Staying engaged: a scoping review of psychological and motivational drivers of adherence to technology-supported physical activity in older adults.

BACKGROUND: As populations age, maintaining physical activity (PA) is essential to reduce chronic disease risk and preserve functional independence in older adults. Technology-supported interventions, such as wearables, mobile applications, and web-based platforms, have emerged as effective tools to promote PA. However, engagement with technology alone is not sufficient. Effectiveness depends on whether digital tools foster sustained adherence to prescribed PA, since health benefits are dose-dependent on activity levels. In this sense, adherence matters not just for short-term participation but for embedding long-term behaviour change, an especially pressing challenge for older adults, who are typically less active and may experience greater barriers to digital engagement. This scoping review aimed to identify psychological and motivational factors that influence adherence to both the physical activity component and the supporting technology. METHODS: A systematic search was conducted across three databases (PubMed, Web of Science, Scopus) for studies published between 2000 and March 2023. Fifty-three studies were included, encompassing qualitative, quantitative, and mixed-methods designs. Behaviour Change Techniques (BCTs) were identified and categorised using the BCT Taxonomy v1, distinguishing between techniques delivered via technology and those delivered through human interaction. Data were synthesised, distinguishing between adherence to physical activity and adherence to technology use. RESULTS: Frequently used BCTs included self-monitoring, goal setting, action planning, feedback, prompts/cues, and social support, with different techniques emphasised in digital versus human-facilitated delivery modes. From the qualitative data, 417 psychological and motivational factors were identified and grouped into 25 thematic categories. These were structured into five domains: (1) user factors related to technology adherence, (2) technology-related factors influencing technology adherence, (3) context factors related to technology adherence, (4) user factors related to PA adherence, and (5) context factors related to PA adherence. Key facilitators included ease of use, personalised content, motivational feedback, and social support, while key barriers included low digital literacy, repetitive content, and lack of guidance. Quantitative findings revealed 19 associations between psychological/motivational variables and adherence outcomes, of which 12 were statistically significant. CONCLUSIONS: This review provides a comprehensive overview supporting the understanding of what determines adherence in technology-supported PA interventions for older adults from a psychological and motivational perspective. By differentiating between technology adherence and PA adherence, and considering the BCTs that are incorporated in the interventions, our findings offer actionable guidance for researchers and developers to design more inclusive, motivating, and sustainable interventions that promote active ageing.