Li XiaoYu ¹ Jun Li ^2* NingLi Zhu ^1* Lei Luo ^1* Siyu Zhang ¹ WenWen Cheng ¹ JiaXue Li ^1* Chen Yu ^1* SongHe Lu ^3* Liang Zhu ^1*

• ¹ School of Preventive Medicine, The Fourth Military Medical University, 西安市, China
• ² Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
• ³ Scientific Research Department, The Fourth Military Medical University, Xi'an, China

Background: Population aging is occurring at an unprecedented pace, rendering “healthy aging” a critical issue of global importance. China is at the forefront of this demographic transformation and faces substantial challenges, especially in its western rural regions. In this context, smart health technology, propelled by advancements in medical care and information technology, emerges as a vital strategy to address the challenges associated with aging. Despite smart technologies’ promising potential, the cognitive and behavioral intentions of older adults living in underdeveloped areas remain poorly understood. Results: The survey results indicate significant progress in promoting smart health initiatives within the rural areas of western China. While the older adult population demonstrates a basic understanding of smart health, particularly concerning wearable devices such as blood pressure monitors and oximeters, this understanding also underscores the urgent need for improved health management and enhanced quality of life among rural older adults. As their comprehension of smart health deepens, a majority of older respondents recognize its potential to benefit personal health management, fulfill their daily needs, and highlight its importance for rural development. In terms of cognitive pathways toward adopting smart health, older individuals prefer recommendations from their children or spouses, as well as guidance from healthcare professionals such as doctors or nurses. Overall, older residents in rural western China exhibited a strong willingness to embrace smart health practices. After experiencing smart health technology, they were inclined to adopt it as their primary method of health management and recommend it to others, thereby presenting promising prospects for future smart health promotion in underdeveloped regions. Conclusion: Smart health has immense potential to enhance the quality of life of older adults, driven by a genuine and pressing demand expressed by rural older adults and a strong behavioral intention toward adoption. Despite facing challenges, such as limited cognitive diversity in smart health, economic constraints, technical usability barriers, and lack of social and familial support, future initiatives must prioritize the actual needs of older adults in rural areas.