Healthcare Technology Self-Efficacy (HTSE) and its influence on individual attitude: An empirical study

A multidimensional gender analysis of health technology self-efficacy among people with Parkinson's disease

BACKGROUND

Digital health technologies (DHT) enable self-tracking of bio-behavioral states and pharmacotherapy outcomes in various diseases. However, the role of gender, encompassing social roles, expectations, and relations, is often overlooked in their adoption and use. This study addresses this issue for persons with Parkinson's disease (PD), where DHT hold promise for remote evaluations.

METHODS

We conducted a cross-sectional survey study in the Netherlands, assessing the impact of gender identity, roles, and relations on health technology self-efficacy (HTSE) and attitude (HTA). An intersectional gender analysis was applied to explore how gender intersects with education, employment, disease duration, and severity in influencing HTSE and HTA.

RESULTS

Among 313 participants (40% women), no significant correlation was found between gender identity or relations and HTSE or HTA. However, individuals with an androgynous (non-binary) gender role orientation demonstrated better HTSE and HTA. The exploratory intersectional analysis suggested that sociodemographic and clinical factors might affect the influence of gender role orientations on HTSE and HTA, indicating complex and nuanced interactions.

CONCLUSION

This study highlights the importance of investigating gender as a multidimensional variable in PD research on health technology adoption and use. Considering gender as a behavioral construct, such as through gender roles and norms, shows more significant associations with HTSE and HTA, although effect sized were generally small. The impact of gender dimensions on these outcomes can be compounded by intersecting social and disease-specific factors. Future studies should consider multiple gender dimensions and intersecting factors to fully understand their combined effects on technology uptake and use among people with PD.

The path to cashless transaction: A study of user intention and attitudes towards quick response mobile payments

This study explores the factors influencing users' behavioral intentions, attitudes and actual adoption of quick response (QR) mobile payment in the least developed country (LDC) of Bangladesh, by extending the original unified theory of acceptance and use of technology (UTAUT) model. The study conducts a mixed-methods investigation by combining the partial least squares (PLS) and focus group discussion (FGD) methods to empirically evaluate the research model and cross-validate the findings. Using purposive sampling, data were gathered from 412 respondents, followed by 10 respondents who took part in the FGD, who all met the sample criteria. The study findings indicate that performance expectancy, effort expectancy, and social influence significantly positively influence users' behavioral intention, while self-concept, perceived self-efficacy, and habit substantially influence their attitudes towards using QR mobile payments. The findings also confirm a positive effect of users' attitudes toward using QR mobile payment on both behavioral intention and actual use, and a positive effect of behavioral intention on the actual use of QR mobile payments. These findings offer several important theoretical and managerial implications.

Evaluating perceived technology self-efficacy and telehealth acceptance in optometry students

CLINICAL RELEVANCE

Constant technological improvements require practitioners to be open to adopting technologies such as telehealth for enhanced patient care. Understanding the barriers and facilitators of telehealth adoption will guide stakeholders in making decisions for safe and effective implementation of telehealth.

BACKGROUND

Effective use of telehealth improves patient outcomes. It is unclear if optometry students feel supported in using and/or are accepting of telehealth. This study evaluated telehealth acceptance of optometry students, its association with their technology self-efficacy, and whether telehealth training alters this relationship.

METHODS

Final-year optometry students at the University of Melbourne were invited to participate in a telehealth course. A 22-item online survey adapted from the Technology Proficiency Self-Assessment for twenty-first Century Learning was used to evaluate technology self-efficacy pre- and post-learning. Telehealth acceptance was evaluated using a 34-item survey according to the Unified Theory of Acceptance and Use of Technology-2. A 5-point Likert scale was used for each item, yielding two total scores. Respondent demographics, frequency of usage and number of devices were recorded. Descriptive statistics, ANOVA and Pearson correlation were used to analyse demographic variables and relationship between technology self-efficacy and telehealth acceptance.

RESULTS

58 (68%) and 49 (58%) students participated in the pre- and post-learning surveys. Majority were 20-29-year-old females. Students used between two and four devices for online activities, with 62% being online at least hourly. Technology self-efficacy scores (average ± SD) pre- and post-learning were 83.8% ± 8.2 and 87.8% ± 7.1. Telehealth acceptance scores pre- and post-learning were 66.1% ± 9.6 and 73.98% ± 9.9. There was no association with gender, number of devices and frequency of online use for all scores. Correlation between technology self-efficacy and telehealth acceptance was insignificant pre-learning (p = 0.3) but was significant post-learning (p = 0.04).

CONCLUSION

Optometry students demonstrated high technology self-efficacy compared to telehealth acceptance. Telehealth training resulted in marked improvement in telehealth acceptance.

Evaluating the Energy Efficiency of Popular US Smartphone Health Care Apps: Comparative Analysis Study Toward Sustainable Health and Nutrition Apps Practices

BACKGROUND

The emergence of smartphones has sparked a transformation across multiple fields, with health care being one of the most notable due to the advent of mobile health (mHealth) apps. As mHealth apps have gained popularity, there is a need to understand their energy consumption patterns as an integral part of the evolving landscape of health care technologies.

OBJECTIVE

This study aims to identify the key contributors to elevated energy consumption in mHealth apps and suggest methods for their optimization, addressing a significant void in our comprehension of the energy dynamics at play within mHealth apps.

METHODS

Through quantitative comparative analysis of 10 prominent mHealth apps available on Android platforms within the United States, this study examined factors contributing to high energy consumption. The analysis included descriptive statistics, comparative analysis using ANOVA, and regression analysis to examine how certain factors impact energy use and consumption.

RESULTS

Observed energy use variances in mHealth apps stemmed from user interactions, features, and underlying technology. Descriptive analysis revealed variability in app energy consumption (150-310 milliwatt-hours), highlighting the influence of user interaction and app complexity. ANOVA verified these findings, indicating the critical role of engagement and functionality. Regression modeling (energy consumption = β₀ + β₁ × notification frequency + β₂ × GPS use + β₃ × app complexity + ε), with statistically significant P values (notification frequency with a P value of .01, GPS use with a P value of .05, and app complexity with a P value of .03), further quantified these bases' effects on energy use.

CONCLUSIONS

The observed differences in the energy consumption of dietary apps reaffirm the need for a multidisciplinary approach to bring together app developers, end users, and health care experts to foster improved energy conservation practice while achieving a balance between sustainable practice and user experience. More research is needed to better understand how to scale-up consumer engagement to achieve sustainable development goal 12 on responsible consumption and production.

Acceptance of voice assistant technology in dental practice: A cross sectional study with dentists and validation using structural equation modeling

Voice assistant technologies (VAT) has been part of our daily lives, as a virtual assistant to complete requested tasks. The integration of VAT in dental offices has the potential to augment productivity and hygiene practices. Prior to the adoption of such innovations in dental settings, it is crucial to evaluate their applicability. This study aims to assess dentists' perceptions and the factors influencing their intention to use VAT in a clinical setting. A survey and research model were designed based on an extended Unified Theory of Acceptance and Use of Technology (UTAUT). The survey was sent to 7,544 Ohio-licensed dentists through email. The data was analyzed and reported using descriptive statistics, model reliability testing, and partial least squares regression (PLSR) to explain dentists' behavioral intention (BI) to use VAT. In total, 257 participants completed the survey. The model accounted for 74.2% of the variance in BI to use VAT. Performance expectancy and perceived enjoyment had significant positive influence on BI to use VAT. Perceived risk had significant negative influence on BI to use VAT. Self-efficacy had significantly influenced perceived enjoyment, accounting for 35.5% of the variance of perceived enjoyment. This investigation reveals that performance efficiency and user enjoyment are key determinants in dentists' decision to adopt VAT. Concerns regarding the privacy of VAT also play a crucial role in its acceptance. This study represents the first documented inquiry into dentists' reception of VAT, laying groundwork for future research and implementation strategies.

The Olera.care Digital Caregiving Assistance Platform for Dementia Caregivers: Preliminary Evaluation Study

BACKGROUND

The increasing prevalence of Alzheimer disease and Alzheimer disease-related dementia in the United States has amplified the health care burden and caregiving challenges, especially for caregivers of people living with dementia. A web-based care planning tool, Olera.care, was developed to aid caregivers in managing common challenges associated with dementia care.

OBJECTIVE

This study aims to preliminarily evaluate the quality and usability of the Olera.care platform and assess the preferences of using the technology and interests in learning about different older adult care services among caregivers.

METHODS

For interview 1, we aim to understand caregiving needs and let the participants start engaging with the platform. After they engage with the platform, we schedule the second interview and let the participants complete the Mobile Application Rating Scale. The survey also included sociodemographic characteristics, caregiving experiences, communication preferences in technology adoption, and older adult care service use and interests. Descriptive statistics were used to describe the quality and usability of the platform and characteristics of the participants. We conducted 2-sample 2-tailed t tests to examine the differences in the Mobile Application Rating Scale evaluation scores by caregiver characteristics.

RESULTS

Overall, 30 adult caregivers in Texas completed the evaluation. The majority were aged ≥50 years (25/30, 83%), women (23/30, 77%), White (25/30, 83%), and financially stable (20/30, 67%). The Olera.care platform evaluation showed high satisfaction, with an overall mean rating of 4.57 (SD 0.57) of 5, and scored well in engagement (mean 4.10, SD 0.61), functionality (mean 4.46, SD 0.44), aesthetics (mean 4.58, SD 0.53), and information quality (mean 4.76, SD 0.44) consistently across all participants. A statistically significant difference (P=.02) was observed in functionality evaluation scores by duration of caregiving, with caregivers dedicating more hours to care rating it higher than those providing less care (mean 4.6, SD 0.4 vs mean 4.2, SD 0.5). In addition, caregivers with less caregiving experience reported significantly higher evaluation scores for aesthetics (P=.04) and information quality (P=.03) compared to those with longer years of caregiving. All participants expressed a willingness to recommend the app to others, and 90% (27/30) rated the app overall positively. Most of the participants (21/30, 70%) favored anonymous interactions before receiving personalized feedback and preferred computer browsers over mobile apps. Medical home health services were the most used, with a diverse range of services being used. Caregiver support groups, medical providers, memory care, meal services, and adult day care were among the most desired services for future exploration.

CONCLUSIONS

The Olera.care web-based platform is a practical, engaging, easy-to-use, visually appealing, and informative tool for dementia caregivers. Future development and research are essential to enhance the platform and comprehensively evaluate it among a broader population.

Usability and Feasibility Testing of an Atrial Fibrillation Educational Website with Patients Referred to an Atrial Fibrillation Specialty Clinic

BACKGROUND

The purpose of this study was to design, usability test, and explore the feasibility of a web-based educational platform/intervention for patients with atrial fibrillation (AF) as part of their virtual AF care.

METHODS

Participants were patients attending a specialized AF clinic. The multiple mixed-methods design included website design, think-aloud usability test, 1-month unstructured pre-testing analysis using Google Analytics, follow-up interviews, and a non-randomized one-group feasibility test using pre/post online surveys and Google Analytics.

RESULTS

Usability testing participants (n = 2) guided adjustments for improving navigation. Pre-testing participants' (n = 9) website activity averaged four sessions (SD = 2.6) at 10 (SD 8) minutes per session during a 1-month study period. In the feasibility test, 30 patients referred to AF specialty clinic care completed the baseline survey, and 20 of these completed the 6-month follow-up survey. A total of 19 patients accessed the website over the 6 months, and all 30 participants were sent email prompts containing information from the website. Health-related quality of life, treatment satisfaction, household activity, and AF knowledge scores were higher at follow-up than baseline. There was an overall downward trend in self-reported healthcare utilization at follow-up.

CONCLUSIONS

Access to a credible education website for patients with AF has great potential to complement virtual and hybrid models of care.

Telehealth Satisfaction in Patients Receiving Virtual Atrial Fibrillation Care: Quantitative Exploratory Study

BACKGROUND

Telehealth can optimize access to specialty care for patients with atrial fibrillation (AF). Virtual AF care, however, may not fit with the complex needs of patients with AF.

OBJECTIVE

This study aims to explore the correlation among attitudes toward health care technologies, self-efficacy, and telehealth satisfaction as part of the future planning of virtual AF clinic care.

METHODS

Patients with AF older than 18 years from an urban-based, highly specialized AF clinic who had an upcoming telehealth visit were invited to participate in a web-based survey. The survey asked about demographic characteristics; use of technology; general, computer, and health care technology self-efficacy (HTSE) and health care technology attitudes, using a validated 30-item tool; and telehealth satisfaction questionnaire using a validated 14-item questionnaire. Data were analyzed with descriptive statistics, correlational analyses, and linear regression modeling.

RESULTS

Participants (n=195 of 579 invited, for a 34% response rate) were primarily older, male, and White, had postsecondary schooling or more, and had high self-reported overall and mental health ratings. A variety of technologies were used in their daily lives and for health care, with the majority of technologies comprising desktop and laptop computers, smartphones, and tablets. Self-efficacy and telehealth satisfaction questionnaire scores were high overall, with male participants having higher general self-efficacy, computer self-efficacy, HTSE, and technology attitude scores. After controlling for age and sex, only HTSE was significantly related to individuals' attitudes toward health care technology. Both general self-efficacy and attitude toward health care technology were positively related to telehealth satisfaction.

CONCLUSIONS

Consistent with a previous study, only HTSE significantly influenced attitudes toward health care technology. This finding confirms that, in this regard, self-efficacy is not a general perception but is domain specific. Considering participants' predominant use of the telephone for virtual care, it follows that general self-efficacy and attitude toward health care technology were significant contributors to telehealth satisfaction. Given our patients' frequent use of technology and high computer self-efficacy and HTSE scores, the use of video for telehealth appointments could be supported.

Increasing acceptance of medical AI: The role of medical staff participation in AI development

BACKGROUND

Medical artificial intelligence (AI) in varying degrees has exerted significant influence on many medical fields, especially in the midst of the COVID-19 pandemic. However, little is known regarding how to address the reluctance of medical staff to use AI technology. While recent research has highlighted the importance of medical staff participation in the development of AI, the current understanding of influence of medical staff participation on acceptance of AI is limited.

OBJECTIVES

To provide insights into the mechanism that how medical staff participation impacts on the medical staff's acceptance of AI and to examine the moderating effect of speciesism.

METHODS

This study was conducted from 6th August to 3rd September. Data was collected from doctors and nurses and a total of 288 valid questionnaires were obtained. Smart PLS 3.2.8 was used as partial least square (PLS) software to validate the research model.

RESULTS

The study determined that medical staff participation had a significant impact on acceptance of medical AI-IDT (β = 0.35, p ≤ 0.001) and acceptance of medical AI-ADT (β = 0.44, p ≤ 0.001). The results also show that AI self-efficacy and AI anxiety have significant mediating effects and speciesism has significant moderating effects among the theoretical model.

CONCLUSIONS

This study provides insights into ways to explore influence factors of acceptance of AI based on user participation perspective. The results indicate that medical staff participation enhances acceptance of medical AI through the cognitive path (i.e., AI self-efficacy) and the affective path (i.e., AI anxiety). These results have practical implications for how organizations assist the staff to accommodate themselves to AI technology in the future.

Protection Motivation Perspective Regarding the Use of COVID-19 Mobile Tracing Apps Among Public Users: Empirical Study

BACKGROUND

Access to data is crucial for decision-making; this fact has become more evident during the pandemic. Data collected using mobile apps can positively influence diagnosis and treatment, the supply chain, and the staffing resources of health care facilities. Developers and health care professionals have worked to create apps that can track a person's COVID-19 status. For example, these apps can monitor positive COVID-19 test results and vaccination status. Regrettably, people may be concerned about sharing their data with government or private sector organizations that are developing apps. Understanding user perceptions is essential; without substantial user adoption and the use of mobile tracing apps, benefits cannot be achieved.

OBJECTIVE

This study aimed to assess the factors that positively and negatively affect the use of COVID-19 tracing apps by examining individuals' perceptions about sharing data on mobile apps, such as testing regularity, infection, and immunization status.

METHODS

The hypothesized research model was tested using a cross-sectional survey instrument. The survey contained 5 reflective constructs and 4 control variables selected after reviewing the literature and interviewing health care professionals. A digital copy of the survey was created using Qualtrics. After receiving approval, data were collected from 367 participants through Amazon Mechanical Turk (MTurk). Participants of any gender who were 18 years or older were considered for inclusion to complete the anonymized survey. We then analyzed the theoretical model using structural equation modeling.

RESULTS

After analyzing the quality of responses, 325 participants were included. Of these 325 participants, 216 (66.5%) were male and 109 (33.5%) were female. Among the participants in the final data set, 72.6% (236/325) were employed. The results of structural equation modeling showed that perceived vulnerability (β=0.688; P<.001), self-efficacy (β=0.292; P<.001), and an individual's prior infection with COVID-19 (β=0.194; P=.002) had statistically significant positive impacts on the intention to use mobile tracing apps. Privacy concerns (β=-0.360; P<.001), risk aversion (β=-0.150; P=.09), and a family member's prior infection with COVID-19 (β=-0.139; P=.02) had statistically significant negative influences on a person's intention to use mobile tracing apps.

CONCLUSIONS

This study illustrates that various user perceptions affect whether individuals use COVID-19 tracing apps. By working collaboratively on legislation and the messaging provided to potential users before releasing an app, developers, health care professionals, and policymakers can improve the use of tracking apps. Health care professionals need to emphasize disease vulnerability to motivate people to use mobile tracing apps, which can help reduce the spread of viruses and diseases. In addition, more work is needed at the policy-making level to protect the privacy of users, which in return can increase user engagement.

Individual Differences in a Multidimensional Measure of Compulsive Mobile Phone Use

Due to their ubiquity, compulsive mobile phone use (CMPU) should include cognitive, psychological, and behavioral dimensions. This study has two main objectives-(a) explicate a multidimensional measure of CMPU and examine individual differences in the various dimensions and (b) conceptualize mobile phone self-efficacy and examine its relationship with CMPU. A survey with 446 U.S. adults was conducted in which respondents completed assessments related to CMPU, mobile phone self-efficacy, and mobile phone use frequency. Results showed the presence of a three-dimensional factor structure for CMPU. While gender, age, and mobile phone activity were associated with CMPU, mobile phone self-efficacy was not. The relevance of the findings is discussed along with implications for future research.

Drivers of digital transformation adoption: A weight and meta-analysis

The advent of the global pandemic has accelerated the growing need for product and service transformation, highlighting the emerging importance of technology and creating the opportunity to update the digital transformation (DT) domain through empirical-quantitative research. This weight and meta-analysis enabled the synthesis and integration of previous literature on the scope of individual DT adoption, evaluating the state of the art and filling a void on the subject. Athwart 88 studies and 99 datasets by international sources, our results demonstrate that attitude and satisfaction are relevant predictors of behavioral intentions and promising outcomes, including compatibility and personal innovativeness. Behavioral intentions, satisfaction, and habit are the best predictors for DT use. Usefulness and ease of use are critical for DT adoption intention and use, being moderated by individualism, as a cultural factor, human capital, and knowledge-technology, as innovation indicators. We present a conceptual model of promising and best predictors for future research on DT individual adoption.

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An update of digital transformation (DT) through a weight and meta-analysis.

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Contribution to DT literature by surpassing biases and limitations of size estimates.

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Identification of promising and best predictors for further DT adoption research.

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Behavioral intentions, satisfaction, and habit are best predictors for DT use.

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Usefulness and ease of use are pivotal, being moderated by culture and innovation.

Willingness to Share Data From Wearable Health and Activity Trackers: Analysis of the 2019 Health Information National Trends Survey Data

BACKGROUND

Sharing data from wearable health and activity trackers (wearables) with others may improve the health and behavioral outcomes of wearable users by generating social support and improving their ability to manage their health. Investigating individual factors that influence US adults' willingness to share wearable data with different types of individuals may provide insights about the population subgroups that are most or least likely to benefit from wearable interventions. Specifically, it is necessary to identify digital health behaviors potentially associated with willingness to share wearable data given that the use of and engagement with various technologies may broadly influence web-based health information-sharing behaviors.

OBJECTIVE

This study aims to identify sociodemographic, health, and digital health behavior correlates of US adults' willingness to share wearable data with health care providers and family or friends.

METHODS

Data for the analytic sample (N=1300) were obtained from the 2019 Health Information National Trends Survey of the National Cancer Institute. Digital health behavior measures included frequency of wearable device use, use of smartphones or tablets to help communicate with providers, use of social networking sites to share health information, and participation in a web-based health community. Multivariable logistic regression analysis of weighted data examined the associations between digital health behaviors and willingness to share wearable device data, controlling for sociodemographics and health-related characteristics.

RESULTS

Most US adults reported willingness to share wearable data with providers (81.86%) and with family or friends (69.51%). Those who reported higher health self-efficacy (odds ratio [OR] 1.97, 95% CI 1.11-3.51), higher level of trust in providers as a source of health information (OR 1.98, 95% CI 1.12-3.49), and higher level of physical activity (OR 2.00, 95% CI 1.21-3.31) had greater odds of willingness to share data with providers. In addition, those with a higher frequency of wearable use (OR 2.15, 95% CI 1.35-3.43) and those who reported use of smartphones or tablets to help communicate with providers (OR 1.99, 95% CI 1.09-3.63) had greater odds of willingness to share data with providers. Only higher level of physical activity was associated with greater odds of willingness to share wearable data with family or friends (OR 1.70, 95% CI 1.02-2.84). Sociodemographic factors were not significantly associated with willingness to share wearable data.

CONCLUSIONS

The findings of this study suggest that, among US adult wearable users, behavior-related factors, rather than sociodemographic characteristics, are key drivers of willingness to share health information obtained from wearables with others. Moreover, behavioral correlates of willingness to share wearable data are unique to the type of recipient (ie, providers vs family or friends). Future studies could use these findings to inform the development of interventions that aim to improve the use of patient-generated data from wearable devices in health care settings.

Thea: empowering the therapeutic alliance of children with ASD by multimedia interaction

The Therapeutic Alliance (TA) between patient and health provider (therapist or clinician) is one of the most relevant factors for the success of a therapy. In the case of people suffering from Autism Spectrum Disorder (ASD), the alliance is extended to all the people involved in their care (i.e., teachers, therapists, clinicians, relatives). In this paper, we propose a multimedia application named Thea for empowering the TA of children with ASD by improving the communication among the TA members, sharing guidelines, multimedia contents, and strategies to comply with challenging behaviors and progress with particular attention towards end-users who are occasional smart-users. A detailed process for empowering the TA members by enhancing the informed interaction among all of them is proposed and implemented. A vocal assistant also supports patients/caregivers and therapists in documenting their activity with the person with ASD by recording videos in a free-hand modality. After a contextual analysis based on Thematic Analysis Template, Thea has been implemented using a user-centered development approach. We performed three iterations involving the end-users. A user study is performed at the third iteration. Results of the user study revealed a positive attitude towards the application. In particular, the perception of empowerment of participants increased after the tool had been used. We also highlighted the guidelines and tools that may be adopted for empowering different kinds of patients. The first results seem to suggest that the use of Thea may increase the belief of the caregivers of a person with ASD to be able to better take care of her, in a more controlled and informed way.

Determinants of Continuance Intention to Use Health Apps among Users over 60: A Test of Social Cognitive Model

Promoting healthy behavior among seniors is important in reducing the burden of care and healthcare expenses in a rapidly aging society. Health apps can play an important role in health promotion for older adults, but the level of user retention in health apps is low. To increase continued health app use among older adults, this study examined the factors influencing older users’ continuance intentions to use health apps. The research model was developed based on the social cognitive theory of health behavior, which integrates cognitive, environmental, and behavioral perspectives. To test the research model, an anonymous online survey was conducted among respondents aged 60 to 79 years who were using health apps. The measurement items in the questionnaire were developed based on validated scales from the literature. A total of 250 samples were analyzed. The assessment of the measurement model indicates that the reliability and validity of the items are satisfactory. The results of testing the structural model illustrate the determinants of health app continuance intention: health technology self-efficacy, self-evaluative outcome expectations, self-regulation, and privacy risk. The interrelationships among determinants are also investigated. Theoretical and practical implications are suggested to encourage older adults’ continued health app use and promote their health behavior over the long term.

Exoskeleton acceptance and its relationship to self-efficacy enhancement, perceived usefulness, and physical relief: A field study among logistics workers

Objective

This field study aimed to explore the effects of exoskeleton use on task-specific self-efficacy beliefs of logistics workers and to relate these effects to usefulness perceptions and technology acceptance.

Background

A growing number of industrial companies have shown interest in having employees wearing exoskeletons to support their physical health. However, psychological consequences of exoskeleton use and mechanisms associated with workers' acceptance or rejection of exoskeletons are not yet sufficiently understood.

Methods

A total of 31 logistics workers of a vehicle manufacturing company reported on their work-related self-efficacy, that is, how capable they felt of performing tasks related to their job well, before partaking in half-hour trials of a passive lift-assistive exoskeleton (Laevo V2.5) during their normal work. Afterward, they completed a questionnaire on their exoskeleton-supported self-efficacy and indicated how useful they found the exoskeleton, how much physical relief they felt from wearing it, and how willing they were to continue with its use.

Results

Overall, wearing the exoskeleton did not lead to increased work-specific self-efficacy. However, indications of interaction effects were found between baseline self-efficacy, perceived physical relief, and perceived usefulness in such a way that workers who experienced the exoskeleton as more strain-relieving or more useful were also more likely to report a post-trial growth in their self-efficacy beliefs. A positive change in self-efficacy, in turn, was associated with a greater willingness to further use the exoskeleton at the workplace.

Research on the use intention of potential designers of unmanned cars based on technology acceptance model

The success of unmanned car, an emerging tool of transportation with so many advantages, depends to a large extent on its user acceptability. Potential designers are both the decision makers of driverless car design and the users of driverless cars. This study aims to explore the influencing factors of the potential designers' intention to use unmanned cars. Based on the theory of Technology Acceptance Model (TAM), this study further expanded the TAM by incorporating perceived trust, perceived enjoyment and self-efficacy, so as to explain and predict potential designers' intention to use unmanned cars. The questionnaire is determined through theoretical literature, pre-tests, etc., and the Structural Equation Model is used to analyze the data of 202 valid survey samples to investigate the influencing factors of the willingness to use unmanned vehicles. The results show that potential designers' intention to use unmanned cars is positively affected by perceived trust, perceived enjoyment, perceived usefulness and perceived ease of use, and perceived trust has a positive effect on perceived ease of use, self-efficacy and perceived ease of use also have a positive effect on perceived usefulness. The findings of this study can provide designers and developers of unmanned cars, policy makers and implementers with guidance in the follow-up design, policy formulation and advertising of unmanned cars.

Responsible Artificial Intelligence (AI) for Value Formation and Market Performance in Healthcare: the Mediating Role of Patient's Cognitive Engagement

The Healthcare sector has been at the forefront of the adoption of artificial intelligence (AI) technologies. Owing to the nature of the services and the vulnerability of a large section of end-users, the topic of responsible AI has become the subject of widespread study and discussion. We conduct a mixed-method study to identify the constituents of responsible AI in the healthcare sector and investigate its role in value formation and market performance. The study context is India, where AI technologies are in the developing phase. The results from 12 in-depth interviews enrich the more nuanced understanding of how different facets of responsible AI guide healthcare firms in evidence-based medicine and improved patient centered care. PLS-SEM analysis of 290 survey responses validates the theoretical framework and establishes responsible AI as a third-order factor. The 174 dyadic data findings also confirm the mediation mechanism of the patient's cognitive engagement with responsible AI-solutions and perceived value, which leads to market performance.

A Technology Acceptance Model for Deploying Masks to Combat the COVID-19 Pandemic in Taiwan (My Health Bank): Web-Based Cross-sectional Survey Study

BACKGROUND

The successful completion of medical practices often relies on information collection and analysis. Government agencies and medical institutions have encouraged people to use medical information technology (MIT) to manage their conditions and promote personal health. In 2014, Taiwan established the first electronic personal health record (PHR) platform, My Health Bank (MHB), which allows people to access and manage their PHRs at any time. In the face of the COVID-19 pandemic in 2020, Taiwan has used MIT to effectively prevent the spread of COVID-19 and undertaken various prevention measures before the onset of the outbreak. Using MHB to purchase masks in an efficient and orderly way and thoroughly implementing personal protection efforts is highly important to contain disease spread.

OBJECTIVE

This study aims to understand people's intention to use the electronic PHR platform MHB and to investigate the factors affecting their intention to use this platform.

METHODS

From March 31 to April 9, 2014, in a promotion via email and Facebook, participants were asked to fill out a structured questionnaire after watching an introductory video about MHB on YouTube. The questionnaire included seven dimensions: perceived usefulness, perceived ease of use, health literacy, privacy and security, computer self-efficacy, attitude toward use, and behavioral intention to use. Each question was measured on a 5-point Likert scale ranging from "strongly disagree" (1 point) to "strongly agree" (5 points). Descriptive statistics and structural equation analysis were performed using SPSS 21 and AMOS 21 software.

RESULTS

A total of 350 valid questionnaire responses were collected (female: 219/350, 62.6%; age: 21-30 years: 238/350, 68.0%; university-level education: 228/350, 65.1%; occupation as student: 195/350, 56.6%; average monthly income

CONCLUSIONS

From the perspective of the populace, this study explored the factors affecting the use of MHB and constructed an interpretation model with a strong goodness of fit. The results of our analysis are consistent with the technology acceptance model. Through the diverse value-added services of MHB, Taiwan's experience in pandemic prevention with smart technology can facilitate future responses to unknown, emerging infectious diseases.

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Key Words

• COVID-19
• electronic health record
• electronic medical record
• intention
• literacy
• model
• my health bank
• personal health record
• privacy
• protection
• security
• structural equation model
• survey
• technology acceptance model
• usage

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MESH Headings

• Adult
• COVID-19/epidemiology
• COVID-19/prevention & control
• COVID-19/transmission
• Cross-Sectional Studies
• Disease Transmission, Infectious/prevention & control
• Female
• Humans
• Internet
• Male
• Masks
• Pandemics
• SARS-CoV-2
• Surveys and Questionnaires
• Taiwan/epidemiology
• Technology
• Young Adult

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Affiliation(s)

Wen-Hsun Tsai Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan Medical Administration Office, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan
Yi-Syuan Wu Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
Chia-Shiang Cheng Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
Ming-Hao Kuo Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
Yu-Tien Chang School of Public Health, National Defense Medical Center, Taipei, Taiwan
Fu-Kang Hu Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan Medical Informatics Office, Tri-Service General Hospital, Taipei, Taiwan
Chien-An Sun Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
Chi-Wen Chang School of Nursing, College of Medicine, Chang-Gung University, Taoyuan, Taiwan Division of Pediatric Endocrinology & Genetics, Department of Pediatrics, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
Ta-Chien Chan Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
Chao-Wen Chen Trauma and Critical Care Service Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Chia-Cheng Lee Medical Informatics Office, Tri-Service General Hospital, Taipei, Taiwan Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan
Chi-Ming Chu Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan School of Public Health, National Defense Medical Center, Taipei, Taiwan Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan Department of Public Health, China Medical University, Taichung, Taiwan Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Healthcare Administration and Medical Informatics, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

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Attitudes Toward Robots as Equipment and Coworkers and the Impact of Robot Autonomy Level

Increasingly, people must interact with robot technologies. In this research, we examined attitudes toward robots as equipment and as coworkers and whether these attitudes are affected by the autonomy of the robot among participants living in the United States (Study 1: N = 1003; Study 2: N = 969). Study 1 revealed that respondents had a more positive attitude toward robots as equipment than as coworkers. Technology use self-efficacy and prior robot use experience were associated with more positive attitudes toward both robot positions. Having a degree in engineering or technology was associated with a positive attitude toward robot coworkers, while neuroticism was associated with a negative attitude. Additionally, technology use self-efficacy was found to have a significant indirect effect on the associations between openness and attitudes toward robots as well as conscientiousness and attitudes toward robots. In Study 2, a three-group online survey experiment showed that teleoperated robots and semi-autonomous robots were preferred as equipment over fully autonomous robots. The robots’ autonomy level did not impact attitude toward robot coworkers. Overall, the results suggest that people prefer non-autonomous robots over autonomous robots in the work-life context. The studies provide a comprehensive overview of attitudes toward robots as both equipment and coworkers, and the key predictors of the noted attitudes. The results suggest a readiness for shared autonomy between a human operator and a robot. This should be considered in the design and successful implementation of new robot technologies in workplaces.

Acceptability of a Patient Portal (Opal) in HIV Clinical Care: A Feasibility Study

Opal (opalmedapps.com), a patient portal in use at the Cedars Cancer Centre of the McGill University Health Centre (MUHC) (Montreal, Canada), gives cancer patients access to their medical records, collects information on patient-reported outcome measures (PROMs), and has demonstrated patient satisfaction with care. This feasibility study aims to evaluate Opal's potential acceptability in the context of HIV care. People living with HIV (PLWH) and their healthcare providers (HCPs) completed cross-sectional surveys from August 2019 to February 2020 at large HIV centers, including the Chronic Viral Illness Service of the MUHC, and other HIV clinical sites in Montreal and Paris, France. This study comprised 114 PLWH (mean age 48 years old, SD = 12.4), including 74% men, 24% women, and 2% transgender or other; and 31 HCPs (mean age 46.5 years old, SD = 11.4), including 32% men, 65% women, and 3% other. Ownership of smartphones and tablets was high (93% PLWH, 96% HCPs), and participants were willing to use Opal (74% PLWH, 68% HCPs). Participants were interested in most Opal functions and PROMs, particularly PROMs capturing quality of life (89% PLWH, 77% HCPs), experience of healthcare (86% PLWH, 97% HCPs), and HIV self-management (92% PLWH, 97% HCPs). This study suggests Opal has high acceptability and potential usefulness as perceived by PLWH and HCPs.

Trust Toward Robots and Artificial Intelligence: An Experimental Approach to Human-Technology Interactions Online

Robotization and artificial intelligence (AI) are expected to change societies profoundly. Trust is an important factor of human-technology interactions, as robots and AI increasingly contribute to tasks previously handled by humans. Currently, there is a need for studies investigating trust toward AI and robots, especially in first-encounter meetings. This article reports findings from a study investigating trust toward robots and AI in an online trust game experiment. The trust game manipulated the hypothetical opponents that were described as either AI or robots. These were compared with control group opponents using only a human name or a nickname. Participants (N = 1077) lived in the United States. Describing opponents with robots or AI did not impact participants' trust toward them. The robot called jdrx894 was the most trusted opponent. Opponents named "jdrx894" were trusted more than opponents called "Michael." Further analysis showed that having a degree in technology or engineering, exposure to robots online and robot use self-efficacy predicted higher trust toward robots and AI. Out of Big Five personality characteristics, openness to experience predicted higher trust, and conscientiousness predicted lower trust. Results suggest trust on robots and AI is contextual and it is also dependent on individual differences and knowledge on technology.

Seniors and mobiles: A qualitative inquiry of mHealth adoption among Singapore seniors

OBJECTIVE

This study examines how seniors in Singapore use mobile devices for healthcare purposes.

METHODS

Semi-structured interviews with 35 mobile phone users aged between 58-82 years old.

RESULTS

Seniors regard mobile phones as important personal devices for socialization, security, and emergency purposes. Most of the seniors consider mobile telephony (voice calls and text messaging) as an accessible platform to access healthcare. Perceived usefulness, ease of use, compatibility, technology anxiety, financial cost, and self-efficacy were identified as factors affecting the use of mHealth among seniors. Although a few adopt mHealth applications and mobile Internet for health-information seeking, some younger seniors show enthusiastic attitudes toward its adoption. Additionally, some seniors also have technology anxiety and resistance toward using mHealth applications.

CONCLUSION

Seniors use mobile phones for healthcare purposes in their daily life, and its use involves several facilitators and barriers. Interpersonal training is likely to reduce their anxiety and increase mHealth literacy and adoption. Theoretical and practical implications are discussed.

Influential Factors in Breast Cancer Patients' Performance Using Malaysian Social Network Support Groups

Social network communities can serve as a health resource for cancer patients to share and disseminate information. Even so, theory-based research into evaluating cancer patients' performance empirically using social network sites (SNSs) is limited, representing an identifiable knowledge gap. This study proposes a research model that integrates social cognitive theory and task technology fit theory to contribute to the understanding of key factors impacting the performance of breast cancer patients using SNSs. Data were collected via a structured paper-based questionnaire. A total of one hundred seventy-eight (178) participants from six cancer support groups and hospitals in Peninsular Malaysia responded to the administered survey. Survey data were analyzed using the partial least squares (PLS) method while Smart PLS was used to test the hypotheses and to validate the proposed model. Results indicate that outcome expectation, self-efficacy, negative affect, positive affect, social support and task technology fit are significant factors affecting the performance of breast cancer patients vis-à-vis Malaysian social network support groups.

Modeling the adoption of personal health record (PHR) among individual: the effect of health-care technology self-efficacy and gender concern

BACKGROUND

With the development of information technology (IT) and medical technology, medical information has been developed from traditional paper-based records into up-to-date medical information exchange system called personal health record (PHR). Empowering PHR provides health awareness and intention for health promotion.

OBJECTIVE

The purpose of this study was to present a research framework to examine individuals' intention to PHR use.

METHODS

This cross-sectional study used the questionnaire to collect data from the individual in Taiwan. Individual's intention to use PHR has been examined by a framework based on extended technology acceptance model (TAM), with gender and health-care technology self-efficacy (HTSE) as external variables. Additionally, gender differences were explored in perceptions and relationships among factors influencing an individual's intention to PHR use. The research framework was evaluated by structural equation modeling (SEM) and represented by Analysis of a Moment Structures (AMOS).

RESULTS

A total of 234 valid responses were used for analysis. The results suggest that the extended TAM model explains 40.6% of the variance of intention to PHR use (R2 = 0.406). The findings also supported that perceived usefulness, perceived ease of use, and attitude toward using PHR significantly influenced individual's intention to PHR use. Additionally, results also indicated that women were more strongly influenced by perceptions of HTSE.

CONCLUSIONS

The extended TAM model contributes reasonable explanation for interprets and anticipates of individuals' intention to use and adopt PHR. Moreover, the results have provided support for HTSE and gender as significant variables in TAM. However, the study identified three relevant factors directly and one factor indirectly influencing on individuals' intention to PHR use. Thus, health care providers and hospital authorities must take these factors and gender difference into consideration in the development and validation of the theories regarding the acceptance of PHR. Based on the findings, the theoretical and practical implications are discussed.

Nurse and Nurse Student Attitudes and Perceived Self-efficacy in Use of Information and Communication Technologies: Professional and Cultural Differences

Information and communication technologies have become essential and design-effective tools in the global healthcare system. Evidence suggests that information and communication technologies can promote nursing practice and patient satisfaction and quality of care. Competency with information and communication technologies is essential for both nurses and nursing students, and attitudes toward its use and perceived self-efficacy are important for implementation in the workplace. This study aimed to explore nurse and nursing student attitudes and perceived self-efficacy regarding information and communication technologies use in clinical practice and to examine professional and cultural differences between these groups in their attitudes and perceived self-efficacy in information and communication technologies use. A cross-sectional study was conducted among Israeli nursing students (n = 144) and registered nurses (n = 104). The findings revealed that respondents held overall positive attitudes toward information and communication technologies' use in clinical practice and perceived themselves as competent in this context. Significant differences were found between nurses and students in their attitudes toward information and communication technologies and information and communication technologies self-efficacy. Cultural group (Jewish/Arab) was found related to positive attitudes toward use of information and communication technologies in clinical practice. Nurse educators and managers should be aware of the potential impact of cultural and professional differences on the adoption and implementation of information and communication technologies and should institute initiatives within the organization and academia to manage cultural and professional discrepancies.

Evaluating students’ learning achievement and flow experience with tablet PCs based on AR and tangible technology in u-learning

Purpose

Advances in technology have led to continuous innovations in teaching and learning methods. Ubiquitous-learning (u-learning) practices are still in the development stages. The current lack of effective learning strategy tools means that students often experience difficulty focusing on the learning objectives. Little research has been done on the educational benefits of integrating augmented reality (AR) technology running on tablet PCs (TPCs), either in the classroom or in a u-learning environment. Still, classroom instruction using TPCs has been shown to be attractive to students and able to effectively increase their motivation to learn. The paper aims to discuss these issues.

Design/methodology/approach

This paper uses a TPC game (an app called SkyView) to help young students understand the theory and practically implement the astronomy concepts of prograde and retrograde motion. The study design is based on the use of AR technology, and the authors divide students into “tablet PC application” (experimental group) and “astrolabe” (control group) games. The authors investigate whether the experimental group surpasses the control group in terms of learning motivation, flow experience (FE), self-efficacy regarding technology, self-efficacy regarding science, positive feelings about the learning experience, and satisfaction with the learning approach (SL).

Findings

The findings show that students in the experimental group performed better in regards to learning achievement. In general, the improved FE helped students enjoy the learning activity to the point that they did not notice the passage of time. In regards to SL, the findings show that the students in the experimental group had an increased willingness to use the TPC to learn.

Originality/value

There is a lack of research investigating the effects of the FE with tangible and AR technology in learning environments. The results of this study show the responses and performance of elementary students who participated in such a learning experience, in terms of their feelings regarding the method and tools, and in terms of their motivation, willingness to learn, and actual learning achievement.

The effectiveness of a group-based educational program on the self-efficacy and self-acceptance of menopausal women: A randomized controlled trial

This study aimed to assess the effectiveness of a group-based educational training on the self-efficacy and self-acceptance of Iranian menopausal women using the PRECEDE-PROCEED model. This Randomized Controlled Trial (RCT) was conducted on 80 menopausal women in the age range of 47-55 years residing in the northeast of Iran. The participants were divided randomly into a test group (n = 40) and a control group (n = 40). We found that designing and implementation of a group-based educational training according to the PRECEDE-PROCEED model can significantly enhance the knowledge and performance of the test group with regard to self-efficacy and self-acceptance.

Role of social media in information-seeking behaviour of international students

Purpose

The purpose of this paper is to investigate the information-seeking behaviour of international students in terms of their information needs and to highlight the role of social media.

Design/methodology/approach

In this paper, a systematic literature survey was conducted in order to investigate information-seeking trends among international students while using social media. As a result, an exhaustive systematic literature review (SLR) was carried out in order to investigate social media as a source for the observation of the behaviours of international students. For this purpose, 71 articles were selected from various well-known sources after an intensive SLR process of searching, filtering and enforcing the inclusion and exclusion criteria.

Findings

As an outcome of this study, the information-seeking behaviour of international students was highlighted with respect to social media as a source of information. In addition, this research identifies the information needs of the international students and categorizes them by the roles played by the social media in fulfilling the information needs.

Practical implications

A comparative study that highlighted the dearth of studies which merge the social media and information-seeking behaviour of international students as well as identify the future direction for the researchers and for benefits of international students.

Originality/value

A detail SLR which highlights the need of shifting the information seeking behaviour from libraries to social media in regard to the new environment for international students.