Internet use patterns among older adults with different frailty statuses: a qualitative user persona study from a health equity perspective

ObjectiveThis study aimed to explore patterns of internet use and related influencing factors among older adults with varying frailty statuses from a health equity perspective by constructing user personas, thereby providing a basis for developing targeted digital inclusion strategies.MethodsA descriptive qualitative design was employed. From October to December 2025, 24 older adults with internet-use experience were recruited from one community hospital and one tertiary hospital in Chongqing, China, using purposive sampling combined with a maximum variation strategy. Frailty status was assessed using the Frailty Index, and data were collected through face-to-face semi-structured interviews. Data were analyzed using inductive content analysis. Individualized multidimensional profiles were constructed for each participant and subsequently compared across cases to develop user personas. The three-level digital divide framework was then applied as an interpretive lens to compare the identified personas.ResultsFour core dimensions were identified: health status and self-management, digital participation foundation and capability, internet-use orientation and behavioral patterns, and constraints and enabling conditions. Based on these dimensions, five user personas were developed: Health-Empowered Integrators, Basic-Function Adapters, Entertainment-Oriented Users, Resource-Limited Users, and Health-Affected Users. The personas differed in internet access, digital capability and actual patterns of use, and opportunities to translate digital participation into health-related resources and potential benefits. Frailty was an important health-related context influencing digital participation, but it did not correspond directly to patterns of internet use. Instead, health-related functional limitations, digital capability, educational and learning resources, and social support jointly contributed to different patterns of digital participation.ConclusionInternet use among older adults is heterogeneous. Patterns of digital participation are not determined by frailty severity alone but are jointly influenced by health, capability, and resource-related conditions. Providing targeted support according to the characteristics of different user personas may help promote more equitable digital participation and access to health-related digital resources among older adults.