Supplementary Material for: Exploring Smartphone App use in older adults with a chronic respiratory disease: ‘The biggest problem I have is I don't understand my phone at all.’

Introduction: In older people with a chronic respiratory disease, we explored; (i) usual Smartphone Application (App) use, (ii) the time taken to download and use an App and (iii) changes in self-efficacy for downloading an App after a single practice session. Methods: Participants were invited to attend one or two separate assessment sessions (Part A and B). Those who attended Part A had data pertaining to their App usage over the previous week extracted from their Smartphone. Those who attended Part B were asked to download and use a pedometer App and ‘think out loud’ during the task. Before and after the task, participants rated their self-efficacy for downloading an App using a Visual Analogue Scale (0-10). Results: Twenty-seven participants (mean±SD 74±5 years) completed Part A. Commonly used Apps related to communication (e.g. texting; median [interquartile range] 15 [9 to 25] min/day) and interest (e.g. news; 14 [4 to 50] min/day). Fifteen participants completed Part B (mean±SD 73±7 years). The median time taken to download and use the App was 24 [22 to 37] min. The ‘think out loud’ data converged into four domains: (i) low self-efficacy for using and learning Apps; (ii) reliance on others for help; (iii) unpleasant emotional responses and (iv) challenges due to changes associated with longevity. Self-efficacy increased by 4 (95% CI 3 to 6). Conclusion: This population used Apps mainly to facilitate social connection. It took participants almost half an hour to download and use an App, but a single practice session improved self-efficacy.