{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:16:54Z","timestamp":1788412614525,"version":"build-2803163510"},"reference-count":46,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Liaoning Provincial Department of Education","award":["JYTZD2023034"],"award-info":[{"award-number":["JYTZD2023034"]}]},{"name":"Liaoning Provincial Federation of Social Sciences","award":["20241s1zdwtkt-27"],"award-info":[{"award-number":["20241s1zdwtkt-27"]}]},{"name":"Dalian Federation of Social Sciences","award":["2025dlskzd068"],"award-info":[{"award-number":["2025dlskzd068"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Sci.","Behavioral Sciences"],"abstract":"<jats:p>As health services shift to digital delivery, older adults face practical online risks, including operational errors, difficulty interpreting clinical information, unclear privacy consent procedures, and telecommunications fraud. Existing empirical work mostly adopts questionnaire and interview designs to document older adults\u2019 real-world digital usage, yet few studies systematically analyze policy documents as an external intervention system and assess how they address four core usage barriers: limited digital proficiency, constrained service access, weak sustained participation, and individualized online safety threats. This paper analyzes 1008 policy records extracted from the Peking University Legal Database covering 2007\u20132025, and develops a four-dimensional analytical framework split into B1 (Digital Capacity and Age-Friendly Support), B2 (Digital Health Management Support), B3 (Home- and Community-Based Care Support), and B4 (Institutional Care and Risk Governance). The analytical toolkit combines a Capability\u2013Opportunity\u2013Motivation\u2013Behavior (COM-B) diagnostic model, an M1\u2013M4 intervention-mechanism coding protocol, Latent Dirichlet Allocation (LDA) topic modeling, and two indices: the Digital Adaptation Policy Orientation Index (DAPOI) and the Behavioral Intervention Diversity Index (BIDI). Coding outputs reveal a pronounced structural imbalance in policy allocation for older adults\u2019 digital health in China: community and institutional governance clauses (B3, B4) dominate the corpus, while person-centred support including one-on-one operational coaching, clinical data interpretation guidance and offline manual backup channels accounts for a marginal share of all coded entries (B1, B2). Age-friendly digital policies issued circa 2020 serve primarily short-term emergency adjustments instead of permanent institutional arrangements. Built on full-text policy coding outputs, this work defines policy-supported digital resilience as a holistic protective system formed by coordinated institutional clauses. Every result reported is sourced exclusively from supply-side policy records, which provides policy-level evidence for subsequent behavioral research on older adults\u2019 digital risk management and digital welfare construction.<\/jats:p>","DOI":"10.3390\/bs16091550","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:08:43Z","timestamp":1788275323000},"page":"1550","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Behavioral Barriers to Digital Health and Conditions of Digital Resilience Among Older Adults: Evidence from China"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6081-8373","authenticated-orcid":false,"given":"Yu","family":"Ren","sequence":"first","affiliation":[{"name":"School of Management, Dalian Polytechnic University, Dalian 116034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihua","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Management, Dalian Polytechnic University, Dalian 116034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan","family":"Li","sequence":"additional","affiliation":[{"name":"School of Management, Dalian Polytechnic University, Dalian 116034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bertolazzi, A., Quaglia, V., and Bongelli, R. (2024). Barriers and facilitators to health technology adoption by older adults with chronic diseases: An integrative systematic review. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-18036-5"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bevilacqua, R., Strano, S., Di Rosa, M., Giammarchi, C., Cerna, K. K., Mueller, C., and Maranesi, E. (2021). eHealth literacy: From theory to clinical application for digital health improvement. Results from the ACCESS training experience. International Journal of Environmental Research and Public Health, 18.","DOI":"10.3390\/ijerph182211800"},{"key":"ref_3","first-page":"993","article-title":"Latent Dirichlet allocation","volume":"3","author":"Blei","year":"2003","journal-title":"Journal of Machine Learning Research"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e52457","DOI":"10.2196\/52457","article-title":"Electronic health literacy Scale-Web3.0 for older adults with noncommunicable diseases: Validation study","volume":"26","author":"Cai","year":"2024","journal-title":"Journal of Medical Internet Research"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e60483","DOI":"10.2196\/60483","article-title":"Engagement with digital health technologies among older people living in socially deprived areas: Qualitative study of influencing factors","volume":"8","author":"Chadwick","year":"2024","journal-title":"JMIR Formative Research"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1017\/S0140525X22002023","article-title":"The i-frame and the s-frame: How focusing on individual-level solutions has led behavioral public policy astray","volume":"46","author":"Chater","year":"2023","journal-title":"Behavioral and Brain Sciences"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e57301","DOI":"10.2196\/57301","article-title":"Relationship between internet use and cognitive function among middle-aged and older Chinese adults: 5-year longitudinal study","volume":"26","author":"Chen","year":"2024","journal-title":"Journal of Medical Internet Research"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1177\/07334648211073605","article-title":"Urban\/rural digital divide exists in older adults: Does it vary by racial\/ethnic groups?","volume":"41","author":"Choi","year":"2022","journal-title":"Journal of Applied Gerontology"},{"key":"ref_9","first-page":"102","article-title":"Organizational integration logic in the transformation of grassroots digital governance effects: On the relationship between organization and technology","volume":"23","author":"Dai","year":"2026","journal-title":"Journal of Public Management"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e52498","DOI":"10.2196\/52498","article-title":"Technology acceptance among low-income Asian American older adults: Cross-sectional survey analysis","volume":"26","author":"Tancredi","year":"2024","journal-title":"Journal of Medical Internet Research"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e48166","DOI":"10.2196\/48166","article-title":"Effectiveness of digital health literacy interventions in older adults: Single-arm meta-analysis","volume":"25","author":"Dong","year":"2023","journal-title":"Journal of Medical Internet Research"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"105124","DOI":"10.1016\/j.ijmedinf.2023.105124","article-title":"Sociodemographic determinants of digital health literacy: A systematic review and meta-analysis","volume":"177","author":"Estrela","year":"2023","journal-title":"International Journal of Medical Informatics"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1177\/07334648241296791","article-title":"Virtual healthcare for older adults with preventable chronic conditions: A meta-synthesis of quality aspects","volume":"44","author":"Hamiduzzaman","year":"2025","journal-title":"Journal of Applied Gerontology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"ooae068","DOI":"10.1093\/jamiaopen\/ooae068","article-title":"Barriers and facilitators to the uptake of electronic collection and use of patient-reported measures in routine care of older adults: A systematic review with qualitative evidence synthesis","volume":"7","author":"Bai","year":"2024","journal-title":"JAMIA Open"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e72274","DOI":"10.2196\/72274","article-title":"eHealth and the digital divide among older Canadians: Insights from a national cross-sectional study","volume":"27","author":"Jaana","year":"2025","journal-title":"Journal of Medical Internet Research"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s13690-024-01428-9","article-title":"The level of electronic health literacy among older adults: A systematic review and meta-analysis","volume":"82","author":"Jiang","year":"2024","journal-title":"Archives of Public Health"},{"key":"ref_17","first-page":"31","article-title":"Short Video APP use and the life of mid-age and older adults: An exploratory study based on a social survey","volume":"45","author":"Jin","year":"2021","journal-title":"Population Research"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"K\u00e4rn\u00e4, E., Aavikko, L., Rohner, R., Gallistl, V., Pihlainen, K., M\u00fcller, C., Ehlers, A., Bevilacqua, R., Strano, S., Maranesi, E., Cerna, K., Hengl, L., Kolland, F., Waldenberger, F., Naegele, G., Park, S., Hess, M., Reuter, V., Frewer-Graumann, S., and Korjonen-Kuusipuro, K. (2022). A multilevel model of older adults\u2019 appropriation of ICT and acquisition of digital literacy. International Journal of Environmental Research and Public Health, 19.","DOI":"10.3390\/ijerph192315714"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e40778","DOI":"10.2196\/40778","article-title":"The relation between eHealth literacy and health-related behaviors: Systematic review and meta-analysis","volume":"25","author":"Kim","year":"2023","journal-title":"Journal of Medical Internet Research"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e65492","DOI":"10.2196\/65492","article-title":"Measuring digital health literacy in older adults: Development and validation study","volume":"27","author":"Kim","year":"2025","journal-title":"Journal of Medical Internet Research"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e59168","DOI":"10.2196\/59168","article-title":"Understanding older adults\u2019 experiences with a digital health platform in general practice: Qualitative interview study","volume":"7","author":"Knotnerus","year":"2024","journal-title":"JMIR Aging"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Koulouvari, A.-D., Margariti, A., Sakellari, E., Barbouni, A., and Lagiou, A. (2025). Applications of behavioral change theories and models in health promotion interventions: A rapid review. Behavioral Sciences, 15.","DOI":"10.3390\/bs15050580"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e46151","DOI":"10.2196\/46151","article-title":"Usability and utility of a mobile app to deliver health-related content to an older adult population","volume":"8","author":"Lemos","year":"2024","journal-title":"JMIR Formative Research"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e58641","DOI":"10.2196\/58641","article-title":"Older adults\u2019 perspectives and experiences with digital health in Singapore: Qualitative study","volume":"11","author":"Leong","year":"2024","journal-title":"JMIR Human Factors"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e59684","DOI":"10.2196\/59684","article-title":"The digital divide and cognitive disparities among older adults: Community-based cohort study in China","volume":"26","author":"Li","year":"2024","journal-title":"Journal of Medical Internet Research"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e12626","DOI":"10.1111\/jjns.12626","article-title":"Barriers and facilitators to bridging the healthcare digital divide for the older adults: A qualitative research from patients in China","volume":"21","author":"Liu","year":"2024","journal-title":"Japan Journal of Nursing Science"},{"key":"ref_27","first-page":"17","article-title":"Analysis framework, concept, and pathways of digital divide governance for older adults: From the perspective of digital divide and knowledge gap theory","volume":"45","author":"Lu","year":"2021","journal-title":"Population Research"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5311","DOI":"10.1007\/s11229-021-03026-6","article-title":"Knowledge, behaviour, and policy: Questioning the epistemic presuppositions of applying behavioural science in public policymaking","volume":"199","year":"2021","journal-title":"Synthese"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: A new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","year":"2011","journal-title":"Implementation Science"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e46522","DOI":"10.2196\/46522","article-title":"Barriers to and facilitators of older people\u2019s engagement with web-based services: Qualitative study of adults aged >75 years","volume":"7","author":"Money","year":"2024","journal-title":"JMIR Aging"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e56653","DOI":"10.2196\/56653","article-title":"Smartphone app designed to collect health information in older adults: Usability study","volume":"11","author":"Murabito","year":"2024","journal-title":"JMIR Human Factors"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e26145","DOI":"10.2196\/26145","article-title":"Measurement of digital literacy among older adults: Systematic review","volume":"23","author":"Oh","year":"2021","journal-title":"Journal of Medical Internet Research"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e48526","DOI":"10.2196\/48526","article-title":"User perception of smart home surveillance among adults aged 50 years and older: Scoping review","volume":"12","author":"Buchan","year":"2024","journal-title":"JMIR mHealth and uHealth"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Pinheiro, J. K. S., Maximiano-Barreto, M. A., Orlandi, F. S., and Bas-Sarmiento, P. (2026). Health literacy training for older adults: A systematic review with meta-analysis. BMC Geriatrics, 26.","DOI":"10.1186\/s12877-026-07402-0"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e65541","DOI":"10.2196\/65541","article-title":"The effects of the COVID-19 pandemic on age-based disparities in digital health technology use: Secondary analysis of the 2017\u20132022 health information national trends survey","volume":"26","author":"Qiu","year":"2024","journal-title":"Journal of Medical Internet Research"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Sardareh, M., Matlabi, H., Shafiee-Kandjani, A. R., Bahreini, R., Mohammaddokht, S., and Azami-Aghdash, S. (2024). Interventions for improving health literacy among older people: A systematic review. BMC Geriatrics, 24.","DOI":"10.1186\/s12877-024-05522-z"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1093\/jamia\/ocab096","article-title":"Benefits, challenges, and contributors to success for national eHealth systems implementation: A scoping review","volume":"28","author":"Scheibner","year":"2021","journal-title":"Journal of the American Medical Informatics Association"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Schirmer, M., Dalko, K., Stoevesandt, D., Paulicke, D., and Jahn, P. (2023). Educational concepts of digital competence development for older adults: A scoping review. International Journal of Environmental Research and Public Health, 20.","DOI":"10.3390\/ijerph20136269"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1038\/163688a0","article-title":"Measurement of diversity","volume":"163","author":"Simpson","year":"1949","journal-title":"Nature"},{"key":"ref_40","unstructured":"Thaler, R. H., and Sunstein, C. R. (2008). Nudge: Improving decisions about health, wealth, and happiness, Yale University Press."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Tsai, Y. I. P., Beh, J., Ganderton, C., and Pranata, A. (2024). Digital interventions for healthy ageing and cognitive health in older adults: A systematic review of mixed method studies and meta-analysis. BMC Geriatrics, 24.","DOI":"10.1186\/s12877-023-04617-3"},{"key":"ref_42","first-page":"90","article-title":"Social design orientation in the application of digital governance technologies: A case study of Xiamen\u2019s \u201cBaixing\u201d App","volume":"23","author":"Wei","year":"2026","journal-title":"Journal of Public Management"},{"key":"ref_43","unstructured":"World Health Organization (2020). Decade of healthy ageing: Baseline report, World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240017900."},{"key":"ref_44","unstructured":"World Health Organization (2021). Global strategy on digital health 2020\u20132025, World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240020924."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Xie, L., and Mo, P. K. H. (2023). Comparison of eHealth literacy scale and digital health literacy instrument in assessing electronic health literacy in Chinese older adults. International Journal of Environmental Research and Public Health, 20.","DOI":"10.3390\/ijerph20043293"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"106997","DOI":"10.1016\/j.ypmed.2022.106997","article-title":"Electronic health literacy and health-related outcomes among older adults: A systematic review","volume":"157","author":"Xie","year":"2022","journal-title":"Preventive Medicine"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/9\/1550\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:40:59Z","timestamp":1788410459000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/9\/1550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":46,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["bs16091550"],"URL":"https:\/\/doi.org\/10.3390\/bs16091550","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}