Determinants of individuals’ intention to use mobile health: insights from India

Intention to Use Mobile-Based Partograph and Its Predictors Among Obstetric Health Care Providers Working at Public Referral Hospitals in the Oromia Region of Ethiopia in 2022: Cross-Sectional Questionnaire Study

BACKGROUND

A partograph is a pictorial representation of the relationship between cervical dilatation and the time used to diagnose prolonged and obstructed labor. However, the utilization of paper-based partograph is low and it is prone to documentation errors, which can be avoided with the use of electronic partographs. There is only limited information on the proportion of intention to use mobile-based partographs and its predictors.

OBJECTIVE

The objective of this study was to determine the proportion of obstetric health care providers at public referral hospitals in Oromia, Ethiopia, in 2022 who had the intention to use mobile-based partographs and to determine the predictors of their intention to use mobile-based partographs.

METHODS

We performed an institution-based cross-sectional study from June 1 to July 1, 2022. Census was conducted on 649 participants. A self-administered structured English questionnaire was used, and a 5% pretest was performed. Data were entered into EpiData version 4.6 and exported to SPSS version 25 for descriptive analysis and AMOS (analysis of moment structure; version 23) for structural and measurement model assessment. Descriptive and structural equation modeling analyses were performed. The hypotheses developed based on a modified Technology Acceptance Model were tested using path coefficients and P values <.05.

RESULTS

About 65.7% (414/630; 95% CI 61.9%-69.4%) of the participants intended to use mobile-based electronic partographs, with a 97% (630/649) response rate. Perceived usefulness had a positive influence on intention to use (β=.184; P=.02) and attitude (β=.521; P=.002). Perceived ease of use had a positive influence on attitude (β=.382; P=.003), perceived usefulness (β=.503; P=.002), and intention to use (β=.369; P=.001). Job relevance had a positive influence on perceived usefulness (β=.408; P=.001) and intention to use (β=.185; P=.008). Attitude positively influenced intention to use (β=.309; P=.002). Subjective norms did not have a significant influence on perceived usefulness (β=.020; P=.61) and intention to use (β=-.066; P=.07).

CONCLUSIONS

Two-thirds of the obstetric health care providers in our study intended to use mobile-based partographs. Perceived usefulness, perceived ease of use, job relevance, and attitude positively and significantly influenced their intention to use mobile-based electronic partographs. The development of a user-friendly mobile-based partograph that meets job and user expectations can enhance the intention to use.

Does mobile renewal make health insurance more responsive to clients? A case study of the National Health Insurance Scheme in Ghana

BACKGROUND

In 2018, Ghana's National Health Insurance Authority (NHIA) introduced a mobile strategy to enhance re-enrolment and improve client knowledge of their entitlements. This study investigated how Ghana's mobile strategy has influenced the NHIA's responsiveness to clients in terms of patient rights and entitlements, equity and satisfaction with health services.

METHODS

We surveyed people (n=1700) in 6 districts who had renewed their insurance in the previous 12 months, using any strategy (mobile or manual). Multiple regression analysis examined correlation between individual characteristics and renewal modality. Policy documents on the mobile programme's design and focus group discussions (n=12) on people's experiences renewing their insurance were analysed thematically.

RESULTS

While the mobile platform was designed for mobile National Health Insurance Scheme (NHIS) renewal and to provide information about insurance entitlements, few people surveyed (20%) knew about these informational features. Among those who renewed their NHIS coverage, 58% did so on the mobile renewal platform. Mobile renewal was high among those with tertiary education and those in the higher wealth quintiles. Mobile renewal was considered convenient, but required literacy in English, a phone and a mobile money wallet. For those who lacked some or all of these prerequisites but wanted to use mobile renewal, mobile vendors emerged as valued facilitators.

CONCLUSION

The mobile platform has increased the responsiveness of Ghana's NHIS through offering clients a more convenient mechanism to renew their insurance policies. It does not, however, eliminate the one month waiting period for activating the card, does not provide prompts to reassure clients of their renewal and does not empower most clients with information on entitlements. To improve the adoption and use of the mobile renewal strategy, the NHIA should publicise the platform's information-sharing functions and explore formally engaging mobile vendors.

Examining behavioural intention of using smart health care technology among females: dynamics of social influence and perceived usefulness

Purpose

The aim of this study is to comprehend the behavioural intention of females' perception toward smart healthcare technology. The study also examines the moderation effect of social influences between perceived smart healthcare technology and perceived usefulness among female users.

Design/methodology/approach

To test the model, this study collected data from female respondents (n = 913) responses. The data were analyzed by structural equation modeling (SEM) using Smart-PLS 3.2. To complement the findings from structural equation modeling, the study also conducted a post-hoc test via experimental research design. The authors also applied a t-test and PROCESS macro analysis to re-confirm the relationship mentioned above.

Findings

The findings revealed that perceived ease of use significantly mediates the relationship between females' perceived smart healthcare technology and intention to use. The findings also show that social influence moderates between smart healthcare technology and the perceived usefulness relationship.

Research limitations/implications

Social influence is one of the major issues while adopting smart healthcare technology because the respondents perceived that they are accustomed to the technologies related to smart health once their surroundings and social environment influence them.

Originality/value

The current study is a pioneer in the context of a developing country and unique in that it makes two contributions: it extends previous research on smart health technology adoption in the healthcare business by considering females, and it gives a broad knowledge of the female healthcare consumers from emerging nations which can be useful for developing technology-driven healthcare services strategies.

Usefulness and barriers of adoption of social media for disability services: an empirical analysis

Purpose

This study aims to examine the factors that influence the adoption of social media to meet the service needs of persons with disabilities.

Design/methodology/approach

This study outlines the social media adoption model in disability services by using theories of persons with disabilities’ resistance, extreme-ableist expressions and exploit-ecological theories. A questionnaire survey is conducted among citizens who participate in disability-related activities.

Findings

The adoption of social media is influenced by disability norms, administrative and platform support. Emerging trends, such as disability politics and inclusion, are inconsequential.

Research limitations/implications

Results implicate that frequent sharing of disability rights perspectives and awareness initiatives can enhance social media platforms for disability services.

Practical implications

In regional disability services, the scope of social media is hampered by a lack of reporting capabilities and a paucity of digital content sensitive to disability.

Originality/value

The disability interest group reported less specialised services enabled by social media from developing nations. The current study addresses this research gap.

A Scoping Review on Accentuating the Pragmatism in the Implication of Mobile Health (mHealth) Technology for Tuberculosis Management in India

Background: India continues to share a colossal count of the global tuberculosis load, with a perturbing 19% spring in the reported cases in 2021. With the National Tuberculosis Elimination Program (NTEP) consolidated to bring this epidemic to an end by 2025, the rapidly growing mobile health technologies can be utilized to offer promising results. Even though the implementation of this novel strategy is escalating around the globe, its triumph is still sub optimal in India. Objectives: This scoping review intends to explore the available mobile health (mHealth) technologies and analyse the effectiveness of the same for tuberculosis management in India. Methods: An elaborate search in electronic databases, such as PubMed and Google scholar, using the key terms and focussing from the year 2015, provided very broad results focussing on mHealth interventions and their utilisation in TB management in India. Further selection of the inclusive publications was carried out based upon the eligibility requirements as formulated for this review, pertaining to the objective of this study. Results: The collaborate search yielded a total of 858 scientific research papers. After the filtering of the obtained results, a total of 45 articles were selected to be analysed for this review. Published manuscripts, articles in peer review and abstracts from reliable databases were included to obtain vast range of information. Conclusion: The extensive literature search showed a preponderance of mHealth intervention studies focusing on TB treatment and drug monitoring. There exists a paucity of mHealth applications targeted to educate the public and intercept this infectious disease. The scientific articles reviewed and analysed in this scoping review strongly recommend the demployment of mHealth applications to achieve the target of eradicating TB by 2025 in India.

Environmental citizenship behavior and sustainability apps: an empirical investigation

Purpose

This study aims to investigate the moderating effect of sustainability app on environmental citizenship behavior on the basis of norm-activation model.

Design/methodology/approach

A questionnaire survey, which comprises five variables (i.e. awareness of consequences, ascription of responsibility, personal norms, environmental citizenship behavior in a private sphere and environmental citizenship behavior in a public sphere) measured through 16 items, was conducted in the USA by using Amazon Mechanical Turk. With 549 valid respondents’ answers in hand, the collected data were analyzed applying a multi-group structural equation modelling technique with IBM SPSS AMOS 23 software program.

Findings

The results revealed that there is a positive and significant relationship between awareness of consequences, ascription of responsibility, personal norms and environmental citizenship behavior in both private and public sphere. Furthermore, this study attested that sustainability apps utilization has a moderating effect on the predictors of environmental citizenship behaviors.

Originality/value

Past studies have seldom examined the contribution of mobile apps to environmental sustainability. This paper enriches the extant academic literature in the field of technology for behavior change, and bears significant implications on how sustainability apps can be adopted by governments, policymakers, organizations and teacher educators to engage people and stimulate environmental citizenship behaviors.

A mixed-method approach to assess users' intention to use mobile health (mHealth) using PLS-SEM and fsQCA

Purpose

Despite the enormous potential of mobile health (mHealth), identifying the asymmetric relationship among the predictors towards intention to use (ITU) of mHealth tends to remain unresolved. This study aims to investigate the predictors and their asymmetric effects on ITU of mHealth through patients and healthcare professionals.

Design/methodology/approach

An integrated information systems (IS) model with four additional constructs has been developed to analyze symmetric and asymmetric effects on ITU of mHealth. An exploratory survey on 452 mHealth users with prior experience was conducted to evaluate the model using a mixed-method approach including partial least squares-based structural equation modeling (PLS-SEM) and fuzzy-set qualitative comparative analysis (fsQCA) technique.

Findings

The findings show that facilitating conditions, personal awareness building, perceived enjoyment, effort expectancy and perceived usefulness have predictive power for ITU of mHealth. In contrast, fsQCA reveals four more alternative solutions, including the main drivers explored by PLS-SEM. The results indicate that various conditions that were not crucial in PLS-SEM analysis are shown to be sufficient conditions in fsQCA.

Research limitations/implications

This study contributes to theory by integrating self-actualization factors (i.e. personal awareness building, patients as decision support unit) into the IS model. And practically, this study makes an essential contribution to users' ITU of mHealth, enabling relevant stakeholders to build strategies to implement mHealth successfully.

Originality/value

While mHealth has revolutionized healthcare and the prior literature only showed linear relationships, this empirical study revealed asymmetrical relationships among the determinants of ITU of mHealth. Thus, this study extends to the growing body of literature on the use of mHealth technology in the least developing nation.

A Case Of Affordances-Collaborative Governance Using Smartphones

This study attempts to explore the contextual factors that play a significant role in promoting collaborative governance using mobile phones in developing countries. The study utilises review of academic literature and experts’ opinion to identify critical conversion factors and their interrelationship. Affordance Theory is used as a theoretical lens to identify eight significant factors covering development of infrastructure, citizen up-skilling, cost of access, ease of use, reliable infrastructure, ensured privacy & security, process accountability and a standardised m-governance policy. A combination of Total Interpretative Structure Modelling (TISM) and Cross-impact matrix multiplication applied to classification (MICMAC) analysis is employed to prioritise these conversion factors and classify them based on their dependence and driving power. A priority-based hierarchical model is proposed for establishing a sustainable m-governance ecosystem.

Managing the COVID-19 pandemic: does social infrastructure matter? Evidence from India

Purpose

The COVID-19 pandemic educed extraordinary policy responses globally, including in India, to flatten the infection-growth curve. The trajectories of infections, recovery, and deaths vastly differed across Indian states. The purpose of this study is to investigate whether persistent investments by states in critical social sectors, such as health and education, explain their preparedness and hence better management of the pandemic.

Design/methodology/approach

This study uses secondary data on the number of infected, recovered and deceased due to COVID-19, along with data on population and income across 302 districts in 11 major states in India. Data on health and education indices are collected at the state-level. Linear regression models that also control for heteroskedasticity are applied.

Findings

This study finds that higher investments in health care and education reduce the propensity of the infection spread. Further, states with persistent investments in health care and education exhibit a higher rate of recovery. This study also finds that death rates are significantly lower in states with higher investments in education.

Research limitations/implications

The findings support the conjecture that states that have consistently invested in social sectors benefited from the associated positive externalities during the crisis that helped them manage the pandemic better.

Originality/value

This study will help policymakers understand the underlying social forces critical to the success in the fight against pandemics. Apart from improving preparedness for future pandemics, the evidence provided in the paper may help give better direction and purpose to tax-financed public spending in states where social sector development has hitherto received low priority.

Mobile health intervention and COVID-19 pandemic outbreak: insights from Indian context

Purpose

This paper discusses the need for government and healthcare organization to implement mobile phone-based solutions for healthcare during the Coronavirus (Covid-19) pandemic. It also highlights the challenges and/or barriers to the rapid introduction, implementation and management of these and other innovative solutions to health service delivery during the current situation

Design/methodology/approach

The data include both qualitative and quantitative, collected from the primary interview-based case study and questionnaire survey. It also uses insights from the general populations, healthcare professionals and health information technology developers to understand the role of a mobile health intervention in the COVID-19 pandemic outbreak.

Findings

Healthcare professionals and health information technology developers are confident that the use of mobile health technology and applications has the ability to assist in monitoring and controlling the COVID-19 outbreak. The key advantages of using mobile phone technology are: increased awareness, improved assistance in tracking and testing casualties, improved assistance in seeking and scheduling health information and medical appointments, increased social distancing, improved overall productivity and quality of life. However, data demonstrated that lack of awareness and accessibility or unwillingness to use the technology, complex healthcare needs, application infrastructure, policies and a dearth of training and support are all barriers to successful implementation of this useful tool.

Practical implications

This research has the potential to make a significant impact on government and healthcare policy through presenting a coherent argument for the importance of designing and deploying mobile health technology and applications for the general population.

Originality/value

prior literature in this domain is inadequate in explaining the importance of mobile phone-based healthcare solutions for health service and during serious disease outbreaks and, in particular, within the Indian context. The findings of this study can be used by government and healthcare organizations to improve health governance during the current global pandemic.

An examination of citizen satisfaction with mandatory e-government services: comparison of two information systems success models

Purpose

The purpose of this study is to empirically examine the utility of information systems (IS) success models in mandatory e-government services, as opposed to the volitional ones that have been the focus of previous studies. The models include the technology acceptance model (TAM) (1989) and Seddon’s model (1997), which involve three (ease of use, usefulness and citizens satisfaction) and four variables (system quality, information quality, usefulness and citizen satisfaction).

Design/methodology/approach

The models were compared based on a survey conducted on 780 foundation year students of government universities in Saudi Arabia. The Saudi Government has launched a mandatory e-government service geared to assist high school graduates in the university academic admission process. The goodness-of-fit and parsimony of fit indices and the explanatory power were used to compare the two models.

Findings

The structural equation modeling techniques revealed that overall, the two models both exhibited reasonable fit with the collected data, whereas TAM showed the best fit to the sample data and yielded superior goodness-of-fit indices over Seddon’s model. In terms of explanatory power, Seddon’s model predicted 28% (R2 = 0.28) of the variance explained for citizen satisfaction, whereas TAM predicted 21% (R2 = 0.21). All the parsimony of fit indices favored TAM over Seddon’s model.

Research limitations/implications

This study examined the validity of TAM and Seddon’s model, using citizen satisfaction as the dependent variable to compare them. TAM and Seddon’s model were modified to better fit the current research context of mandatory e-government services; thus, the findings may not hold for their original or other voluntary settings. In addition, the focus on a single survey for a certain time in a certain territory of mandatory e-government service may have limited the generalizability of the results to other mandatory contexts. Future research should make use of large, cross-sectional samples in different mandatory contexts to enhance result generalization.

Practical implications

This study’s findings can provide e-government practitioners with deeper perceptions of how to address citizen satisfaction with mandatory e-government services. The results exposed usefulness as the common and major construct, having the strongest influence on citizen satisfaction in both TAM and Seddon’s model; thus, maximizing the benefits of e-government services for citizens is crucial to their success. The causal relationship between information quality and citizen satisfaction was not supported. This supports the perspective that e-government services are currently evolving quickly, becoming more integrated and easier-to-use, generally requiring only a few clicks and less information.

Originality/value

This study has extended the assessment of the validity of IS success models to a mandatory IS usage setting. The comparison study of different IS success models is crucial as it acts as a guide for researchers to determine the trade-off between the models used to conduct research on a particular context. The study concludes that TAM is the most parsimonious and universal model for the study of user satisfaction in mandatory contexts. The findings will provide e-government practitioners with insights into IS success measures suited to enhance the effectiveness of newly and future mandated e-government services.