Background: Older adults are more likely to experience digital inequalities compared to other groups and tend to have limited digital skills. In a digitalised society, it is important to understand how older adults engage with technology and explore who supports them.

Aim: To explore facilitators and barriers to older adults engaging with communicative e-health services. To explore the differences between internal and external support for older adults learning to use digital technology.

Methods: Mixed qualitative methods were used. The research began with a qualitative synthesis using meta-ethnography, followed by a longitudinal participant observation study involving over 130 hours of contact with 11 participants. This study incorporated two semi-structured interviews at different time points to examine external support services. Next, paired interviews were conducted with eight dyads to explore internal support networks. Finally, the triangulation protocol integrated the findings from the latter two studies, providing a comprehensive understanding of the roles and approaches of different support networks assisting older adults with digital technology.

Qualitative Synthesis Findings: The reviewed studies highlighted multiple barriers older adults faced in adopting communicative e-health services, yet access to support networks appeared to be crucial in overcoming these challenges.

Longitudinal Participant Observation Results: Interpretative phenomenological analysis (IPA) highlighted that participants turned to external services when internal support was lacking, valuing one-to-one, step-by-step guidance with opportunities to practice.

Paired Interview Results: IPA revealed that close family relationships and personalised, step-by-step in-person support were key to positive learning experiences for older adults.

Integration Results: Five key areas were identified in how to best support older adults with digital technology, which align with the wider literature: teaching methods, learning conditions, relational support, motivation and practical strategies.

Conclusion: This PhD offers valuable methodological insights and develops guidance for supporting older adults with digital technology, applicable to individuals, community services and policymakers.