Modifying UTAUT2 for a cross-country comparison of telemedicine adoption

Exploring the factors influencing the adoption of online medical services by older adults: a modified UTAUT2 based study

Objective

The adoption rate of online medical services (OMS) among older adults remains notably low. Existing literature on OMS has rarely focused on older adults and the influences of individual characteristics within this population remain underexplored. To explore the factors influencing the adoption of OMS by older adults in China, this study proposes a modified Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model by integrating technology anxiety, trust, and perceived risk and adding new moderating variables such as education level and health status.

Method

Data was collected through a face-to-face survey, which included 379 valid questionnaires. Structural equation modeling (SEM) was used to analyze the data and test the research hypotheses.

Results

For older adults, performance expectancy (β = 0.375, p < 0.001), effort expectancy (β = 0.244, p < 0.01), social influence (β = 0.198, p < 0.01), and trust (β = 0.237, p < 0.01) positively influence the usage intention of OMS, whereas technological anxiety (β = -0.129, p < 0.01) and perceived risk (β = -0.296, p < 0.001) negatively influenced the usage intention of OMS. No significant influence of facilitating conditions (β = 0.057, p = 0.293) or price value (β = 0.035, p = 0.721) on usage intention was found in this study. Meanwhile, the age, education level, and health status of the participants were found to moderate the effects of some major constructs on usage intention significantly.

Discussion

Our empirical research discovers the drivers and barriers influencing the adoption of OMS by older adults. Based on the findings, we provide some recommendations to promote the adoption of OMS among older adults. Our findings and recommendations can aid providers, developers, policymakers, market practitioners, and managers of OMS in developing better services and strategies to successfully implement OMS among the older population.

Catenation between mHealth application advertisements and cardiovascular diseases: moderation of artificial intelligence (AI)-enabled internet of things, digital divide, and individual trust

BACKGROUND

World Health Organization (WHO) identified noncommunicable diseases as the foremost risk to public health globally and the cause of approximately 80% of premature deaths. However, Cardiovascular diseases account for most of these premature deaths and established threats to public health. Recently, digitization of health consultancy services through mHealth (e.g., mobile applications) using artificial intelligence (AI)-enabled Internet of Things has notably facilitated the accessibility of expert advice and continuous monitoring of Cardiac health on public health matters, making it more convenient for adoption in recent times. Nonetheless, scant attention has been paid to how digital media might encourage the adoption of digitally based health consulting services while accounting for the current IoT, Digital Divide, and Individual Trust conditions. Given this status quo, this study contributes to the body of literature by delving into an unexplored evaluation of the role digital media advertising plays in outlining the characteristics and effectiveness of AI-enabled IoT mHealth.

METHOD

The study used a cross-sectional online survey to collect data from 495 middle-aged adults.

RESULTS

The findings showed that social influence, performance expectation, effort expectancy, and facilitating conditions are critical factors in predicting intention to use mobile health applications. While the advertisements of mobile health are effective in ingraining the perception of their better performance regarding evading cardiovascular diseases added with the Internet of Things is an effective tool in adopting mobile health applications.

CONCLUSION

The utilization of digital media to promote emerging elements like the AI-enabled Internet of Things in health consulting to counter noncommunicable diseases, e.g., cardiovascular disease, has not yet been thoroughly explored. Consequently, the effectiveness of these communication features promotion among middle-aged adults remains largely uncharted. This research examines how middle-aged adults respond to advertisements showcasing the AI-enabled Internet of Things in digital media. Drawing an analogy with a UTAUT-3 theory, this research investigates how digital media advertisement can effectively promote recently integrated AI-enabled Internet of Things mHealth consultation services. Remarkably, findings identified that trust in AI-enabled IoTs-based mHealth applications remained insignificant. However, the digital divide resulting from low digital literacy in the Global South, especially Pakistan, is the primary obstacle to adopting mHealth apps for digital health services. This study suggests organizations such as WHO, mHealth apps, and telemedicine service providers employ health messaging and instructional advertising to educate the public.

Patient Adoption of Digital Use Cases in Family Medicine and a Nuanced Implementation Approach for Family Doctors: Quantitative Web-Based Survey Study

BACKGROUND

Digital use cases describe the application of technology to achieve specific outcomes. Several studies in health care have examined patients' overall attitudes toward digitalization and specific use cases. However, these studies have failed to provide a comparison of patient acceptance criteria between inherently different digital use cases in family medicine.

OBJECTIVE

To address this research gap, this paper aimed to assist family doctors in selecting digital use cases by comparing the underlying patient adoption factors and in driving usage of these use cases by presenting a differentiated implementation approach.

METHODS

Adapting an established Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire to 4 digital use cases in family medicine, we surveyed a large cross-sectional sample of adults living in Germany. The results of the web-based survey were then analyzed via descriptive statistics, ANOVA, and hierarchical regression models to compare the effects of sociodemographic and technology acceptance factors on the intention to use a specific use case.

RESULTS

Our web-based survey included 1880 participants. Of these 1880 participants, only 304 (16.2%) agreed that the degree of digitalization is important when selecting a family practice. However, more digitally literate participants attributed greater importance to this criterion (B=0.226, SE 0.023; β=.223; P<.001), and digital literacy was found to be dependent on age (Welch F3,968.29=53.441; P<.001). Regarding sociodemographic characteristics, only digital literacy demonstrated a significant effect on the intention to use for all use cases, particularly scheduling doctor appointments online (B=0.322, SE 0.033; β=.408; P<.001). Furthermore, performance expectancy was the strongest predictor of the intention to use for all use cases, while further effects of technology acceptance factors depended on the use case (receiving medical consultations via video: B=0.603, SE 0.049; β=.527; P<.001; scheduling doctor appointments online: B=0.566, SE 0.043; β=.513; P<.001; storing personal medical information via electronic health records: B=0.405, SE 0.047; β=.348; P<.001; and providing personal information before consultation digitally [digital anamnesis]: B=0.434, SE 0.048; β=.410; P<.001). To illustrate, perceived privacy and security had an effect on the intention to use electronic health records (B=0.284, SE 0.040; β=.243; P<.001) but no effect on the intention to use video consultations (B=0.068, SE 0.042; β=.053; P=.10).

CONCLUSIONS

In the selection and implementation of digital use cases, family doctors should always prioritize the perceived value of the digital use case for the patient, and further criteria might depend on the digital use case. Practice owners should therefore always harmonize the introduction of digital use cases with their own patient care strategies. Not every digital innovation fits every strategy and therefore every practice.

Modeling telemedicine continuance usage: findings from PLS-SEM and fsQCA

PURPOSE

With the pandemic reshaping healthcare delivery, telemedicine has emerged as a vital solution for overcoming access barriers, particularly in resource-constrained settings. Hence, this study explores the key drivers behind the sustained use of telemedicine services in low-income countries during the post-pandemic period.

DESIGN/METHODOLOGY/APPROACH

Using a quantitative research approach and purposive sampling technique, 273 valid responses were gathered from participants in Bangladesh. A comparative analysis utilizing partial least squares structural equation modeling (PLS-SEM) and fuzzy-set qualitative comparative analysis (fsQCA) were conducted to ensure greater accuracy.

FINDINGS

The PLS-SEM analysis revealed that expectation confirmation and perceived ease of use positively influence satisfaction. Similarly, perceived usefulness and perceived ease of use directly impact Attitude toward telemedicine services. However, perceived usefulness and perceived security were not significantly associated with satisfaction and attitude toward telemedicine services, respectively. The findings highlight that user satisfaction drives continuance use intention for telemedicine services, but only when it also cultivates a positive attitude toward telemedicine services. While the PLS-SEM findings indicate that perceived usefulness has no significant relationship with satisfaction and perceived security is not significantly associated with attitude toward telemedicine services, the fsQCA results offer a different perspective. fsQCA reveals that perceived usefulness retains a significant association with satisfaction and that perceived security, regardless of whether its effect is high or low, is equally effective in contributing to the intention for continuous telemedicine use. These findings underscore fsQCA's ability to provide deeper insights into the complex causal relationships among the antecedents.

PRACTICAL IMPLICATIONS

The findings provide valuable insights for hospitals, doctors and telemedicine providers on retaining existing users. Additionally, governments can leverage this information to address healthcare disparities between urban and rural areas. The study also identifies strategies to reduce costs and improve the efficiency of healthcare services.

ORIGINALITY/VALUE

This study advances telemedicine research by employing the extended technology continuance theory (ETCT) alongside a hybrid analytical approach that integrates PLS-SEM and fsQCA. It highlights that telemedicine organizations can boost patient confidence and encourage continued use by enhancing satisfaction and cultivating a positive user attitude. The innovative use of ETCT and the combined methodologies provide a comprehensive analysis, offering actionable strategies to retain telemedicine users in low-income countries during the post-pandemic period.

The psychometric properties of Chinese version of the Gilles de la Tourette syndrome-quality of life scale (GTS-QOL) for children and adolescents

BACKGROUND

Gilles de la Tourette syndrome (GTS) is a persistent neurological disorder that profoundly affects the quality of life for afflicted individuals, however, tailored health-related quality of life (QOL) measures for Chinese pediatric GTS patients are lacking. This pioneering study aims to develop a QOL scale for Chinese children with GTS.

METHODS

A cohort of 1,121 children (aged 6-16 years) diagnosed with GTS participated in scale development. Internal consistency was evaluated using Cronbach's alpha. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to assess the factor structure of the GTS-QOL-Chinese, examining goodness-of-fit indices, factor loadings of individual items, and covariances between factors. Validity was determined through interscale correlations and comparisons with external measures to establish convergent and discriminant validity.

RESULTS

Following reliability and validity analyses, a Chinese version of the 24-item GTS-specific quality of life scale was conclusively established, encompassing five subscales (psychological, compulsive, cognitive, physical, social). The scale demonstrated high internal consistency with a Cronbach's alpha coefficient of 0.93, and validity was substantiated through interscale correlations ranging from 0.46 to 0.68. EFA identified five factors, explaining 61.26% of the total variation. CFA further confirmed the scale's robustness, with all goodness-of-fit indicators meeting acceptable criteria (AGFI = 0.86, PCFI = 0.78, GFI = 0.89, CFI = 0.89, RMSEA = 0.07, SRMR = 0.06).

CONCLUSIONS

The Chinese version of the GTS-QOL scale has exhibits robust reliability and validity and is valuable for assessing the quality of life of Chinese children and adolescents with GTS. This scale may assist in tailoring interventions and improving patient care.

The role of Contact-Tracing Mobile Apps in pandemic prevention: A multidisciplinary perspective on health beliefs, social, and technological factors

During the recent COVID-19 pandemic, governments implemented mobile applications for contact tracing as a rapid and effective solution to mitigate the spread of the virus. However, these seemingly straightforward solutions did not achieve their intended objectives. In line with previous research, this paper aims to investigate the factors that influence the acceptance and usage of contact-tracing mobile apps (CTMAs) in the context of disease control. The research model in this paper integrates the Unified Theory of Acceptance and Use of Technology and the Health Belief Model (HBM). The present study involved a diverse sample of 770 French participants of all genders, ages, occupations, and regions. Critical elements from the Health Belief Model, technological factors related to the app, and social factors, including the centrality of religiosity, were assessed using well-established measurement scales. The research's findings demonstrate that several factors, such as perceived benefits and perceived severity, social influence, health motivation, and centrality of religiosity, significantly impact the intention to use a CTMA. These findings suggest that CTMAs hold promise as valuable tools for managing future epidemics. However, addressing challenges, revising implementation strategies, and potentially collaborating with specialized industry partners under regulatory frameworks are crucial. This practical insight can guide policymakers and public health officials in their decision-making.

Exploring user usability perceptions and acceptance of chording-enabled keyboards: A perspective between human-computer interaction

In recent years, a variety of alternative keyboard designs have emerged with the primary goal of enhancing user comfort and productivity compared to conventional keyboards. The objective of this study was to determine the variables affecting the acceptance and perceptions of people towards chording-enabled keyboards. A holistic analysis was done with the use of an extended framework of unified theory of acceptance and use of technology (UTAUT2), analyzed through partial least square structural equation modeling. Gathering a total of 430 valid respondent through purposive sampling, perceived usability, behavioral intention, usage behavior, habit, performance expectancy, social influence, and hedonic motivation were seen to be important factors in adopting chord-enabled keyboards. From the output, it was posited that the attributes of the keyboards' functionality, ease of use, adaptability, and people's willingness to use it, significantly affected their intention of using the keyboard. The findings and suggestions included in this study will benefit not only users but also the developers by providing insights into user preferences. Efficiently improving and marketing chording enabled keyboards could be considered as suggested in the implications. Moreover, the study's model construct could also be utilized in other studies related to user acceptance of technology in different countries.

Sanctions and opportunities: Factors affecting China's high-tech SMEs adoption of artificial intelligence computing leasing business

Due to sanctions, more Chinese high-tech SMEs are turning to rent AI computing power through cloud service providers. Therefore, it is necessary to give a variety of suggestions for China's high-tech SMEs to better develop AI applications through computing power leasing. Because traditional theories are difficult to explain this new technology adoption behavior, this research combines and extends TTF and UTAUT2 theories to take an empirical research. A total of 387 questionnaires were received, of which incomplete questionnaires and invalid questionnaires were issued, leaving 281 valid questionnaires. The results indicate that SME innovativeness, perceived risk, performance expectancy, price value and task technology fit are all significantly related to usage, whereas task technology fit moderates the other relationships significantly. Results give a variety of suggestions for China's high-tech SMEs to better develop AI applications through computing power leasing in the context of sanctions. This study not only suggests ways to increase the competitiveness of SMEs by optimizing leasing services but also give directions in investors' investment decisions. The findings are also applicable to the large-scale application of China's domestic AI chips in computing power leasing scenarios in the future.

Developing the teledentistry acceptance survey for dentists - TAS-D: a Delphi study

INTRODUCTION

The increasing interest in teledentistry since the COVID-19 pandemic warrants an evaluation of dentists' willingness to adopt it. This study aimed to develop a questionnaire to assess dentist's intention to use teledentistry and the associated factors.

METHODS

A literature search was used to identify items for the questionnaire. The Unified Theory of Acceptance and Use of Technology (UTAUT2) was adopted as framework. A Delphi panel was constituted of researchers with relevant publications and the International Association of Dental Research e-Oral Health Network members. Three Delphi consultations were conducted to establish consensus on items. Consensus was set at 80% agreement and content validity ratio (CVR), reaffirmed iteratively.

RESULTS

Nineteen out of 25 (76%) invited experts participated in the first round, 17 in the second and 15 in the third. The preliminary questionnaire had 81 items in three sections, reduced to 66, 45 and 33 items in the first, second and third rounds. After revision, the final version comprised eight items assessing dentists' backgrounds in Sect. 1, seven items identifying teledentistry uses in Sect. 2, and 17 items assessing intention to use teledentistry and its determinants in seven dimensions in Sect. 3. The initial CVR was 0.45, which increased to 0.80 at the end of the third round.

CONCLUSION

A survey tool was developed to assess the acceptance of teledentistry, and its determinants based on the UTAUT2 framework through consensus among teledentistry experts. The tool had excellent validity and needs further evaluation of its psychometric properties.

Understanding the Role of Technology Anxiety in the Adoption of Digital Health Technologies (DHTs) by Older Adults with Chronic Diseases in Shanghai: An Extension of the Unified Theory of Acceptance and Use of Technology (UTAUT) Model

The unprecedented rapid growth of digital health has brought new opportunities to the health field. However, elderly patients with chronic diseases, as an important potential beneficiary group, are affected by the digital divide, leading to unsatisfactory usage of digital health technologies (DHTs). Our study focused on the factors influencing the adoption of DHTs among this vulnerable group. To extend the UTAUT theory, technology anxiety and several demographic predictors were included to address the age characteristics of the respondents. An on-site survey was conducted in general, district, and community hospitals in Shanghai (n = 309). Facilitating conditions negatively influenced technology anxiety. Technology anxiety hindered behavioural intention. Social influence had a significant but negative impact on behavioural intention. Education, whether older adults have had experience with DHTs and previous smartphone usage experiences were significantly associated with technology anxiety. The findings provide valuable information for multiple stakeholders, including family members of elderly users, product designers, and policymakers. Ameliorating facilitating conditions, improving devices' usage experience, encouraging attempts and focusing on groups with lower educational levels can help to reduce technology anxiety and promote DHT acceptance and use in older age groups.

Social influence, performance expectancy, and price value as determinants of telemedicine services acceptance in Chile

Medicine is a discipline based on and nurtured by scientific research and technological development. The use of health services supported by information technology is increasing worldwide, and Latin America is no exception. Factors such as needing more specialists in peripheral cities, large geographic areas, and socio-cultural aspects limit the possibility of receiving timely and quality medical care services. Information Technology (IT) for health purposes, such as e-health, is a cost-effective solution for equitable access to quality healthcare services and optimization of the rising associated costs. As an e-health service, telemedicine facilitates and mediates distance communication between the patient and medical staff. Even though Latin America is at the beginning of the development of telemedicine, it would have a relevant impact, given the geographic and socioeconomic conditions of the population in this part of the world. Drawing on the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) theory, we developed a theoretical model to identify the latent factors influencing the public acceptance of telemedicine and examined their interrelationships. A survey questionnaire was designed and administered to 391 residents in Antofagasta, a mine region of Chile. After that, structural equation modeling was employed to analyze the survey data. The results reveal that the UTAUT2 factors' performance expectancy, social influence, and price value significantly impact the intention to use (R 2 = 0.693). Additionally, the model presented a good fit. This study enriches the existing theoretical research on the acceptance of telemedicine services and offers insights into understanding and managing technology in the Chilean health sector.

Confirmation of the viability of a metaverse yoga class and investigation into the impact on pain, anxiety, and depression associated with low back pain after engaging in virtual yoga sessions

This study aimed to explore the influence of metaverse technology (MT) factors like presence, usability, and enjoyment on patients' satisfaction, with a focus on examining potential mediating effects. In addition, it sought to assess whether the yoga practice as an intervention therapy in MT induces changes in the pain, anxiety, and depression levels of patients experiencing back pain. From the pool of 202 participants, this study chose participants who had reported enduring low back pain over 12 weeks, with a visual analogue scale (VAS) rating of 4 or higher. After completing the questionnaire, patients were randomly assigned to either the control group (COG, n=100) or the yoga exercise group (YEG, n=99). Results showed that the construct validity for questionnaires and a reasonable model fit were confirmed, and that presence showed a statistically significant effect on psychological satisfaction via the mediating path of enjoyment (β=0.592, P=0.001). Following 8 weeks of the yoga practice, the VAS increased for the COG, while it decreased significantly by ~29% for the YEG (P=0.001). YEG also exhibited a decrease in the Oswestry Disability Index by ~17%, anxiety by ~7%, and depression by ~10% (P=0.001). In conclusion, psychological satisfaction in a yoga practice using a metaverse cannot be achieved solely through the sense of presence; enjoyment is necessary for patients' satisfaction. Moreover, it was verified that virtual yoga practice is effective in ameliorating psychological factors resulting from back pain.

Unpacking the influencing factors of telehealth usage among older consumers

This research unpacks the challenges and motivations of telehealth usage among older consumers-an understudied population in the extant telehealth literature. Through surveying a sample of older consumers who regularly migrate to winter in the southern areas of the United States, our qualitative analysis uncovers motivations (i.e., convenience, ease of use, efficiency, and a forced option) and challenges (i.e., telehealth limitations, privacy concerns, and lack of trust, access, and skills) of older consumers' telehealth usage. Furthermore, logistic regression identifies attitude toward telehealth, gender, and health status as significant predictors of telehealth usage behavior. Contributions to theory and practice are also discussed.

Factors influencing telemedicine adoption among physicians in the Malaysian healthcare system: A revisit

Background

The Malaysian healthcare system is under strain due to an aging population, the rising prevalence of chronic diseases, and heavy workloads among physicians. As costs and requirements continue to rise, telemedicine is critical for bridging gaps in supply and demand. However, there are limited studies on telemedicine adoption among Malaysian physicians. Furthermore, the existing literature on telemedicine adoption does not contain a comprehensive framework that integrates the multidimensional social influence, and technological, clinical, and individual factors.

Objective

This research investigates the adoption of telemedicine among Malaysian physicians. It draws from the Technology Acceptance Model (TAM) and Kelman's Social Influence Theory.

Methods

A survey was conducted among 230 participants in hospitals located in Kuala Lumpur and Selangor. The data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM).

Results

The study identified crucial factors influencing telemedicine adoption, including informational influences, rewards, perceived ease of use, and usefulness. Meanwhile, the Importance-performance Map Analysis (IPMA) identified perceived ease of use as the most important factor for physicians, but the highest performance was patient's records.

Conclusions

The proposed integrated model enhances the understanding of telemedicine adoption and highlights the differential effects of individual, technological, clinical, and multidimensional social influence factors from the physicians' perspective. The findings can guide future studies and influence implementation strategies for telemedicine promotion in the Malaysian healthcare context. Hospitals should prioritize user-friendly technology and information provision, while telemedicine providers should enhance the accessibility of patient records to facilitate telemedicine adoption. Policymakers should consider supporting training programs that will boost physicians' confidence in effectively utilizing telemedicine.

Empowering Healthcare through Precision Medicine: Unveiling the Nexus of Social Factors and Trust

This study investigated the impact of social factors on the acceptance of precision medicine (PM) using a quantitative survey grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. The findings revealed that social influence has a significantly positive effect on PM acceptance, while the influence of social media is found to be insignificant. Performance expectancy emerged as the most influential factor, demonstrating a significant relationship with PM acceptance. Trust plays a crucial moderating role, mitigating the impact of social factors on PM acceptance. While exploring the mediating effects of trust, we identified a significant mediation effect for social influence and performance expectancy on PM acceptance. However, the mediation effect of social media influence is insignificant. These findings highlight the importance of trust in shaping decisions regarding PM acceptance. These findings have significant implications for healthcare practitioners and policymakers aiming to promote the adoption of precision medicine in clinical practice.

A machine learning ensemble approach to predicting factors affecting the intention and usage behavior towards online groceries applications in the Philippines

The emergence of e-commerce platforms, especially online grocery shopping, is heightened by the COVID-19 pandemic. Filipino consumers started to adapt online due to the strict quarantine implementations in the country. This study intended to predict and evaluate factors influencing the intention and usage behavior towards online groceries incorporating the integrated Protection Motivation Theory and an extended Unified Theory of Acceptance and Use of Technology applying machine learning ensemble. A total of 373 Filipino consumers of online groceries responded to the survey and evaluated factors under the integrated framework. Artificial Neural Network that is 96.63 % accurate with aligned with the result of the Random Forest Classifier (96 % accuracy with 0.00 standard deviation) having Perceived Benefits as the most significant factor followed by Perceived Vulnerability, Behavioral Intention, Performance Expectancy, and Perceived. These factors will lead to very high usage of online grocery applications. It was established that machine learning algorithms can be used in predicting consumer behavior. These findings may be applied and extended to serve as a framework for government agencies and grocers to market convenient and safe grocery shopping globally.

Diagnostic efficiency and psychometric properties of CBCL DSM-oriented scales in a large sample of Chinese school-attending students aged 5-16

BACKGROUND

Children and adolescents are vulnerable to various psychiatric disorders during the critical phase of individual development. In China, the child behavior checklist (CBCL) is a widely employed psychometric questionnaire for assessing children and adolescents. However, further validation of the psychometric properties and diagnostic effectiveness of the CBCL DSM-oriented scales is necessary. These scales were developed based on DSM diagnosis and require evaluation using a substantial sample of Chinese individuals.

METHODS

This study involved the analysis of a substantial dataset consisting of 72,109 samples collected from five provinces in China. Data was gathered using the CBCL (Parent Rating Scale), and rigorous assessments of reliability and validity were conducted. The mini-international neuropsychiatric interview for children and adolescents (MINI-KID) and the diagnostic and statistical manual of mental disorders-IV (DSM-IV) interview were employed to diagnose the participants. To ensure the accuracy of the diagnoses, receiver operating characteristic curve (ROC curves) were utilized, and the Youden Index was calculated to determine the appropriate diagnostic cut-off point for each specific target diagnosis.

RESULTS

The study included a total sample of 72,109 cases, out of which 19,782 cases underwent MINI-KID assessment and structured or semi-structured interviews based on DSM-IV to clarify the diagnosis. Reliability and validity analyses showed that the reliability of the subscales and total scales was good, except for Anxiety Problems. The Cronbach's alpha for the CBCL DSM-oriented scales was 0.92. In addition, the validity of all scales was good (CFI = 0.80). For the sample with a clear diagnosis, all five subscales of the CBCL DSM-oriented scales showed fair diagnostic efficiency for the target diagnosis. Among them, the area under curves (AUC) of Mood disorder, Anxiety, Attention deficit and hyperactivity disorder (ADHD), Oppositional defiant disorder (ODD) and Conduct disorder (CD) are 0.80, 0.74, 0.75, 0.74, 0.74. Among the three sample groups, the highest diagnostic efficiency was found in Affective Problems to Mania. The diagnostic cut-off point for each subscale on target diagnoses was clearly defined.

CONCLUSION

Overall, the reliability, validity and diagnostic efficiency of CBCL DSM-oriented scales in Chinese children and adolescents were within acceptable limits. In addition, we used ROC curves and cut-off points to predict the cut-off values of common child and adolescent psychiatric disorders mentioned in the CBCL DSM-oriented scales. This provides an important reference for the clinical application of the CBCL DSM-oriented scales in Chinese samples.

Perception and Willingness to Use Telepharmacy Among the General Population in Jordan

Objective

This research aimed to explore how telepharmacy is perceived, whether it would be willingly used by the overall population in Jordan, and the associated socioeconomic disparities that might affect its acceptance.

Methods

This is a survey-based cross-sectional study involving the general public of Jordan. The study took place in various Jordanian cities from May 2nd to June 1st, 2023. Using Google forms, the questionnaire was shared through various social media channels (such as Facebook and WhatsApp).

Results

The questionnaire received responses from 800 participants. The data showed that a sizable portion of the Jordanian population were unaware of telepharmacy (n= 343, 42.9%), and a majority had never utilized it (n= 131, 16.4%). The participants viewed the main advantage of telepharmacy as minimizing unnecessary trips to pharmacies (n= 668, 83.5%) and reducing travel time and expenses (n= 632, 79.0%). However, the primary concern was the mental effort required to use this service (n= 465, 58.1%). Of the respondents, 61.3% (n= 490) indicated a willingness to adopt telepharmacy services in the future. Regression analysis indicated that men were more likely to use this service compared to women (OR= 1.947, p<0.001), and people living in northern and southern Jordan exhibited a greater willingness compared to those inhabiting the central region (OR= 2.168, p<0.001).

Conclusion

The results reveal a positive attitude towards and a significant readiness to embrace telepharmacy among the Jordanian population. However, for broader acceptance and utilization, apprehensions regarding the service need to be addressed. Doing so could improve access to pharmaceutical care, particularly for patients living in far-flung areas of Jordan.

Acceptance of Telemedicine Compared to In-Person Consultation From the Providers' and Users' Perspectives: Multicenter, Cross-Sectional Study in Dermatology

BACKGROUND

Teledermatology is currently finding its place in modern health care worldwide as a rapidly evolving field.

OBJECTIVE

The aim of this study was to investigate the acceptance of teledermatology compared to in-person consultation from the perspective of patients and professionals.

METHODS

This multicenter, cross-sectional pilot study was performed at secondary and tertiary referral centers of dermatology in Switzerland from August 2019 to January 2020. A customized questionnaire addressing demographics and educational data, experience with telemedicine, and presumed willingness to replace in-patient consultations with teledermatology was completed by dermatological patients, dermatologists, and health care workers in dermatology.

RESULTS

Among a total of 664 participants, the ones with previous telemedicine experience (171/664, 25.8%) indicated a high level of overall experience with it (patients: 73/106, 68.9%, dermatologists: 6/8, 75.0%, and health care workers: 27/34, 79.4%). Patients, dermatologists, and health care workers were most likely willing to replace in-person consultations with teledermatology for minor health issues (353/512, 68.9%; 37/45, 82.2%; and 89/107, 83.2%, respectively). We observed a higher preference for telemedicine among individuals who have already used telemedicine (patients: P<.001, dermatologists: P=.03, and health care workers, P=.005), as well as among patients with higher educational levels (P=.003).

CONCLUSIONS

This study indicates that the preference for teledermatology has a high potential to increase over time since previous experience with telemedicine and a higher level of education were associated with a higher willingness to replace in-patient consultations with telemedicine. We assume that minor skin problems are the most promising issue in teledermatology. Our findings emphasize the need for dermatologists to be actively involved in the transition to teledermatology.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04495036; https://classic.clinicaltrials.gov/ct2/show/NCT04495036.

Factors Predicting Older People's Acceptance of a Personalized Health Care Service App and the Effect of Chronic Disease: Cross-Sectional Questionnaire Study

BACKGROUND

Mobile health (mHealth) services enable real-time measurement of information on individuals' biosignals and environmental risk factors; accordingly, research on health management using mHealth is being actively conducted.

OBJECTIVE

The study aims to identify the predictors of older people's intention to use mHealth in South Korea and verify whether chronic disease moderates the effect of the identified predictors on behavioral intentions.

METHODS

A cross-sectional questionnaire study was conducted among 500 participants aged 60 to 75 years. The research hypotheses were tested using structural equation modeling, and indirect effects were verified through bootstrapping. Bootstrapping was performed 10,000 times, and the significance of the indirect effects was confirmed through the bias-corrected percentile method.

RESULTS

Of 477 participants, 278 (58.3%) had at least 1 chronic disease. Performance expectancy (β=.453; P=.003) and social influence (β=.693; P<.001) were significant predictors of behavioral intention. Bootstrapping results showed that facilitating conditions (β=.325; P=.006; 95% CI 0.115-0.759) were found to have a significant indirect effect on behavioral intention. Multigroup structural equation modeling testing the presence or absence of chronic disease revealed a significant difference in the path of device trust to performance expectancy (critical ratio=-2.165). Bootstrapping also confirmed that device trust (β=.122; P=.039; 95% CI 0.007-0.346) had a significant indirect effect on behavioral intention in people with chronic disease.

CONCLUSIONS

This study, which explored the predictors of the intention to use mHealth through a web-based survey of older people, suggests similar results to those of other studies that applied the unified theory of acceptance and use of technology model to the acceptance of mHealth. Performance expectancy, social influence, and facilitating conditions were revealed as predictors of accepting mHealth. In addition, trust in a wearable device for measuring biosignals was investigated as an additional predictor in people with chronic disease. This suggests that different strategies are needed, depending on the characteristics of users.

Exploration of the acceptability of different behaviors of an autonomous vehicle in so-called conflict situations

The acceptability of autonomous vehicles is an important issue for car manufacturers. The subject of this work attempts to address this issue in the context of conflict situations in urban environments. We present the results of a preliminary study that was conducted to investigate the effects of the driving mode and context on the acceptability of the behavior of an autonomous vehicle. We thus measured acceptability on 30 drivers confronted with three driving modes (defensive, aggressive, and transgressive) as well as different situations constituted by the most common urban intersections in France. We then formulated hypotheses on the effects that the driving mode, the context, or the socio-demographic characteristics of the passengers may have on their acceptability of the autonomous vehicle behavior. In the context of our study, the driving mode of the vehicle was the most influential parameter on the level of acceptability assessed by the participants. The type of intersection used did not result in a significant difference, nor did the socio-demographic characteristics studied. The results of these works allow an interesting first approach and lead us to guide our future works on the study of the parameters involved in the driving modes of autonomous vehicles.

Extending UTAUT2 with knowledge to test Chinese consumers' adoption of imported spirits flash delivery applications

Despite the rapid growth in sales of imported spirits in the Chinese market, consumers are struggling to easily buy high-quality imported spirits with favorable price. The imported spirits flash delivery applications are proposed to provide Chinese consumers with high-quality services delivered within a few hours. This study extends UTUAT2 with knowledge, risk and innovativeness to identify factors influencing Chinese consumers' use of flash delivery services for imported spirits. With the help of service providers, 315 valid questionnaires were collected and an empirical study was carried out. Findings suggest that social influence, habit, innovativeness and knowledge all have significant effects on usage. In particular, knowledge has significant moderating effects on relationships between social influence, habit, innovativeness and usage. This research is supposed to help imported spirits flash delivery providers to further expand the market, and will be of great help to the investment decisions of multinational spirits manufacturers in China.

"Extending the Technology Acceptance Model (TAM) to Predict University Students' Intentions to Use Metaverse-Based Learning Platforms"

Metaverse, which combines a number of information technologies, is the Internet of the future. A media for immersive learning, metaverse could set future educational trends and lead to significant reform in education. Although the metaverse has the potential to improve the effectiveness of online learning experiences, metaverse-based educational implementations are still in their infancy. Additionally, what factors impact higher education students' adoption of the educational metaverse remains unclear. Consequently, the aim of this study is to explore the main factors that affect higher education students' behavioral intentions to adopt metaverse technology for education. This study has proposed an extended Technology Acceptance Model (TAM) to achieve this aim. The novelty of this study resides in its conceptual model, which incorporates both technological, personal, and inhibiting/enabling factors. The empirical data were collected via online questionnaires from 574 students in both private and public universities in Jordan. Based on the PLS-SEM analysis, the study identifies perceived usefulness, personal innovativeness in IT, and perceived enjoyment as key enablers of students' behavioral intentions to adopt the metaverse. Additionally, perceived cyber risk is found as the main inhibitor of students' metaverse adoption intentions. Surprisingly, the effect of perceived ease of use on metaverse adoption intentions is found to be insignificant. Furthermore, it is found that self-efficacy, personal innovativeness, and perceived cyber risk are the main determinants of perceived usefulness and perceived ease of use. While the findings of this study contribute to the extension of the TAM model, the practical value of these findings is significant since they will help educational authorities understand each factor's role and enable them to plan their future strategies.

Digital transformation of healthcare during the COVID-19 pandemic: Patients’ teleconsultation acceptance and trusting beliefs

The COVID-19 pandemic boosted the digital transformation of many services, including healthcare, and access to medical care using teleconsultation has increased rapidly. Thus, a growing number of online platforms have been developed to accommodate patients’ needs. This paper examines the factors that predict the intention to use medical teleconsultation by extending the unified theory of acceptance and use of technology (UTAUT2) with the three dimensions of trusting beliefs and self-efficacy. A survey was administered to patients who had used a teleconsultation platform during the pandemic period. As one of the largest studies to date, a sample of 1233 respondents was collected and analyzed using a partial least squares approach, often mobilized in the information systems (IS) domain. Furthermore, a deep analysis using all recommended metrics was performed. The results highlight the significance of trusting beliefs, and self-efficacy in the adoption of digital healthcare services. These findings contribute to both theory and practice in COVID-19 research.

S. A machine learning approach on analysing the sentiments in the adoption of telemedicine application during COVID-19

Purpose

The purpose of this paper is to understand the customer sentiment towards telemedicine apps and also to apply machine learning algorithms to analyse the sentiments in the adoption during the COVID-19 pandemic.

Design/methodology/approach

Text mining that uses natural language processing to extract insights from unstructured text is used to find out the customer sentiment towards the telemedicine apps during the COVID-19 pandemic. Machine learning algorithms like support vector machine (SVM) and Naïve Bayes classifier are used for classification, and their sensitivity and specificity are found using a confusion matrix.

Findings

The paper explores the customer sentiment towards telemedicine apps and their adoption during the COVID-19 pandemic. Text mining that uses natural language processing to extract insights from unstructured text is used to find out the customer sentiment towards the telemedicine apps during the COVID-19 pandemic. Machine learning algorithms like SVM and Naïve Bayes classifier are used for classification, and their sensitivity and specificity are found using a confusion matrix. The customers who used telemedicine apps have positive sentiment as well as negative sentiment towards the telemedicine apps. Some of the customers have concerns about the medicines delivered, their delivery time, the quality of service and other technical difficulties. Even a small percentage of doctors feel uncomfortable in online consultation through the application.

Originality/value

The primary value of this paper lies in providing an overview of the customers’ approach towards the telemedicine apps, especially during the COVID-19 pandemic.

Will Smart Improvements to Child Restraints Increase Their Popularity?

In developing countries, child safety seat use remains low, which contributes to the consistently high rate of child injuries and deaths in traffic accidents. In order to protect the safety of child passengers, it is necessary to improve the public acceptance of child restraints. We improved the shortcomings of the traditional child restraints by adding some new features: 1, tightening Isofix automatically; 2, using temperature sensing, a high-temperature alarm, automatic ventilation, and cooling; 3, using pressure sensing, if the child is left alone it will set off the car alarm; 4, voice control to adjust the angle of the backrest; 5, the seat can be folded into the trunk. These functions make human-computer interaction more humane. The authors collected changes in parental acceptance of child restraints using the interview method and questionnaires. We found that acceptance increased significantly after making intelligent improvements to the child restraints. The authors used the Technology Acceptance Model to identify the key caveats influencing users' use of intelligent child restraints. Performance expectations, effort expectations, social influence, convenience, and hedonic motivation positively and significantly impacted the willingness to use intelligent child restraints, so the authors suggest that these points should be emphasized when promoting the product. The current study findings have theoretical and practical implications for smart child restraint designers, manufacturers, sellers, and government agencies. To better understand and promote child restraint, researchers and marketers can analyze how people accept child restraint based on our research model.

Application and extension of the UTAUT2 model for determining behavioral intention factors in use of the artificial intelligence virtual assistants

Virtual Assistants, also known as conversational artificial intelligence, are transforming the reality around us. These virtual assistants have challenged our daily lives by assisting us in the different dimensions of our lives, such as health, entertainment, home, and education, among others. The main purpose of this study is to develop and empirically test a model to predict factors that affect users' behavioral intentions when they use intelligent virtual assistants. As a theoretical basis for investigating behavioral intention of using virtual assistants from the consumers' perspective, researchers employed the extended Unified Theory of Acceptance and Use of Technology (UTAUT2). For this research paper, seven variables were analyzed: performance expectancy, effort expectancy, facilitating conditions, social influence, hedonic motivation, habit, and price/value. In order to improve consumer behavior prediction, three additional factors were included in the study: perceived privacy risk, trust, and personal innovativeness. Researchers carried out an online survey with 304 responses. The obtained sample was analyzed with Structural Equation Modeling (SEM) through IBM SPSS V. 27.0 and AMOS V 27.0. The main study results reveal that factors, such as habit, trust, and personal innovation, have a significant impact on the adoption of virtual assistants. However, on the other side, performance expectancy, effort expectancy, facilitating conditions, social influence, hedonic motivation, price/value, and perceived privacy risk were not significant factors in the users' intention to adopt this service. This research paper examines the effect of personal innovation, security, and trust variables in relation to the use of virtual assistants. It contributes to a more holistic understanding of the adoption of these intelligent devices and tries to fill the knowledge gap on this topic, as it is an emerging technology. This investigation also provides relevant information on how to successfully implement these technologies.

A study of college students' intention to use metaverse technology for basketball learning based on UTAUT2

Recent advancements in virtual reality technology have attracted increasing attention from enterprises and scholars, and many new related products have been launched. Due to the current COVID-19 epidemic, the non-face-to-face teaching environment will seriously affect students' basketball learning. We therefore combined basketball learning with metaverse technology, discussed basketball teaching in a virtual reality environment, and examined the influencing factors of college students' intentions to use metaverse technology. In the light of UTAUT2, a new research model was proposed, and quantitative research was carried out. The results of a survey of 1074 valid samples revealed that habits and attitudes are crucial factors in the success of basketball learning using a metaverse. The findings also indicate that grade and gender are moderator variables.

Assessing the Effects of the COVID-19 Pandemic on M-Commerce Adoption: An Adapted UTAUT2 Approach

The COVID-19 pandemic has impacted consumers’ lives and their shopping patterns, leading them towards mobile commerce. To address current shopping circumstances, an adapted UTAUT2 model aims to integrate trust and perceptions of the effects of the COVID-19 pandemic on consumers’ behavioral intention to rely on m-commerce during this period. The study proposes a research model which is investigated with the help of structural equation modelling in AMOS. Using the framework of a cross-sectional study, data were collected from an emerging market in Romania, where internet speed ranks 4th worldwide and where the yearly increase in internet and social media users is approximately 10%. By using confirmatory factor analysis and structural equation modelling, the research validates the applicability of UTAUT2 in examining consumers’ behavioral intent of using m-commerce during a pandemic. Hedonic motivation is the strongest predictor of consumers’ behavioral intentions to continue using m-commerce. The findings contribute to understandings of consumers’ behavior with m-commerce in an emerging market, extending knowledge based on the adapted UTAUT2 model and allowing for comprehension of the key role of trust and social influences in affecting consumers’ perceptions of the COVID-19 outbreak in relation to shopping patterns.