Analyzing older users' home telehealth services acceptance behavior-applying an Extended UTAUT model

Investigating Continuance Intention for Telehealth Visits in Children's Hospitals: Survey-Based Study

BACKGROUND

Telehealth visits are remote health care consultations conducted using digital technologies, such as video calls, phone calls, or web-based platforms. This type of service offers numerous benefits for both health care users and health care providers. Users save time and money by avoiding traveling to health care facilities. At the same time, health care providers can expand access to care for users in remote areas and enhance the continuity of care. These advantages are even more evident in pediatric settings, where attending in-person services must align with the commitments of the patient (eg, school activities) and the caregiver. Although the potential benefits of telehealth visits for users and health care providers were already known before the COVID-19 pandemic, its widespread adoption only occurred during it. Having experienced its benefits, hospitals are now, in the postpandemic phase, determined to maintain and strengthen their remote service offerings. It has, therefore, become crucial for them to understand the factors influencing users' intention to continue using telehealth visits (or "continuance intention"), even now after the access restrictions to health care facilities imposed during the COVID-19 pandemic have been lifted. However, the literature lacks comprehensive, valid, and reliable models explaining users' continuance intention toward telehealth visit services.

OBJECTIVE

This study aims to investigate the variables impacting users' continuance intention toward telehealth visits and identify suggestions for improvement.

METHODS

Two models of variables impacting users' continuance intention toward telehealth visits were developed. The first model applied to all users undergoing telehealth visits, while the second one applied only to patients who received a telehealth visit using videoconferencing tools. The models were created based on the literature and a qualitative study comprising interviews with physicians with extensive experience in telehealth visits. The models were then tested using partial least squares structural equation modeling on 477 responses obtained by administering a survey to guardians of patients who had received at least 1 telehealth visit in a major European children's hospital.

RESULTS

Both models showed that the variable information quality positively influenced the variables continuance intention and perceived usefulness and that perceived usefulness positively influenced continuance intention. The first model was robust to the medical specialty and the channel used to deliver the visit. The second model also showed that systems quality positively influenced information quality.

CONCLUSIONS

This study has identified and tested 2 comprehensive, valid, and reliable models on the variables influencing users' continuance intention toward telehealth visits. Moreover, the study's results provide insights for hospitals to improve telehealth visit services.

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.

Patient perceptions and predictors of intention to use telehealth for follow-up care: a mixed methods study among adults living with HIV in Kampala, Uganda

BACKGROUND

The human immunodeficiency virus (HIV) remains a significant global public health challenge. Despite progress in addressing the pandemic, people living with HIV continue to report challenges in accessing HIV testing, care, and treatment services. Telehealth presents a promising solution to some of these barriers. However, its potential remains unrealized, particularly in low- and middle-income settings, partly due to insufficient supporting evidence.

METHODS

Our mixed methods study investigated patient perceptions and predictors of intention to use telehealth for follow-up HIV care in Uganda. Quantitative data were collected from 266 participants using a questionnaire, followed by one-on-one interviews with 12 people living with HIV. Quantitative analysis involved Chi-square tests, t-tests, and binary logistic regression, while qualitative data were analyzed using conventional content analysis.

RESULTS

Our findings show that the intention to use telehealth was significantly associated with effort expectancy (aOR 1.26, CI 1.13-1.41), facilitating conditions (aOR 1.44, CI 1.19-1.73), estimated monthly income (aOR 2.94, CI 1.05-8.23; aOR 7.29, CI 1.12-47.49), and antiretroviral medication adherence (aOR 1.93, CI 1.12-3.33). Qualitative insights underscore the importance of digital literacy and availability of support services to enhance the utilization of telehealth. While performance expectation and stigma score did not significantly predict intention to use telehealth, participants perceived telehealth to be beneficial in combating stigma and improving access to HIV care services.

CONCLUSIONS

To optimize the utilization of telehealth, we recommend measures aimed at addressing economic disparities and enhancing digital literacy among people living with HIV. Future research should explore the effectiveness of economic empowerment programs in promoting telehealth use and investigate the impact of telehealth on HIV care models, stigma reduction, and linkage and retention in HIV care.

Factors Influencing Health Care Technology Acceptance in Older Adults Based on the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology: Meta-Analysis

BACKGROUND

The technology acceptance model (TAM) and the unified theory of acceptance and use of technology (UTAUT) are widely used to examine health care technology acceptance among older adults. However, existing literature exhibits considerable heterogeneity, making it difficult to determine consistent predictors of acceptance and behavior.

OBJECTIVE

We aimed to (1) determine the influence of perceived usefulness (PU), perceived ease of use (PEOU), and social influence (SI) on the behavioral intention (BI) to use health care technology among older adults and (2) assess the moderating effects of age, gender, geographic region, type of health care technology, and presence of visual demonstrations.

METHODS

A systematic search was conducted across Google Scholar, Web of Science, Scopus, IEEE Xplore, and ProQuest databases on March 15, 2024, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Of the 1167 initially identified studies, 41 studies (11,574 participants; mean age 67.58, SD 4.76 years; and female:male ratio=2.00) met the inclusion criteria. The studies comprised 12 mobile health, 12 online or telemedicine, 9 wearable, and 8 home or institution hardware investigations, with 23 studies from Asia, 7 from Europe, 7 from African-Islamic regions, and 4 from the United States. Studies were eligible if they used the TAM or UTAUT, examined health care technology adoption among older adults, and reported zero-order correlations. Two independent reviewers screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale, evaluating selection, comparability, and outcome assessment with 34% (14/41) of studies rated as good quality and 66% (27/41) as satisfactory.

RESULTS

Random-effects meta-analysis revealed significant positive correlations for PU-BI (r=0.607, 95% CI 0.543-0.665; P<.001), PEOU-BI (r=0.525, 95% CI 0.462-0.583; P<.001), and SI-BI (r=0.551, 95% CI 0.468-0.624; P<.001). High heterogeneity was observed across studies (I²=95.9%, 93.6%, and 95.3% for PU-BI, PEOU-BI, and SI-BI, respectively). Moderator analyses revealed significant differences based on geographic region for PEOU-BI (Q=8.27; P=.04), with strongest effects in Europe (r=0.628) and weakest in African-Islamic regions (r=0.480). Technology type significantly moderated PU-BI (Q=8.08; P=.04) and SI-BI (Q=14.75; P=.002), with home or institutional hardware showing the strongest effects (PU-BI: r=0.736; SI-BI: r=0.690). Visual demonstrations significantly enhanced PU-BI (r=0.706 vs r=0.554; Q=4.24; P=.04) and SI-BI relationships (r=0.670 vs r=0.492; Q=4.38; P=.04). Age and gender showed no significant moderating effects.

CONCLUSIONS

The findings indicate that PU, PEOU, and SI significantly impact the acceptance of health care technology among older adults, with heterogeneity influenced by geographic region, type of technology, and presence of visual demonstrations. This suggests that tailored strategies for different types of technology and the use of visual demonstrations are important for enhancing adoption rates. Limitations include varying definitions of older adults across studies and the use of correlation coefficients rather than controlled effect sizes. Results should therefore be interpreted within specific contexts and populations.

Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey Study

BACKGROUND

The aging population and the accompanying rise in chronic diseases have intensified the need to study the adoption of telehealth services. However, the success of telehealth services depends not only on their ease and usefulness but also on addressing broader concerns. Despite being a substantial user group in traditional health services, older adults may encounter barriers to adopting telehealth services. Increasing the adoption of telehealth among the older adult population is crucial for enhancing their access to care and managing the challenges of aging effectively.

OBJECTIVE

We aimed to explore factors influencing the adoption of telehealth services among older adults in Malaysia, going beyond the conventional framework by incorporating transition cost and subjective well-being as additional constructs.

METHODS

A cross-sectional survey was conducted among 119 adults aged ≥60 years in Malaysia, using 39 survey items adapted from existing studies. Data analysis was performed using partial least squares structural equation modeling, with both the measurement model and structural model being evaluated. To determine the predictive relevance of the model, PLSpredict was applied. In addition, importance-performance map analysis was conducted to further expand on the structural model results by assessing the performance of each variable.

RESULTS

Of the 119 participants, 52 (43.7%) were women and 67 (56.3%) were men. The study found that subjective well-being (β=0.448; P<.001) was the most significant factor, followed by attitude (β=0.242; P<.001), transition cost (β=-0.163; P<.001), and perceived usefulness (β=0.100, P=.02) in influencing telehealth service intention. Furthermore, perceived ease of use (β=0.271; P<.001), availability (β=0.323; P<.001), subjective well-being (β=0.261; P<.001), and trust (β=0.156, P=.004) positively influenced perceived usefulness, while inertia (β=0.024, P=.22) did not. In addition, availability (β=0.420; P<.001) and subjective well-being (β=0.260; P<.001) were positively related to perceived ease of use, with inertia (β=-0.246; P<.001) having a negative impact. The importance-performance map analysis results showed that subjective well-being (importance=0.532) was the most crucial factor for older adult users, while availability (importance=70.735) had the highest performance in telehealth services.

CONCLUSIONS

This research underscores the importance of catering to the subjective well-being of older adults and optimizing the availability of telehealth services to encourage adoption, ultimately advancing health care accessibility and quality for this vulnerable demographic.

Ageing and digital shopping: Measurement and validation of an innovative framework

Senior citizens are the fastest growing demographic in the world. Amid an intensification of digitalisation across every sector, evidence suggests older people are slow to adopt and use many online tools and services. Moreover, despite studies showing differences in the online behaviour of older people compared to the rest of the population, established models specifically dedicated to explaining their behaviour have remained limited. Therefore, based on components of UTAUT, we propose a new conceptual model that specifically focuses on senior citizens. We introduce four new constructs: health needs, place of settlement (rural/urban), perceived trust, and perceived risk. Data were collected from 320 seniors in Russia and a structural equation modelling was used for data analysis. With a cumulative variance of 86%, the test and validation results demonstrate that our proposed model provides a better explanation of older people's online shopping behaviour than the original UTAUT model. This model provides an important framework for future studies on the digital shopping behaviours of seniors.

Exploring farmers' psychological perspectives on multimedia-based agro-advisory services

Agro-advisory through multimedia plays a crucial role for improving farmers' access to information and serves as a ready reckoner for the stakeholders to make better and informed decisions. Although there is existing research on multimedia-based agro-advisory services (MAS), there remains a significant gap in understanding the psychological factors that affect their usage behaviour (UB), especially among agricultural stakeholders. This demands further investigation through region-specific studies to comprehensively address this gap and devise target-based interventions for their uptake. The current study developed a conceptual model by adapting a well-established framework of the Unified Theory of Acceptance and Use of Technology (UTAUT) to elucidate the psychological elements that impact agricultural stakeholders' MAS usage behaviour. The developed model included constructs such as effort expectancy (EE), self-efficacy (SE), credibility (CR), risk perception (RP), and perceived benefit (PB), which was evaluated using exploratory and confirmatory factor analysis followed by the covariance-based Survey Weighted Structural Equation Modeling (SWSEM) approach from the responses of 225 farmers from Indo-Gangetic plains of India. The findings suggested that EE, SE, and CR of the sources of MAS are the significant determinants of the perceived benefits of MAS with Comparative Fit Index = 0.942, Tucker-Lewis Index = 0.933, and RMSE of Approximation = 0.063 and SRMR = 0.069 and perceived benefit is positively associated with usage behaviour of MAS. The outcomes contribute to the literature on MAS and offer valuable insights for the researchers, policymakers, academicians, and extension advisory service providers.

Telehealth perceptions and associated factors among older adults with chronic conditions in Saudi Arabia: a comparative study of users and non-users

Background

Telehealth is a promising approach for healthcare delivery that uses telecommunication technologies to enhance accessibility by providing remote health services. This study aimed to identify psychosocial factors that best predict behavioral intention to use telehealth/telemedicine, as mediated by attitude toward use, among older adults with chronic conditions in the Jazan region of Saudi Arabia, and to compare users and non-users.

Methods

Participants were aged 60 years or above, residing in Jazan, and presenting with at least one chronic condition. This study used a quantitative research approach with a cross-sectional questionnaire survey. We stratified all analyses by telehealth use status (users or non-users).

Results

Our study sample comprised 466 participants aged 60 or above with at least one chronic condition. The most prevalent condition was diabetes (29%), followed by arthritis (23%). Among the telehealth users (n = 256), a high percentage (42%) reported that telehealth was better than in-person appointments. Among telehealth users, we found that perceived usefulness [(users: β = 0.501; p < 0.001) (non-users: β = 0.441; p < 0.001)] and facilitating conditions [(users: β = 0.768; p = 0.001) (non-users: β = 0.807; p < 0.001)] positively affected attitudes to using telehealth. Telehealth users and non-users reported dislike or fear of the service and unavailability of appointments as the most important barriers to using telehealth services.

Conclusion

The results of this study are important for designing new telehealth applications, especially for older adults in Saudi Arabia. Designers and developers must understand that the attributes and capabilities of telehealth applications should be simple and user-friendly to encourage older adults to increase their intention to use telehealth.

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.

Acceptability of Telerehabilitation Among Stroke Survivors in Nigeria

BackgroundThe Covid-19 pandemic has accelerated the adoption of telerehabilitation as a tool to overcome geographical barriers, scarcity of care providers, and improve access to rehabilitation services. However, limited studies exist on its acceptability among care recipients particularly in low-and-middle-income countries.ObjectiveThis mixed-methods study explored the perception and acceptability of telerehabilitation among stroke survivors in Ibadan, Nigeria.MethodsA convenient sample of 44 stroke survivors was surveyed, and six participated in a focus group discussion (FGD). Quantitative data was analyzed using inferential statistics at p < 0.05. Qualitative data was thematically analysed.ResultsParticipants (61.4% males) were aged 60.93 ± 13.10 years. 19(43.3%) of them were favorably disposed to receiving treatment via telerehabilitation. Acceptability differed significantly across marital status, level of education, and socioeconomic status (p < 0.05). Qualitative findings indicated positive perceptions, although participants preferred telerehabilitation as an adjunct to face-to-face physiotherapy. Barriers included unstable internet connectivity, high costs of data, and lack of personal contact with physiotherapists. Facilitators included using telerehabilitation for additional or missed sessions, and the provision of necessary equipment and data by the government.ConclusionOur findings revealed limited acceptability of telerehabilitation among stroke survivors in Ibadan, Nigeria. This underscores the need to address the identified concerns and barriers, to enhance acceptability. A contextualized and multifaceted approach can help create awareness about the effectiveness of telerehabilitation and improve its acceptability.

The mediating effects of perceived usefulness and perceived ease of use on nurses' intentions to adopt advanced technology

This study explored the role of technology systems in influencing nurses' intentions to adopt medical applications that enhance their performance and how technology contributes to improvements in hospital systems. The study examines the intention to use technology through the mediating effects of perceived usefulness and perceived ease of use, with technology sophistication. A random sampling method was employed to gather 687 responses from nurses. The statistical analysis was conducted using AMOS version 25.0 and SPSS. The findings indicate a significant association between technology sophistication (TS), perceived usefulness (PU), perceived ease of use (PEU), and intention to use (IU). Additionally, PU and PEU positively mediate the relationship between TS and IU. This research will benefit policymakers aiming to enhance nurses' performance by adopting modern technology. Authorities should consider introducing advanced technology systems to meet the goals of hospital administration and support nurses effectively.

The Sri Lankan enigma: demystifying public healthcare information systems acceptance

The deployment of Health Information Systems (HIS) in Sri Lanka has been low in adoption compared to developed countries. There has been a dearth of studies to identify the factors that improve the adoption of HIS in developing countries. Thus, this study investigates the factors influencing the acceptance of HIS among public healthcare staff. A survey was administered among 170 medical professionals, including nurses and doctors. Partial Least Squares Structural Equation Modelling (PLS-SEM) was applied to the dataset with 5000 bootstrap subsamples. The research model was developed based on the prior literature and by extending the Technology Acceptance Model (TAM) to the context of public healthcare. A positive relationship was observed between the actual use of HIS and constructs such as perceived usefulness, perceived ease of use, attitude, behavioural intention, prior use of HIS by supervisors, computer anxiety and facilitating conditions. These findings confirm the applicability of the proposed extended TAM in the public healthcare system of a developing country. Furthermore, HIS practitioners and policymakers in the healthcare sector would find these results valuable.

User Experience and Extended Technology Acceptance Model in Commercial Health Care App Usage Among Patients With Cancer: Mixed Methods Study

BACKGROUND

The shift in medical care toward prediction and prevention has led to the emergence of digital health care as a valuable tool for managing health issues. Aiding long-term follow-up care for cancer survivors and contributing to improved survival rates. However, potential barriers to mobile health usage, including age-related disparities and challenges in user retention for commercial health apps, highlight the need to assess the impact of patients' abilities and health status on the adoption of these interventions.

OBJECTIVE

This study aims to investigate the app adherence and user experience of commercial health care apps among cancer survivors using an extended technology acceptance model (TAM).

METHODS

The study enrolled 264 cancer survivors. We collected survey results from May to August 2022 and app usage records from the app companies. The survey questions were created based on the TAM.

RESULTS

We categorized 264 participants into 3 clusters based on their app usage behavior: short use (n=77), medium use (n=101), and long use (n=86). The mean usage days were 9 (SD 11) days, 58 (SD 20) days, and 84 (SD 176) days, respectively. Analysis revealed significant differences in perceived usefulness (P=.01), interface satisfaction (P<.01), equity (P<.01), and utility (P=.01) among the clusters. Structural equation modeling indicated that perceived ease-of-use significantly influenced perceived usefulness (β=0.387, P<.01), and both perceived usefulness and attitude significantly affected behavioral intention and actual usage.

CONCLUSIONS

This study showed the importance of positive user experience and clinician recommendations in facilitating the effective usage of digital health care tools among cancer survivors and contributing to the evolving landscape of medical care.

The Uses and Experiences of Synchronous Communication Technology for Home-Dwelling Older Adults in a Home Care Services Context: Qualitative Systematic Review

BACKGROUND

European health care systems regard information and communication technology as a necessity in supporting future health care provision by community home care services to home-dwelling older adults. Communication technology enabling synchronous communication between 2 or more human actors at a distance constitutes a significant component of this ambition, but few reviews have synthesized research relating to this particular type of technology. As evaluations of information and communication technology in health care services favor measurements of effectiveness over the experiences and dynamics of putting these technologies into use, the nuances involved in technology implementation processes are often omitted.

OBJECTIVE

This review aims to systematically identify and synthesize qualitative findings on the uses and experiences of synchronous communication technology for home-dwelling older adults in a home care services context.

METHODS

The review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist for reporting. We conducted a cross-disciplinary search in 5 databases for papers published between 2011 and 2023 that yielded 4210 citations. A total of 13 studies were included after 4 screening phases and a subsequent appraisal of methodological quality guided by the Critical Appraisal Skills Programme tool. From these, prespecified data were extracted and incorporated in a 3-stage thematic synthesis producing 4 analytical themes.

RESULTS

The first theme presented the multiple trajectories that older users' technology acceptance could take, namely straightforward, gradual, partial, and resistance laden, notwithstanding outright rejection. It also emphasized both instrumental and emotional efforts by the older adults' relatives in facilitating acceptance. Moving beyond acceptance, the second theme foregrounded the different types of work involved in attempts to integrate the technology by older users, their relatives, and health care providers. Theme 3 highlighted how the older users' physical and cognitive conditions formed a contextual backdrop challenging this integration work, together with challenges related to spatial context. Finally, consequences derived from taking the technology into use could be of a both enabling and complicating nature as integration reconfigured the way users related to themselves and each other.

CONCLUSIONS

The acceptance and integration of synchronous communication technology for older adults involves multiple user groups in work tending to the technology, to the users themselves, and to each other through intergroup negotiations. This review's original contribution consists of its attention to the dynamics across different user groups in deriving consequences from using the technology in question, in addition to its assertion that such consequences may be both intentional and unintentional. We argue that our findings may be used to provide nuance to policies addressing-and practices taking place in-contexts that involve similar user technology constellations to the ones explored in this paper.

TRIAL REGISTRATION

PROSPERO CRD42023414243; https://tinyurl.com/wrha6j3f.

Understanding older adults' acceptance of Chatbots in healthcare delivery: an extended UTAUT model

Background

Chatbots are increasingly integrated into the lives of older adults to assist with health and wellness tasks. This study aimed to understand the factors that enhance older adults' acceptance of chatbots in healthcare delivery.

Methods

This study proposed an extended Unified Theory of Acceptance and Use of Technology model (UTAUT), including aging factors of perceived physical condition, self-actualization needs, and technology anxiety. The model was tested by PLS (Partial Least Squares) with data collected from 428 Chinese citizens aged 60 and above.

Results

The results reveal that performance expectancy, effort expectancy, and social influence significantly affected older adults' behavioral intention to use chatbots. The facilitating conditions, self-actualization needs, and perceived physical condition significantly affected the actual use behavior of chatbots by older adults, whereas technology anxiety did not. Furthermore, the influence of effort expectancy and social influence on behavioral intention were moderated by experience.

Conclusion

The behavioral intentions of older adults with low experience are more strongly influenced by social influences and effort expectancy. Furthermore, healthcare providers, designers, and policymakers should emphasize the impact of facilitating conditions, self-actualization needs, and perceived physical conditions on chatbot applications among older adults.

Predictors of the continuous use of an infectious disease self-management app for epidemiological investigations: a survey of young and middle-aged adults in South Korean citizens

BACKGROUND

In the wake of the coronavirus disease-19 (COVID-19) pandemic, research on the difficulties faced by epidemiologists conducting epidemiological investigations has been progressing steadily. However, few studies have developed applications (apps) that can directly support epidemiological investigations via information and communication (ICT) technology, and conducted usability evaluations on them via user responses. This has caused difficulties when developing such technologies. We introduced and evaluated two mobile apps that support epidemiological investigations. This study attempted to identify the predictors affecting the acceptance of infectious disease self-management apps.

METHODS

We developed two infectious disease self-management smartphone apps for epidemiological investigations: KODARI (the Korean version) and MEDARI (in English version). We collected data from 248 users of KODARI by surveying Korean citizens. This study was conducted from November 15 to December 14, 2022. We used multiple regression analysis to identify the variables that affected continuous intention to use the KODARI app. We conducted two independent-samples t-tests to determine whether there were any differences in the perception of each variable in relation to demographic and COVID-19-related user characteristics.

RESULTS

The factors that affected continuous intention to use the KODARI app, in order of relative importance, were: price value, satisfaction, performance expectancy, and facilitating conditions. Overall, male participants were more satisfied with the KODARI app than female ones, and more willing to continue using it. The male participants also evaluated facilitating conditions more positively than the female ones did. Married participants rated the app higher than single ones in terms of price value, performance expectancy, and continued intention to use.

CONCLUSIONS

The study suggests factors that increase the use of health apps and suggests that use of these apps may increase further in the event of a future pandemics. These results are expected to help researchers study other infectious disease apps in the context of public health surveillance.

[Factors Affecting the Intention to Use Smartmonitor-Based Mobile Health in Middle-Aged in Patients Applying the Technology Acceptance Model II]

PURPOSE

This study aimed to identify factors that influence the intention to use smart monitor-based mobile health (SBM) technology among middle-aged inpatients, based on the technology acceptance model II (TAM II).

METHODS

A total of 222 participants were surveyed. Data were analyzed using SPSS Statistics 23.0 and IBM SPSS Amos 23. Seven exogenous variables-social influence (SI), personal self-efficacy, (PSE), environmental self-efficacy (ESE), health literacy, health concerns, resistance to innovative technology (RIT), accessibility (AC)-and three endogenous variables-perceived ease of use (PEOU), perceived usability (PU), and intention to use (ITU)-were investigated.

RESULTS

The hypothesized path model demonstrated a good fit for the data. SI (β = .13, p = .042), PU (β = .46, p < .001), and PEOU (β = .16, p = .008) had significant direct effects on the ITU, which explained 39.5% of the variance. Additionally, SI (β = .27, p < .001), ESE (β = .16, p = .010), RIT (β = -.12, p = .026), AC (β = .28, p < .001), and PEOU (β = .20, p = .001) indirectly affected ITU through PU, which explained 50.7% of the variance. Furthermore, PSE (β = .38, p < .001) indirectly influenced ITU via PEOU, which explained 38.4% of the variance.

CONCLUSION

This study demonstrates that the TAM II can be used to effectively predict ITU in SBMs among middle-aged inpatients. To expand the intention to use SBMs, it is necessary to develop SBMs that include content and programs that promote PU, SI, and PEOU.

Determinants of the intention to use mHealth in the future: Evidence from an intervention study of patients with chronic diseases in Slovenia

BACKGROUND

Mobile health (mHealth) implementation is crucial for developing sustainable healthcare systems, but it faces the challenge of user acceptance. Extending traditional acceptance models allows for the cognitive, emotional and social aspects of engaging with mHealth to be captured, creating a more comprehensive understanding of users' intentions to use it in the future. User-centred intervention studies based on users' real experiences with mHealth are essential for accurate assessments and for improving upon studies that rely merely on anticipated mHealth use.

METHODS

An intervention study was conducted with 103 patients with at least one chronic condition (type 2 diabetes and/or arterial hypertension) who had used an mHealth service for three months. They were recruited through purposive sampling at a community health centre in Slovenia. Path analysis was applied to the survey data collected after a three-month testing period to validate an explanatory model with eight hypotheses.

RESULTS

The intensity of mHealth use affected usability, which in turn affected acceptability, the psychosocial impacts of engagement with mHealth and intention for future use. The results showed that the intensity of mHealth use did not affect mHealth acceptability. Likewise, acceptability did not affect the psychosocial impacts of engagement with mHealth or the intention for its future use. Notably, perceptions of the psychosocial impacts of mHealth had no significant effect on the intention for future use.

CONCLUSION

Usability and intensity of use play a central role in the post-intervention usage of mHealth, offering valuable insights for policymakers and healthcare providers involved in the delivery of mHealth-based treatment to patients with chronic diseases.

Determining the acceptance of e-mental health interventions in elite athletes using the unified theory of acceptance and use of technology

Background

Elite athletes are exposed to many different sport-specific stressors that may put them at particular risk for mental health symptoms and disorders. E-mental health interventions could be a feasible option to support elite athletes in need. The aim of the present study was to assess the acceptance of e-mental health interventions among elite athletes and explore its underlying drivers and barriers.

Materials and methods

A cross-sectional study was conducted with N = 382 elite athletes. Of these, N = 275 (71.99%, 167 females) were included in the statistical analyses. The impact of various sociodemographic, sport-related and medical characteristics on acceptance was assessed. EHealth-related data and acceptance of e-mental health interventions were examined using a modified assessment based on the Unified Theory of Acceptance and Use of Technology (UTAUT).

Results

Overall, the acceptance of e-mental health interventions in elite athletes can be classified as high (M = 3.69 SD = 0.97). In the UTAUT regression model sex, financial situation, depression symptoms, digital confidence, digital overload as well as the UTAUT predictors performance expectancy, effort expectancy, and social influence predicted acceptance significantly.

Conclusions

The UTAUT model has proven to be a valuable instrument in predicting of acceptance of e-mental health interventions in elite athletes. Given the strong association between acceptance and future use, new interventions should focus on the explored factors to establish effective e-mental health interventions for elite athletes.

The acceptability and effectiveness of artificial intelligence-based chatbot for hypertensive patients in community: protocol for a mixed-methods study

BACKGROUND

Chatbots can provide immediate assistance tailored to patients' needs, making them suitable for sustained accompanying interventions. Nevertheless, there is currently no evidence regarding their acceptability by hypertensive patients and the factors influencing the acceptability in the real-world. Existing evaluation scales often focus solely on the technology itself, overlooking the patients' perspective. Utilizing mixed methods can offer a more comprehensive exploration of influencing factors, laying the groundwork for the future integration of artificial intelligence in chronic disease management practices.

METHODS

The mixed methods will provide a holistic view to understand the effectiveness and acceptability of the intervention. Participants will either receive the standard primary health care or obtain a chatbot speaker. The speaker can provide timely reminders, on-demand consultations, personalized data recording, knowledge broadcasts, as well as entertainment features such as telling jokes. The quantitative part will be conducted as a quasi-randomized controlled trial in community in Beijing. And the convergent design will be adopted. When patients use the speaker for 1 month, scales will be used to measure patients' intention to use the speaker. At the same time, semi-structured interviews will be conducted to explore patients' feelings and influencing factors of using speakers. Data on socio-demography, physical examination, blood pressure, acceptability and self-management behavior will be collected at baseline, as well as 1,3,6, and 12 months later. Furthermore, the cloud database will continuously collect patients' interactions with the speaker. The primary outcome is the efficacy of the chatbot on blood pressure control. The secondary outcome includes the acceptability of the chatbot speaker and the changes of self-management behavior.

DISCUSSION

Artificial intelligence-based chatbot speaker not only caters to patients' self-management needs at home but also effectively organizes intricate and detailed knowledge system for patients with hypertension through a knowledge graph. Patients can promptly access information that aligns with their specific requirements, promoting proactive self-management and playing a crucial role in disease management. This study will serve as a foundation for the application of artificial intelligence technology in chronic disease management, paving the way for further exploration on enhancing the communicative impact of artificial intelligence technology.

TRIAL REGISTRATION

Biomedical Ethics Committee of Peking University: IRB00001052-21106, 2021/10/14; Clinical Trials: ChiCTR2100050578, 2021/08/29.

Understanding the predictors of health professionals' intention to use electronic health record system: extend and apply UTAUT3 model

BACKGROUND

The implementation of Electronic Health Record (EHR) systems is a critical challenge, particularly in low-income countries, where behavioral intention plays a crucial role. To address this issue, we conducted a study to extend and apply the Unified Theory of Acceptance and Use of Technology 3 (UTAUT3) model in predicting health professionals' behavioral intention to use EHR systems.

METHODS

A quantitative research approach was employed among 423 health professionals in Southwest Ethiopia. We assessed the validity of the proposed model through measurement and structural model statistics. Analysis was done using SPSS AMOS version 23. Hypotheses were tested using structural equation modeling (SEM) analysis, and mediation and moderation effects were evaluated. The associations between exogenous and endogenous variables were examined using standardized regression coefficients (β), 95% confidence intervals, and p-values, with a significance level of p-value < 0.05.

RESULTS

The proposed model outperformed previous UTAUT models, explaining 84.5% (squared multiple correlations (R2) = 0.845) of the variance in behavioral intention to use EHR systems. Personal innovativeness (β = 0.215, p-value < 0.018), performance expectancy (β = 0.245, p-value < 0.001), and attitude (β = 0.611, p-value < 0.001) showed significant associations to use EHR systems. Mediation analysis revealed that performance expectancy, hedonic motivation, and technology anxiety had significant indirect effects on behavioral intention. Furthermore, moderation analysis indicated that gender moderated the association between social influence, personal innovativeness, and behavioral intention.

CONCLUSION

The extended UTAUT3 model accurately predicts health professionals' intention to use EHR systems and provides a valuable framework for understanding technology acceptance in healthcare. We recommend that digital health implementers and concerned bodies consider the comprehensive range of direct, indirect, and moderating effects. By addressing personal innovativeness, performance expectancy, attitude, hedonic motivation, technology anxiety, and the gender-specific impact of social influence, interventions can effectively enhance behavioral intention toward EHR systems. It is crucial to design gender-specific interventions that address the differences in social influence and personal innovativeness between males and females.

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.

Acceptance of a mobile telepresence robot used to teach adapted physical activity to isolated older adults: extending and testing the technology acceptance model

This study aimed to investigate the acceptance of adapted physical activity (APA) by teachers and students before the use of a mobile telepresence robot (MTR), used to remotely supervise isolated older adults' physical activity. While previous studies have shown MTR to be fairly well accepted by older adults, nothing is known about its acceptance by APA teachers themselves. However, if they did not accept it, the MTR would not be used in the end. This would be a public health issue because isolated older adults would not benefit from supervised APA, yet beneficial to their health. To this end, 334 participants answered a survey that measured different psychological variables, based on the technology acceptance model (TAM). Student's t-tests and structural equation modeling were used for data processing. Results showed that, before use, there was not any significant difference between teachers' and students' acceptance of the MTR. Then, perceived usefulness for teaching APA, perceived ease of use, perceived enjoyment, and intention to use the MTR were lower than the mean of the scale, while perceived usefulness for older adults was higher than the mean of the scale. Finally, this study has validated an extended version of the TAM (including the need for competence and MTR self-efficacy), which allowed it to explain 84.3% of the variance of the students' and APA teachers' intention to use the MTR for teaching APA to isolated older adults. Initial obstacles to the use of the MTR seem to exist on the part of APA teachers, prior to their first use, whereas this is not the case for older adults. APA teachers' acceptance should therefore be investigated in future studies to examine whether this trend is confirmed after the effective use of the MTR.

Enhancing telehealth services development in Pakistani healthcare sectors through examining various medical service quality characteristics

Introduction

The telehealth service increased attention both during and after the Covid-19 outbreak. Nevertheless, there is a dearth of research in developing countries, including Pakistan. Hence, the objective of this study was to examine telehealth service quality dimensions to promote the telehealth behavior intention and sustainable growth of telehealth in Pakistan.

Methods

This study employed a cross-sectional descriptive design. Data were collected from doctors who were delivering telehealth services through a well-designed questionnaire. To examine the hypothesis of the study, we employed the Smart PLS structural equation modeling program, namely version 0.4.

Results

The study findings indicate that medical service quality, affordability, information quality, waiting time, and safety have a positive impact on the intention to engage in telehealth behavior. Furthermore, the adoption of telehealth behavior has a significant favorable effect on the actual utilization of telehealth services, which in turn has a highly good impact on sustainable development.

Conclusion

The study determined that telehealth services effectively decrease the amount of time and money spent on travel, while still offering convenient access to healthcare. Furthermore, telehealth has the potential to revolutionize payment methods, infrastructure, and staffing in the healthcare industry. Implementing a well-structured telehealth service model can yield beneficial results for a nation and its regulatory efforts in the modern age of technology.

Development and Validation of the Saudi Telehealth Acceptance Scale Based on the Unified Theory of Acceptance and Use of Technology

Background

Telehealth is in early stages in the Kingdom of Saudi Arabia (KSA). Identifying barriers to using telehealth is an essential step prior to its implementation; however, no theoretically based scales exist for the same purpose.

Objective

To design a theory-based scale capable of measuring telehealth users' perceptions of benefits, barriers, and social influence in the KSA.

Methods

The Saudi Telehealth Acceptance Scale (STAS) was constructed based on the Unified Theory of Acceptance and Use of Technology and its content validity was determined by eight experts using the modified Delphi process. Only items with a content validity index score of ≥0.83 were chosen. Finally, the face validity of the questionnaire for healthcare professionals, which was in English, was determined by eight healthcare professionals, and for the patient version, which was in Arabic, by six patients.

Results

Initially, 37 items were identified; however, after Round 1, 29 items remained and after Round 2, 24 items were included in the STAS for both healthcare professionals and patients. In the healthcare professionals scale, there were 7 performance expectancy (PE) items, 6 effort expectancy (EE) items, 3 social influence (SI) items, 4 facilitating conditions (FC) items, and 4 behavioral intention (BI) items, while in the scale for patients, there were 9 PE items, 4 EE items, 3 SI items, 4 FC items, and 4 BI items.

Conclusions

The two new scales showed evidence of content and face validity. The significance of the two scales is that they were both designed in the context of the healthcare system in the KSA and could provide standardized data collection tools to measure the acceptance of telehealth among HCPs and patients.

Health professionals' acceptance of mobile-based clinical guideline application in a resource-limited setting: using a modified UTAUT model

INTRODUCTION

Clinical guidelines are crucial for assisting health professionals to make correct clinical decisions. However, manual clinical guidelines are not accessible, and this increases the workload. So, a mobile-based clinical guideline application is needed to provide real-time information access. Hence, this study aimed to assess health professionals' intention to accept mobile-based clinical guideline applications and verify the unified theory of acceptance and technology utilization model.

METHODS

Institutional-based cross-sectional study design was used among 803 study participants. The sample size was determined based on structural equation model parameter estimation criteria with stratified random sampling. Amos version 23 software was used for analysis. Internal consistency of latent variable items, and convergent and divergent validity, were evaluated using composite reliability, AVE, and a cross-loading matrix. Model fitness of the data was assessed based on a set of criteria, and it was achieved. P-value < 0.05 was considered for assessing the formulated hypothesis.

RESULTS

Effort expectancy and social influence had a significant effect on health professionals' attitudes, with path coefficients of (β = 0.61, P-value < 0.01), and (β = 0.510, P-value < 0.01) respectively. Performance expectancy, facilitating condition, and attitude had significant effects on health professionals' acceptance of mobile-based clinical guideline applications with path coefficients of (β = 0.37, P-value < 0.001), (β = 0.44, P-value < 0.001) and (β = 0.57, P-value < 0.05) respectively. Effort expectancy and social influence were mediated by attitude and had a significant partial relationship with health professionals' acceptance of mobile-based clinical guideline application with standardized estimation coefficients of (β = 0.22, P-value = 0.027), and (β = 0.19, P-value = 0.031) respectively. All the latent variables accounted for 57% of health professionals' attitudes, and latent variables with attitudes accounted for 63% of individuals' acceptance of mobile-based clinical guideline applications.

CONCLUSIONS

The unified theory of acceptance and use of the technology model was a good model for assessing individuals' acceptance of mobile-based clinical guidelines applications. So, enhancing health professionals' attitudes, and computer literacy through training are needed. Mobile application development based on user requirements is critical for technology adoption, and people's support is also important for health professionals to accept and use the application.

Child Health Nurses' Acceptance and Use of a Novel Telehealth Platform: A Mixed-Method Study

Telehealth appointments in the healthcare sector have increased since the COVID-19 pandemic, increasing patients' access to services. However, research exploring nurse perceptions of implemented telehealth services in the community sector is limited. Within the context of quality improvement, the current study aimed to understand child health nurses' acceptance and use of a novel telehealth platform using mixed methods. A total of 38 child health nurses completed an online survey that included multiple-choice questions based on an expanded Technology Acceptance Model and open-ended questions exploring barriers and facilitators to use. Results demonstrated that despite 70% of nurse users having completed less than three sessions with parents, perception and acceptance scores were high. Overall, 85% of variance in satisfaction with the platform and 46% of variance in intention to use the platform were predicted by perception scores. Three consistent themes generated from data were facilitators for use and five as barriers, which provided further understanding to findings. To ensure telehealth is adapted into routine clinical care, facilitators and barriers for implementation need to be identified and addressed. Nurses need to be engaged in implementation and ongoing maintenance to ensure the uptake and optimal use of technology within nursing care.

Factors Associated with Intention to Use Telerehabilitation for Children with Special Needs: A Cross-Sectional Study

Background: Children with special health care needs (CSHCN) require long-term and ongoing rehabilitation interventions supporting their development. Telerehabilitation can provide continuous rehabilitation services for CSHCN. However, few studies have explored the intention of CSHCN and their caregivers to use telerehabilitation and its impact on them. Objective: The objective of this study was to identify factors that influence the intention to use telerehabilitation among CSHCN and their caregivers. Methods: This study was a cross-sectional study. Based on the unified theory of acceptance and use of technology, extended with additional predictors (trust and perceived risk [PR]), this study developed a research model and proposed 10 hypotheses. A structured questionnaire was distributed to 176 caregivers. Data were analyzed and research hypotheses were tested using partial least squares structural equation modeling to better understand the factors influencing the use of telerehabilitation. Results: A total of 164 valid questionnaires were collected. CSHCN and their caregivers were overall satisfied with this telerehabilitation medical service. The results of the structural model analysis indicated that social influence (SI), facilitating conditions (FC), and trust had significant effects on behavioral intention (BI) to use telerehabilitation, while the paths between performance expectancy (PE), effort expectancy (EE), and PR and BI were not significant. PE, EE, and SI had a significant effect on trust. Moreover, EE and SI had indirect effects on BI, with trust as the mediator. Conclusions: The results indicated that SI, FC, and trust are significant factors influencing CSHCN and their caregivers' use of telerehabilitation. Trust is also an important mediator for the intention and highly influenced by PE, EE, and SI.

Acceptance of voice assistant technology in dental practice: A cross sectional study with dentists and validation using structural equation modeling

Voice assistant technologies (VAT) has been part of our daily lives, as a virtual assistant to complete requested tasks. The integration of VAT in dental offices has the potential to augment productivity and hygiene practices. Prior to the adoption of such innovations in dental settings, it is crucial to evaluate their applicability. This study aims to assess dentists' perceptions and the factors influencing their intention to use VAT in a clinical setting. A survey and research model were designed based on an extended Unified Theory of Acceptance and Use of Technology (UTAUT). The survey was sent to 7,544 Ohio-licensed dentists through email. The data was analyzed and reported using descriptive statistics, model reliability testing, and partial least squares regression (PLSR) to explain dentists' behavioral intention (BI) to use VAT. In total, 257 participants completed the survey. The model accounted for 74.2% of the variance in BI to use VAT. Performance expectancy and perceived enjoyment had significant positive influence on BI to use VAT. Perceived risk had significant negative influence on BI to use VAT. Self-efficacy had significantly influenced perceived enjoyment, accounting for 35.5% of the variance of perceived enjoyment. This investigation reveals that performance efficiency and user enjoyment are key determinants in dentists' decision to adopt VAT. Concerns regarding the privacy of VAT also play a crucial role in its acceptance. This study represents the first documented inquiry into dentists' reception of VAT, laying groundwork for future research and implementation strategies.

Revolutionizing elderly care: Building a healthier aging society through innovative long-term care systems and assessing the long-term care acceptance model

AIM

With a growing elderly population, the demand for caregivers is increasing in Khon Kaen, Thailand, with approximately 17 000 elderly residents. This growing number of older people and a shortage of caregivers could overload the healthcare system.

METHODS

The present study involved 129 healthcare volunteers (caregivers for questionnaires study) and the collection of health data from 290 elderly residents from northeastern Thailand. After training, the volunteers assessed its usefulness through questionnaires. Tool reliability and statistical hypotheses were tested using stratified regression analysis (hierarchical regression) and multiple regression.

RESULTS

The relative mean scores of perceived usefulness, perceived ease of use, attitude toward usage and behavioral intention to use technology were 4.51, 4.29, 4.44 and 4.41, respectively. In addition, perceived usefulness and user attitudes positively affected volunteers' willingness to use the system.

CONCLUSION

The study was developed from the awareness of enhancing community quality and ecosystem through a long-term care system application. Analyzing external factors can enhance technology's future effectiveness. Geriatr Gerontol Int 2024; 24: 477-485.

A meta-analysis of technology acceptance in healthcare from the consumer's perspective

Consumer-oriented health care technologies are increasingly available and transforming global health delivery systems. However, there is a paucity of research that systematically investigates health care technology acceptance from the consumer's perspective. This study conducts a literature review and meta-analysis to examine consumers' adoption intentions toward health care technologies. The findings suggest that technology acceptance models are transferable to health care technology with modifications, and factors such as perceived risks, technology performance expectancy, consumer trust, and habit significantly correlate with consumers' adoption intentions. This study provides valuable insights into health care technology management and practical implications for health care service designers, providers, and regulatory authorities.

Telehealth Care Through Internet Hospitals in China: Qualitative Interview Study of Physicians' Views on Access, Expectations, and Communication

BACKGROUND

Internet hospitals in China are an emerging medical service model similar to other telehealth models used worldwide. Internet hospitals are currently in a stage of rapid development, giving rise to a series of new opportunities and challenges for patient care. Little research has examined the views of chronic disease physicians regarding internet hospitals in China.

OBJECTIVE

We aimed to explore the experience and views of chronic disease physicians at 3 tertiary hospitals in Changsha, China, regarding opportunities and challenges in internet hospital care.

METHODS

We conducted semistructured qualitative interviews with physicians (n=26) who had experience working in internet hospitals affiliated with chronic disease departments in 3 tertiary hospitals in Changsha, Hunan province, south central China. Interviews were transcribed verbatim and analyzed by content analysis using NVivo software (version 11; Lumivero).

RESULTS

Physicians emphasized that internet hospitals expand opportunities to conduct follow-up care and health education for patients with chronic illnesses. However, physicians described disparities in access for particular groups of patients, such as patients who are older, patients with lower education levels, patients with limited internet or technology access, and rural patients. Physicians also perceived a gap between patients' expectations and the reality of limitations regarding both physicians' availability and the scope of services offered by internet hospitals, which raised challenges for doctor-patient boundaries and trust. Physicians noted challenges in doctor-patient communication related to comprehension and informed consent in internet hospital care.

CONCLUSIONS

This study explored the experience and views of physicians in 3 tertiary hospitals in Changsha, China, regarding access to care, patients' expectations versus the reality of services, and doctor-patient communication in internet hospital care. Findings from this study highlight the need for physician training in telehealth communication skills, legislation regulating informed consent in telehealth care, public education clarifying the scope of internet hospital services, and design of internet hospitals that is informed by the needs of patient groups with barriers to access, such as older adults.

Informing existing technology acceptance models: a qualitative study with older persons and caregivers

New technologies can help older persons age in place and support their caregivers. However, they need to be accepted by the end-users to do so. Technology acceptance models, such as TAM and UTAUT and their extensions, use factors like performance expectancy and effort expectancy to explain acceptance. Furthermore, they are based on quantitative methods. Our qualitative study investigates factors fostering and hindering acceptance among older persons and their caregivers for a variety of assistive technologies, including wearables, ambient sensors at home with and without cameras and social companion robots. The goal of this paper is twofold: On the one hand, it investigates the factors of technology acceptance models in a qualitative setting. On the other hand, it informs these models with aspects currently overlooked by them. The results reveal that performance expectancy and effort expectancy are relevant for acceptance. We also find that reliability, anxiety around technology and different social aspects have an influence on acceptance of assistive technology in aged care for all end-user groups. Our findings can be used to update current technology acceptance models and provide in-depth knowledge about the currently used factors.

Factors Predicting Intentions of Adoption and Continued Use of Artificial Intelligence Chatbots for Mental Health: Examining the Role of UTAUT Model, Stigma, Privacy Concerns, and Artificial Intelligence Hesitancy

Background: Artificial intelligence-based chatbots (AI chatbots) can potentially improve mental health care, yet factors predicting their adoption and continued use are unclear. Methods: We conducted an online survey with a sample of U.S. adults with symptoms of depression and anxiety (N = 393) in 2021 before the release of ChatGPT. We explored factors predicting the adoption and continued use of AI chatbots, including factors of the unified theory of acceptance and use of technology model, stigma, privacy concerns, and AI hesitancy. Results: Results from the regression indicated that for nonusers, performance expectancy, price value, descriptive norm, and psychological distress are positively related to the intention of adopting AI chatbots, while AI hesitancy and effort expectancy are negatively associated with adopting AI chatbots. For those with experience in using AI chatbots for mental health, performance expectancy, price value, descriptive norm, and injunctive norm are positively related to the intention of continuing to use AI chatbots. Conclusions: Understanding the adoption and continued use of AI chatbots among adults with symptoms of depression and anxiety is essential given that there is a widening gap in the supply and demand of care. AI chatbots provide new opportunities for quality care by supporting accessible, affordable, efficient, and personalized care. This study provides insights for developing and deploying AI chatbots such as ChatGPT in the context of mental health care. Findings could be used to design innovative interventions that encourage the adoption and continued use of AI chatbots among people with symptoms of depression and anxiety and who have difficulty accessing care.

Strengthening health monitoring: Intention and adoption of Internet of Things-enabled wearable healthcare devices

Objective

Health self-monitoring technologies are gaining popularity worldwide, but they face low adoption rates in emerging countries. There is a deficiency in studies that have applied the value-belief-norm (VBN) model to understand the adoption of IoT-enabled wearable healthcare devices (WHDs). This study investigates the adoption of IoT-enabled WHDs among older adults in China, using the VBN model as a theoretical framework.

Methods

Using a convenience sampling method and a web-based cross-sectional survey method, we collected data from 476 respondents, which we analyzed using partial least squares structural equation modeling using Smart PLS version 3.3.5.

Results

The findings highlight the significance of health values and motivation in shaping personal health beliefs, which, in turn, influence personal norms and awareness of consequences. Particularly, awareness of consequences and attributions of responsibility significantly impact personal norms. Personal and social norms, in turn, strongly affect the intention to adopt IoT-enabled WHDs, ultimately driving their actual adoption.

Conclusion

This research contributes novel insights into the behavioral dynamics surrounding the adoption of IoT-enabled WHDs, providing valuable guidance for marketers and policymakers. Marketers can leverage these insights to develop tailored marketing strategies within the IoT-enabled WHD industry. Additionally, policymakers are urged to prioritize campaigns aimed at enhancing awareness and understanding of self-healthcare monitoring, with a focus on promoting the unique health benefits of IoT-enabled WHDs.

Preparing for aging: Understanding middle-aged user acceptance of AI chatbots through the technology acceptance model

Background

Preparing for aging with personalized technology is crucial due to the growing elderly population. Artificial Intelligence (AI), notably AI chatbots in healthcare, has transformed technology by simulating human-like conversations. Research on middle-aged adults' acceptance of AI chatbots is limited. Assessing middle-aged individuals' intentions to use AI is vital for enhancing AI competency among the elderly and guiding future interventions.

Objective

This study aims to explore the acceptance of middle-aged individuals toward AI chatbots and influencing factors and verify the usability of Technology Acceptance Model 2 (TAM2) in the use of AI technology in middle-aged people, also to inspire the design of future intelligent systems and online interventions for improving the health and well-being of the aging population.

Methods

A cross-sectional design and snowball sampling method were utilized to conduct an online questionnaire survey among middle-aged adults. The questionnaire was compiled based on TAM2 and was created using the online survey platform. SPSS 26.0 software was used for statistical analysis.

Results

A total of 259 valid questionnaires were included in the final data analysis. The study reported the Cronbach's α of 0.94 for the questionnaire. We found that perceived ease of use, subjective norm, and user image significantly influence users' intention to use AI chatbots. Notably, perceived usefulness emerged as a complete mediator in the relationship between subjective norm and intention to use, highlighting its central role in shaping user perceptions. The study also revealed a moderate acceptance level among middle-aged adults, emphasizing the need for targeted interventions.

Conclusions

This study emphasized the importance of customizing AI technology to improve its adoption among middle-aged adults, providing valuable guidance for developers and policymakers. The findings indicated the need for effective aging preparation that includes technological competency, suggesting that future planning should encompass comprehensive preparations for aging to enhance AI competency among the middle-aged population.

Factors Influencing the Behavioral Intentions and Use Behaviors of Telemedicine in Patients With Diabetes: Web-Based Survey Study

BACKGROUND

Telemedicine has great potential for diabetes management. The COVID-19 pandemic has boosted the development of telemedicine. However, the factors influencing the behavioral intentions to use and use behaviors of telemedicine in patients with diabetes in China are not clear.

OBJECTIVE

We aimed to understand the determinants of behavioral intention to use telemedicine based on an extended Unified Theory of Acceptance and Use of Technology model and to identify demographic factors associated with telemedicine use in patients with diabetes in China.

METHODS

Patients with diabetes who are aged ≥18 years were surveyed from February 1 to February 7, 2023. We distributed the survey link in 3 WeChat groups including a total of 988 patients with diabetes from the outpatient department or patients discharged from Changsha Central Hospital. Structural equation modeling was used to understand the determinants of behavioral intention. A multivariate logistic regression analysis was used to identify the demographic factors associated with telemedicine use.

RESULTS

In total, 514 questionnaires were collected. Of the respondents, 186 (36.2%) were diagnosed with COVID-19. The measurement model showed acceptable reliability, convergent validity, discriminant validity, and data fit indices. The model explained 63.8% of the variance in behavioral intention. Social influence, performance expectancy, and facilitating conditions positively influenced behavioral intention (β=.463, P<.001; β=.153, P=.02; and β=.257, P=.004, respectively). Perceived susceptibility, perceived severity, and effort expectancy had no significant impact on behavioral intention (all P>.05). The overall use of telemedicine was 20.6% (104/514). After adjusting for the behavioral intention score, the multivariate regression analysis showed that age, education, and family income were associated with telemedicine use. Telemedicine use was higher in the 40 to 59 years and 18 to 39 years age groups than in the ≥60 years age group (odds ratio [OR] 4.35, 95% CI 1.84-10.29, P=.001; OR 9.20, 95% CI 3.40-24.88, P<.001, respectively). Telemedicine use was higher in the senior high school and the university and more groups than in junior high school education and less group (OR 2.45, 95% CI 1.05-5.73, P=.04; OR 2.63, 95% CI 1.11-6.23, P=.03, respectively). Patients with a higher family income used telemedicine more often than the patients who had an annual family income ≤¥10,000 (CNY ¥1=US $0.1398; ¥10,000-¥50,000 group: OR 3.90, 95% CI 1.21-12.51, P=.02; ¥50,000-¥100,000 group: OR 3.91, 95% CI 1.19-12.79, P=.02; >¥100,000 group: OR 4.63, 95% CI 1.41-15.27, P=.01).

CONCLUSIONS

Social influence, performance expectancy, and facilitating conditions positively affected the behavioral intention of patients with diabetes to use telemedicine. Young patients, highly educated patients, and patients with high family income use telemedicine more often. Promoting behavioral intention and paying special attention to the needs of older adult patients, patients with low income, and patients with low levels of education are needed to encourage telemedicine use.

Determinants of parental self-reported uptake of influenza vaccination in preschool children during the COVID-19 pandemic

In China, the coverage rate of influenza vaccination among the general population is significantly lower than that of high-income countries, with only 2.46% of the population vaccinated. Preschool-aged children are particularly susceptible to influenza viruses, yet the factors that influence parents' willingness to vaccinate their children are not well understood. To address this research gap, we developed a theoretical model grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT), which explores six key factors influencing parental self-reported uptake of influenza vaccination in preschool children: performance expectancy, effort expectancy, social influence, facilitating conditions, knowledge, and behavioral intention. We collected data from 872 parents of children in five major cities in China and employed structural equation modeling to examine the significance of the theoretical model and explore the potential moderating effects of demographic variables on path relationships. Our analysis revealed that several positive factors influenced parents' intention of influenza vaccination for preschool children, including effort expectancy (β = 0.38), social influence (β = 0.17), and knowledge (β = 0.52). Facilitating conditions (β = 0.34), knowledge (β = 0.40), and behavioral intention (β = 0.34) were found to be associated with self-reported uptake. Furthermore, we observed significant moderating effects of the child's gender and age, as well as the guardian's category and income, on the theoretical models. Parents' willingness to vaccinate preschool children against influenza is influenced by both psychological and demographic variables. Further studies are needed to determine if these relationships persist over time and across different regions.

Student nurses' attitudes, perceived utilization, and intention to adopt artificial intelligence (AI) technology in nursing practice: A cross-sectional study

AIM

The aim of this study was to investigate the attitudes and intentions of student nurses towards Artificial Intelligence (AI) in the context of nursing practice and to explore the relationship between their attitudes towards AI, their perceptions of AI utilization in nursing practice, and their intentions to adopt AI technology. The study hypothesized that perceived utilization of AI in nursing practice would positively influence the intention to use AI and that attitudes towards AI would mediate this relationship.

BACKGROUND

AI has the potential to revolutionize various aspects of healthcare, including nursing practice. As AI technology continues to advance, it becomes increasingly important for nurse education to prepare student nurses to leverage AI technology and be willing to adopt it in their nursing practice.

DESIGN

Cross-sectional design.

METHODS

A total of 200 student nurses from two government-owned nursing schools participated in the study. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4).

RESULTS

Perceived AI utilization in nursing practice had a significant positive effect on student nurses' attitudes towards AI (β = 0.450, p < 0.001) and their intention to adopt AI technology (β = 0.458, p < 0.001). Attitudes towards AI partially mediated the relationship between perceived AI utilization in nursing practice and the intention to adopt AI technology (β = 0.255).

CONCLUSION

The findings suggest that student nurses had favorable perceptions of AI utilization in nursing practice, expressed high intentions to adopt AI technology, and held positive attitudes towards AI. Furthermore, student nurses' perceptions of AI utilization in nursing practice influenced their attitudes towards AI, which, in turn, affected their intentions to adopt AI technology. Nursing education programs should incorporate AI-focused coursework, training, and experiential learning to further enhance students' readiness and proficiency in utilizing AI technology. Additionally, healthcare institutions should consider creating a supportive environment for nursing students to explore and embrace AI, ultimately preparing them for the evolving landscape of AI-enhanced healthcare practice.

TWEETABLE ABSTRACT

Student nurses' attitudes towards AI technology were influenced by their perceptions of AI utilization in nursing practice, which subsequently influenced their intentions to adopt AI technology.

Online grocery shopping intention: Elderly's perspective in Malaysia

Purpose

This study investigates the factors associated with the elderly's intention to use OGS. Building on the Technology Acceptance Model, we propose several elderly-specific and functional-ageing constructs related to the perceived ease of use and usefulness of OGS.

Methods

The questionnaire was distributed physically and digitally to non-OGS users aged above 60, living in the Klang Valley, Malaysia, using a non-probability sampling approach. A total of 302 data were analysed using PLS structural equation modelling.

Results

The findings indicate that perceived ease of use, functional ability, life-course events, and digital literacy are associated with the elderly's perception of OGS's usefulness, while life-course events, digital literacy, technology anxiety, and facilitating conditions are associated with the perceived ease of use.

Conclusion

This study contributes to the OGS literature by addressing ageing complexities with OGS adoption among the elderly population, thereby offering insights for marketers and the government to tailor services and provide relevant support.

The healthy moms and babies app to prevent postpartum depression: analysis of user-profiles and dropout cases

Introduction

Perinatal depression affects mothers, babies and society. Preventive interventions are needed, but face barriers to access. E-health interventions could be an effective and accessible option. To date, few studies have attempted to understand the use of mobile health (m-health) applications and why they are not more widely used. This study aims to understand the demographic characteristics of enrolled participants and examine dropout patterns through the Healthy Moms and Babies app.

Methods

A longitudinal study was conducted with a sample of 511 women recruited between 2020 and 2022. Data were collected from the app, including sociodemographic information, the participant's progress through the modules of the app, and the permissions granted to use the app.

Results

Out of the 511 women who completed the initial form to initiate participation, 279 downloaded the app and completed the evaluation. Results indicated that granting permission to be notified about the module's availability is related to an increase in the use of the first modules.

Conclusion

This study shows the importance of establishing follow-ups in the use of mobile apps during the perinatal period.

Effectiveness of Home-Based Telerehabilitation Interventions for Dysphagia in Patients With Head and Neck Cancer: Systematic Review

BACKGROUND

Multimodal treatment-induced dysphagia has serious negative effects on survivors of head and neck cancer. Owing to advances in communication technologies, several studies have applied telecommunication-based interventions that incorporate swallowing exercises, education, monitoring, feedback, self-management, and communication. It is especially urgent to implement home-based remote rehabilitation in the context of the COVID-19 pandemic. However, the optimal strategy and effectiveness of remote interventions are unclear.

OBJECTIVE

This systematic review aimed to examine the evidence regarding the efficacy of telerehabilitation for reducing physiological and functional impairments related to swallowing and for improving adherence and related influencing factors among head and neck cancer survivors.

METHODS

The PubMed, MEDLINE, CINAHL, Embase, and Cochrane Library databases were systematically searched up to July 2023 to identify relevant articles. In total, 2 investigators independently extracted the data and assessed the methodological quality of the included studies using the quality assessment tool of the Joanna Briggs Institute.

RESULTS

A total of 1465 articles were initially identified; ultimately, 13 (0.89%) were included in the systematic review. The quality assessment indicated that the included studies were of moderate to good quality. The results showed that home-based telerehabilitation improved the safety of swallowing and oral feeding, nutritional status, and swallowing-related quality of life; reduced negative emotions; improved swallowing rehabilitation adherence; was rated by participants as highly satisfactory and supportive; and was cost-effective. In addition, this review investigated factors that influenced the efficacy of telerehabilitation, which included striking a balance among swallowing training strategy, intensity, frequency, duration, and individual motor ability; treating side effects of radiotherapy; providing access to medical, motivational, and educational information; providing feedback on training; providing communication and support from speech pathologists, families, and other survivors; and addressing technical problems.

CONCLUSIONS

Home-based telerehabilitation has shown great potential in reducing the safety risks of swallowing and oral feeding, improving quality of life and adherence, and meeting information needs for dysphagia among survivors of head and neck cancer. However, this review highlights limitations in the current literature, and the current research is in its infancy. In addition, owing to the diversity of patient sociodemographic, medical, physiological and functional swallowing, and behavioral factors, we recommend the development of tailored telemedicine interventions to achieve the best rehabilitation effects with the fewest and most precise interventions.

Awareness and attitudes of elderly Southeast Asian adults towards telehealth during the COVID-19 pandemic: a qualitative study

Introduction

We aimed to understand the awareness and attitudes of elderly Southeast Asians towards telehealth services during the coronavirus disease 2019 (COVID-19) pandemic in this study.

Methods

In this qualitative study, 78 individuals from Singapore (51.3% female, mean age 73.0 ± 7.6 years) were interviewed via telephone between 13 May 2020 and 9 June 2020 during Singapore's first COVID-19 'circuit breaker'. Participants were asked to describe their understanding of telehealth, their experience of and willingness to utilise these services, and the barriers and facilitators underlying their decision. Transcripts were analysed using thematic analysis, guided by the United Theory of Acceptance Use of Technology framework.

Results

Of the 78 participants, 24 (30.8%) were able to describe the range of telehealth services available and 15 (19.2%) had previously utilised these services. Conversely, 14 (17.9%) participants thought that telehealth comprised solely home medication delivery and 50 (51.3%) participants did not know about telehealth. Despite the advantages offered by telehealth services, participants preferred in-person consultations due to a perceived lack of human interaction and accuracy of diagnoses, poor digital literacy and a lack of access to telehealth-capable devices.

Conclusion

Our results showed poor overall awareness of the range of telehealth services available among elderly Asian individuals, with many harbouring erroneous views regarding their use. These data suggest that public health education campaigns are needed to improve awareness of and correct negative perceptions towards telehealth services in elderly Asians.

Analysis of Driving Factors in the Intention to Use the Virtual Nursing Home for the Elderly: A Modified UTAUT Model in the Chinese Context

As a unique form of mobile health service (m-Health) for elderly care in China, the virtual nursing home is considered a reliable alternative to the traditional model of home-based care, but services from virtual nursing homes are infrequently used by the elderly in practice. Thus, this study aims to measure the driving factors affecting the behavioral intention to use the virtual nursing home by designing a research framework that combined the unified theory of acceptance and use of technology (UTAUT) with the technology acceptance model (TAM). Furthermore, a new variable, conformist mentality, is proposed as a moderator. In order to validate the model, a well-structured questionnaire using mature scales was used, and the linear regression analysis method was conducted on 200 valid data samples collected during a field study in Harbin, China. The results show that performance expectancy, effort expectancy, and social influence significantly affect behavioral intention. However, the effect of facilitating conditions is not significant. Moreover, performance expectancy and effort expectancy have a positive effect on attitude toward use, and attitude toward use not only affects behavioral intention but also plays a mediating role in the effect of performance expectancy and effort expectancy on behavioral intention. This study also innovatively proposes and confirms conformist mentality as a moderator to strengthen the driving effect of social influence on behavioral intention. This is the first time that conformist mentality is introduced as a moderator in a study on the behavioral perception and acceptance of virtual nursing homes among Chinese older adults. Based on these findings, this study offers theoretical contributions and management implications that are conducive to the sustainable development of virtual nursing homes, thereby making extensive contributions to this field. Additionally, it also aids in the contextual expansion of the UTAUT model.

Determinants of health-conscious consumers’ intention to adopt fitness apps

This study aims to investigate the factors influencing consumers’ intention to adopt health fitness apps. The target population for this study were current users of health fitness apps. The data collection process was completed using a Google e-mail form with a cover letter for the convenience of customers, wherein 308 respondents were the final sample size. Data were collected from current members of health clubs and fitness centers in Dhaka, Bangladesh. Most of the respondents were males (56%, n = 308), whereas females were 44%, n = 134. Five-point Likert scale was used, where ‘1’ means ‘Strongly Disagree’ and ‘5’ ‘Strongly Agree’, to clarify the item-wise questionnaire. SPSS data analysis software for research purposes was used to evaluate the hypotheses. Cronbach Alpha (α) value was used to justify the reliability of the variables. Four items measure price value; perceived performance, health consciousness, facilitating condition, hedonic motivation are measured by two items; self-efficacy – by three. The results show that the selected six determinants positively and significantly affect consumers’ intention to use health fitness apps. Overall, these variables can explain 55.50% of the variance in predicting behavioral intentions to adopt health fitness apps. Furthermore, this results could provide significant clues to health fitness app developers that can severely influence users to adopt health fitness apps for their wellbeing.

A qualitative study of factors influencing ePHR adoption by caregivers and care providers of Alzheimer's patients: An extension of the unified theory of acceptance and use of technology model

Background and Aims

As the nowadays provision of many healthcare services relies on technology, a better understanding of the factors contributing to the acceptance and use of technology in health care is essential. For Alzheimer's patients, an electronic personal health record (ePHR) is one such technology. Stakeholders should understand the factors affecting the adoption of this technology for its smooth implementation, adoption, and sustainable use. So far, these factors have not fully been understood for Alzheimer's disease (AD)-specific ePHR. Therefore, the present study aimed to understand these factors in ePHR adoption based on the perceptions and views of care providers and caregivers involved in AD care.

Methods

This qualitative study was conducted from February 2020 to August 2021 in Kerman, Iran. Seven neurologists and 13 caregivers involved in AD care were interviewed using semi-structured and in-depth interviews. All interviews were conducted through phone contacts amid Covid-19 imposed restrictions, recorded, and transcribed verbatim. The transcripts were coded using thematic analysis based on the unified theory of acceptance and use of technology (UTAUT) model. ATLAS.ti8 was used for data analysis.

Results

The factors affecting ePHR adoption in our study comprised subthemes under the five main themes of performance expectancy, effort expectancy, social influence, facilitating conditions of the UTAUT model, and the participants' sociodemographic factors. From the 37 facilitating factors and 13 barriers identified for ePHR adoption, in general, the participants had positive attitudes toward the ease of use of this system. The stated obstacles were dependent on the participants' sociodemographic factors (such as age and level of education) and social influence (including concern about confidentiality and privacy). In general, the participants considered ePHRs efficient and useful in increasing neurologists' information about their patients and managing their symptoms in order to provide better and timely treatment.

Conclusion

The present study gives a comprehensive insight into the acceptance of ePHR for AD in a developing setting. The results of this study can be utilized for similar healthcare settings with regard to technical, legal, or cultural characteristics. To develop a useful and user-friendly system, ePHR developers should involve users in the design process to take into account the functions and features that match their skills, requirements, and preferences.

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.

A study on community older people's willingness to use smart home-an extended technology acceptance model with intergenerational relationships

Introduction

Despite the potential of smart home technology to promote sustainable lifestyles, the adoption rate among older adults remains relatively low. This study aims to investigate the influence of intergenerational relationships on the acceptance of smart home services among seniors.

Methods

A survey was conducted among 298 older adults in China, and data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). Ten predictor variables were examined to assess their impact on the willingness to use smart home services.

Results

Intergenerational relationships significantly influenced the utilization of smart home services among older adults. Specifically, intergenerational instrumental support had a direct positive effect on the behavioral intention to use smart homes. Additionally, intergenerational emotional and financial support affected life satisfaction, which subsequently influenced the behavioral intention to use smart homes.

Discussion

The assistance and guidance provided by younger generations play a crucial role in shaping the willingness of older adults to adopt smart home technology. Intergenerational support can contribute positively to enabling aging individuals to age in place through the utilization of technology.

Factors influencing user acceptance of weight management apps among Chinese obese individuals during the COVID-19 pandemic

Background

During the COVID-19 epidemic, the number of obesities increased rapidly in China. Weight management apps have potential value in controlling obesity.

Objective

Explore the mechanisms behind the adoption of weight management applications by overweight and obese individuals, including psychological factors and demographic variables.

Methods

The theoretical model was extended from the technology acceptance model (TAM), and the structural equation model was used for hypothesis testing. From January 2020 to December 2021, we conducted a cross-sectional survey in six megacities in mainland China during the COVID-19 pandemic by an online questionnaire.

Results

1364 participants completed the questionnaire, and the proposed theoretical model explained 55.7% of the variance in behavioral intention. Perceived usefulness was predicted by perceived ease of use (β = 0. 290), attitude was jointly predicted by perceived usefulness (β = 0.118) and perceived ease of use (β = 0.159). Behavioral intention was predicted by perceived usefulness (β = 0. 256), perceived ease of use (β = 0. 463), attitude (β = 0. 293), and perceived risk (β = -0.136). Health awareness (β=0.016) did not significantly affect behavioral intention. Four demographic variables gender, age, education, and residence exerted significant moderating effects in theoretical model.

Conclusions

During the COVID-19 epidemic, the health awareness and behavior patterns of obese people have changed significantly. Psychological factors and demographic characteristics dynamically interact to generate user behavioral intentions of weight management applications. Weight management application developers and marketers should focus on perceived usefulness, safety, ease of use, and health awareness.

What drives the adoption of online health communities? An empirical study from patient-centric perspective

BACKGROUND

Online health communities (OHCs) provide platforms for patients to seek advice from physicians and receive professional suggestions online. It can improve the efficiency of patients' diagnosis of simple diseases and alleviate hospital congestion. However, few empirical studies have comprehensively explored the factors influencing patients' intention to use OHCs through objective data. This study aims to fill this gap by identifying key factors that influence patients' acceptance of OHCs and proposing effective ways to promote the applications of OHCs in China.

METHODS

Based on the Unified Theory of Acceptance and Usage of Technology (UTAUT), extended with additional constructs identified with patients' information demands in OHCs, this study developed a research model and proposed nine hypotheses. An online survey involving 783 valid responses was conducted in China to collect data to validate the proposed model. Confirmatory factor analysis and partial least squares (PLS) path model were conducted for instrument validation and hypothesis testing.

RESULTS

Price value, eHealth literacy, and performance expectancy are the most prominent constructs in the study context. Interestingly, relation quality was also found to have a significant positive relationship with behavioral intention.

CONCLUSIONS

Based on these findings, OHC operators need to create a user-friendly platform, improve information quality, set reasonable prices, and establish consummate security systems. Physicians and related organizations can raise awareness and assist patients in developing the skills to appropriately comprehend and utilize information in OHCs. This study contributes to both technology adoption theory and practice.