Optimising the provision of health information for older adults across paper and screen formats - A requirement study with content producers and consumers.

The global shift toward digital health communication presents both opportunities and challenges for older adults, whose populations is expanding rapidly. This study explored how older adults and health content producers engage with health information across paper and digital formats, and assessed the potential of hybrid approaches such as augmented paper. Two qualitative studies were conducted in Surrey, UK: focus groups with older adults (n = 9) and interviews with public health professionals (n = 6). Data were analysed through content and thematic analysis to identify user requirements. Findings show that older adults continue to value printed materials for familiarity and reliability, but turn to digital formats for timeliness and convenience. Trust in online content, ease of use, and device compatibility emerged as central concerns shaping engagement. Content producers echoed these challenges, highlighting cost constraints and the need for accessible, multi-format materials. Both stakeholder groups favoured app-free connections between print and digital content, with QR codes preferred for their simplicity, familiarity, and avoidance of app installation. Participants also emphasised the importance of multimodal presentation (e.g., text, video, audio) and options to self-print key materials. While based on a small, UK-specific sample, the study highlights design implications for inclusive health communication. Hybrid solutions that combine print with carefully curated digital resources can reduce barriers linked to trust and usability, and extend access for older adults with varied levels of digital confidence. These insights provide actionable guidance for public health organisations and policymakers seeking to balance cost-effectiveness with accessibility. Broader testing in more diverse populations is recommended to refine these strategies and ensure equitable health communication worldwide. These findings underline the importance of designing hybrid health communication strategies that are not only user-friendly but also equitable, supporting the goals of the WHO Decade of Healthy Ageing by promoting inclusive access to reliable health information for older adults worldwide.