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Joseph AM, Alsalman RA, Almasoud WA, Almutairi R, Alammari RB, Deeban YAM, Mustafa MZ, Thakare AA. Predicting the employment of teledentistry in clinical practice by the Saudi dental community using a theoretical model. Digit Health 2024; 10:20552076241253739. [PMID: 38736733 PMCID: PMC11085021 DOI: 10.1177/20552076241253739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction There are very few scholastic studies applying a theory-driven methodology to analyse the employment of teledentistry in clinical practice by the Saudi dental community. The objective of this research was to predict the employment of teledentistry in clinical practice by the Saudi dental community using the UTAUT (Unified Theory of Acceptance and Use of Technology) model. Methods A countrywide survey was executed from November 2022 to April 2023 among the dental community (pre-graduate students, graduates, post-graduate students, general dentists, and specialist dentists) involved in clinical practice. The survey employed the UTAUT model, which has four fundamental constructs: performance expectancy (PE), effort expectancy (EE), social influence (SI) and facilitating conditions (FC). These constructs are known to impact the user's behavioural intention (BI). The four fundamental constructs were independent, and BI was the dependent variable. A Likert scale with five scores was used to record each variable. Descriptive statistics were used to describe all the constructs. Cronbach's alpha scores were used to measure the inner consistency of the Likert scale. Simple linear regression and multiple linear regression were used to determine the correlation between all the constructs and the overall model's prediction. The Statistical Package for the Social Sciences was applied for analysis. The study had 80% power and an alpha threshold of .05. Results The electronic survey was sent to 3000 participants, out of whom 2143 responded (response rate = 71.43%). PE (R2= 26%, p < .01) was the most significant predictor of the Saudi dental community BI to employ teledentistry in clinical practice, followed by SI (R2= 24%, p < .01), EE (R2= 19%, p < .01) and FC (R2= 6%, p < .01). With statistically significant predictive power, the UTAUT model explained 32% of the variance in the BI (R2= 0.32, p < .01). Conclusions Each UTAUT construct and the entire model were significantly correlated with the employment of teledentistry in clinical practice by the Saudi dental community. PE had the most salient correlation, followed by SI, EE and FC. The participants have perceived the benefits of teledentistry, increasing the future likelihood of its utilisation. The Saudi government could consider the UTAUT constructs to promote teledentistry in tandem with Vision 2030.
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Affiliation(s)
- Angel M Joseph
- Department of Dental Restoration and Prosthodontics, College of Dentistry, Majmaah University, Al- Majmaah, Saudi Arabia
| | - Rasha A Alsalman
- Intern, College of Dentistry, Majmaah University, Al- Majmaah, Saudi Arabia
| | - Wjoud A Almasoud
- Intern, College of Dentistry, Majmaah University, Al- Majmaah, Saudi Arabia
| | - Reem Almutairi
- Department of Dental Restoration and Prosthodontics, College of Dentistry, Majmaah University, Al- Majmaah, Saudi Arabia
| | - Rawan B Alammari
- Department of Dental Restoration and Prosthodontics, College of Dentistry, Majmaah University, Al- Majmaah, Saudi Arabia
| | - Yahya AM Deeban
- Department of Dental Restoration and Prosthodontics, College of Dentistry, Majmaah University, Al- Majmaah, Saudi Arabia
| | - Mohammed Z Mustafa
- Department of Dental Restoration and Prosthodontics, College of Dentistry, Majmaah University, Al- Majmaah, Saudi Arabia
| | - Amar A Thakare
- Department of Dental Restoration and Prosthodontics, College of Dentistry, Majmaah University, Al- Majmaah, Saudi Arabia
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Mohammed R, Elmajid EA, Amine H, Khadija C. Acceptance factors of telemedicine technology during Covid‐19 pandemic among health professionals: A qualitative study. Healthc Technol Lett 2023; 10:23-33. [PMID: 37077882 PMCID: PMC10107386 DOI: 10.1049/htl2.12042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 01/25/2023] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
Objective Health professionals are the main users of telemedicine systems, and their acceptance will contribute to the successful implementation of this technology. The objective of this study is to provide a better understanding of the issues surrounding the acceptance of telemedicine technology by Moroccan health professionals in the public sector, in the preparation for a possible generalization of this technology in Morocco. Method Following a literature review, the authors mobilized a modified version of the unified model of technology acceptance and use, to explain and understand the determinants of health professionals' intention to accept telemedicine technology. The authors' methodology is based on a qualitative analysis and is primarily based on data obtained through semi-structured interviews with health professionals, who the authors believe are the primary actors in the acceptance of this technology within Moroccan hospitals. Results The authors' results suggest that performance expectancy, effort expectancy, compatibility, facilitating conditions, perceived incentives, and social influence have a significant positive impact on health professionals' behavioural intention to accept telemedicine technology. Practical implications From a practical point of view, the results of this study can help the government, organizations responsible for the implementation of telemedicine, and policymakers to understand the key factors that may affect the behaviour of future users of this technology, and to develop very specific strategies and policies for a successful generalization.
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Affiliation(s)
- Rouidi Mohammed
- National School of Applied Sciences Ibn Tofail University Kenitra Morocco
| | | | - Hamdoune Amine
- Faculty of Economics and Management Hassan 1er University Settat Morocco
| | - Choujtani Khadija
- Faculty of Legal, Economic and Social Sciences Mohammed V University Rabat Morocco
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Addotey-Delove M, Scott RE, Mars M. Healthcare Workers' Perspectives of mHealth Adoption Factors in the Developing World: Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1244. [PMID: 36673995 PMCID: PMC9858911 DOI: 10.3390/ijerph20021244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND mHealth applications provide health practitioners with platforms that enable disease management, facilitate drug adherence, facilitate drug adherence, speed up diagnosis, monitor outbreaks, take and transfer medical images, and provide advice. Many developing economies are investing more in mobile telecommunication infrastructure than in road transport and electric power generation. Despite this, mHealth has not seen widespread adoption by healthcare workers in the developing world. This study reports a scoping review of factors that impact the adoption of mHealth by healthcare workers in the developing world, and based on these findings, a framework is developed for enhancing mHealth adoption by healthcare workers in the developing world. METHODS A structured literature search was performed using PubMed and Scopus, supplemented by hand searching. The searches were restricted to articles in English during the period January 2009 to December 2019 and relevant to the developing world that addressed: mobile phone use by healthcare workers and identified factors impacting the adoption of mHealth implementations. All authors reviewed selected papers, with final inclusion by consensus. Data abstraction was performed by all authors. The results were used to develop the conceptual framework using inductive iterative content analysis. RESULTS AND DISCUSSION Of 919 articles, 181 met the inclusion criteria and, following a review of full papers, 85 reported factors that impact (promote or impede) healthcare worker adoption of mHealth applications. These factors were categorised into 18 themes and, after continued iterative review and discussion were reduced to 7 primary categories (engagement/funding, infrastructure, training/technical support, healthcare workers' mobile-cost/ownership, system utility, motivation/staffing, patients' mobile-cost/ownership), with 17 sub-categories. These were used to design the proposed framework. CONCLUSIONS Successful adoption of mHealth by healthcare workers in the developing world will depend on addressing the factors identified in the proposed framework. They must be assessed in each specific setting prior to mHealth implementation. Application of the proposed framework will help shape future policy and practice of mHealth implementation in the developing world and increase adoption by health workers.
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Affiliation(s)
- Michael Addotey-Delove
- Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Richard E. Scott
- Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Maurice Mars
- Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
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4
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Korsah KA, Abdulai E, Dzansi G, Gamor N. Perception of nurses on the use of mobile phone text messaging for the management of diabetes mellitus in rural Ghana. Nurs Open 2023; 10:3415-3423. [PMID: 36611225 PMCID: PMC10077418 DOI: 10.1002/nop2.1596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/12/2022] [Accepted: 12/23/2022] [Indexed: 01/09/2023] Open
Abstract
AIM This study aims to explore the perception of nurses on the use of mobile phone SMS for managing diabetes in rural Ghana. DESIGN Exploratory Descriptive Qualitative Design. METHODS Purposive sampling was used to recruit (13) participants relative to data saturation after ethical clearance (REDACTED); using a semi-structured interview guide. All interviews were transcribed verbatim and analysed using thematic content analysis. RESULTS Participants believe SMS was useful in facilitating interaction between nurses, clients, family and statistically significant others; improving medication adherence and supporting blood glucose monitoring. The use of infographics was preferred to traditional SMS among digitally literate patients and voice calls for those who were illiterate. Participants had limited knowledge of downloadable diabetic applications. Participants were willing to accept and use SMS for the management of diabetes mellitus. PATIENT OR PUBLIC CONTRIBUTION Thirteen nurses actively participated in the study.
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Affiliation(s)
| | - Eliasu Abdulai
- School of Nursing and Midwifery, College of Health SciencesUniversity of GhanaLegonGhana
| | - Gladys Dzansi
- School of Nursing and MidwiferyUniversity of GhanaLegonGhana
| | - Nathan Gamor
- Catholic Hospital BattorUniversity of GhanaLegonGhana
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García AS, Fernández-Sotos P, González P, Navarro E, Rodriguez-Jimenez R, Fernández-Caballero A. Behavioral intention of mental health practitioners toward the adoption of virtual humans in affect recognition training. Front Psychol 2022; 13:934880. [PMCID: PMC9600723 DOI: 10.3389/fpsyg.2022.934880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
This paper explores the key factors influencing mental health professionals' behavioral intention to adopt virtual humans as a means of affect recognition training. Therapies targeting social cognition deficits are in high demand given that these deficits are related to a loss of functioning and quality of life in several neuropsychiatric conditions such as schizophrenia, autism spectrum disorders, affective disorders, and acquired brain injury. Therefore, developing new therapies would greatly improve the quality of life of this large cohort of patients. A questionnaire based on the second revision of the Unified Theory of Acceptance and Use of Technology (UTAUT2) questionnaire was used for this study. One hundred and twenty-four mental health professionals responded to the questionnaire after viewing a video presentation of the system. The results confirmed that mental health professionals showed a positive intention to use virtual reality tools to train affect recognition, as they allow manipulation of social interaction with patients. Further studies should be conducted with therapists from other countries to reach more conclusions.
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Affiliation(s)
- Arturo S. García
- Unidad Multidisciplinar de Investigación de la Neurocognición y Emoción en Entornos Virtuales y Reales, Instituto de Investigación en Informática de Albacete, Albacete, Spain
- Departamento de Sistemas Informáticos, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Patricia Fernández-Sotos
- Servicio de Salud Mental, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
- Biomedical Research Networking Center in Mental Health (CIBERSAM), Madrid, Spain
| | - Pascual González
- Unidad Multidisciplinar de Investigación de la Neurocognición y Emoción en Entornos Virtuales y Reales, Instituto de Investigación en Informática de Albacete, Albacete, Spain
- Departamento de Sistemas Informáticos, Universidad de Castilla-La Mancha, Albacete, Spain
- Biomedical Research Networking Center in Mental Health (CIBERSAM), Madrid, Spain
| | - Elena Navarro
- Unidad Multidisciplinar de Investigación de la Neurocognición y Emoción en Entornos Virtuales y Reales, Instituto de Investigación en Informática de Albacete, Albacete, Spain
- Departamento de Sistemas Informáticos, Universidad de Castilla-La Mancha, Albacete, Spain
- Biomedical Research Networking Center in Mental Health (CIBERSAM), Madrid, Spain
| | - Roberto Rodriguez-Jimenez
- Biomedical Research Networking Center in Mental Health (CIBERSAM), Madrid, Spain
- Cognición y Psicosis, Area de Neurociencias y Salud Mental, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- CogPsy-Group, Universidad Complutense de Madrid, Madrid, Spain
| | - Antonio Fernández-Caballero
- Unidad Multidisciplinar de Investigación de la Neurocognición y Emoción en Entornos Virtuales y Reales, Instituto de Investigación en Informática de Albacete, Albacete, Spain
- Departamento de Sistemas Informáticos, Universidad de Castilla-La Mancha, Albacete, Spain
- Biomedical Research Networking Center in Mental Health (CIBERSAM), Madrid, Spain
- *Correspondence: Antonio Fernández-Caballero
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Alsyouf A, Lutfi A, Al-Bsheish M, Jarrar M, Al-Mugheed K, Almaiah MA, Alhazmi FN, Masa’deh R, Anshasi RJ, Ashour A. Exposure Detection Applications Acceptance: The Case of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127307. [PMID: 35742560 PMCID: PMC9223380 DOI: 10.3390/ijerph19127307] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022]
Abstract
The pandemic's context is rife with numerous dangerous threats and high fear levels, influencing human decision-making. Such characteristics are identified by investigating the acceptance of exposure detection apps from the technology acceptance model (TAM) perspective. This study purposed a model to investigate protection technology acceptance, specifically exposure detection apps in the context of COVID-19. Quantitative study approach and a cross-section design targeted 586 participants from Saudi Arabia. As the study model is complex, the study hypotheses were analysed using the structural equation modelling-partial least squares (SEM-PLS3) approach. The findings support the entire model hypothesis except the link between social media awareness and exposure detection apps' intention. Mediation of COVID-19 anxiety and influence was confirmed as well. The current paper contributes to the technologies acceptance domain by developing a context-driven model comprising the major pandemic characteristics that lead to various patterns of technology acceptance. This study also fills the literature gap regarding mediating effects of social influence and COVID-19 anxiety in the relationship between trust in government and exposure detection apps implementation, and between COVID-19 anxiety and exposure detection apps implementation, respectively. The results may assist government agencies, health policymakers, and health organisations in the wide world and specifically Saudi Arabia, in their attempts to contain the COVID-19 pandemic spread.
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Affiliation(s)
- Adi Alsyouf
- Department of Managing Health Services and Hospitals, Faculty of Business Rabigh, College of Business (COB), King Abdulaziz University, Jeddah 21991, Saudi Arabia
- Correspondence: (A.A.); (A.L.)
| | - Abdalwali Lutfi
- Department of Accounting, College of Business Administration, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Correspondence: (A.A.); (A.L.)
| | - Mohammad Al-Bsheish
- Health Management Department, Batterjee Medical College, Jeddah 21442, Saudi Arabia;
| | - Mu’taman Jarrar
- Medical Education Department, King Fahd Hospital of the University, Al-Khobar 34445, Saudi Arabia;
- Vice Deanship for Quality and Development, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Khalid Al-Mugheed
- Surgical Nursing Department, Faculty of Nursing, Near East University, Nicosia 99138, Cyprus;
| | - Mohammed Amin Almaiah
- Department of Computer Networks, College of Computer Sciences and Information Technology, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Fahad Nasser Alhazmi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Ra’ed Masa’deh
- Department of Management Information Systems, School of Business, University of Jordan, Amman 11942, Jordan;
| | - Rami J. Anshasi
- Prosthodontics Department, Faculty of Dentistry, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Abdallah Ashour
- Department of Nursing, Faculty of Nursing, Philadelphia University, Amman 19392, Jordan;
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Siebert JN, Gosetto L, Sauvage M, Bloudeau L, Suppan L, Rodieux F, Haddad K, Hugon F, Gervaix A, Lovis C, Combescure C, Manzano S, Ehrler F. Usability Testing and Technology Acceptance of an mHealth App at the Point of Care During Simulated Pediatric In- and Out-of-Hospital Cardiopulmonary Resuscitations: Study Nested Within 2 Multicenter Randomized Controlled Trials. JMIR Hum Factors 2022; 9:e35399. [PMID: 35230243 PMCID: PMC8924787 DOI: 10.2196/35399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/03/2022] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mobile apps are increasingly being used in various domains of medicine. Few are evidence-based, and their benefits can only be achieved if end users intend to adopt and use them. To date, only a small fraction of mobile apps have published data on their field usability and end user acceptance results, especially in emergency medicine. OBJECTIVE This study aims to determine the usability and acceptance of an evidence-based mobile app while safely preparing emergency drugs at the point of care during pediatric in- and out-of-hospital cardiopulmonary resuscitations by frontline caregivers. METHODS In 2 multicenter randomized controlled parent trials conducted at 6 pediatric emergency departments from March 1 to December 31, 2017, and 14 emergency medical services from September 3, 2019, to January 21, 2020, the usability and technology acceptance of the PedAMINES (Pediatric Accurate Medication in Emergency Situations) app were evaluated among skilled pediatric emergency nurses and advanced paramedics when preparing continuous infusions of vasoactive drugs and direct intravenous emergency drugs at pediatric dosages during standardized, simulation-based, pediatric in- and out-of-hospital cardiac arrest scenarios, respectively. Usability was measured using the 10-item System Usability Scale. A 26-item technology acceptance self-administered survey (5-point Likert-type scales), adapted from the Unified Theory of Acceptance and Use of Technology model, was used to measure app acceptance and intention to use. RESULTS All 100% (128/128) of nurses (crossover trial) and 49.3% (74/150) of paramedics (parallel trial) were assigned to the mobile app. Mean total scores on the System Usability Scale were excellent and reached 89.5 (SD 8.8; 95% CI 88.0-91.1) for nurses and 89.7 (SD 8.7; 95% CI 87.7-91.7) for paramedics. Acceptance of the technology was very good and rated on average >4.5/5 for 5 of the 8 independent constructs evaluated. Only the image construct scored between 3.2 and 3.5 by both participant populations. CONCLUSIONS The results provide evidence that dedicated mobile apps can be easy to use and highly accepted at the point of care during in- and out-of-hospital cardiopulmonary resuscitations by frontline emergency caregivers. These findings can contribute to the implementation and valorization of studies aimed at evaluating the usability and acceptance of mobile apps in the field by caregivers, even in critical situations. TRIAL REGISTRATION ClinicalTrials.gov NCT03021122; https://clinicaltrials.gov/ct2/show/NCT03021122. ClinicalTrials.gov NCT03921346; https://clinicaltrials.gov/ct2/show/NCT03921346. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-019-3726-4.
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Affiliation(s)
- Johan N Siebert
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Laëtitia Gosetto
- Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - Manon Sauvage
- Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | | | - Laurent Suppan
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Frédérique Rodieux
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Kevin Haddad
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Florence Hugon
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Alain Gervaix
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christian Lovis
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Medical Information Sciences, Department of Radiology and Medical Informatics, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Combescure
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Clinical Epidemiology, Department of Health and Community Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sergio Manzano
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Frederic Ehrler
- Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
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Jeyaraj A. Models of information systems habit: An exploratory meta-analysis. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2022. [DOI: 10.1016/j.ijinfomgt.2021.102436] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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TAM-UTAUT and the acceptance of remote healthcare technologies by healthcare professionals: A systematic review. INFORMATICS IN MEDICINE UNLOCKED 2022. [DOI: 10.1016/j.imu.2022.101008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Schinle M, Erler C, Kaliciak M, Milde C, Stock S, Gerdes M, Stork W. Digital Health Applications in the Context of Dementia: A Questionnaire Study to Assess the Likelihood of Use among Physicians (Preprint). JMIR Form Res 2021; 6:e35961. [PMID: 35731567 PMCID: PMC9260525 DOI: 10.2196/35961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 04/08/2022] [Accepted: 04/29/2022] [Indexed: 02/05/2023] Open
Abstract
Background Age-related diseases such as dementia are playing an increasingly important role in global population development. Thus, prevention, diagnostics, and interventions require more accessibility, which can be realized through digital health apps. With the app on prescription, Germany made history by being the first country worldwide to offer physicians the possibility to prescribe and reimburse digital health apps as of the end of the year 2020. Objective Considering the lack of knowledge about correlations with the likelihood of use among physicians, this study aimed to address the question of what makes the use of a digital health app by physicians more likely. Methods We developed and validated a novel measurement tool—the Digital Health Compliance Questionnaire (DHCQ)—in an interdisciplinary collaboration of experts to assess the role of proposed factors in the likelihood of using a health app. Therefore, a web-based survey was conducted to evaluate the likelihood of using a digital app called DemPredict to screen for Alzheimer dementia. Within this survey, 5 latent dimensions (acceptance, attitude toward technology, technology experience, payment for time of use, and effort of collection), the dependent variable likelihood of use, and answers to exploratory questions were recorded and tested within directed correlations. Following a non–probability-sampling strategy, the study was completed by 331 physicians from Germany in the German language, of whom 301 (90.9%) fulfilled the study criteria (eg, being in regular contact with patients with dementia). These data were analyzed using a range of statistical methods to validate the dimensions of the DHCQ. Results The DHCQ revealed good test theoretical measures—it showed excellent fit indexes (Tucker-Lewis index=0.98; comparative fit index=0.982; standardized root mean square residual=0.073; root mean square error of approximation=0.037), good internal consistency (Cronbach α=.83), and signs of moderate to large correlations between the DHCQ dimensions and the dependent variable. The correlations between the variables acceptance, attitude toward technology, technology experience, and payment for the time of use and the dependent variable likelihood of use ranged from 0.29 to 0.79, and the correlation between effort of the collection and likelihood of use was −0.80. In addition, we found high levels of skepticism regarding data protection, and the age of the participants was found to be negatively related to their technical experience and attitude toward technology. Conclusions In the context of the results, increased communication between the medical and technology sectors and significantly more awareness raising are recommended to make the use of digital health apps more attractive to physicians as they can be adjusted to their everyday needs. Further research could explore the connection between areas such as adherence on the patient side and its impact on the likelihood of use by physicians.
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Affiliation(s)
- Markus Schinle
- Medical Information Technology, Embedded Systems and Sensors Engineering, FZI Research Center for Information Technology, Karlsruhe, Germany
| | - Christina Erler
- Medical Information Technology, Embedded Systems and Sensors Engineering, FZI Research Center for Information Technology, Karlsruhe, Germany
| | - Mayumi Kaliciak
- Biological Psychology, Department of Psychology, University of Koblenz and Landau, Landau, Germany
| | - Christopher Milde
- Biological Psychology, Department of Psychology, University of Koblenz and Landau, Landau, Germany
| | - Simon Stock
- Institut fuer Technik der Informationsverarbeitung, Department of Electrical Engineering & Information Technology, KIT Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Marius Gerdes
- Institut fuer Technik der Informationsverarbeitung, Department of Electrical Engineering & Information Technology, KIT Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Wilhelm Stork
- Institut fuer Technik der Informationsverarbeitung, Department of Electrical Engineering & Information Technology, KIT Karlsruhe Institute of Technology, Karlsruhe, Germany
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Binyamin SS, Zafar BA. Proposing a mobile apps acceptance model for users in the health area: A systematic literature review and meta-analysis. Health Informatics J 2021; 27:1460458220976737. [PMID: 33438494 DOI: 10.1177/1460458220976737] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
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.
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12
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Birkmeyer S, Wirtz BW, Langer PF. Determinants of mHealth success: An empirical investigation of the user perspective. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2021; 59:102351. [DOI: 10.1016/j.ijinfomgt.2021.102351] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 12/18/2020] [Accepted: 03/25/2021] [Indexed: 11/28/2022]
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13
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Aboelmaged M, Ali I, Hashem G. Mobile apps use for wellness and fitness and university students’ subjective wellbeing. INFORMATION DEVELOPMENT 2021. [DOI: 10.1177/02666669211020498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Subjective wellbeing among mobile application users attracted researchers’ interest in recent years due to its prevalent role in enhancing everyday life, particularly during the recent coronavirus pandemic (COVID-19). While previous work has primarily focused on users’ intention to adopt mobile apps for wellness and fitness (MAWF) purposes, scarce attention has been paid to the post-adoption impact of these apps on users’ subjective wellbeing. This study empirically integrates ‘technology readiness’ and ‘technology acceptance’ models (TRAM) to predict subjective wellbeing among MAWF users. It also critically assesses the strength of the mediating effects on the link between technology readiness and subjective wellbeing. Data analysis of 694 actual users of MAWF by means of SEM-PLS approach proves the robust power of the TRAM model in predicting subjective wellbeing. In addition to their mediating effects, technology acceptance constructs tend to be more influenced by positive dimensions (i.e., optimism and innovativeness) than that of negative dimensions (i.e., insecurity and discomfort) of technology readiness. This study is one of the first attempts to predict subjective wellbeing among actual users of MAWF. The study also delineates a broad spectrum of implications that enrich existing research and better inform decision makers in mobile health field.
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14
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Aboelmaged M, Hashem G, Mouakket S. Predicting subjective well-being among mHealth users: a readiness – value model. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2021. [DOI: 10.1016/j.ijinfomgt.2020.102247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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15
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Eysenbach G, Buis L, Scheel-Sailer A, Brach M, Rubinelli S. Opportunities and Challenges of a Self-Management App to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e22452. [PMID: 33295876 PMCID: PMC7758166 DOI: 10.2196/22452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/14/2020] [Accepted: 10/09/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Mobile health applications can offer tailored self-management support to individuals living with chronic health conditions. However, there are several challenges to the adoption of these technologies in practice. Co-design is a promising approach to overcoming some of these challenges by enabling the development of solutions that meet the actual needs and preferences of the relevant stakeholder groups. OBJECTIVE Taking spinal cord injury as a case in point, the overall objectives of this study were to identify the perceived benefits of a co-designed self-management app that could promote its uptake and to explore the factors that may impede adoption. METHODS We adopted a qualitative research approach guided by the Technology Acceptance Model. Data were collected through semistructured interviews with individuals with spinal cord injury (n=15) and two focus groups with health care professionals specialized in spinal cord injury (n=7, n=5). Prior to the interviews and focus groups, study participants were given time to explore the app prototype. All interviews were transcribed verbatim and analyzed using inductive thematic analysis. RESULTS Findings of our analysis indicate that study participants perceived the app prototype as potentially useful for supporting individuals with spinal cord injury in preventing pressure injuries. In particular, we identified three concrete use cases highlighting the benefits of the app for different audiences: (1) a companion for newly injured individuals, (2) an emergency kit and motivational support, and 3) a guide for informal caregivers and family members. We also uncovered several challenges that might impede the adoption of the self-management app in practice, including (1) challenges in motivating individuals to use the app, (2) concerns about the misuse and abuse of the app, and (3) organizational and maintenance challenges. CONCLUSIONS This study adds to a growing body of research that investigates individuals' adoption and nonadoption behavior regarding mobile health solutions. Building on earlier work, we make recommendations on how to address the barriers to the adoption of mobile health solutions identified by this study. In particular, there is a need to foster trust in mobile health among prospective users, including both patients and health care professionals. Moreover, increasing personal relevance of mobile health solutions through personalization may be a promising approach to promote uptake. Last but not least, organizational support also plays an instrumental role in mobile health adoption. We conclude that even though co-design is promoted as a promising approach to develop self-management tools, co-design does not guarantee adoption. More research is needed to identify the most promising strategies to promote the adoption of evidence-based mobile health solutions in practice.
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Affiliation(s)
| | | | - Anke Scheel-Sailer
- Swiss Paraplegic Center, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Mirjam Brach
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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16
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Lew S, Tan GWH, Loh XM, Hew JJ, Ooi KB. The disruptive mobile wallet in the hospitality industry: An extended mobile technology acceptance model. TECHNOLOGY IN SOCIETY 2020; 63:101430. [PMID: 33071395 PMCID: PMC7550096 DOI: 10.1016/j.techsoc.2020.101430] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/28/2020] [Accepted: 10/10/2020] [Indexed: 05/12/2023]
Abstract
Given that the mobile wallet has become a disruptive innovation, especially in the Malaysian hospitality industry, this study investigates the adoption of mobile wallet in the hospitality industry among consumers. Different from the extant literature, this study extends the newly proposed mobile technology acceptance model with self-efficacy theory, critical mass theory, and flow theory to explain the behavioural intention to adopt. A self-administered questionnaire was utilised to collect data from mobile wallet users who have used a mobile wallet while dining out in restaurants and cafes. Other than technology self-efficacy and perceived critical mass, mobile usefulness, mobile ease of use, mobile self-efficacy, and perceived enjoyment were discovered to have a positive and significant association with the behavioural intention to adopt mobile wallet in the hospitality industry. The findings also suggested there were interrelationships between the constructs employed. Overall, the extended model was able to explain 61% of the variance in behavioural intention to adopt mobile wallet.
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Affiliation(s)
- Susan Lew
- Faculty of Business and Finance, Universiti Tunku Abdul Rahman, Kampar, Malaysia
| | - Garry Wei-Han Tan
- Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia
- School of Finance and Economics, Nanchang Institute of Technology, Nan Chang City, China
| | - Xiu-Ming Loh
- Faculty of Business and Finance, Universiti Tunku Abdul Rahman, Kampar, Malaysia
| | - Jun-Jie Hew
- Faculty of Business and Finance, Universiti Tunku Abdul Rahman, Kampar, Malaysia
| | - Keng-Boon Ooi
- Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia
- College of Management, Chang Jung Christian University, Tainan City, Taiwan
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17
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Jacob C, Sanchez-Vazquez A, Ivory C. Factors Impacting Clinicians' Adoption of a Clinical Photo Documentation App and its Implications for Clinical Workflows and Quality of Care: Qualitative Case Study. JMIR Mhealth Uhealth 2020; 8:e20203. [PMID: 32965232 PMCID: PMC7542402 DOI: 10.2196/20203] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/05/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) tools have shown promise in clinical photo and wound documentation for their potential to improve workflows, expand access to care, and improve the quality of patient care. However, some barriers to adoption persist. OBJECTIVE This study aims to understand the social, organizational, and technical factors affecting clinicians' adoption of a clinical photo documentation mHealth app and its implications for clinical workflows and quality of care. METHODS A qualitative case study of a clinical photo and wound documentation app called imitoCam was conducted. The data were collected through 20 in-depth interviews with mHealth providers, clinicians, and medical informatics experts from 8 clinics and hospitals in Switzerland and Germany. RESULTS According to the study participants, the use of mHealth in clinical photo and wound documentation provides numerous benefits such as time-saving and efficacy, better patient safety and quality of care, enhanced data security and validation, and better accessibility. The clinical workflow may also improve when the app is a good fit, resulting in better collaboration and transparency, streamlined daily work, clinician empowerment, and improved quality of care. The findings included important factors that may contribute to or hinder adoption. Factors may be related to the material nature of the tool, such as the perceived usefulness, ease of use, interoperability, cost, or security of the app, or social aspects such as personal experience, attitudes, awareness, or culture. Organizational and policy barriers include the available clinical practice infrastructure, workload and resources, the complexity of decision making, training, and ambiguity or lack of regulations. User engagement in the development and implementation process is a vital contributor to the successful adoption of mHealth apps. CONCLUSIONS The promising potential of mHealth in clinical photo and wound documentation is clear and may enhance clinical workflow and quality of care; however, the factors affecting adoption go beyond the technical features of the tool itself to embrace significant social and organizational elements. Technology providers, clinicians, and decision makers should work together to carefully address any barriers to improve adoption and harness the potential of these tools.
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Affiliation(s)
- Christine Jacob
- Anglia Ruskin University, Cambridge, United Kingdom
- University of Applied Sciences Northwestern Switzerland, Brugg, Switzerland
| | - Antonio Sanchez-Vazquez
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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18
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Jacob C, Sanchez-Vazquez A, Ivory C. Understanding Clinicians' Adoption of Mobile Health Tools: A Qualitative Review of the Most Used Frameworks. JMIR Mhealth Uhealth 2020; 8:e18072. [PMID: 32442132 PMCID: PMC7381026 DOI: 10.2196/18072] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/15/2020] [Accepted: 04/26/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Although there is a push toward encouraging mobile health (mHealth) adoption to harness its potential, there are many challenges that sometimes go beyond the technology to involve other elements such as social, cultural, and organizational factors. OBJECTIVE This review aimed to explore which frameworks are used the most, to understand clinicians' adoption of mHealth as well as to identify potential shortcomings in these frameworks. Highlighting these gaps and the main factors that were not specifically covered in the most frequently used frameworks will assist future researchers to include all relevant key factors. METHODS This review was an in-depth subanalysis of a larger systematic review that included research papers published between 2008 and 2018 and focused on the social, organizational, and technical factors impacting clinicians' adoption of mHealth. The initial systematic review included 171 studies, of which 50 studies used a theoretical framework. These 50 studies are the subject of this qualitative review, reflecting further on the frameworks used and how these can help future researchers design studies that investigate the topic of mHealth adoption more robustly. RESULTS The most commonly used frameworks were different forms of extensions of the Technology Acceptance Model (TAM; 17/50, 34%), the diffusion of innovation theory (DOI; 8/50, 16%), and different forms of extensions of the unified theory of acceptance and use of technology (6/50, 12%). Some studies used a combination of the TAM and DOI frameworks (3/50, 6%), whereas others used the consolidated framework for implementation research (3/50, 6%) and sociotechnical systems (STS) theory (2/50, 4%). The factors cited by more than 20% of the studies were usefulness, output quality, ease of use, technical support, data privacy, self-efficacy, attitude, organizational inner setting, training, leadership engagement, workload, and workflow fit. Most factors could be linked to one framework or another, but there was no single framework that could adequately cover all relevant and specific factors without some expansion. CONCLUSIONS Health care technologies are generally more complex than tools that address individual user needs as they usually support patients with comorbidities who are typically treated by multidisciplinary teams who might even work in different health care organizations. This special nature of how the health care sector operates and its highly regulated nature, the usual budget deficits, and the interdependence between health care organizations necessitate some crucial expansions to existing theoretical frameworks usually used when studying adoption. We propose a shift toward theoretical frameworks that take into account implementation challenges that factor in the complexity of the sociotechnical structure of health care organizations and the interplay between the technical, social, and organizational aspects. Our consolidated framework offers recommendations on which factors to include when investigating clinicians' adoption of mHealth, taking into account all three aspects.
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Affiliation(s)
- Christine Jacob
- Anglia Ruskin University, Cambridge, United Kingdom
- University of Applied Sciences Northwestern Switzerland, Brugg, Switzerland
| | - Antonio Sanchez-Vazquez
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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19
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Cherrez-Ojeda I, Vanegas E, Felix M, Mata VL, Jiménez FM, Sanchez M, Simancas-Racines D, Cherrez S, Gavilanes AWD, Eschrich J, Chedraui P. Frequency of Use, Perceptions and Barriers of Information and Communication Technologies Among Latin American Physicians: An Ecuadorian Cross-Sectional Study. J Multidiscip Healthc 2020; 13:259-269. [PMID: 32214821 PMCID: PMC7082627 DOI: 10.2147/jmdh.s246253] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 02/27/2020] [Indexed: 01/13/2023] Open
Abstract
Objective In recent years, the use of information and communication technologies (ICTs) has increased in various sectors, among which the healthcare service is no exception. However, studies have mostly focused on the use of ICTs among patients with chronic diseases, with few reports on the advantages and barriers of these technologies among physicians, particularly in Latin America. We designed this study to fill in the gap, as an objective assessment of the frequency of use, perceptions, and barriers of ICTs among physicians remains crucial for a successful implementation of these technologies into the mainstream medical practice. Methods We conducted an anonymous cross-sectional survey-based study in 640 Ecuadorian physicians. The survey used consisted of 13 items and evaluated the frequency of use, perceptions, and barriers of ICTs among physicians. Chi-square tests for goodness of fit and independence were performed, whilst Phi coefficient was interpreted to assess the strength of associations. Fisher exact test was performed when required. Results Over 90% of physicians reported the use of ICTs to message other colleagues and patients (p=0.000). While 89.5% of physicians used social media to interact with other colleagues, only 58.1% used them to interact with patients (p=0.000). Most participants reported the use of ICTs to search for academic information (p=0.000). Moreover, more than 80.0% agree that ICTs may be used to promote health and medical services, search new job opportunities, get involved in research projects and promote teamwork with colleagues. However, 83.6% of physicians expressed concerns about privacy and patient confidentiality, while 53.8% stated that they lacked the time to use ICTs. Conclusion High usage of ICTs was found among Ecuadorian physicians. Younger physicians, with less postgraduate years, and non-specialists were more likely to have a positive perception toward ICTs. Privacy and patient confidentiality, followed by time management, were the most reported barriers in our study.
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Affiliation(s)
- Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respira Lab Research Group, Guayaquil, Ecuador
| | - Emanuel Vanegas
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respira Lab Research Group, Guayaquil, Ecuador
| | - Miguel Felix
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respira Lab Research Group, Guayaquil, Ecuador
| | - Valeria L Mata
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respira Lab Research Group, Guayaquil, Ecuador
| | - Fanny M Jiménez
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respira Lab Research Group, Guayaquil, Ecuador
| | - Mabel Sanchez
- Universidad Laica Eloy Alfaro, Manabí, Ecuador.,Universidad Estatal Del Sur Del Manabí, Manabí, Ecuador
| | - Daniel Simancas-Racines
- Centro De Investigación En Salud Pública y Epidemiología Clínica, Facultad De Ciencias De La Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador
| | - Sofia Cherrez
- School of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Antonio W D Gavilanes
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | | | - Peter Chedraui
- Instituto De Investigación e Innovación En Salud Integral, Facultad De Ciencias Médicas, Universidad Católica De Santiago De Guayaquil, Guayaquil, Ecuador.,Facultad De Ciencias De La Salud, Universidad Católica "Nuestra Señora De La Asunción", Asunción, Paraguay
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20
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Alpert JM, Manini T, Roberts M, Kota NSP, Mendoza TV, Solberg LM, Rashidi P. Secondary care provider attitudes towards patient generated health data from smartwatches. NPJ Digit Med 2020; 3:27. [PMID: 32140569 PMCID: PMC7054258 DOI: 10.1038/s41746-020-0236-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/24/2020] [Indexed: 01/07/2023] Open
Abstract
Wearable devices, like smartwatches, are increasingly used for tracking physical activity, community mobility, and monitoring symptoms. Data generated from smartwatches (PGHD_SW) is a form of patient-generated health data, which can benefit providers by supplying frequent temporal information about patients. The goal of this study was to understand providers' perceptions towards PGHD_SW adoption and its integration with electronic medical records. In-depth, semi-structured qualitative interviews were conducted with 12 providers from internal medicine, family medicine, geriatric medicine, nursing, surgery, rehabilitation, and anesthesiology. Diffusion of Innovations was used as a framework to develop questions and guide data analysis. The constant comparative method was utilized to formulate salient themes from the interviews. Four main themes emerged: (1) PGHD_SW is perceived as a relative advantage; (2) data are viewed as compatible with current practices; (3) barriers to overcome to effectively use PGHD_SW; (4) assessments from viewing sample data. Overall, PGHD_SW was valued because it enabled access to information about patients that were traditionally unattainable. It also can initiate discussions between patients and providers. Providers consider PGHD_SW important, but data preferences varied by specialty. The successful adoption of PGHD_SW will depend on tailoring data, frequencies of reports, and visualization preferences to correspond with the demands of providers.
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Affiliation(s)
- Jordan M. Alpert
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL USA
| | - Todd Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL USA
| | - Megan Roberts
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL USA
| | - Naga S. Prabhakar Kota
- Computer & Information Science & Engineering, University of Florida, Gainesville, FL USA
| | - Tonatiuh V. Mendoza
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL USA
| | - Laurence M. Solberg
- Veterans Health Administration, NF/SG VHS, Geriatrics Research, Education and Clinical Center (GRECC), Gainesville, FL USA
- College of Nursing, University of Florida, Gainesville, FL USA
| | - Parisa Rashidi
- Computer & Information Science & Engineering, University of Florida, Gainesville, FL USA
- J. Crayton Pruitt Family Department of Biomedical Engineering (BME), University of Florida, Gainesville, FL USA
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21
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Jacob C, Sanchez-Vazquez A, Ivory C. Social, Organizational, and Technological Factors Impacting Clinicians' Adoption of Mobile Health Tools: Systematic Literature Review. JMIR Mhealth Uhealth 2020; 8:e15935. [PMID: 32130167 PMCID: PMC7059085 DOI: 10.2196/15935] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/03/2019] [Accepted: 12/31/2019] [Indexed: 01/22/2023] Open
Abstract
Background There is a growing body of evidence highlighting the potential of mobile health (mHealth) in reducing health care costs, enhancing access, and improving the quality of patient care. However, user acceptance and adoption are key prerequisites to harness this potential; hence, a deeper understanding of the factors impacting this adoption is crucial for its success. Objective The aim of this review was to systematically explore relevant published literature to synthesize the current understanding of the factors impacting clinicians’ adoption of mHealth tools, not only from a technological perspective but also from social and organizational perspectives. Methods A structured search was carried out of MEDLINE, PubMed, the Cochrane Library, and the SAGE database for studies published between January 2008 and July 2018 in the English language, yielding 4993 results, of which 171 met the inclusion criteria. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and the Cochrane handbook were followed to ensure a systematic process. Results The technological factors impacting clinicians’ adoption of mHealth tools were categorized into eight key themes: usefulness, ease of use, design, compatibility, technical issues, content, personalization, and convenience, which were in turn divided into 14 subthemes altogether. Social and organizational factors were much more prevalent and were categorized into eight key themes: workflow related, patient related, policy and regulations, culture or attitude or social influence, monetary factors, evidence base, awareness, and user engagement. These were divided into 41 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. Conclusions The study results can help inform mHealth providers and policymakers regarding the key factors impacting mHealth adoption, guiding them into making educated decisions to foster this adoption and harness the potential benefits.
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Affiliation(s)
- Christine Jacob
- Anglia Ruskin University, Cambridge, United Kingdom.,University of Applied Sciences Northwestern Switzerland, Brugg, Switzerland
| | - Antonio Sanchez-Vazquez
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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22
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Jacob C, Sanchez-Vazquez A, Ivory C. Social, Organizational, and Technological Factors Impacting Clinicians' Adoption of Mobile Health Tools: Systematic Literature Review. JMIR Mhealth Uhealth 2020. [PMID: 32130167 DOI: 10.2196/preprints.15935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND There is a growing body of evidence highlighting the potential of mobile health (mHealth) in reducing health care costs, enhancing access, and improving the quality of patient care. However, user acceptance and adoption are key prerequisites to harness this potential; hence, a deeper understanding of the factors impacting this adoption is crucial for its success. OBJECTIVE The aim of this review was to systematically explore relevant published literature to synthesize the current understanding of the factors impacting clinicians' adoption of mHealth tools, not only from a technological perspective but also from social and organizational perspectives. METHODS A structured search was carried out of MEDLINE, PubMed, the Cochrane Library, and the SAGE database for studies published between January 2008 and July 2018 in the English language, yielding 4993 results, of which 171 met the inclusion criteria. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and the Cochrane handbook were followed to ensure a systematic process. RESULTS The technological factors impacting clinicians' adoption of mHealth tools were categorized into eight key themes: usefulness, ease of use, design, compatibility, technical issues, content, personalization, and convenience, which were in turn divided into 14 subthemes altogether. Social and organizational factors were much more prevalent and were categorized into eight key themes: workflow related, patient related, policy and regulations, culture or attitude or social influence, monetary factors, evidence base, awareness, and user engagement. These were divided into 41 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. CONCLUSIONS The study results can help inform mHealth providers and policymakers regarding the key factors impacting mHealth adoption, guiding them into making educated decisions to foster this adoption and harness the potential benefits.
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Affiliation(s)
- Christine Jacob
- Anglia Ruskin University, Cambridge, United Kingdom
- University of Applied Sciences Northwestern Switzerland, Brugg, Switzerland
| | - Antonio Sanchez-Vazquez
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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Kong T, Scott MM, Li Y, Wichelman C. Physician attitudes towards-and adoption of-mobile health. Digit Health 2020; 6:2055207620907187. [PMID: 32128235 PMCID: PMC7036486 DOI: 10.1177/2055207620907187] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 01/21/2020] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Smartphone apps and mobile devices are an emerging method of healthcare data collection. This study sought to understand how physicians currently view mobile health (mHealth) technologies and use them in patient care. METHODS A total of 186 physicians affiliated with Washington University School of Medicine in St. Louis, Missouri, USA completed a survey in 2016 regarding their current implementation of mHealth technologies for patient care and support for further development. RESULTS More than half of respondents were willing to discuss health apps and mobile devices with patients. However, most were not currently recommending them to patients. Apps/devices that encouraged a healthy diet and weight or tracked heart rate received the highest satisfaction ratings. Apps/devices that accessed the EMR (electronic medical record) remotely, provided medication reminders, or enrolled research subjects garnered the most interest despite respondents lacking prior experience. A majority agreed that collected biometrics are useful for promoting a healthy lifestyle (68%), tracking medical treatment (64%), or conducting research (56%); and agreed that proof of accuracy and precision (81%) and the efficient integration of collected data (68%) are necessary improvements. Uploading data automatically and updating physicians in real-time was the most preferred method of data integration into the EMR. CONCLUSIONS Physicians show interest in using mHealth technologies for patient care but have limited experience, usually with those specific to their specialties. Proof of quality and a method to integrate data into the EMR are necessary for a mainstream role in healthcare.
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Affiliation(s)
- Tracie Kong
- Fourth year medical students, Washington University School of
Medicine, USA
| | - Mary Morgan Scott
- Fourth year medical students, Washington University School of
Medicine, USA
| | - Yang Li
- Fourth year medical students, Washington University School of
Medicine, USA
| | - Cynthia Wichelman
- Department of Emergency Medicine, Washington University School
of Medicine, USA
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24
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Jacob C, Sanchez-Vazquez A, Ivory C. Clinicians' Role in the Adoption of an Oncology Decision Support App in Europe and Its Implications for Organizational Practices: Qualitative Case Study. JMIR Mhealth Uhealth 2019; 7:e13555. [PMID: 31066710 PMCID: PMC6524456 DOI: 10.2196/13555] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/13/2019] [Accepted: 04/03/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Despite the existence of adequate technological infrastructure and clearer policies, there are situations where users, mainly physicians, resist mobile health (mHealth) solutions. This is of particular concern, bearing in mind that several studies, both in developed and developing countries, showed that clinicians' adoption is the most influential factor in such solutions' success. OBJECTIVE The aim of this study was to focus on understanding clinicians' roles in the adoption of an oncology decision support app, the factors impacting this adoption, and its implications for organizational and social practices. METHODS A qualitative case study of a decision support app in oncology, called ONCOassist, was conducted. The data were collected through 17 in-depth interviews with clinicians and nurses in the United Kingdom, Ireland, France, Italy, Spain, and Portugal. RESULTS This case demonstrates the affordances and constraints of mHealth technology at the workplace, its implications for the organization of work, and clinicians' role in its constant development and adoption. The research findings confirmed that factors such as app operation and stability, ease of use, usefulness, cost, and portability play a major role in the adoption decision; however, other social factors such as endorsement, neutrality of the content, attitude toward technology, existing workload, and internal organizational politics are also reported as key determinants of clinicians' adoption. Interoperability and cultural views of mobile usage at work are the key workflow disadvantages, whereas higher efficiency and performance, sharpened practice, and location flexibility are the main workflow advantages. CONCLUSIONS Several organizational implications emerged, suggesting the need for some actions such as fostering a work culture that embraces new technologies and the creation of new digital roles for clinicians both on the hospitals or clinics and on the development sides but also more collaboration between health care organizations and digital health providers to enable electronic medical record integration and solving of any interoperability issues. From a theoretical perspective, we also suggest the addition of a fourth step to Leonardi's methodological guidance that accounts for user engagement; embedding the users in the continuous design and development processes ensures the understanding of user-specific affordances that can then be made more obvious to other users and increase the potential of such tools to go beyond their technological features and have a higher impact on workflow and the organizing process.
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Affiliation(s)
- Christine Jacob
- Anglia Ruskin University, Cambridge, United Kingdom.,University of Applied Sciences Northwestern Switzerland, Brugg, Switzerland
| | - Antonio Sanchez-Vazquez
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovation and Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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25
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Abejirinde IOO, Zweekhorst M, Bardají A, Abugnaba-Abanga R, Apentibadek N, De Brouwere V, van Roosmalen J, Marchal B. Unveiling the Black Box of Diagnostic and Clinical Decision Support Systems for Antenatal Care: Realist Evaluation. JMIR Mhealth Uhealth 2018; 6:e11468. [PMID: 30578177 PMCID: PMC6320439 DOI: 10.2196/11468] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/29/2018] [Accepted: 10/04/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Digital innovations have shown promise for improving maternal health service delivery. However, low- and middle-income countries are still at the adoption-utilization stage. Evidence on mobile health has been described as a black box, with gaps in theoretical explanations that account for the ecosystem of health care and their effect on adoption mechanisms. Bliss4Midwives, a modular integrated diagnostic kit to support antenatal care service delivery, was piloted for 1 year in Northern Ghana. Although both users and beneficiaries valued Bliss4Midwives, results from the pilot showed wide variations in usage behavior and duration of use across project sites. OBJECTIVE To strengthen the design and implementation of an improved prototype, the study objectives were two-fold: to identify causal factors underlying the variation in Bliss4Midwives usage behavior and understand how to overcome or leverage these in subsequent implementation cycles. METHODS Using a multiple case study design, a realist evaluation of Bliss4Midwives was conducted. A total of 3 candidate program theories were developed and empirically tested in 6 health facilities grouped into low and moderate usage clusters. Quantitative and qualitative data were collected and analyzed using realist thinking to build configurations that link intervention, context, actors, and mechanisms to program outcomes, by employing inductive and deductive reasoning. Nonparametric t test was used to compare the perceived usefulness and perceived ease of use of Bliss4Midwives between usage clusters. RESULTS We found no statistically significant differences between the 2 usage clusters. Low to moderate adoption of Bliss4Midwives was better explained by fear, enthusiasm, and high expectations for service delivery, especially in the absence of alternatives. Recognition from pregnant women, peers, supervisors, and the program itself was a crucial mechanism for device utilization. Other supportive mechanisms included ownership, empowerment, motivation, and adaptive responses to the device, such as realignment and negotiation. Champion users displayed high adoption-utilization behavior in contexts of participative or authoritative supervision, yet used the device inconsistently. Intervention-related (technical challenges, device rotation, lack of performance feedback, and refresher training), context-related (staff turnover, competing priorities, and workload), and individual factors (low technological self-efficacy, baseline knowledge, and internal motivation) suppressed utilization mechanisms. CONCLUSIONS This study shed light on optimal conditions necessary for Bliss4Midwives to thrive in a complex social and organizational setting. Beyond usability and viability studies, advocates of innovative technologies for maternal care need to consider how implementation strategies and contextual factors, such as existing collaborations and supervision styles, trigger mechanisms that influence program outcomes. In addition to informing scale-up of the Bliss4Midwives prototype, our results highlight the need for interventions that are guided by research methods that account for complexity.
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Affiliation(s)
- Ibukun-Oluwa Omolade Abejirinde
- Athena Institute, Faculty of Science, Vrije Universiteit, Amsterdam, Netherlands.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,ISGlobal, Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Marjolein Zweekhorst
- Athena Institute, Faculty of Science, Vrije Universiteit, Amsterdam, Netherlands
| | - Azucena Bardají
- ISGlobal, Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | | | - Vincent De Brouwere
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jos van Roosmalen
- Athena Institute, Faculty of Science, Vrije Universiteit, Amsterdam, Netherlands.,Department of Obstetrics, Leiden University Medical Centre, Leiden, Netherlands
| | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Cao B, Zhao P, Bien-Gund C, Tang W, Ong JJ, Fitzpatrick T, Tucker JD, Luo Z. The Web-Based Physician is Ready to See You: A Nationwide Cross-Sectional Survey of Physicians Using a Mobile Medical App to Evaluate Patients With Sexually Transmitted Diseases in China. JMIR Mhealth Uhealth 2018; 6:e10531. [PMID: 30377148 PMCID: PMC6234337 DOI: 10.2196/10531] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/17/2018] [Accepted: 08/27/2018] [Indexed: 01/13/2023] Open
Abstract
Background Web-based medical service provision is increasingly becoming common. However, it remains unclear how physicians are responding to this trend and how Web-based and offline medical services are linked. Objective The objectives of this study were to examine physicians’ use of mobile medical apps for sexually transmitted disease (STD) consultations and identify the physicians who frequently use mobile medical apps to evaluate patients with STD. Methods In August 2017, we conducted a nationwide cross-sectional survey among physicians registered on a mobile medical app in China. We collected data on physicians’ demographic information, institutional information, and Web-based medical practices. We compared physicians who used mobile medical apps to evaluate patients with STD frequently (at least once a week) with infrequent users. Bivariate and multivariate logistic regressions were used to identify physicians who frequently evaluated patients with STD on mobile medical apps. Results A total of 501 physicians participated in the survey. Among them, three-quarters were men and the average age was 37.6 (SD 8.2) years. Nearly all physicians (492/501, 98.2%) recommended their last Web-based patient with STD to subsequently see a physician in the clinic. More than half (275/501, 54.9%) of physicians recommended STD testing to Web-based patients, and 43.9% (220/501) provided treatment advice to patients with STD. Of all physicians, 21.6% (108/501) used mobile medical apps to evaluate patients with STD through Web more than once a week. Overall, 85.2% (427/501) physicians conducted follow-up consultation for patients with STD using mobile medical apps. Physicians working at institutions with STD prevention materials were associated with frequent evaluation of patients with STD on mobile medical apps (adjusted odds ratio=2.10, 95% CI 1.18-3.74). Conclusions Physicians use mobile medical apps to provide a range of services, including Web-based pre- and posttreatment consultations and linkage to offline clinical services. The high rates of referral to clinics suggest that mobile medical apps are used to promote clinic-seeking, and not replace it. Physicians’ use of mobile medical apps could benefit sexual minorities and others who avoid formal clinic-based services.
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Affiliation(s)
- Bolin Cao
- Shenzhen University, Shenzhen, China.,University of North Carolina Project - China, Guangzhou, China.,Social Entrepreneurship to Spur Health, Guangzhou, China
| | - Peipei Zhao
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Cedric Bien-Gund
- University of North Carolina Project - China, Guangzhou, China.,Social Entrepreneurship to Spur Health, Guangzhou, China
| | - Weiming Tang
- University of North Carolina Project - China, Guangzhou, China.,Social Entrepreneurship to Spur Health, Guangzhou, China.,University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jason J Ong
- Social Entrepreneurship to Spur Health, Guangzhou, China.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas Fitzpatrick
- Social Entrepreneurship to Spur Health, Guangzhou, China.,University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Joseph D Tucker
- University of North Carolina Project - China, Guangzhou, China.,Social Entrepreneurship to Spur Health, Guangzhou, China.,University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Zhenzhou Luo
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
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27
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Al-Muhtadi J, Shahzad B, Saleem K, Jameel W, Orgun MA. Cybersecurity and privacy issues for socially integrated mobile healthcare applications operating in a multi-cloud environment. Health Informatics J 2017; 25:315-329. [DOI: 10.1177/1460458217706184] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Kashif Saleem
- College of Computer and Information Sciences (CCIS), Center of Excellence in Information Assurance (CoEIA), King Saud University, Saudi Arabia
| | - Wasif Jameel
- COMSATS Institute of Information Technology, Pakistan
| | - Mehmet A Orgun
- Macquarie University, Australia; Macau University of Science and Technology, China
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