An Empirical Study on Patients' Acceptance of Physician-Patient Interaction in Online Health Communities

Portuguese Validation of the Unified Theory of Acceptance and Use of Technology Scale (UTAUT) to a COVID-19 Mobile Application: A Pilot Study

The use of technology has proven to be a powerful tool in the fight against COVID-19 and its variants of concern (Gamma, Beta, Alpha, Delta, and Omicron). The urgency of responding to this worldwide pandemic has accelerated the development of monitoring systems and contact tracing applications. Without technology's contribution, the adverse effects on humanity economically, socially, and psychologically would be even more devastating. This study aimed to translate, adapt, and validate the Unified Theory of Acceptance and Use of Technology (UTAUT) model in a Portuguese university population, to evaluate adherence to a mobile application for tracking COVID-19. An observational cross-sectional study was developed using a sample with 1081 participants (71% female, 59.2% with ages between 16 and 24, and 78.2% of the respondent's university students). The Portuguese version model showed a good reliability (Cronbach's α = 0.82) and an acceptable overall adjustment to the sample under study (χ²/df = 3.732, CFI = 0.955, TLI = 0.944, RMSEA = 0.05, SRMR = 0.06); however, this model could be improved, as we proved. Since this is a pilot study, more studies are needed. The results indicated that the P-UTAUT can be improved for evaluating adherence to a COVID-19 mobile application.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

The Roles of Trust and Its Antecedent Variables in Healthcare Consumers' Acceptance of Online Medical Consultation during the COVID-19 Pandemic in China

Online medical consultation (OMC) is generating considerable interest among researchers and practitioners due to the mandatory quarantine measures implemented during the COVID-19 pandemic in China. However, the acceptance rate of OMC has declined over time. This paper aims to empirically investigate OMC acceptance using a proposed research model by integrating the technology acceptance model (TAM) with trust and its antecedent variables. A quantitative self-administered cross-sectional survey was conducted to collect data from 260 healthcare consumers. A partial least squares structural equation modeling method was used to examine the data. Results revealed that healthcare consumers' behavioral intention was influenced by attitudes, while perceived usefulness and trust significantly influenced behavioral intention through attitude as a mediator. In addition, perceived risk, perceived privacy protection, network externalities, cognitive reputation, and interactivity directly influenced trust. Overall, the research model explained 50% of the variance in attitude and 71% of the variance in behavioral intention. The study's findings should provide useful insights into making effective design, development, and implementation decisions for OMC services.

Factors affecting wearable ECG device adoption by general practitioners for atrial fibrillation screening: cross-sectional study

Introduction

Atrial fibrillation (AF) is a challenging cardiovascular disease worldwide. Wearable electrocardiograph devices (WEDs) have great potential to improve the detection rate of AF in primary care. However, the factors that influence general practitioners' (GPs) perception and acceptance of WEDs are not well understood. To identify factors that influence the intention of GPs to utilize WEDs in a clinical setting to screen patients for AF.

Method

The research hypotheses and questionnaire items were designed and developed based on the unified theory of acceptance and technology (UTAUT) framework. We used stratified sampling and obtained the data through an online survey. Structural equation modeling was used to analyze the collected data.Results: A total of 1,004 valid questionnaires from GPs across Sichuan province in China were collected. Three factors increased GPs' intention to utilize WEDs to screen patients for AF, including performance expectancy (β = 0.121, p = 0.004), social influence (β = 0.356, p < 0.001), and price perception (β = 0.587, p < 0.001). Perception risk (β = -0.059, p < 0.001) decreased usage intention, while effort expectancy (β = -0.079, p = 0.155) and facilitating conditions (β = -0.014, p = 0.868) did not affect usage intention. Gender (β = -0.022, p = 0.179), age (β = 0.006, p = 0.699), education level (β = -0.22, p = 0.184) and training (β = 0.007, p = 0.69) were not significantly correlated with usage intention, and these four factors had no moderating effect on the path coefficients.

Discussion

GPs' intention to utilize WEDs is affected by performance expectancy, price perception, perception risk and social influence. Researcher should improve the usability and perception of WEDs for screening and carry out studies to provide high-quality evidence for the security and efficacy of wearable devices.

Anxiety and depression among pregnant women undergoing IVF-ET and WeChat group peer support during the COVID-19 pandemic: Study protocol for a randomized controlled trial

INTRODUCTION

The psychological well-being of pregnant women following assisted reproductive has increasingly gained attention in recent years. Anxiety and depression may be associated to pregnancy outcomes. This study aims to determine whether peer support and the WeChat group platform will reduce anxiety and depression among in vitro fertilization and embryo transfer (IVF-ET) women.

METHODS AND ANALYSIS

In the present randomized controlled study, 296 patients with confirmed clinical pregnancy following IVF-ET will be randomly assigned to receive standard intervention support or WeChat peer support on a 1:1 basis. The levels of anxiety and depression are the primary endpoints. Assessments will be performed at baseline measurements, first trimester, second trimester, and third trimester, and data will be collected.

ETHICS AND DISSEMINATION

This study has been approved as ethical by the affiliated hospital of Shandong University of Traditional Chinese Medicine's Reproductive Ethics Committee. Each patient will sign a written statement of informed permission. All information and biological samples will be legally protected. A peer-reviewed academic journal will publish the findings of this investigation.

DISCUSSION

Given the inconvenience of visits due to the current pandemic of COVID-19, this study addresses the patient's visit needs by combining WeChat, the most widely used social software in China, with peer support, while helping improve maternal anxiety, depression, and pregnancy outcomes following IVF-ET.

Promotion strategy for online healthcare platform during the COVID-19 pandemic: Evidence from Spring Rain Doctor in China

INTRODUCTION

Online healthcare platform (OHP) is a new form of medical treatment that solves the problems of an unbalanced distribution of medical resources in China. Especially during the COVID-19 pandemic, OHP has greatly reduced the medical pressure of the hospital and the risk of cross-infection.

METHODS

Based on self-determination theory (SDT) (Ryan and Deci, 2000), privacy calculus theory (PCT) (Culnan, 1999) and perceived value theory (PVT) (Choi, 2004), this study uses evolutionary game theory to analyze behavioral strategies and their dynamic evolution in the promotion of OHP. Moreover, we conduct numerical simulations with the help of program compilation.

RESULTS

The results demonstrate that (1) both the qualification inspection of doctors and the investment in information protection influence doctors' participation in and patients' usage of OHP; (2) both the initial probabilities of doctor participation and patient usage influence the multi-game results; (3) the trend of doctors joining OHP is affected by registration cost, time cost, and reputation loss; and (4) the trend of patients using online healthcare is mainly decided by the cost.

CONCLUSION

This study takes the Spring Rain Doctor as an example to verify the game results. To further popularize online medical treatment among patients, the platform should attach importance to the inspection of doctors and the protection of privacy information and strengthen its publicity in remote places.

Double chain system for online and offline medical data sharing private and consortium blockchain: A system design study

With the informatization development and digital construction in the healthcare industry, electronic medical records and Internet medicine facilitate people's medical treatment. However, the current data storage method has the risk of data loss, leakage, and tampering, and can't support extensive and secure sharing of medical data. To realize effective and secure medical data storage and sharing among offline medical institutions and Internet medicine platforms, this study used a combined private blockchain and consortium blockchain to design a medical blockchain double-chain system (MBDS). This system can store encrypted medical data in distributed storage mode and systematically integrate the medical data of patients in offline medical institutions and Internet medicine platforms, to achieve equality, credibility, and data sharing among participating nodes. The MBDS system constructed in this study incorporated Internet medicine care services into the current healthcare system and provided new solutions and practical guidance for the future development of collaborative medical care. This study helped to solve the problems of medical data interconnection and resource sharing, improve the efficiency and effect of disease diagnosis, alleviate the contradiction between doctors and patients, and facilitate personal health management. This study has substantial theoretical and practical implications for the research and application of medical data storage and sharing.

Willingness to Adopt Health Information Among Social Question-and-Answer Community Users in China: Cross-sectional Survey Study

BACKGROUND

COVID-19 has spread around the world and has increased the public's need for health information in the process. Meanwhile, in the context of lockdowns and other measures for preventing SARS-CoV-2 spread, the internet has surged as a web-based resource for health information. Under these conditions, social question-and-answer communities (SQACs) are playing an increasingly important role in improving public health literacy. There is great theoretical and practical significance in exploring the influencing factors of SQAC users' willingness to adopt health information.

OBJECTIVE

The aim of this study was to establish an extended unified theory of acceptance and use of technology model that could analyze the influence factors of SQAC users' willingness to adopt health information. Particularly, we tried to test the moderating effects that different demographic characteristics had on the variables' influences.

METHODS

This study was conducted by administering a web-based questionnaire survey and analyzing the responses from a final total of 598 valid questionnaires after invalid data were cleaned. By using structural equation modelling, the influencing factors of SQAC users' willingness to adopt health information were analyzed. The moderating effects of variables were verified via hierarchical regression.

RESULTS

Performance expectation (β=.282; P<.001), social influence (β=.238; P=.02), and facilitating conditions (β=.279; P=.002) positively affected users' willingness to adopt health information, whereas effort expectancy (P=.79) and perceived risk (P=.41) had no significant effects. Gender had a significant moderating effect in the structural equation model (P<.001).

CONCLUSIONS

SQAC users' willingness to adopt health information was evidently affected by multiple factors, such as performance expectation, social influence, and facilitating conditions. The structural equation model proposed in this study has a good fitting degree and good explanatory power for users' willingness to adopt health information. Suggestions were provided for SQAC operators and health management agencies based on our research results.

Assessing the telemedicine acceptance for adults in Brazil

PURPOSE

This study aimed to find factors influencing the acceptance of telemedicine for adults in Brazil. Moreover, it investigates the moderating role of disease complexity and the generational digital divide phenomenon on the intention to use the telemedicine service.

DESIGN/METHODOLOGY/APPROACH

A quasi-experiment was employed. Primary data were collected using a survey research method considering two different scenarios based on disease complexity and symptom severity. A total of 248 responses were collected using a structured questionnaire. The authors also tested these two scenarios in three generations (X, Y and Z) of adults. Partial least squares structural equation modeling (PLS-SEM) was used to analyze the collected data and test the research hypotheses.

FINDINGS

The results indicated that performance expectancy and perceived security and reliability are two predictors of the behavioral intention to use telemedicine, whereas effort expectancy and social influence showed no statistical significance. Furthermore, the results demonstrated that adults tend to adopt telemedicine regardless of the level of disease complexity. Finally, this study does not support the existence of a digital divide in the three generations.

ORIGINALITY/VALUE

The study applies the UTAUT model to assess the telemedicine acceptance for younger generations. It examines patient risk perception (security and reliability) as one antecedent of telemedicine acceptance.

Exploring the Effect of Market Conditions on Price Premiums in the Online Health Community

Online health communities allow doctors to fully use existing medical resources to serve remote patients. They broaden and diversify avenues of interaction between doctors and patients using Internet technology, which have built an online medical consultation market. In this study, the theory of supply and demand was adopted to explore how market conditions of online doctor resources impact price premiums of doctors’ online service. Then, we investigated the effect of the stigmatized diseases. We used resource supply and resource concentration to characterize the market conditions of online doctor resources and a dummy variable to categorize whether the disease is stigmatized or ordinary. After an empirical study of the dataset (including 68,945 doctors), the results indicate that: (1) the supply of online doctor resources has a significant and negative influence on price premiums; (2) compared with ordinary diseases, doctors treating stigmatized diseases can charge higher price premiums; (3) stigmatized diseases positively moderate the relationship between resource supply and price premiums; and (4) the concentration of online doctor resources has no significant influence on price premiums. Our research demonstrates that both the market conditions of online doctor resources and stigmatized diseases can impact price premiums in the online medical consultation market. The findings provide some new and insightful implications for theory and practice.