ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1673340
This article is part of the Research TopicDesigning for Engagement in Digital Health for Chronic and Long-Term CareView all 12 articles
Exploring Behavioral Factors and Emotional Mechanisms Underlying Elderly Users' Adoption of Smart Health Services: Evidence from PLS-SEM and FsQCA
Provisionally accepted
Mingxi Sun*
Zhifeng Zhao*- Suzhou University, Suzhou, China
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Introduction: In a population aging society, home-based elderly care as the primary model have experienced a robust growth in demand for Smart Health Services (SHS), reflecting an active response to evolving elderly care needs. However, elderly users' adoption rates are constrained by the interplay of technological and emotional factors, with the underlying mechanisms remain unclear. Methods: To address this concern, this study integrates the Technology Acceptance Model (TAM) and Emotional Durable Design (EDD) theory to uncover the behavioral factors and emotional driving mechanisms behind elderly users' adoption of SHS. A total of 244 valid questionnaires from elderly users were collected. Partial Least Squares Structural Equation Modeling (PLS-SEM) was employed to analyze the net effects of variables, combined with fuzzy-set Qualitative Comparative Analysis (fsQCA) to identify configurational paths. Results and discussion: The results show that perceived ease of use, perceived usefulness, and perceived emotion directly and positively influence behavioral intention. Mental interaction, self-actualization, and dynamic adaptation in emotional durable design exert indirect effects on behavioral intention through internalization processes. fsQCA identified 7 configurational paths leading to high behavioral intention, confirming the combined effects of "technology-emotion" factors, with no single factor constituting a necessary condition. This study contributes to expanding the emotional explanatory dimension of TAM, providing a theoretical foundation and practical guidelines for the human-centered design and promotion of SHS.
Keywords: Emotionally durable design, TAM, Smart health services, PLS-SEM, fsQCA
Received: 28 Jul 2025; Accepted: 05 Sep 2025.
Copyright: © 2025 Sun and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Mingxi Sun, Suzhou University, Suzhou, China
Zhifeng Zhao, Suzhou University, Suzhou, China
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