing on the Technology Acceptance Model and social capital theory,we developed a comprehensive framework to understand digital health adoptionpathways. A quantitative telephone survey was conducted with 802 participantsaged 55 and above across Hong Kong from July to August 2024. Partial LeastSquares Structural Equation Modeling (PLS-SEM) analyzed the complexrelationships among variables. Results revealed that online informal socialcapital significantly enhances perceived usefulness (β = 0.246, p < .001).Perceived usefulness strongly influences positive attitudes (β = 0.450, p <.001) and reduces negative attitudes (β = -0.348, p < .001). Critically,perceived usefulness does not directly affect health service utilization,challenging traditional Technology Acceptance Model assumptions. Instead, bothpositive attitudes (β = 0.145, p < .01) and negative attitudes (β = -0.125,p < .05) serve as complete mediators between perceived usefulness and actualservice adoption. These findings highlight that recognizing technology’sbenefits alone is insufficient for older adults’ adoption; emotional acceptancethrough positive attitudes is essential. The study contributes to technologyacceptance literature by demonstrating attitude-mediated pathways and providespractical insights for developing age-friendly digital health interventions.Recommendations include leveraging family and community networks as “techambassadors” and implementing programs that foster positive technologyattitudes rather than solely emphasizing functional benefits.