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Cheng YS, Lin CP, Chen LYA, Hwang WR, Lin YC, Chen YC. Short-Term Effects of an eHealth Care Experiential Learning Program Among Patients With Type 2 Diabetes: Randomized Controlled Trial. J Med Internet Res 2024; 26:e53509. [PMID: 39150761 PMCID: PMC11364949 DOI: 10.2196/53509] [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: 10/09/2023] [Revised: 02/07/2024] [Accepted: 06/21/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Type 2 diabetes is a chronic disease with a significant medical burden. eHealth care integrates medicine and technology to enhance the outcomes of such patients; however, adequate eHealth literacy (eHL) is necessary for that to happen. Fostering eHL is crucial for patients with diabetes to engage with eHealth care and receive quality care and timely support. Experiential learning theory can enhance patients' eHL and skills to use eHealth care technology in their daily care. OBJECTIVE This study explored the effectiveness of an eHealth care experiential learning program in improving eHL, patient health engagement, and eHealth care use status among patients with type 2 diabetes in 3 months. METHODS In this randomized controlled trial, patients under case management services from various clinics in Taiwan were randomly assigned to either the intervention group receiving the 6-session eHealth care experiential learning program or the control group receiving the usual care. Data were collected using structured questionnaires at 3 time points: pretest, postintervention, and 3 months after the intervention. Descriptive data were presented using frequency distribution, percentage, mean, and SD. The outcomes were analyzed using a generalized estimating equation method by intention-to-treat analysis. RESULTS A total of 92 participants (46 in each group) were recruited in this study. Of these, 86 completed the course and follow-up evaluations with a mean age of 62.38 (SD 12.91) years. After completing the intervention, the intervention group had significantly higher posttest scores in eHL (β=19.94, SE 3.52; P<.001), patient health engagement (β=.28, SE 0.13; P=.04), and eHealth use (β=3.96, SE 0.42; P<.001) than the control group. Furthermore, the intervention group maintained these significant improvements in eHL (β=18.19, SE 3.82; P<.001) and eHealth use (β=3.87, SE 0.49; P<.001) after 3 months. CONCLUSIONS Participating in the eHealth care experiential learning program resulted in significant improvements in eHL, patient health engagement, and eHealth use among patients with type 2 diabetes. Our interventional program can inform future clinical practice and policies to strengthen self-management skills and facilitate the use of health technology in caring for patients with chronic diseases. TRIAL REGISTRATION ClinicalTrials.gov NCT05180604; https://clinicaltrials.gov/ct2/show/NCT05180604.
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Affiliation(s)
- Yu-Shan Cheng
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
| | - Cheng-Pei Lin
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
| | - Lu-Yen Anny Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | - Yi-Chun Lin
- Rong-Yang Clinic, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Chi Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Ahuna JK, Becker KD, Chorpita BF. Predicting Therapists' Intentions to Use Innovations: Comparing the Role of Individual, Organizational, and Innovation Characteristics. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:946-965. [PMID: 37715814 DOI: 10.1007/s10488-023-01295-6] [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] [Accepted: 08/16/2023] [Indexed: 09/18/2023]
Abstract
Theories emphasize the role of individual and organizational characteristics in implementation outcomes, yet research indicates that these characteristics account for only a small amount of variance in those outcomes. Innovation characteristics might be important proximal determinants of implementation outcomes but are infrequently examined in mental health services research. This study examined the relative variance explained by individual, organizational, and innovation characteristics on behavioral intentions, a central implementation outcome in implementation theories. Data were collected from 95 therapists and 28 supervisors who participated in a cluster randomized trial that tested the effectiveness of two clinical decision-making innovations. Multilevel models compared individual, organizational, and innovation characteristics as predictors of therapists' intentions to use the innovations. Subsequent mediational path analyses tested whether innovation characteristics mediated the effect of innovation type on intentions. Individual and organizational characteristics explained 29% of the variability in therapists' intentions. Approximately 75% of the variability in therapists' intentions was accounted for by innovation characteristics. Individual and organizational characteristics were not statistically significant predictors of intentions after controlling for innovation characteristics. The indirect effect of innovation type on intentions through therapists' beliefs was statistically significant (B = 0.410, 95% Bootstrapped CI = [0.071, 0.780]), but the direct effect of innovation type was not (B = 0.174, p = .365). Innovation characteristics are related to therapist intentions and might explain why some innovations are received more favorably than others. Future studies should explore the complex interrelationships between these beliefs alongside other individual or organizational characteristics.
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Affiliation(s)
- Jonathan K Ahuna
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite #220, Columbia, SC, 29208, USA
| | - Kimberly D Becker
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite #220, Columbia, SC, 29208, USA
| | - Bruce F Chorpita
- Department of Psychology, University of California, Los Angeles, Box 951563, Los Angeles, CA, 90095, USA.
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Zhang Q, Zhang R, Lu X, Zhang X. What drives the adoption of online health communities? An empirical study from patient-centric perspective. BMC Health Serv Res 2023; 23:524. [PMID: 37221504 DOI: 10.1186/s12913-023-09469-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 04/28/2023] [Indexed: 05/25/2023] Open
Abstract
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.
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Affiliation(s)
- Qianyao Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing, 100044, China
| | - Runtong Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing, 100044, China.
| | - Xinyi Lu
- School of Management and E-business, Zhejiang Gongshang University, Hangzhou, Zhejiang, China
| | - Xijing Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing, 100044, China
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Drissi N, Ouhbi S, Serhani MA, Marques G, de la Torre Díez I. Connected Mental Health Solutions: Global Attitudes, Preferences, and Concerns. Telemed J E Health 2023; 29:315-330. [PMID: 35730979 DOI: 10.1089/tmj.2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Connected mental health (CMH) presents several technology-based solutions, which can help overcome many mental care delivery barriers. However, attitudes toward the use of CMH are diverse and differ from a cohort to another. Objective: The purpose of this study is to investigate the global attitudes toward CMH use and assess the use of technology for mental care. Methods: This study presents a synthesis of literature available in Scopus, Science Direct, and PubMed digital libraries, investigating attitudes toward CMH in different cohorts from different countries, based on a systematic review of relevant publications. This study also analyzes technology use patterns of the cohorts investigated, the reported preferred criteria that should be considered in CMH, and issues and concerns regarding CMH use. Results: One hundred and one publications were selected and analyzed. These publications were originated from different countries, with the majority (n = 23) being conducted in Australia. These studies reported positive attitudes of investigated cohorts toward CMH use and high technology use and ownership. Several preferred criteria were reported, mainly revolving around providing blended care functionalities, educational content, and mental health professionals (MHPs) support. Whereas concerns and issues related to CMH use addressed technical problems related to access to technology and to CMH solutions, the digital divide, lack of knowledge and use of CMH, and general reservations to use CMH. Concerns related to institutional and work barriers were also identified. Conclusions: Attitudes toward CMH show promising results from users and MHP views. However, factors such as providing blended care options and considering technical concerns should be taken into consideration for the successful adoption of CMH.
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Affiliation(s)
- Nidal Drissi
- Department of Information Systems and Security and CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sofia Ouhbi
- Department of Computer Science and Software Engineering, CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mohamed Adel Serhani
- Department of Information Systems and Security and CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Gonçalo Marques
- Polytechnic of Coimbra, School of Technology and Management of Oliveira do Hospital (ESTGOH), Coimbra, Portugal
| | - Isabel de la Torre Díez
- Department of Signal Theory and Communications and Telematics Engineering, University of Valladolid, Valladolid, Spain
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Tan CH, Koo AC, Rahmat H, Siew WF, Cheang AWO, Amir Sharji E. A quantitative study exploring the acceptance of the eHealth model for mental wellness among digital workers. F1000Res 2022; 11:111. [PMID: 35811794 PMCID: PMC9214265 DOI: 10.12688/f1000research.73482.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/20/2022] Open
Abstract
Background: eHealth makes use of information and communication technologies (ICT) to improve health. In the digital age, the use of eHealth applications and other health-related applications has gained popularity, particularly during the COVID-19 pandemic. As a result of the pandemic, many uncertainties have arisen, causing stress and affecting the mental health of many skilled workers in the digital industry, particularly in the ICT, computing, and creative media industries. eHealth applications have the potential to benefit people's health. As a prerequisite for effective implementation of eHealth for mental wellness (EHMW), this paper examines the acceptance of EHMW among digital workers in Malaysia. The objectives of this research are two-fold: 1) To explore the acceptance of EHMW among digital workers in a local Premier Digital Tech Institution (PDTI), and 2) To explore how these talents' demographic profiles, mental health literacy and workplace wellness influence their acceptance of EHMW. Methods: This research surveyed 41 digital workers who played vital roles in providing digital skills at a tertiary education level. Results: Most respondents agreed that eHealth was appropriate for managing mental wellness. Among the three eHealth domains for managing mental wellness, the acceptance level is the highest for the application domain of "interacting for health", with male respondents more likely to accept the use of EHMW. Conclusions: This small-scale survey could not fully examine the acceptance of eHealth and its usage patterns for mental wellness among digital workers in Malaysia. Future research will target more digital workers in Malaysia. This research addresses the research gap on the eHealth perspectives of digital workers on their acceptance, and the potential influence of demographic profiles, mental health literacy, and workplace wellness on EHMW's acceptance of digital health tools/platforms to promote their mental wellness.
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Affiliation(s)
- Choon Hong Tan
- Persiaran Multimedia, Multimedia University (MMU), Cyberjaya, Selangor, 63100, Malaysia
| | - Ah Choo Koo
- Persiaran Multimedia, Multimedia University (MMU), Cyberjaya, Selangor, 63100, Malaysia
| | - Hawa Rahmat
- Persiaran Multimedia, Multimedia University (MMU), Cyberjaya, Selangor, 63100, Malaysia
| | - Wei Fern Siew
- International Medical University (IMU), 126, JIn Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, 57000, Malaysia
| | - Alexius Weng Onn Cheang
- International Medical University (IMU), 126, JIn Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, 57000, Malaysia
| | - Elyna Amir Sharji
- Persiaran Multimedia, Multimedia University (MMU), Cyberjaya, Selangor, 63100, Malaysia
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Bernard RM, Toppo C, Raggi A, de Mul M, de Miquel C, Pugliese MT, van der Feltz-Cornelis CM, Ortiz-Tallo A, Salvador-Carulla L, Lukersmith S, Hakkaart-van Roijen L, Merecz-Kot D, Staszewska K, Sabariego C. Strategies for Implementing Occupational eMental Health Interventions: Scoping Review. J Med Internet Res 2022; 24:e34479. [PMID: 35648457 PMCID: PMC9201704 DOI: 10.2196/34479] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/02/2022] [Accepted: 03/30/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The implementation of eMental health interventions, especially in the workplace, is a complex process. Therefore, learning from existing implementation strategies is imperative to ensure improvements in the adoption, development, and scalability of occupational eMental health (OeMH) interventions. However, the implementation strategies used for these interventions are often undocumented or inadequately reported and have not been systematically gathered across implementations in a way that can serve as a much-needed guide for researchers. OBJECTIVE The objective of this scoping review was to identify implementation strategies relevant to the uptake of OeMH interventions that target employees and detail the associated barriers and facilitation measures. METHODS A scoping review was conducted. The descriptive synthesis was guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework and the Consolidated Framework for Implementation Research. RESULTS A total of 31 of 32,916 (0.09%) publications reporting the use of the web-, smartphone-, telephone-, and email-based OeMH interventions were included. In all, 98 implementation strategies, 114 barriers, and 131 facilitators were identified. The synthesis of barriers and facilitators produced 19 facilitation measures that provide initial recommendations for improving the implementation of OeMH interventions. CONCLUSIONS This scoping review represents one of the first steps in a research agenda aimed at improving the implementation of OeMH interventions by systematically selecting, shaping, evaluating, and reporting implementation strategies. There is a dire need for improved reporting of implementation strategies and combining common implementation frameworks with more technology-centric implementation frameworks to fully capture the complexities of eHealth implementation. Future research should investigate a wider range of common implementation outcomes for OeMH interventions that also focus on a wider set of common mental health problems in the workplace. This scoping review's findings can be critically leveraged by discerning decision-makers to improve the reach, effectiveness, adoption, implementation, and maintenance of OeMH interventions.
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Affiliation(s)
| | - Claudia Toppo
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Marleen de Mul
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
| | - Carlota de Miquel
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Maria Teresa Pugliese
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | | | - Ana Ortiz-Tallo
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.,Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Luis Salvador-Carulla
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
| | - Sue Lukersmith
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
| | | | | | - Kaja Staszewska
- Department of Health and Work Psychology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Carla Sabariego
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Center for Rehabilitation in Global Health Systems, World Health Organization Collaborating Center, University of Lucerne, Lucerne, Switzerland
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7
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Scheutzow J, Attoe C, Harwood J. Acceptability of Web-Based Mental Health Interventions in the Workplace: Systematic Review. JMIR Ment Health 2022; 9:e34655. [PMID: 35544305 PMCID: PMC9133994 DOI: 10.2196/34655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Web-based interventions have proven to be effective not only in clinical populations but also in the occupational setting. Recent studies conducted in the work environment have focused on the effectiveness of these interventions. However, the role of employees' acceptability of web-based interventions and programs has not yet enjoyed a similar level of attention. OBJECTIVE The objective of this systematic review was to conduct the first comprehensive study on employees' level of acceptability of web-based mental health interventions based on direct and indirect measures, outline the utility of different types of web-based interventions for work-related mental health issues, and build a research base in the field. METHODS The search was conducted between October 2018 and July 2019 and allowed for any study design. The studies used either qualitative or quantitative data sources. The web-based interventions were generally aimed at supporting employees with their mental health issues. The study characteristics were outlined in a table as well as graded based on their quality using a traffic light schema. The level of acceptability was individually rated using commonly applied methods, including percentile quartiles ranging from low to very high. RESULTS A total of 1303 studies were identified through multiple database searches and additional resources, from which 28 (2%) were rated as eligible for the synthesis. The results of employees' acceptability levels were mixed, and the studies were very heterogeneous in design, intervention characteristics, and population. Approximately 79% (22/28) of the studies outlined acceptability measures from high to very high, and 54% (15/28) of the studies reported acceptability levels from low to moderate (overlap when studies reported both quantitative and qualitative results). Qualitative studies also provided insights into barriers and preferences, including simple and tailored application tools as well as the preference for nonstigmatized language. However, there were multiple flaws in the methodology of the studies, such as the blinding of participants and personnel. CONCLUSIONS The results outline the need for further research with more homogeneous acceptability studies to draw a final conclusion. However, the underlying results show that there is a tendency toward general acceptability of web-based interventions in the workplace, with findings of general applicability to the use of web-based mental health interventions.
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Affiliation(s)
- Johanna Scheutzow
- Department of Psychosis, Institute of Psychiatry, Psychology and Neuroscience, School of Academic Psychiatry, King's College London, London, United Kingdom
| | - Chris Attoe
- Department of Psychosis, Institute of Psychiatry, Psychology and Neuroscience, School of Academic Psychiatry, King's College London, London, United Kingdom.,Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Joshua Harwood
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, United Kingdom
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Apolinário-Hagen J, Harrer M, Salewski C, Lehr D, Ebert DD. Akzeptanz und Nutzung von E-Mental-Health-Angeboten unter Studierenden. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2022. [PMCID: PMC9037969 DOI: 10.1007/s11553-022-00945-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Zusammenfassung
Zielsetzung
Trotz der Effektivität verschiedener E‑Mental-Health-Interventionen wurden bislang verhältnismäßig geringe Nutzungsraten, selbst unter Digital Natives wie Studierenden, identifiziert. Ziel dieser Studie ist daher, das Verhältnis der generellen Akzeptanz, dem konkreten Interesse und der tatsächlichen Registrierung für ausgewählte, zielgruppenspezifische E‑Mental-Health-Programme zu untersuchen.
Methodik
Wir führten eine Sekundäranalyse einer in ein Online-Experiment eingebetteten Befragungsstudie mit n = 451 Studierenden (89 % Fernstudierende) zu Informationseffekten auf die Akzeptanz von E‑Mental-Health-Angeboten mit Untersuchung der Nutzungsabsicht sowie des Interesses im Verhältnis zu objektiven Daten, d. h. Registrierungen für ausgewählte E‑Mental-Health-Angebote zur Stressprävention und Gesundheitsförderung, durch.
Ergebnisse
Eine hierarchische Regressionsanalyse ergab das Stresslevel, wahrgenommene Ähnlichkeit mit Informationsquellen und Einstellungen als Determinanten der Nutzungsabsicht (R2 = 0,49). Aktuelles Interesse an der Teilnahme an einem bestimmten E‑Mental-Health-Angebot berichtete weniger als ein Drittel der Stichprobe (31 %). Überdies war die Intentions-Verhaltens-Lücke bei der Follow-up-Messung (n/N in %) beim Programm für Berufstätige geringer (85 % registriert) als für das Programm für Studierende (69 % registriert; insgesamt: 77 %).
Schlussfolgerung
Über drei Viertel der interessierten Studierenden haben sich für ein Programm registriert, was für die Bereitstellung einfacher, direkter Zugangsoptionen spricht. Zukünftige Studien sollten die Determinanten der Nutzung sowie Adhärenz bei E‑Mental-Health-Angeboten in Abhängigkeit von der Akzeptanz für verschiedene Subgruppen von Studierenden zur Entwicklung passgenauer Akzeptanzförderungsmaßnahmen genauer untersuchen.
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Drissi N, Ouhbi S, Amiri L, Al Mugaddam F, Jan RK, Isomursu M. A Conceptual Framework to Design Connected Mental Health Solutions in the United Arab Emirates: Questionnaire Study. JMIR Form Res 2022; 6:e27675. [PMID: 35129458 PMCID: PMC8861868 DOI: 10.2196/27675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/22/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background Connected mental health (CMH) is a field presenting information and communications technology–based mental care interventions that could help overcome many mental care delivery barriers. Culture and background influence people’s attitudes, preferences, and acceptance of such solutions. Therefore, the suitability of CMH solutions to the targeted population is an important factor in their successful adoption. Objective The aim of this study is to develop a framework for the design and creation of CMH solutions suitable for the UAE context. The framework is based on investigating enablers and barriers of CMH adoption in the United Arab Emirates, from the mental health professional's (MHP) perspective and from related literature. Methods A survey of literature on relevant studies addressing the use of technology for mental care in Arab countries, and a web-based questionnaire-based survey with 17 MHPs practicing in the United Arab Emirates investigating their attitudes and views toward CMH was conducted. Results from the questionnaire and from related studies were analyzed to develop the design framework. Results On the basis of findings from the literature survey and analyzing MHP answers to the web-based survey, a framework for the design of CMH solutions for the UAE population was developed. The framework presents four types of recommendation categories: favorable criteria, which included blended care, anonymity, and ease of use; cultural factors including availability in multiple languages, mainly Arabic and English, in addition to religious and cultural considerations; technical considerations, including good-quality communication, availability in formats compatible with mobile phones, and providing technical support; and users’ health and data safety considerations, including users’ suitability testing, confidentiality, and ensuring MHP integrity. Conclusions CMH has the potential to help overcome many mental care barriers in the United Arab Emirates in particular and in the Arab world in general. CMH adoption in the United Arab Emirates has a potential for success. However, many factors should be taken into account, mainly cultural, religious, and linguistic aspects.
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Affiliation(s)
- Nidal Drissi
- Department of Computer Science & Software Engineering, College of Information Technology, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Sofia Ouhbi
- Department of Computer Science & Software Engineering, College of Information Technology, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Leena Amiri
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fadwa Al Mugaddam
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Reem K Jan
- College of Medicine, Mohammed Bin Rashid University Of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Minna Isomursu
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
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Abstract
Understanding the factors affecting the use of healthcare technologies is a crucial topic that has been extensively studied, specifically during the last decade. These factors were studied using different technology acceptance models and theories. However, a systematic review that offers extensive understanding into what affects healthcare technologies and services and covers distinctive trends in large-scale research remains lacking. Therefore, this review aims to systematically review the articles published on technology acceptance in healthcare. From a yield of 1768 studies collected, 142 empirical studies have met the eligibility criteria and were extensively analyzed. The key findings confirmed that TAM and UTAUT are the most prevailing models in explaining what affects the acceptance of various healthcare technologies through different user groups, settings, and countries. Apart from the core constructs of TAM and UTAUT, the results showed that anxiety, computer self-efficacy, innovativeness, and trust are the most influential factors affecting various healthcare technologies. The results also revealed that Taiwan and the USA are leading the research of technology acceptance in healthcare, with a remarkable increase in studies focusing on telemedicine and electronic medical records solutions. This review is believed to enhance our understanding through a number of theoretical contributions and practical implications by unveiling the full potential of technology acceptance in healthcare and opening the door for further research opportunities.
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Sora B, Nieto R, Montesano Del Campo A, Armayones M. Acceptance and Use of Telepsychology From the Clients' Perspective: Questionnaire Study to Document Perceived Advantages and Barriers. JMIR Ment Health 2021; 8:e22199. [PMID: 34652276 PMCID: PMC8556637 DOI: 10.2196/22199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/19/2020] [Accepted: 08/02/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Telepsychology is increasingly being incorporated in clinical practice, being offered in many psychotherapy centers, especially after the impact of the pandemic. However, there seems to be a remarkable discrepancy between the offer, or interest in, and real-world uptake of e-mental health interventions among the population. A critical precondition is clients' willingness to accept and use telepsychology, although this issue has thus far been overlooked in research. OBJECTIVE The aim of this study was to examine people's acceptance and use of telepsychology by adopting an extended model of the unified theory of acceptance and use of technology (UTAUT) that integrates perceived telepsychology advantages and barriers, usefulness perceptions, behavioral intention, and telepsychology use. METHODS An online survey was conducted with a convenience sample of 514 participants. Structural equation models were computed to test a mediation model. RESULTS Results supported the UTAUT model to explain participants' acceptance and use of telepsychology. They showed a causal chain in which perceived telepsychology advantages and barriers were related to telepsychology use through the perceived usefulness of and intention to use telepsychology. CONCLUSIONS Telepsychology use may be explained according to the UTAUT model when coupled with participants' perceptions of telepsychology advantages and barriers. Mental health stakeholders could consider these factors in order to increase the acceptance and use of telepsychology.
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Affiliation(s)
- Beatriz Sora
- Department of Psychology, Rovira i Virgili University, Tarragona, Spain
| | - Rubén Nieto
- Department of Psychology, eHealth Center, Open University of Catalonia, Barcelona, Spain
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Xu L, Li P, Hou X, Yu H, Tang T, Liu T, Xiang S, Wu X, Huang C. Middle-aged and elderly users' continuous usage intention of health maintenance-oriented WeChat official accounts: empirical study based on a hybrid model in China. BMC Med Inform Decis Mak 2021; 21:257. [PMID: 34479566 PMCID: PMC8413706 DOI: 10.1186/s12911-021-01625-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022] Open
Abstract
Background Although middle-aged and elderly users are the main group targeted by health maintenance-oriented WeChat official accounts (HM-WOAs), few studies have explored the relationship of these accounts and their users. Exploring the factors that influence the continuous adoption of WOAs is helpful to strengthen the health education of middle-aged and elderly individuals. Objective We developed a new theoretical model and explored the factors that influence middle-aged and elderly individuals' continuous usage intention for HM-WOA. Performance expectancy mediated the effects of the model in explaining continuous usage intention and introduced health literacy into the model.
Methods We established a hybrid theoretical model on the basis of the unified theory of acceptance and use of technology 2 model (UTAUT2), the health belief model (BHM), protection motivation theory (PMT), and health literacy. We collected valid responses from 396 middle-aged and elderly users aged ≥ 45 years in China. To verify our hypotheses, we analyzed the data using structural equation modeling.
Results Performance expectancy (β = 0.383, P < 0.001), hedonic motivation (β = 0.502, P < 0.001), social influence (β = 0.134, P = 0.049), and threat appraisal (β = 0.136, P < 0.001) positively influenced middle-aged and elderly users' continuous usage intention. Perceived health threat (β = − 0.065, P = 0.053) did not have a significant effect on continuous usage intention. Both threat appraisal (β = 0.579, P < 0.001) and health literacy (β = 0.579, P < 0.001) positively affected performance expectancy. Threat appraisal indirectly affected continuous usage intention through performance expectancy mediation. Conclusions Our new theoretical model is useful for understanding middle-aged and elderly users' continuous usage intention for HM-WOA. Performance expectancy plays a mediation role between threat appraisal and continuous usage intention, and health literacy positively affects performance expectancy.
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Affiliation(s)
- Lin Xu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Pengfei Li
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Xiaorong Hou
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Hongfan Yu
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Tingting Tang
- The Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Liu
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Shoushu Xiang
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Xiaoqian Wu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Cheng Huang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China.
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13
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Einfluss akzeptanzfördernder Interventionen auf die Nutzung einer Online-Selbsthilfe. PSYCHOTHERAPEUT 2021. [DOI: 10.1007/s00278-021-00530-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Zusammenfassung
Hintergrund
Trotz wachsender empirischer Evidenz zur Wirksamkeit in der Behandlung psychischer Erkrankungen sind internetbasierte Interventionen (IBI) mit geringen Akzeptanz- und hohen Abbruchraten konfrontiert. Akzeptanzfördernde Interventionen (AFI) stellen eine vielversprechende Maßnahme dar, um die Akzeptanz zukünftiger Nutzer*innen zu verbessern. Die Wirksamkeit von AFI auf die Adhärenz, die maßgeblichen Einfluss auf die Wirksamkeit von IBI hat, wurde bisher in nur wenigen empirischen Untersuchungen überprüft.
Ziel der Arbeit (Fragestellung)
Ziel der vorliegenden Untersuchung ist die Überprüfung des Einflusses einer AFI auf die Akzeptanz, die initiale Nutzung und die Adhärenz des transdiagnostischen psychodynamischen Online-Selbsthilfeprogramms „Die Kraft der eigenen Emotionen nutzen (KEN-Online)“.
Material und Methoden
Es wurden Routinedaten von 231 Patient*innen ausgewertet, die während ihrer (teil‑)stationären Behandlung im Rahmen einer ins Routinesetting integrierten AFI das Angebot bekommen haben, KEN-Online behandlungsbegleitend zu nutzen. Im Kohortendesign werden Patient*innen, die an einer AFI teilgenommen haben, mit einer historischen Kontrollgruppe von Patient*innen verglichen, die dieses Angebot nicht erhielten. Zudem wird der Zusammenhang zwischen der Einstellung und der Akzeptanz des Programms in der Untersuchungsgruppe (mit AFI) überprüft.
Ergebnisse
Sowohl die Akzeptanz als auch die initiale Nutzung von KEN-Online waren um knapp 20 % höher (jeweils p < 0,01) unter den Teilnehmenden der AFI-Gruppe, verglichen mit der Kontrollgruppe. In Bezug auf die Adhärenz von KEN-Online zeigte sich ein kleiner Unterschied dahingehend, dass Teilnehmende der Kontrollgruppe signifikant (p < 0,05) mehr Einheiten abgeschlossen haben als Teilnehmende der Interventionsgruppe. Allerdings war der Anteil der „completer“ von KEN-Online mit 13,4 % insgesamt sehr gering. Ein Einfluss der Einstellung auf die Akzeptanz wurde nicht nachgewiesen.
Diskussion
Die vorliegende Untersuchung zeigt, dass AFI dazu beitragen können, die Akzeptanz und initiale Nutzung von IBI zu fördern, indem Patient*innen der (teil‑)stationären Routineversorgung standardisiert und strukturiert über die Intervention informiert werden. Hinsichtlich der Förderung der Adhärenz sind jedoch zusätzliche Maßnahmen erforderlich.
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Zhou M, Long P, Kong N, Campy KS. Characterizing Wuhan residents' mask-wearing intention at early stages of the COVID-19 pandemic. PATIENT EDUCATION AND COUNSELING 2021; 104:1868-1877. [PMID: 33390304 PMCID: PMC7836404 DOI: 10.1016/j.pec.2020.12.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/30/2020] [Accepted: 12/22/2020] [Indexed: 05/26/2023]
Abstract
OBJECTIVE As an effective measure to prevent the COVID-19 pandemic, wearing mask is widely recommended in countries around the world. This study aims to identify factors that explain the behavioral intention of Wuhan City urban residents to wear masks. METHODS A theoretical model was extended on UTAUT by incorporating the feature on residents having relevant knowledge and sufficient awareness on the pandemic. During early stages of the COVID-19 outbreak, an online survey was conducted in Wuhan City and 728 valid samples were collected from 35 communities. Structural equations modeling and bootstrapping were applied. RESULTS Sample data present acceptable reliability and validity. Performance expectancy, effort expectancy, social influence, and knowledge about COVID-19 have positive effects on behavioral intention. Facilitating condition, knowledge, and behavioral intention have significant effects on use behavior. Gender, age, education, income, and current marital status are significant moderators in the theoretical model. CONCLUSION Having relevant knowledge on the pandemic, together with performance expectancy, effort expectancy, social influence, and facilitating condition, affects behavioral intention and usage behavior of Wuhan residents to wear masks at early stages of the COVID-19 pandemic. Subgroups have different psychological mechanisms based on their demographic characteristics. PRACTICE IMPLICATIONS Health policy makers should focus on enhancing residents' knowledge on infectious disease and their awareness of the risk mitigation, and develop personalized measures for different subgroups.
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Affiliation(s)
- Min Zhou
- International Business School, Hunan University of Technology and Business, Changsha, China; Weldon School of Biomedical Engineering, Purdue University, West Lafayette, USA.
| | - Piao Long
- School of Business Administration, Hunan University of Technology and Business, Changsha, China
| | - Nan Kong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, USA
| | - Kathryn S Campy
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, USA
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15
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Apolinário-Hagen J, Harrer M, Dederichs M, Fritsche L, Wopperer J, Wals F, Loerbroks A, Lehr D, Salewski C, Angerer P, Ebert DD. Exploring the influence of testimonial source on attitudes towards e-mental health interventions among university students: Four-group randomized controlled trial. PLoS One 2021; 16:e0252012. [PMID: 34038455 PMCID: PMC8153476 DOI: 10.1371/journal.pone.0252012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 05/09/2021] [Indexed: 11/18/2022] Open
Abstract
Electronic mental health services (eMHSs) offer additional options for the dissemination of psychological interventions for university students. Still, many university students are reluctant to use eMHSs. Narrative messages may help increase the awareness and acceptance of quality-approved programs. However, little is known about the usefulness of narrative messages to improve attitudes towards eMHSs. In this experiment, we thus aimed to explore in how far different ways of targeting information to students affect their attitudes towards eMHSs for stress prevention and therapy, and to identify potential determinants of attitude change. N = 451 students (Mean = 32.6 years, SD = 10.2, 75% female, 7% with eMHS experience) were randomly assigned to one of four study arms involving information designed to induce different levels of perceived similarity. While the active control condition only received general information (arm 1, “information only”, n = 116), the other experimental arms were additionally exposed to testimonials on specific eMHSs either addressing an unspecified audience (arm 2, n = 112), employees (arm 3, n = 115) or working university students (arm 4, n = 108). Two-way ANOVA revealed no impact of information on the alteration of attitudes towards eMHSs for stress coping (d = 0.20). Only a small effect of target-group specific testimonials on attitudes towards online therapies was identified at post-intervention (d = 0.29). Regression analyses demonstrated significant influences of source credibility and perceived similarity on attitudes for preventative eMHSs (ps<0.01), as well as a partial mediation effect of perceived similarity in favor of testimonials targeted to students (95% CI [0.22, 0.50]). Overall, this study indicated no meaningful impact of information on attitudes and limited evidence for benefits of tailored narrative messages. Since attitudes were already positive at baseline, further research with a representative student sample mimicking real-world decision scenarios is needed to gain an in-depth understanding of acceptance-facilitating message features that may contribute to promote the adoption of evidence-based eMHSs.
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Affiliation(s)
- Jennifer Apolinário-Hagen
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- * E-mail:
| | - Mathias Harrer
- Department of Clinical Psychology and Psychotherapy, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Melina Dederichs
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Fritsche
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Jeannette Wopperer
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Frank Wals
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Adrian Loerbroks
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Dirk Lehr
- Department of Health Psychology, Leuphana University Lueneburg, Lueneburg, Germany
| | - Christel Salewski
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Peter Angerer
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - David Daniel Ebert
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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16
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Li P, Xu L, Tang T, Wu X, Huang C. Willingness to Adopt Health Information Among Social Question-and-Answer Community Users in China: Cross-sectional Survey Study. J Med Internet Res 2021; 23:e27811. [PMID: 33970865 PMCID: PMC8143873 DOI: 10.2196/27811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/10/2021] [Accepted: 05/08/2021] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- PengFei Li
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Lin Xu
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Tingting Tang
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,The Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoqian Wu
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Cheng Huang
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
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17
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Michaelis M, Burgess S, Junne F, Rothermund E, Gündel H, Zipfel S, Wolf M, Rieger MA. Mental Health Applications for Primary and Secondary Prevention of Common Mental Disorders: Attitudes of German Employees. Front Psychiatry 2021; 12:508622. [PMID: 34017269 PMCID: PMC8130826 DOI: 10.3389/fpsyt.2021.508622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/29/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Web-based and mobile mental health applications for the prevention and treatment of common mental disorders (CMDs) are on the rise. Under certain circumstances they have proved to be effective for a range of conditions (e.g., depression). Objective: There is not sufficient evidence regarding the benefits and barriers especially for mobile phone apps and for programs in the field of primary prevention. Studies on the acceptance of potential users of mental health apps yielded mixed outcomes. In a large survey we investigated the attitudes of employees toward mental health apps and various traditional mental health services. Our main research question in this contribution focuses on the acceptance of apps compared to other measures and the moderating influence of individual characteristics. Methods: The standardized survey was completed by members of an online access panel with different job types. A set of 33 self-developed items, including three questions on e-health, captured the perceived relevance of prevention at the (A) occupational, (B) individual, and (C) societal level. On the basis of an exploratory factor analysis, mean scores for mapping seven (sub-)dimensions were constructed and compared using the Wilcoxon test. The influence of potential predictors was analyzed in linear regression models. Results: The data of 610 respondents were analyzed (response rate 75%). Support from mental health applications was rated significantly less important compared to all other dimensions at the levels (A) to (C). Respondents were more likely to use mental health apps if they felt literate with electronic devices, perceived a high relevance of work-related demands as causal factors for CMDs, stated they would be ashamed of having a CMD, and would be willing to begin psychotherapy if recommended. Discussion and Conclusions: The results confirm the critical attitudes of potential mental health app users found in other studies. Since users with a negative attitude toward e-health might have a higher risk for dropout and non-adherence as well as lower intervention effects, well-designed educational strategies should be carried out beforehand.
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Affiliation(s)
- Martina Michaelis
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
- Research Centre for Occupational and Social Medicine (FFAS), Freiburg, Germany
| | - Stephanie Burgess
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
| | - Florian Junne
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center/Leadership Personality Centre, Ulm University, Ulm, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center/Leadership Personality Centre, Ulm University, Ulm, Germany
| | - Stephan Zipfel
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Markus Wolf
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Monika A. Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
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18
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Apolinário-Hagen J, Hennemann S, Kück C, Wodner A, Geibel D, Riebschläger M, Zeißler M, Breil B. Exploring User-Related Drivers of the Early Acceptance of Certified Digital Stress Prevention Programs in Germany. Health Serv Insights 2020; 13:1178632920911061. [PMID: 32206013 PMCID: PMC7074489 DOI: 10.1177/1178632920911061] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/14/2020] [Indexed: 12/29/2022] Open
Abstract
Electronic mental health services represent innovative instruments to increase the dissemination of stress programs in primary prevention. However, little is known about facilitators of their uptake. This study aimed to explore determinants of the acceptance of centrally certified digital stress coping programs and preferences for service delivery modes among adult members of German statutory health insurances. Participants completed a multi-construct 45-item questionnaire covering acceptance of digital stress prevention (behavioral use intention) and potential predictors we assessed using hierarchical regression analysis-(1) socio-demographic variables and time spent online, (2) openness to experience, (3) perceived stress, and (4) attitudes toward e-mental health. Preferences in terms of the willingness to use online, face-to-face and blended programs were analyzed using paired t-tests. Participants (N = 171, 66% female, 18-69 years) reported a moderate acceptance of digital stress management (M = 2.76, SD = 1.16, range: 1-5). We identified younger age (ß = -0.16, P = .009), openness to experience (ß = 0.17, P = .003), and positive attitudes (ß = 0.61, P < .001) as predictors of acceptance (R 2 = .50, P < .001). Face-to-face was preferred over online (d = 0.40) and blended (d = 0.33), and blended over stand-alone online delivery mode (d = 0.19; all P < .001). Our findings indicate that promoting favorable attitudes toward digital stress prevention through tailored information may be a starting point to facilitate their adoption.
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Affiliation(s)
- Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Institute of Psychology, University of Mainz, Mainz, Germany
| | - Christina Kück
- Faculty of Psychology, University of Hagen, Hagen, Germany
| | | | - Dorota Geibel
- Faculty of Psychology, University of Hagen, Hagen, Germany
| | | | - Martin Zeißler
- Faculty of Psychology, University of Hagen, Hagen, Germany
| | - Bernhard Breil
- Faculty of Health Care, Hochschule Niederrhein, University of Applied Sciences, Krefeld, Germany
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Lu X, Zhang R, Zhu X. An Empirical Study on Patients' Acceptance of Physician-Patient Interaction in Online Health Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245084. [PMID: 31842465 PMCID: PMC6949919 DOI: 10.3390/ijerph16245084] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 12/15/2022]
Abstract
In China, the utilization of medical resources is contentious, and a large of hospitals are seriously congested because of the huge population and uneven distribution of medical resources. Online health communities (OHCs) provide patients with platforms to interact with physicians and to get professional suggestions and emotional support. This study adopted the unified theory of acceptance and use of technology to identify factors influencing patients’ behavioral intention and usage behavior when interacting with physicians in OHCs. An investigation involving 378 valid responses was conducted through several Chinese OHCs to collect data. Confirmatory factor analysis and structural equation modelling were utilized to test hypotheses. Both the reliability and validity of the scales were acceptable. All five hypotheses were supported, and behavioral intention played a significant mediating role between independent variables and dependent variables. This study clarified the mechanism by which performance expectancy, effort expectancy, social influence and attitude toward using technology affect usage behavior through the mediation of behavioral intention in OHCs. These findings suggest that OHCs can change the actions of websites such as adopting some incentives to promote patients’ intention of interaction. Physicians should understand patients’ actual attitudes toward OHCs and try to guide patients in their interactions, improving the quality of physician–patient interaction.
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Affiliation(s)
- Xinyi Lu
- School of Economics and Management, Beijing Jiaotong University, No. 3 Shangyuancun, Haidian District, Beijing 100044, China; (X.L.); (R.Z.)
| | - Runtong Zhang
- School of Economics and Management, Beijing Jiaotong University, No. 3 Shangyuancun, Haidian District, Beijing 100044, China; (X.L.); (R.Z.)
| | - Xiaomin Zhu
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, No. 3 Shangyuancun, Haidian District, Beijing 100044, China
- Correspondence: ; Tel.: +86-10-5168-3854
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20
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Apolinário-Hagen J, Hennemann S, Fritsche L, Drüge M, Breil B. Determinant Factors of Public Acceptance of Stress Management Apps: Survey Study. JMIR Ment Health 2019; 6:e15373. [PMID: 31697243 PMCID: PMC6873149 DOI: 10.2196/15373] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/12/2019] [Accepted: 10/11/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Chronic stress is a major public health concern. Mobile health (mHealth) apps can help promote coping skills in daily life and prevent stress-related issues. However, little is known about the determinant factors of public acceptance of stress management in relation to preferences for psychological services. OBJECTIVE The aim of this survey study was to (1) assess determinant factors of public acceptance (behavioral use intention) of stress management apps based on an adapted and extended version of the Unified Theory of Acceptance and Use of Technology (UTAUT) model and (2) explore preferences for mHealth apps compared with other mental health services. METHODS Using convenience sampling, participants completed a multiscale 54-item Web-based survey. Based on significant correlations with acceptance, hierarchical stepwise regression analysis was performed within three blocks: (1) background and stress-related control variables, (2) beliefs and attitudes toward using mHealth, and (3) the core UTAUT determinants. The preference for mHealth apps in comparison with nine other mental health services (operationalized as readiness to use) was analyzed using paired t tests. RESULTS Of 141 participants, nearly half (69/141, 48.9%) indicated prior mHealth use. Acceptance of stress coping apps was moderate (mean 3.10, SD 1.03, range 1-5). Hierarchical stepwise regression including four of 11 variables (R2=.62; P=.01, f2=1.63) identified positive attitudes toward using mHealth for stress coping (beta=0.69, P<.001, 46% R2 increase above block 1, f2=0.85), skepticism/perceived risks (beta=-0.14, P=.01, f2=0.16), and stress symptoms (beta=0.12, P=.03, f2=0.14) as significant predictors of acceptance. UTAUT determinants added no predictive contribution beyond attitudes (all P>.05, R2 increase of 1%), whereas post hoc analysis showed significant R2 increases of attitudes and skepticism/perceived risks beyond UTAUT determinants (all P<.001, R2 increase of 13%). The readiness to use apps was equivalent to or significantly higher than most service types, but lower than information websites. CONCLUSIONS Attitudes may be at least as predictive for the acceptance of stress management apps as for more elaborated outcome beliefs. Efforts aimed at improving the public adoption of mHealth could put more emphasis on the pleasant aspects of app use, address misconceptions, offer stress screening tools on health websites, and increase options to try high-quality apps.
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Affiliation(s)
- Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Faculty of Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Institute of Psychology, University of Mainz, Mainz, Germany
| | - Lara Fritsche
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
| | - Marie Drüge
- Psychotherapy Research, Department of Clinical Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Bernhard Breil
- Faculty of Health Care, Niederrhein University of Applied Sciences, Krefeld, Germany
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21
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HabITec: A Sociotechnical Space for Promoting the Application of Technology to Rehabilitation. SOCIETIES 2019. [DOI: 10.3390/soc9040074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Society is currently facing unprecedented technological advances that simultaneously create opportunities and risks. Technology has the potential to revolutionize rehabilitation and redefine the way we think about disability. As more advanced technology becomes available, impairments and the environmental barriers that engender disability can be significantly mitigated. The opportunity to apply technology to rehabilitation following serious injuries or illnesses is becoming more evident. However, the translation of these innovations into practice remains limited and often inequitable. This situation is exacerbated by the fact that not all relevant parties are involved in the decision-making process. Our solution was to create a sociotechnical system, known as HabITec, where people with disabilities, practitioners, funders, researchers, designers and developers can work together and co-create new solutions. Sociotechnical thinking is collaborative, interdisciplinary, adaptive, problem-solving and focused on a shared set of goals. By applying a sociotechnical approach to the healthcare sector, we aimed to minimize the lag in translating new technologies into rehabilitation practice. This collaborative co-design process supports innovation and ensures that technological solutions are practical and meaningful, ethical, sustainable and contextualized. In this conceptual paper, we presented the HabITec model along with the empirical evidence and theories on which it has been built.
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Zwerenz R, Baumgarten C, Becker J, Tibubos A, Siepmann M, Knickenberg RJ, Beutel ME. Improving the Course of Depressive Symptoms After Inpatient Psychotherapy Using Adjunct Web-Based Self-Help: Follow-Up Results of a Randomized Controlled Trial. J Med Internet Res 2019; 21:e13655. [PMID: 31651403 PMCID: PMC6838691 DOI: 10.2196/13655] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/20/2019] [Accepted: 07/07/2019] [Indexed: 01/13/2023] Open
Abstract
Background We recently showed in a randomized controlled trial that Web-based self-help as an adjunct improved the effectiveness of multimodal inpatient psychotherapy for depression. Objective The aims of this study were (1) to determine whether a Web-based self-help adjunctive to multimodal inpatient psychotherapeutic treatment could also improve the course of depressive symptoms and (2) to identify predictors of residual depressive symptoms at follow-up. Methods Overall, 229 patients were randomized either to the Web-based self-help intervention group (Deprexis) or an active control group (Web-based information about depression and depressive symptoms) in addition to multimodal inpatient psychotherapy. Participants in both groups were able to access their respective Web-based programs for 12 weeks, which meant that they typically had access after discharge from the inpatient unit (mean hospitalization duration: 40 days, T1). Follow-up was performed 6 months after study intake (T3). Results At follow-up, participants of the Web-based self-help group had considerably lower symptom load regarding depressive symptoms (d=0.58) and anxiety (d=0.46) as well as a better quality of life (d=0.43) and self-esteem (d=0.31) than participants of the control group. Nearly 3 times as many participants of the intervention group compared with the control group achieved remission in accordance with less deterioration. The number needed to treat based on the Beck Depression Inventory-II (BDI-II) improved over time (T1: 7.84, T2: 7.09, and T3: 5.12). Significant outcome predictors were BDI at discharge and treatment group. Conclusions Web-based self-help as an add-on to multimodal inpatient psychotherapy improved the short-term course of depressive symptoms beyond termination. Residual symptoms at discharge from inpatient treatment and utilization of the Web-based self-help were the major predictors of depressive symptoms at follow-up. Challenges and barriers (eg, costs, therapists’ concerns, or technical barriers) of adding Web-based interventions to inpatient treatment have to be addressed. Trial Registration ClinicalTrials.gov NCT02196896; https://clinicaltrials.gov/ct2/show/NCT02196896.
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Affiliation(s)
- Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Carlotta Baumgarten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Jan Becker
- Institute for Teachers' Health, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Ana Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Martin Siepmann
- Clinic for Psychosomatic Medicine, Rhön-Klinikum AG, Bad Neustadt/ Saale, Germany.,Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Rudolf J Knickenberg
- Clinic for Psychosomatic Medicine, Rhön-Klinikum AG, Bad Neustadt/ Saale, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
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Zwerenz R, Baumgarten C, Dahn I, Labitzke N, Schwarting A, Rudolph M, Ferdinand P, Dederichs-Masius U, Beutel ME. Implementation of a Web-Based Work-Related Psychological Aftercare Program Into Clinical Routine: Results of a Longitudinal Observational Study. J Med Internet Res 2019; 21:e12285. [PMID: 31215515 PMCID: PMC6604507 DOI: 10.2196/12285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/20/2019] [Accepted: 04/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As inpatient medical rehabilitation serves to promote work ability, vocational reintegration is a crucial outcome. However, previous Web-based trials on coping with work-related stress have been limited to Web-based recruitment of study participants. OBJECTIVE The aim of our study was to evaluate the implementation of an empirically supported transdiagnostic psychodynamic Web-based aftercare program GSA (Gesund und Stressfrei am Arbeitsplatz [Healthy and stress-less at the workplace])-Online plus into the clinical routine of inpatient medical rehabilitation, to identify characteristics of patients who have received the recommendation for GSA-Online plus, and to determine helpfulness of the intervention and satisfaction of the participants as well as improvement in quality of life and mental health status of the regular users of GSA-Online plus. METHODS GSA-Online plus was prescribed by physicians at termination of orthopedic psychosomatic inpatient rehabilitation. Participants' use of the program, work-related attitudes, distress, and quality of life were assessed on the Web. RESULTS In 2 rehabilitation centers, 4.4% (112/2562) of rehabilitants got a recommendation for GSA-Online plus during inpatient rehabilitation. Compared with usual person aftercare, the Web-based aftercare program was rarely recommended by physicians. Recommendations were made more frequently in psychosomatic (69/1172, 5.9%) than orthopedic (43/1389, 3.1%) rehabilitation (χ21=11.845, P=.001, Cramér V=-0.068) and to younger patients (P=.004, d=0.28) with longer inpatient treatment duration (P<.001, r=-0.12) and extended sick leaves before inpatient medical rehabilitation (P=.004; Cramér V=0.072). Following recommendation, 77% (86/112) of rehabilitants participated in Web-based aftercare. Completers (50/86, 58%) reported statistically significant improvements between discharge of inpatient treatment and the end of the aftercare program for subjective work ability (P=.02, d=0.41), perceived stress (P=.01, d=-0.38), functioning (P=.002, d=-0.60), and life satisfaction (P=.008, d=0.42). CONCLUSIONS Physicians' recommendations of Web-based aftercare are well accepted by patients who derive considerable benefits from participation. However, a low rate of prescription compared with other usual aftercare options points to barriers among physicians to prescribing Web-based aftercare.
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Affiliation(s)
- Rüdiger Zwerenz
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Carlotta Baumgarten
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Ingo Dahn
- Knowledge Media Institute, University of Koblenz-Landau, Koblenz, Germany
| | - Nicole Labitzke
- Center for Audiovisual Production, Johannes Gutenberg-University, Mainz, Germany
| | - Andreas Schwarting
- Center of Rheumatology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Matthias Rudolph
- Mittelrhein-Klinik, German Statutory Pension Insurance Rhineland-Palatinate, Boppard, Bad Salzig, Germany
| | - Peter Ferdinand
- Knowledge Media Institute, University of Koblenz-Landau, Koblenz, Germany
| | - Ute Dederichs-Masius
- Drei-Burgen-Klinik, German Statutory Pension Insurance Rhineland-Palatinate, Bad Kreuznach, Germany
| | - Manfred E Beutel
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
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Zhou M, Zhao L, Kong N, Campy KS, Qu S, Wang S. Factors influencing behavior intentions to telehealth by Chinese elderly: An extended TAM model. Int J Med Inform 2019; 126:118-127. [PMID: 31029253 DOI: 10.1016/j.ijmedinf.2019.04.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/10/2018] [Accepted: 04/02/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND PURPOSE Telehealth bring significant benefits including improved quality of healthcare, efficiency and cost containment, especially for chronic patients and the elderly. China is the second largest country of investment in telemedicine systems, but the acceptance and behavioral intentions of the technology are still low in the elderly. The objective of this study is to explain the micro-mechanism that determines the behavioral intentions to use telemedicine systems from the perspective of elderly patients based on an extended Technology Acceptance Model. METHODS A sample consisting of 436 elderlies selected through multistage cluster sampling from four cities in mainland China. The empirical study was conducted to examine the proposed model by two aspects: measurement model and structural model. RESULTS The study determined that medical service satisfaction (t = 6.770, β = 0.332), ease of use (t = 5.200, β = 0.179), information quality (t = 12.540, β = 0.639) had a significant impact on the elderly patients' acceptance to telehealth, and the acceptance had a significant impact (t = 14.356, β = 0.697) on the elderly patients' behavior intentions of telehealth. The results also show that the variable of acceptance has significant mediating effects among the theoretical model. CONCLUSIONS This study confirms the applicability of the extended Technology Acceptance Model in the behavioral intentions among elderly people in China using telehealth systems. The results indicate that relationship between telehealth systems and physical medical services are mutually reinforcing rather than alternative. The study will help technology developers better understand the behavioral characteristics of the elderly and encourage healthcare providers to better understand the true need of telehealth systems. These findings provide valuable information to telehealth system developers, governments, investors, and hospitals to promote the use of this technology by elderly patients.
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Affiliation(s)
- Min Zhou
- College of Business Administration, Hunan University of Commerce, Changsha, China; School of Economics and Management, Southeast University, Nanjing, China; Weldon School of Biomedical Engineering, Purdue University, West Lafayette, USA
| | - Lindu Zhao
- School of Economics and Management, Southeast University, Nanjing, China.
| | - Nan Kong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, USA
| | - Kathryn S Campy
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, USA
| | - Shujuan Qu
- The Third Xiangya Hospital, Central South University, Changsha, China.
| | - Song Wang
- College of Business Administration, Hunan University of Commerce, Changsha, China
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