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Tools that can help older adults self-manage multiple health goals in collaboration with their care managers are rare to find. Informed by the Self-Determination Theory, Goal-Oriented Care paradigm and our prior findings, we used an iterative, user-centered process to design a tablet application to facilitate Goal-Oriented care in community-dwelling low income older adults with chronic (multi)morbidity. A formative in-situ evaluation was conducted in which 20 participants used the app to set and track health and wellness goals for 24 weeks, while participants' interactions with the app were logged. At the end of the study, semi-structured interviews were administered to understand how the app was used. Thirteen participants used the app throughout the study, while the remaining abandoned after short usage. Thematic analysis of the qualitative feedback shows that participants who used the app increased their commitment towards their goals and adopted healthy behaviors. Health issues, time constraints, lack of technical know-how and doubts about goal-setting paradigm were identified as primary reasons for low app usage and abandonment. Tools for Goal-Oriented care should support personalized goal exploration, build trust in the care paradigm, support collaboration, design for motivation, lower barriers to tracking and support re-engagement after abandonment. Carefully designed mobile apps have the potential to support Goal-Oriented care for older adults.
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