A meta-analysis of online health adoption and the moderating effect of economic development level

Public value and digital health: The example of guiding values in the national digital health strategy of France

INTRODUCTION

In the WHO European Region, 44 of 53 reporting Member States (MS) have a national digital health strategy (NDHS) or policy. Their formulation is heterogenous and evolving and should best reflect public common interest. This research aims to explore how a public value approach improves the relevance of digital health policies and services, increasing their capacity to better serve the diverse range of societal interests. It utilises the guiding values within the French NDHS as an example before discussing other digital health policies such as the European Heath Data Space.

METHODS

Three homogenous focus group discussions were conducted in November and December 2023. Each focus group separately gathered distinct stakeholders: public clients, health professionals, private sector. 19 participants were included in the study. Data collection comprised live polling and semi-structured discussion. Results were analysed considering the pre-defined stakeholder groups and the values discussed during the study.

RESULTS

Findings reveal both technical and cultural challenges in digital health that highlight the need for adaptable frameworks across different contexts. Stakeholder insights informed a framework classifying public values into democratic and managerial categories, suggesting themes that may be relevant to digital health strategies in other national and regional settings.

DISCUSSION

Public value is discussed as a multidimensional concept, and the plurality of its perceptions give basis for tailored approaches to serve different value-beneficiaries comprehensively. We propose this values-based approach as a systematic model for supra-, sub-, and national scales and additional policy topics, beyond digital health strategies.

CONCLUSION

The study suggests that using a public value lens considering multiple perceptions is valuable for advancing digital health policy in a responsible and ethical manner. Such an approach could promote wider governance of and adoption of digital health. To evolve the framework, application in multiple and large ecosystems at different levels should be considered.

Unveiling the bidirectional link between electric vehicle sales and charging infrastructure: Evidence from 95 cities in China

Constructing electric vehicle charging piles (EVCPs) is crucial for promoting electric vehicle (EV) sales. Yet, empirical evidence on the bidirectional relationship between EV sales and public EVCPs is limited, with most related works relying on simulations. We empirically investigate this relationship using panel vector autoregression (PVAR) across 95 Chinese cities from 2018 to 2022. Results show EVCPs significantly boost EV sales, especially in colder regions. Higher air pollution and purchase subsidies inhibit the promoting impact of EV sales on EVCPs. The propelling effect of EVCPs on EV sales is impaired in higher housing prices regions. A significant and positive bidirectional relationship exists between EVCPs and battery electric vehicles (BEVs) sales exists, but not with plug-in hybrid electric vehicles (PHEVs) present. Our findings have implications for stakeholders, such as the construction of fast charging infrastructure under lower temperatures, and differentiated charging demands of EVs with different powertrains need to be addressed.

Switching from offline to online health consultation in the post-pandemic era: the role of perceived pandemic risk

Introduction

Due to its effectiveness and various benefits, the use of online health consultation (OHC) has dramatically increased in recent years, especially since the outbreak of the COVID-19 pandemic. However, underlying mechanism whereby the pandemic impacted OHC usage is still unclear.

Methods

Via an online survey (N=318), the present paper measures the users' perceptions towards both offline and online services, their intention to switch to OHC, and the perceived pandemic risks. The relationships among these factors are conceptualized by the push-pull-mooring framework, and tested via structural equation modelling.

Results

Dissatisfaction with offline service (process inefficiency and consultation anxiety), the attractiveness of OHC (perceived benefits and perceived ease of use), and users' behavioral inertia (switching cost and habit) jointly influence the intention to switching to OHC. The significant role of the perceived pandemic risk of going to medical facilities is particularly addressed. On the one hand, the perceived pandemic risk is found with an indirect impact on the switching intention by enlarging the dissatisfaction with offline service and the attractiveness of OHC. On the other hand, a high perceived pandemic risk induces more actual switching behavior and also amplifies the transition from switching intention to behavior.

Discussion

The study provides novel insights into the understanding of OHC usage in the post-pandemic era, and also informs medical facilities, OHC platforms, and policymakers on managing and balancing the online and offline healthcare provision.

A meta-analysis of social commerce adoption and the moderating effect of culture

Purpose

As a derivative model of e-commerce, social commerce has received increasing attention in recent years. Empirical studies on social commerce have examined the key factors that influence users' attitudes or adoption intentions, but their conclusions are context-based and are not entirely consistent. This study aims to draw a general conclusion by systematically synthesizing the findings of previous studies and examine whether cultural differences play a moderating role in users' social commerce adoption.

Design/methodology/approach

A meta-analysis based on 11,786 independent samples from 39 empirical studies was conducted to integrate their results and develop a comprehensive conceptual model. A moderator analysis was carried out to investigate the moderating effect of culture by dividing the context into subgroups of individualistic and collectivistic cultures.

Findings

The results show that this comprehensive conceptual model can help better understand the adoption of social commerce. Meanwhile, the moderator analysis indicates that cultural differences have a significant moderating effect on the relationship between the determinants and the adoption of social commerce.

Originality/value

The findings of this paper have theoretical implications and make managerial contributions.

Medical information seeking behavior of urban patients in Zhejiang Province, China: a cross-sectional study

Background

Health information seeking behavior (HISB) is a prevalent research topic. However, little is known about sociodemographic factors of HISB in China. This study aimed to examine the HISB of urban patients in China and identify predictors of source preference, online information seeking, and the timing of online seeking.

Methods

Based on the Health Information National Trends Survey (HINTS), this study conducted a cross-sectional survey of 1653 participants in different types of hospitals in 3 cities of different income levels within Zhejiang Province, China. Binary logistic regression analysis and multinomial logistic regression analysis were used to identify predictors of source preference, online medical information seeking, and the timing of online seeking for urban patients.

Results

The offline was the primary source of medical information for 58.61% of adult urban patients, while 78.19% had ever sought medical information online. 36.81% of online medical information seekers sought information before the medical visit, 8.65% sought information after the visit, and 54.54% sought information before and after the visit. China’s urban patients with higher education levels, higher income levels, young, active in internet use, and living in high-income cities were more likely to be active online medical information seekers (using the internet as the primary source) and online medical information seekers (having ever sought medical information online). Except for gender and age, most sociodemographic characteristics were not significantly associated with the timing of online medical information seeking.

Conclusions

Significant predictors of active online medical information seekers and online medical information seekers in China were almost the same. Regional economic development had a significant direct impact on medical information seekers. Most sociodemographic characteristics were not significantly associated with the timing of online medical information seeking. The findings of this study imply that China’s health information technology industry has Chinese characteristics.

Antecedents and consequences of adopting CLTS among tribal communities to become open defecation free: case study on Indian Swachh Bharat Abhiyan

The Swachh Bharat Mission undertaken by the Government of India (GoI) has been successful in accomplishing this objective within a short period thereby catalyzing governance following Sustainable Development Goals (SDGs). It is the responsibility of any democratic nation to ensure that its citizens have universal access to adequate and equitable sanitation. The key approach adapted to igniting a change in sanitation behavior rather than constructing toilets. An effort has been made in the study to affirm that even the marginalized sections of the society residing in tribal communities of West Bengal and Chhattisgarh have benefitted from this Government of India Mission and derived the required benefits. There is enough literature available to support the justification that civil participation holds the key for successful implementation of CLTS thereby making the communities open defecation free (ODF). It is therefore imperative to understand the behavioral transformation that takes place during the CLTS implementation. A hybrid model has been proposed in the study making use of the theory of reasoned action (TRA) and theory of planned behavior (TPB) to understand the pre-adoption and post-adoption behavior of residents. In present study, used model was empirically tested for several hypotheses. The finding reflects towards subjective norms and facilitating conditions as major determinants that ensure the continuation of intention for CLTS. They play a pivotal role in improving the health and hygiene conditions in the region and thus decrease the risk of spread of epidemic diseases.

An Integrated Analysis of Social, Economic, and Environmental Indicators' Effects on Public Health and Health Inequality Globally: From the Perspective of Vulnerability

Public health and health inequality have been widely researched as they are essential for human development and social justice. Although factors influencing public health and health inequality have been explored, an integrated and comprehensive analysis of social, economic, and environmental indicators' effects on public health and health inequality globally is yet to be conducted. The current study addresses this gap by using a theoretical framework that integrates these three dimensions, examining their effects on public health and health inequality from the perspective of vulnerability. Considering the spatial heterogeneity across countries, spatial econometric models and geographically weighted regressions were conducted for the examination of these effects. Our findings reveal the social indicators of urbanisation ratio, social education level, and social governance capacity had positive effects on public health promotion and health inequality elimination globally. Besides these, environmental risk and economic capacity had relatively low impacts on health inequality. Further, the geographically weighted regression results indicate that vulnerability's effects on public health and health inequality varied significantly across countries. This integrated analysis provides national policymakers with a new perspective of vulnerability for public health promotion and health inequality reduction.

Perceptions of Patients and Physicians on Teleconsultation at Home for Diabetes Mellitus: Survey Study

Background

Diabetes mellitus (DM) is one of the most challenging diseases in the 21st century and is the sixth leading cause of death. Telemedicine has increasingly been implemented in the care of patients with DM. Although teleconsultations at home have shown to be more effective for inducing HbA_1c reduction than other telemedicine options, before the 2019 coronavirus disease crisis, their use had been lagging behind. Studies on physicians’ or patients’ perceptions about telemedicine have been performed independently of each other, and very few have focused on teleconsultations. In a time of great pressure for health systems and when an important portion of health care has to be assured at a distance, obtaining insights about teleconsultations at home from the stakeholders directly involved in the health care interaction is particularly important.

Objective

The perceptions of patients and physicians about their intentions to use home synchronous teleconsultations for DM care are examined to identify drivers and barriers inherent to programs that involve home teleconsultations.

Methods

Two identical questionnaires integrating the technology acceptance model and the unified theory of acceptance and use of technology and assessing the confidence in information and communication technology use of patients and physicians were developed. Responses by patients (n=75) and physicians (n=68) were analyzed using canonical correlation analysis.

Results

Associations between predictor constructs (performance, effort, social influence, facilitating conditions, and attitude) and intention to use yielded significant functions, with a canonical R² of 0.95 (for physicians) and 0.98 (patients). The main identified barriers to patient intention to use were the expected effort to explain the medical problem, and privacy and confidentiality issues. The major drivers were the facilitation of contact with the physician, which is beneficial to patient disease management and treatment, time savings, and reciprocity concerning physicians’ willingness to perform teleconsultations. Responses from physicians revealed an association between intention to use and the expected performance of home teleconsultations. The major barrier to intention to use expressed in physicians’ answers was doubts concerning the quality of patient examination. The major drivers were time savings, productivity increases, improvements in patient’s health and patient management, National Health System costs reduction, and reciprocity relative to patients’ willingness to engage in teleconsultations.

Conclusions

To promote the use of home teleconsultations for DM, decision makers should improve patients’ health literacy so the physician–patient communication is more effective; explore information and communication technology developments to reduce current limitations of non–face-to-face examinations; ensure patient privacy and data confidentiality; and demonstrate the capabilities of home teleconsultations to physicians.

Factors Affecting User Intention to Pay via Online Medical Service Platform

With regard to platform performance and trust, we study the influencing factors of users’ intention to pay on an online medical service platform. Results of this paper will provide a new perspective for online medical service platform research in the context of the Internet.A questionnaire survey is administered to collect 312 effective sample data, and the data are analyzed by partial least squares structural equation modeling. Results showed that the information quality, system quality, and convenience of the platform significantly affect the perceived benefit (PB) of users. Users’ perceived reliability of the platform significantly positively affects doctor reliability (DR). Users’ PB significantly positively affects their ITP and DR, and DR significantly positively affects the users’ ITP. The misdiagnosis risk positively regulates the relationship between the users’ trust tendency and DR. The timeliness of the response of the platform positively adjusts the relationship between DR and users’ ITP.

Online Health Information Seeking: A Review and Meta-Analysis

Online health information, as an emerging field in health communication research, has attracted close attention from researchers. To identify major determinants of why individuals seek health information online, we conducted a meta-analysis that systematically accumulates the existing research findings. To that end, by integrating three theories or models for examining information-seeking behavior, we developed a theoretical framework for the current meta-analysis that emphasizing psychosocial, instrumental, contextual, and demographic factors. By analyzing the effect sizes from 44 articles representing 54 empirical samples, we found that the quality, trustworthiness, and utility of online health information were the dominant predictors of seeking it and that instrumental factors were more important than psychological ones in determining whether individuals did so. Moreover, the development of information and communication technology, the sampling method, and the type of information sought significantly moderated pairwise relationships between determinants and seeking behavior, whereas culture did not. Herein, we discuss the theoretical implications of our findings as well as directions for future research.

A Meta-Analysis of Online Impulsive Buying and the Moderating Effect of Economic Development Level

Online impulsive buying has become increasingly prevalent in e-commerce and social commerce research, yet there is a paucity of systematically examining this particular phenomenon in the paradigm of information systems. To advance this line of research, this study aims to gain insight into online impulsive buying through a meta-analysis of relevant research. Derived from 54 articles, this meta-analysis categorized the critical factors that influence online impulsive buying into the website, marketing, and affective stimuli. This study further explores the moderating effect of economic development level. The empirical results reveal that the chosen 13 main factors are significantly and positively related to online impulsive buying except for website security, price, novelty, and negative emotion. Moreover, economic development level moderates the relationship between several factors (i.e., website visual appeal, ease of use, price, promotion, pleasure, and positive emotion) and online impulsive buying. This study contributes to both theory and practice. It not only extends the impulsive buying literature to the online context by emphasizing the IT-supported website stimuli, but also provides implications for future research on online impulsive buying behavior across different economic development levels. Moreover, it provides guidelines for practitioners on how to leverage information technology to induce online impulsive buying.

Proposing a mobile apps acceptance model for users in the health area: A systematic literature review and meta-analysis

Due to rapid advancements in the field of information and communication technologies, mobile health (mHealth) has become a significant topic in the delivery of healthcare. Despite the perceived advantages and the large number of mHealth initiatives, the success of mHealth ultimately relies on whether these initiatives are used; their benefits will be diminished should people not use them. Previous literature has found that the adoption of mHealth by users is not yet widespread, and little research has been conducted on this problem. Therefore, this study identifies the antecedents of the intention to use mHealth and proposes a general model that might prove beneficial in explaining the acceptance of mHealth. The authors performed a quantitative meta-analysis of 49 journal papers published over the past 10 years and systematically reviewed the evidence regarding the most commonly identified factors that may affect the acceptance of mHealth. The findings indicate that the proposed model includes the seven most commonly used relationships in the selected articles. More specifically, the model assumes that perceived usefulness positively affects perceived ease of use and user behavioral intention to use mHealth is commonly influenced by five factors: perceived usefulness, perceived ease of use, attitude toward behavior, subjective norms, and facilitating conditions. The results of this work provide important insights into the predictors of mHealth acceptance for future researchers and practitioners.