Predicting tablet computer use: An extended Technology Acceptance Model for physicians

Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study

BACKGROUND

Current clinician-led melanoma surveillance models require frequent routinely scheduled clinic visits, with associated travel, cost, and time burden for patients. Patient-led surveillance is a new model of follow-up care that could reduce health care use such as clinic visits and medical procedures and their associated costs, increase access to care, and promote early diagnosis of a subsequent new melanoma after treatment of a primary melanoma. Understanding patient experiences may allow improvements in implementation.

OBJECTIVE

This study aims to explore patients' experiences and perceptions of patient-led surveillance during the 6 months of participation in the MEL-SELF pilot randomized controlled trial. Patient-led surveillance comprised regular skin self-examination, use of a mobile dermatoscope to image lesions of concern, and a smartphone app to track and send images to a teledermatologist for review, in addition to usual care.

METHODS

Semistructured interviews were conducted with patients previously treated for melanoma localized to the skin in New South Wales, Australia, who were randomized to the patient-led surveillance (intervention group) in the trial. Thematic analysis was used to analyze the data with reference to the technology acceptance model.

RESULTS

We interviewed 20 patients (n=8, 40% women and n=12, 60% men; median age 62 years). Patients who were more adherent experienced benefits such as increased awareness of their skin and improved skin self-examination practice, early detection of melanomas, and opportunities to be proactive in managing their clinical follow-up. Most participants experienced difficulty in obtaining clear images and technical problems with the app. These barriers were overcome or persevered by participants with previous experience with digital technology and with effective help from a skin check partner (such as a spouse, sibling, or friend). Having too many or too few moles decreased perceived usefulness.

CONCLUSIONS

Patients with melanoma are receptive to and experience benefits from patient-led surveillance using teledermoscopy. Increased provision of training and technical support to patients and their skin check partners may help to realize the full potential benefits of this new model of melanoma surveillance.

Factors Affecting the Perceived Usability of the COVID-19 Contact-Tracing Application "Thai Chana" during the Early COVID-19 Omicron Period

Thai Chana is one of the mobile applications for COVID-19 disease-control tracking, especially among the Thais. The purpose of this study was to determine factors affecting the perceived usability of Thai Chana by integrating protection motivation theory, the extended technology acceptance model, and the system usability scale. In all, 800 Thais participated and filled an online questionnaire with 56 questions during the early COVID-19 omicron period (15 December 2021 to 14 January 2022). Structural equation modeling (SEM) showed that the understanding of COVID-19 has significant effects on perceived severity and perceived vulnerability, which subsequently leads to perceived usefulness. In addition, perceived usefulness and perceived ease of use have significant direct effects on attitude, which subsequently leads to the intention to use, actual use, and perceived usability. This study is one of the first studies that have analyzed the mobile application for COVID-19 disease-control tracking. The significant and substantial findings can be used for a theoretical foundation, particularly in designing a new mobile application for disease-control tracking worldwide. Finally, protection motivation theory, the extended technology acceptance model, and the system usability scale can be used for evaluating other disease-control tracking mobile applications worldwide.

Drivers of iPad use by undergraduate medical students: the Technology Acceptance Model perspective

BACKGROUND

Medical students need to acquire a continuously growing body of knowledge during their training and throughout their practice. Medical training programs should aim to provide students with the skills to manage this knowledge. Mobile technology, for example, could be a strategy used through training and practice. The objective of this study was to identify drivers of using mobile technology (an iPad) in a UGME preclinical settings and to study the evolution of those drivers over time.

METHODS

We solicited all students from two cohorts of a preclinical component of a Canadian UGME program. They were asked to answer two online surveys: one on their first year of study and another on the second year. Surveys were built based on the Technology Acceptance Model (TAM) to which other factors were also added. Data from the two cohorts were combined and analysed with partial least squares structural equation modelling (PLS-SEM) to test two measurement models, one for each year.

RESULTS

We tested fifteen hypotheses on both data sets (first year and second year). Factors that explained the use of an iPad the first year were knowledge, preferences, perceived usefulness and anticipation. In the second year, perceived usefulness, knowledge and satisfaction explained the use of an iPad. Other factors have also significantly, but indirectly influenced the use of the iPad.

CONCLUSIONS

We identified factors that influenced the use of an iPad in a preclinical medical program. These factors differed from the first year to the second year in the program. Our results suggest that interventions should be tailored for different point in time to foster the use of an iPad. Further study should investigate how interventions based on these factors may influence implementation of mobile technology to help students acquire ability to navigate efficiently through medical knowledge.

Technology Acceptance in Healthcare: A Systematic Review

Understanding the factors affecting the use of healthcare technologies is a crucial topic that has been extensively studied, specifically during the last decade. These factors were studied using different technology acceptance models and theories. However, a systematic review that offers extensive understanding into what affects healthcare technologies and services and covers distinctive trends in large-scale research remains lacking. Therefore, this review aims to systematically review the articles published on technology acceptance in healthcare. From a yield of 1768 studies collected, 142 empirical studies have met the eligibility criteria and were extensively analyzed. The key findings confirmed that TAM and UTAUT are the most prevailing models in explaining what affects the acceptance of various healthcare technologies through different user groups, settings, and countries. Apart from the core constructs of TAM and UTAUT, the results showed that anxiety, computer self-efficacy, innovativeness, and trust are the most influential factors affecting various healthcare technologies. The results also revealed that Taiwan and the USA are leading the research of technology acceptance in healthcare, with a remarkable increase in studies focusing on telemedicine and electronic medical records solutions. This review is believed to enhance our understanding through a number of theoretical contributions and practical implications by unveiling the full potential of technology acceptance in healthcare and opening the door for further research opportunities.

An Empirical Study of Renewable Energy Technology Acceptance in Ghana Using an Extended Technology Acceptance Model

Energy consumption, and its impact on the environment, has become an increased focal point in Ghana, a sub-Saharan African country, following population growth and rapid urbanization. Ghana has high potential for renewable energy generation; nevertheless, low acceptance and usage have been found. An extensive study is required to understand the causes driving poor acceptability and the intentions to use renewable energy. This study aims to empirically investigate the acceptance of renewable energy using an extended technology acceptance model (TAM). A cross-sectional survey was conducted, from 1 February 2021 to 30 June 2021, using a self-administered questionnaire. The survey was carried out on Ghanaian adults of the age 18 years and above. Data was collected from 1068 respondents from Ghana’s northern and southern parts and analyzed using partial least squares structural equation modeling (PLS-SEM) with SmartPLS software. The results of the data analysis reveal that environmental awareness is the biggest predictor of the intention to use renewable energy in Ghana. Perceived affordability was also found to be the most significant predictor of attitudes towards the use of renewable energy in Ghana. The findings of this research will give policymakers, manufacturers, and the providers of renewable energy appliances a better understanding of the factors that determine the intention to use renewable energy.

Impact of Physicians' Competence and Warmth on Chronic Patients' Intention to Use Online Health Communities

In China, medical resources are unevenly distributed, and hospitals are very congested. Online health communities (OHCs) provide a new way for patients to communicate and obtain health-related information, thereby alleviating the pressure of treatment in hospitals. However, little is known about how to increase individuals’ use intention for OHCs from the perspective of physicians. This study aims to investigate the impact of physicians’ competence and warmth on chronic patients’ intention to use physician-centered OHCs based on the technology acceptance model. A formal investigation was anonymously conducted through a web-based questionnaire survey addressed to participants, and 710 valid responses were received. A research model was constructed and the hypotheses were tested by structural equation modeling. The findings suggest that competence and warmth positively affect chronic patients’ behavioral intention to use (BIU) OHCs through the mediation of perceived usefulness (PU) and perceived ease of use (PEOU). All hypotheses were supported at the 0.05 significant level. Compared with competence, warmth has a slightly stronger impact on PU and PEOU. PEOU has a stronger impact on chronic patients’ BIU OHCs than PU. This study provides a comprehensive understanding of the impacts of physicians’ characteristics in physician-driven OHCs. Compared with competence, physicians’ warmth should be paid more attention to motivate more chronic patients to use OHCs. Enhancing physicians’ warmth and the ease of use are the preferred ways to improve chronic patients’ intention to use OHCs.

Determinants of Catalan public primary care professionals' intention to use digital clinical consultations (eConsulta) in the post-COVID-19 context: optical illusion or permanent transformation?

BACKGROUND

During lockdown due to the COVID-19 pandemic, telemedicine has become a necessary component of clinical practice for the purpose of providing safer patient care, and it has been used to support the healthcare needs of COVID-19 patients and routine primary care patients alike. However, this change has not been fully consolidated.

OBJECTIVE

The objective of this study was to analyse the determinants of healthcare professionals' intention to use the eConsulta digital clinical consultations tool in the post-COVID-19 context.

METHODS

A literature review of the Technology Acceptance Model (TAM) allowed us to construct a theoretical model and establish a set of hypotheses derived from it about the influence that a variety of different factors relating to both healthcare professionals and the institutions where they work had on those professionals' intention to use eConsulta. In order to confirm the proposed model, a mixed qualitative and quantitative methodology was used, and a questionnaire was designed to serve as the data collection instrument. The data were analysed using univariate and bivariate analysis techniques. To confirm the theoretical model, exploratory factor analysis and binary logistic regression were applied.

RESULTS

The most important variables were those referring to perceived benefits (B=2.408) and the type of use that individuals habitually made of eConsulta (B=0.715). Environmental pressure (B=0.678), experience of technology (B=0.542), gender (B=0.639) and the degree of eConsulta implementation (B=0.266) were other variables influencing the intention to use the tool in the post-COVID-19 context. When replicating the previous analysis by professional group, experience of technology and gender in the physician group, and experience of the tool's use and the centre where a professional works in the nurse group, were found to be of considerable importance.

CONCLUSIONS

The implementation and use of eConsulta had increased significantly as a consequence of the COVID-19 pandemic, and the majority of the healthcare professionals were satisfied with its use in practice and planned to incorporate it into their practices in the post-COVID-19 context. Perceived benefits and environmental pressure were determining factors in the attitude towards and intention to use eConsulta.

CLINICALTRIAL

Exploring telehealth in the graduate curriculum

Background

With an increase in patient demand and a decrease in healthcare professionals, telehealth is able to provide needed services to patients, but appropriate training in telehealth is crucial for providers to deliver excellent patient care.

Method

Nurse researchers developed a quality improvement project targeting telehealth in the graduate nursing curriculum. A two‐part evidence‐based curriculum was developed for graduate family nurse practitioner (FNP) students. Part one consisted of a lecture that focused on increasing students' knowledge, and part two enhanced skills through simulation.

Results

Data were collected through qualitative and quantitative surveys. The qualitative data were analyzed for themes and statistical analysis of the quantitative data was completed (t‐scores and descriptive statistics). Results showed that FNP students perceived the telehealth curriculum as educational and recommend it be continued for future FNP cohorts.

Conclusion

Using evidence‐based practice and telehealth experts graduate nursing programs should introduce the telehealth curriculum for FNP students through in class lecture and simulation.

Behavioral Intention to Use Mobile Technology in Language Teaching

This study aimed to qualitatively investigate the factors that influence teachers' behavioral intention to use mobile technology (BIU) for language teaching employing the original technology acceptance model (TAM) as a framework. Semi-structured interviews were conducted with 28 Arabic and English teachers. The study results revealed that there were several external variables influencing teachers' behavioral intention to use mobile technology. It was also found that participants had mixed levels of perceived ease of use (PEOU), perceived usefulness (PU), and attitude toward use (ATU). Moreover, it was concluded that ATU had a direct impact on BIU and PU was the responsible factor for participants who had a mixed ATU.

Digital technology adoption scale in the blended learning context in higher education: Development, validation and testing of a specific tool

The main aim of the present study was to develop, validate and test an extended Technology Acceptance Model (TAM) that contributes to the overall understanding of students' intention to use digital tools in a blended learning context of higher education. The external bidimensional factor of familiarity with digital tools, which is not usually explained by the TAM, was included, and evaluated. Following a four-stage scale development technique, a seven-dimensional 25-item survey was developed, which includes two external correlated variables: familiarity with high-tech digital tools and familiarity with traditional digital tools, two mediator variables—computer anxiety, and perceived barriers, and three response variables, perceived usefulness, perceived ease of use and intention to use. The initial version of the survey was administered on 250 undergraduate students. Next, for another sample of 206 students, latent dimensions of the survey were tested using exploratory factor analysis. The structure of the survey was validated in two other subsequent stages with one sample of 262 responses of undergraduates and one of 310 responses of master's students from two different universities. All students who agreed to participate in research attended blended learning. The validity, reliability and invariance of the instrument were established by psychometric analyses. Collected data indicated that the survey has an adequate multifactorial structure that is reliable and invariant across degree levels. The scale is recommended for use in higher education studies targeting the promotion of blended learning and reduction of negative attitudes of learners toward digital instruments, supporting university professors to select their own efficient way to teach.

Factors influencing acceptance of robotics in hospital pharmacy: a longitudinal study using the Extended Technology Acceptance Model

OBJECTIVES

To explore factors influencing hospital pharmacy staff acceptance of a pharmacy robotic dispensing system during implementation and over time.

METHODS

A single centred, prospective, longitudinal cohort quantitative study was conducted in an Australian tertiary public hospital using the Extended Technology Acceptance Model (ETAM). Staff were surveyed during the implementation of a pharmacy dispensing robot (May 2016) and again after working with the system for fifteen months (August 2017). Fishers exact test and correlation analysis of paired responses were used to identify significant factors influencing use of the system between the two time points.

KEY FINDINGS

Sixty four respondents completed surveys during implementation (n=64) and 34-paired surveys were collected fifteen months later. Respondents were predominantly young, female with a tertiary qualification. Initial perceptions did not change over time, with the exception of reliability. Departmental leaders had greatest influence on technology acceptance during implementation and over time. Other key factors correlating with acceptance included: how useful the robot was perceived to be; ease of use and how relevant the robot was for an individual role. Higher levels of education had a negative association with usage during implementation and age was not a factor.

CONCLUSION

This study identified critical insights influencing staff acceptance of pharmacy robots that will help inform future implementation. The influence of pharmacy leaders emerged as key influence on technology acceptance. Leveraging on this influence a communication strategy prior to implementation should include information on useful functions and known benefits of the system customised for individual roles.

Power Gaps Among Stakeholders in Israel's Primary Care and the Role of Primary Care Physicians' Relative Power in Their Intention to Use Video-Consultations with Patients

Introduction: Although some correlates of primary care physicians (PCPs) telemedicine adoption have been studied, little is known about whether the intention to use video-consultations (VCs) relates to how PCPs view their power, relative to other stakeholder groups in primary care. The aim of this study was (1) to describe PCPs', patients', and policy makers' (PMs) views of their power and (2) to explore how PCPs views of power are associated with their intention to use VC. Methods: A convergent parallel mixed-methods design was used. Interviews were conducted with five focus groups that comprised 42 patients; five focus groups with 52 PCPs; and 24 individual interviews with PMs. A total of 508 patients, 311 PCPs, and 141 PMs completed the questionnaire, assessing intention to use VC and stakeholders' relative power. The qualitative data were analyzed using the thematic method; survey data were analyzed using quantitative methods. Results: All stakeholder groups rated PCPs' power as significantly lower, relative to that of patients and managers. PCPs' intention to use telemedicine was found to be significantly related to perceived power gaps between them and patients (r = -0.24, p < 0.001) and between them and managers (r = -0.45, p < 0.001). Themes revealed in the analysis describing how PCPs' low power influences their intention to use VC were as follows: PCPs' low-impact telemedicine-related decisions, increased work overload, "big brother" control, and Health Maintenance Organization demands for telemedicine mandatory usage. Conclusions: To successfully adopt VC, efforts should be made to increase PCPs' relative power, by strengthening their involvement in decision-making procedures and by increasing PCPs' control over their work environment.

A six-year repeated evaluation of computerized clinical decision support system user acceptability

OBJECTIVE

Long-term acceptability among computerized clinical decision support system (CDSS) users in pediatrics is unknown. We examine user acceptance patterns over six years of our continuous computerized CDSS integration and updates.

MATERIALS AND METHODS

Users of Child Health Improvement through Computer Automation (CHICA), a CDSS integrated into clinical workflows and used in several urban pediatric community clinics, completed annual surveys including 11 questions covering user acceptability. We compared responses across years within a single healthcare system and between two healthcare systems. We used logistic regression to assess the odds of a favorable response to each question by survey year, clinic role, part-time status, and frequency of CHICA use.

RESULTS

Data came from 380 completed surveys between 2011 and 2016. Responses were significantly more favorable for all but one measure by 2016 (OR range 2.90-12.17, all p < 0.01). Increasing system maturity was associated with improved perceived function of CHICA (OR range 4.24-7.58, p < 0.03). User familiarity was positively associated with perceived CDSS function (OR range 3.44-8.17, p < 0.05) and usability (OR range 9.71-15.89, p < 0.01) opinions.

CONCLUSION

We present a long-term, repeated follow-up of user acceptability of a CDSS. Favorable opinions of the CDSS were more likely in frequent users, physicians and advanced practitioners, and full-time workers. CHICA acceptability increased as it matured and users become more familiar with it. System quality improvement, user support, and patience are important in achieving wide-ranging, sustainable acceptance of CDSS.

Understanding the perception towards using mHealth applications in practice

The objective of this study was to investigate physicians’ perceptions to use mobile health applications in practice, and to identify influencing factors to use the technology. An mHealth technology acceptance model was proposed (M-TAM), and a cross-sectional survey was implemented using structured questionnaire to collect data. Online tools were used for inviting participants (physicians) and data collection from Turkey. The data was analyzed using Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM). A total of 128 physicians participated in the survey. The model explained the perception of physicians towards mHealth application use by 51% of total variance. The influential factors were identified as Effort Expectancy, Mobile Anxiety, Perceived Service Availability and Technical Training and Support. The study provided a new model to the literature of health information technology. Findings of the research contributed by unveiling latent constructs and their influence on physicians’ perceptions towards a new healthcare technology: mHealth applications.