The extended Unified Theory of Acceptance and Use of Technology (UTAUT2): A systematic literature review and theory evaluation

How do patients experience and use home blood pressure monitoring? A qualitative analysis with UTAUT 2

Background: Hypertension is an important cardiovascular risk factor with potentially harmful consequences. Home blood pressure monitoring is a promising method for following the effect of hypertension treatment. The use of technology-enabled care and increased patient involvement might contribute to more effective treatment methods. However, more knowledge is needed to explain the motivations and consequences of patients engaging in what has been called 'do-it-yourself healthcare'. Aim: This study aimed to investigate patients' experiences of home blood pressure monitoring through the theoretical frame of the Unified Theory of Acceptance and Use of Technology (UTAUT 2). Methods: The study had a qualitative design, with focus group interviews using the web-based platform Zoom. The data were analysed using qualitative deductive content analysis, inspired by Graneheim and Lundman. Results: The results are presented using the seven theoretical constructs of UTAUT 2: Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions, Hedonistic Motivation, Price Value and Habit. We found one overarching theme ‒ 'It's all about the feeling of security'. The patients were influenced by relatives or healthcare personnel and experienced the home monitoring process as being easy to conduct. The patients emphasised that the quality of the blood pressure monitor was more important than the price. Patients reported home monitoring of blood pressure as a feasible method to follow-up care of their hypertension. Discussion: This study indicates that among motivated patients, home blood pressure measurement entails minimal effort, increases security, and leads to better communication about blood pressure between healthcare personnel and patients.

Unveiling the adoption of metaverse technology in Bangkok metropolitan areas: A UTAUT2 perspective with social media marketing and consumer engagement

As the metaverse emerges as a transformative digital realm, its adoption and integration into various aspects of society are subjects of increasing scholarly and practical interest. This research investigated the factors influencing the intention to use metaverse technology (IU) in Bangkok metropolitan areas, with a particular focus on the extended Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) framework, alongside the role of social media marketing (SMM) and consumer engagement (CE). To verify behavioral intention, gender, age, and experience are proposed as moderating factors affecting the constructs on individuals' behavioral intention of metaverse technology usage. The study collected data from 403 Thai internet users living in Bangkok and its surrounding areas using an online questionnaire. Subsequently, the PLS-SEM method was employed to validate the research model's robustness and reliability. Structural model analysis revealed significant relationships among constructs, highlighting SMM's direct influence on UTAUT2 (β = 0.787) and CE (β = 0.211). Serial mediation analyzes demonstrated a fully mediating role of SMM influencing UI through CE (β = 0.572) and UTAUT2 (β = 0.306). Moderation analyzes revealed the association between SMM and IU, mediated through UTAUT2 and CE, is moderated by age and experience. Additionally, the integration of PLS-SEM and artificial neural network (ANN) models underscored the accuracy and predictive power of the proposed framework. The findings of this study not only contribute to academic literature but also offer practical implications for marketers aiming to navigate the metaverse landscape effectively. They emphasize the pivotal role of UTAUT2 constructs and the subtle interplay between SMM, CE, and IU in shaping successful marketing strategies.

"A Matter of Life and Death": Mitigating the Gray Digital Divide in Using Health Information Technologies in the Post-Pandemic Era

A pervasive issue in healthcare is that elderly populations have fallen far behind in using healthcare technologies, a phenomenon known as the gray digital divide. Even more concerningly, the COVID-19 pandemic has dramatically catalyzed health digitization with the potential for lasting demographic-wide impacts. Against this backdrop and drawing on both the digital divide literature and the unified theory of acceptance and use of technology (UTAUT2), we investigated elderly populations' usage of healthcare technologies through analyzing HINTS 6 (2022) survey data. Results show a widespread first- and second-level digital divide in using health information technologies (HITs) between people aged 65 and up and people aged 18-64, including Internet access, health-related Internet use, health-related social media use, health app use, use of wearable electronic health devices, telehealth visits, and accessing online medical records. Moreover, this study finds that education consistently positively predicts Internet use and use of various HITs by the elderly; income is the next reliable predictor but not as consistent as education. Health-related variables are less consistent in predicting the elderly's use of HITs. Theoretical and practical implications of these results are discussed to inform the mitigation of the gray digital divide in healthcare.

Informing existing technology acceptance models: a qualitative study with older persons and caregivers

New technologies can help older persons age in place and support their caregivers. However, they need to be accepted by the end-users to do so. Technology acceptance models, such as TAM and UTAUT and their extensions, use factors like performance expectancy and effort expectancy to explain acceptance. Furthermore, they are based on quantitative methods. Our qualitative study investigates factors fostering and hindering acceptance among older persons and their caregivers for a variety of assistive technologies, including wearables, ambient sensors at home with and without cameras and social companion robots. The goal of this paper is twofold: On the one hand, it investigates the factors of technology acceptance models in a qualitative setting. On the other hand, it informs these models with aspects currently overlooked by them. The results reveal that performance expectancy and effort expectancy are relevant for acceptance. We also find that reliability, anxiety around technology and different social aspects have an influence on acceptance of assistive technology in aged care for all end-user groups. Our findings can be used to update current technology acceptance models and provide in-depth knowledge about the currently used factors.

Factors influencing older adults' participation in telehealth interventions for primary prevention and health promotion: A rapid review

OBJECTIVE

To identify facilitators and barriers to older adults' participation in telehealth interventions for primary prevention and health promotion.

METHODS

Relevant articles were searched using keywords in Embase and MEDLINE. Study characteristics, type of telehealth interventions and technology involved, as well as facilitators and barriers to their use, were extracted from selected articles. The Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model was used to organise data.

RESULTS

A total of 24 articles (pertaining to 20 studies) were included. Nine facilitators and 11 barriers influencing the participation in telehealth interventions for primary prevention and health promotion among older adults were identified. The most recurrent facilitators were related to the individual's performance expectancy and effort expectancy, as well as the presence of a social dimension associated with the intervention (i.e. having a good relationship with the other participants in the program). The two most prevalent barriers were also related to effort expectancy and performance expectancy, followed by barriers related to the inherent characteristics of the technology and older adults' health condition. Experience, age and gender were also found to moderate technology use and acceptance.

CONCLUSIONS

This rapid review highlights the importance of adopting a holistic perspective when designing telehealth interventions aimed at preventive and health promotion purposes among older adults.

Referring physicians' intention to use hospital report cards for hospital referral purposes in the presence or absence of patient-reported outcomes: a randomized trial

PURPOSE

This study aims to determine the intention to use hospital report cards (HRCs) for hospital referral purposes in the presence or absence of patient-reported outcomes (PROs) as well as to explore the relevance of publicly available hospital performance information from the perspective of referring physicians.

METHODS

We identified the most relevant information for hospital referral purposes based on a literature review and qualitative research. Primary survey data were collected (May-June 2021) on a sample of 591 referring orthopedists in Germany and analyzed using structural equation modeling. Participating orthopedists were recruited using a sequential mixed-mode strategy and randomly allocated to work with HRCs in the presence (intervention) or absence (control) of PROs.

RESULTS

Overall, 420 orthopedists (mean age 53.48, SD 8.04) were included in the analysis. The presence of PROs on HRCs was not associated with an increased intention to use HRCs (p = 0.316). Performance expectancy was shown to be the most important determinant for using HRCs (path coefficient: 0.387, p < .001). However, referring physicians have doubts as to whether HRCs can help them. We identified "complication rate" and "the number of cases treated" as most important for the hospital referral decision making; PROs were rated slightly less important.

CONCLUSIONS

This study underpins the purpose of HRCs, namely to support referring physicians in searching for a hospital. Nevertheless, only a minority would support the use of HRCs for the next hospital search in its current form. We showed that presenting relevant information on HRCs did not increase their use intention.

User engagement with organizational mHealth stress management intervention - A mixed methods study

Mobile health (mHealth) demonstrates great promise for providing effective and accessible interventions within an organizational context. Compared with traditional workplace interventions, mHealth solutions may be significantly more scalable and easier to standardize. However, inadequate user engagement is a major challenge with mHealth solutions that can negatively impact the potential benefits of an intervention. More research is needed to better understand how to ensure sufficient engagement, which is essential for designing and implementing effective interventions. To address this issue, this study employed a mixed methods approach to investigate what factors influence user engagement with an organizational mHealth intervention. Quantitative data were collected using surveys (n = 1267), and semi-structured interviews were conducted with a subset of participants (n = 17). Primary findings indicate that short and consistent interactions as well as user intention are key drivers of engagement. These results may inform future development of interventions to increase engagement and effectiveness.

Predicting adoption of the assistive technology open platform: extended unified theory of acceptance and use of technology

PURPOSE

The Assistive Technology (AT) Open Platform supports people with disabilities, older people, and developers in co-creating new assistive products outside the business realm. To address dissatisfaction with and non-adoption of commercial assistive products, the National Rehabilitation Centre in South Korea created an AT Open Platform as an open-source AT sharing platform to research and develop appropriate assistive technology suitable for users' needs. The emerging concept of AT Open Platform is new for both assistive product users and developers in South Korea. The Extended Unified Theory of Acceptance and Use of Technology (UTAUT2) was utilised to understand the factors influencing the adoption of the AT Open Platform and to gain further insights on its design and future use.

MATERIALS AND METHODS

Interviews were conducted with six potential AT Open Platform users to develop a questionnaire for predicting behavioural intention. Subsequently, we surveyed 175 potential users to validate the UTAUT2.

RESULTS

The results revealed that behavioural intention was significantly predicted by social influence, performance expectancy, facilitating conditions, and hedonic motivation.

CONCLUSIONS

The AT Open Platform should focus on both online and offline platforms to educate and facilitate the co-creation of ATs for assistive product users and makers. This study, which targeted assistive product users and developers, has significant implications for policymakers and future research in using and adopting the AT Open Platform as it reflects the actual voices of the platform's stakeholders.

Expanding the UTAUT2 framework to determine the drivers of mobile shopping behaviour among older adults

In the current severe aging of the population, the problem of "digital divide" of the elderly has become increasingly prominent, and the elderly market represents a vast demographic that is increasingly becoming an important customer segment for mobile shopping in the future. However, there is currently insufficient attention given to the research on mobile shopping behavior among older adults. This study tries to answer what are the driving factors of mobile phone shopping behavior among the elderly? The purpose of this study is to analyze the factors that drive the elderly's mobile phone shopping behavior, and to establish a mobile phone shopping acceptance model for the elderly to predict the factors of the elderly's behavioral intention of using smart phones. Based on the second edition of Unified Theory of Acceptance and Use of Technology theory (UTAUT 2), this study proposed a mobile phone shopping acceptance model for the elderly. The study collected valid data from 389 Chinese elderly people through questionnaires and analyzed them using structural equation models. The results showed that utilitarian, anxiety, trust, performance expectancy, effort expectancy, social influence, facilitating conditions and habit directly impact the older adults' intention to engage in mobile shopping. Additionally, facilitating conditions, habit and the older adults' intention to engage in mobile shopping act as driving factors for actual use behavior. This study further expands the UTAUT theoretical model, provides a theoretical basis for the research of mobile shopping behavior of the elderly, and enricues the application groups and fields of the UTAUT theoretical model. The results of this study provide inspiration for the development, design and marketing of age-appropriate mobile shopping products, and contribute to the realization and further adoption of age-appropriate mobile shopping, and also contribute to promoting the active aging of the elderly.

Do Chinese viewers watch e-sports games for a different reason? Motivations, attitude, and team identification in predicting e-sports online spectatorship

Introduction

Understanding factors that predict the intention of e-sports game online spectatorship has drawn a great deal of scholarly attention. Prior work on this topic has primarily focused on explaining the mediation mechanism between the spectator motivations and behavioral intention, such as attitude and subjective well-being, while overlooking the specific role of team identification and satisfaction with past experience, which were understudied in the previous studies but also prominent in the context of e-sports spectatorship. Besides, previous research was mainly conducted in a Western context; therefore, little was known about the online e-sports audience in China and their motivations to view e-sports games on live-streaming platforms.

Methods

The current study thus aims to examine if and how these factors are related to the intention of watching e-sports games online by hierarchical regression and structural equation modeling.

Results

Results from a survey of 452 Chinese e-sports online audiences suggested that three motivations (skill improvement, entertainment, and friends bonding), attitude towards e-sports game online spectatorship, and satisfaction with past experience were positively related to watching intention. These motivations and satisfaction also positively influenced attitude, while socialization opportunity (one of the motivations) negatively influenced attitude. Furthermore, team identification negatively moderated the relationship between satisfaction with past experience and behavioral intention. Also, attitude mediated the association between motivations, satisfaction, and behavioral intention.

Discussion

In general, our study identifies the motivations that relate to Chinese e-sports viewers' attitude as well as their watching intention, and underscores the role of satisfaction with past experience, attitude, and team identification in the context of e-sports. These findings contribute to deriving a holistic view of e-sports game online spectatorship.

A Beta-Prototype Chatbot for Increasing Health Literacy of Patients With Decompensated Cirrhosis: Usability Study

BACKGROUND

Health literacy is low among patients with chronic liver disease (CLD) and associated with poor health outcomes and increased health care use. Lucy LiverBot, an artificial intelligence chatbot was created by a multidisciplinary team at Monash Health, Australia, to improve health literacy and self-efficacy in patients with decompensated CLD.

OBJECTIVE

The aim of this study was to explore users' experience with Lucy LiverBot using an unmoderated, in-person, qualitative test.

METHODS

Lucy LiverBot is a simple, low cost, and scalable digital intervention, which was at the beta prototype development phase at the time of usability testing. The concept and prototype development was realized in 2 phases: concept development and usability testing. We conducted a mixed methods study to assess usability of Lucy LiverBot as a tool for health literacy education among ambulatory and hospitalized patients with decompensated CLD at Monash Health. Patients were provided with free reign to interact with Lucy LiverBot on an iPad device under moderator observation. A 3-part survey (preuser, user, and postuser) was developed using the Unified Acceptance Theory Framework to capture the user experience.

RESULTS

There were 20 participants with a median age of 55.5 (IQR 46.0-60.5) years, 55% (n=11) of them were female, and 85% (n=17) of them were White. In total, 35% (n=7) of them reported having difficulty reading and understanding written medical information. Alcohol was the predominant etiology in 70% (n=14) of users. Participants actively engaged with Lucy LiverBot and identified it as a potential educational tool and device that could act as a social companion to improve well-being. In total, 25% (n=5) of them reported finding it difficult to learn about their health problems and 20% (n=4) of them found it difficult to find medical information they could trust. Qualitative interviews revealed the conversational nature of Lucy LiverBot was considered highly appealing with improvement in mental health and well-being reported as an unintended benefit of Lucy LiverBot. Patients who had been managing their liver cirrhosis for several years identified that they would be less likely to use Lucy LiverBot, but that it would have been more useful at the time of their diagnosis. Overall, Lucy LiverBot was perceived as a reliable and trustworthy source of information.

CONCLUSIONS

Lucy LiverBot was well received and may be used to improve health literacy and address barriers to health care provision in patients with decompensated CLD. The study revealed important feedback that has been used to further optimize Lucy LiverBot. Further acceptability and validation studies are being undertaken to investigate whether Lucy LiverBot can improve clinical outcomes and health related quality of life in patients with decompensated CLD.

Understanding student intentions to take online courses: A theory-driven examination of adoption factors and prior experience

Online education options have expanded rapidly, yet empirical knowledge of students' adoption choices remains relatively limited. Within higher education, it is important for both instructors and administrators to understand what students value in online courses in order to provide a quality learning experience and manage enrollment demands. The current work applies and expands on the Unified Theory of Acceptance and Use of Technology (UTAUT) to examine factors involved in course modality choices. Study 1 (N = 257) uses a single discipline to validate measures of online course perceptions and provide initial predictive evidence. Study 2 (N = 1257) examines adoption intentions among students in a wide range of disciplines. Performance expectancies, hedonic motivation, and flexibility emerged as the most substantial factors in student decisions about course modality. The results also reveal shifts in online course perceptions over time, including larger shifts for students with no prior online course experience. These findings expand current understanding of why students choose to take (or avoid) online courses, particularly concerning the role of flexibility in enrollment decisions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10639-023-11823-4.

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.

The ABC of algorithmic aversion: not agent, but benefits and control determine the acceptance of automated decision-making

While algorithmic decision-making (ADM) is projected to increase exponentially in the coming decades, the academic debate on whether people are ready to accept, trust, and use ADM as opposed to human decision-making is ongoing. The current research aims at reconciling conflicting findings on ‘algorithmic aversion’ in the literature. It does so by investigating algorithmic aversion while controlling for two important characteristics that are often associated with ADM: increased benefits (monetary and accuracy) and decreased user control. Across three high-powered (Ntotal = 1192), preregistered 2 (agent: algorithm/human) × 2 (benefits: high/low) × 2 (control: user control/no control) between-subjects experiments, and two domains (finance and dating), the results were quite consistent: there is little evidence for a default aversion against algorithms and in favor of human decision makers. Instead, users accept or reject decisions and decisional agents based on their predicted benefits and the ability to exercise control over the decision.

A co-designed health information system implementation into residential aged care: A mixed-method evaluation

INTRODUCTION

Internationally, the adoption of technology into residential aged care settings has been slow and fraught with multiple challenges for residents, staff and service providers. The aim of this study was to evaluate the acceptability, efficiency, and quality of health information system implementation into aged care.

METHODS

Three-stage, mixed-methods participatory action research, concurrent with the natural experiment of a co-designed health information system implementation into a 169-bed aged care home in Australia. Data were collected pre-, during, and post implementation between 2019 and 2021. Qualitative data included focus groups, interviews, and observations. Quantitative data included work observations, pedometers, record audits, incident reports and staff and resident surveys. There were 162 participants composed of 65 aged care residents, 90 staff, and 7 managers/consultants.

RESULTS

Improved work efficiency included reduced staff time searching for information (6%); reduced nurse time on documentation (20.4% to 6.4%), and 25% less steps. Documentation improvement included resident assessments (68% to 96%); resident-focused goals (56% to 88%) and evaluations (31% to 88%). The staff reported being better equipped to manage the 'delicacies of dignity'.

CONCLUSION

Implementation of a health information system into a residential aged care facility was associated with improved resident-focused care and staff efficiency.

CLINICAL RELEVANCE

Technology can support nurses and care staff to spend more time with residents in residential aged care homes, improve the quality of resident care, and assist meeting regulatory reporting requirements. Flexible and tailored co-design strategies can enhance both effectiveness and success of technology implementation into residential aged care.

The Acceptability of Technology-Based Physical Activity Interventions in Postbariatric Surgery Women: Insights From Qualitative Analysis Using the Unified Theory of Acceptance and Use of Technology 2 Model

BACKGROUND

Bariatric surgery offers an opportunity for physical activity (PA) promotion due to patients' increased ability to engage in PA. Technology-based PA interventions are promising tools for promoting PA to support patients in this key period. The Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model is a recognized theoretical model for examining technology acceptability. Although a previous study reported that 92% of women with obesity have high acceptability of at least one technology-based PA intervention, little is known about the factors that lead to different levels of acceptability between technologies and therefore the reasons for choosing a preferred intervention.

OBJECTIVE

The purpose of this study was to (1) characterize the acceptability of 3 technology-based PA interventions (ie, telehealth, active video game, mobile app) in the context of bariatric surgery, and (2) explore patients' preference motives. This study, using a qualitative design, examined the suitability of the UTAUT2 model in this specific context.

METHODS

Participants (n=26) read written French descriptions of the technology-based PA interventions with illustrations and chose their preferred intervention. Semidirective interviews were conducted to explore the reasons for their choice of the preferred intervention, notably using the UTAUT2 framework. Data were analyzed based on inductive and deductive approaches.

RESULTS

All participants who preferred a technology-based PA intervention (ie, active video game, n=10; mobile app, n=10; telehealth, n=6) expressed a behavioral intention to use it. In addition, some of them expressed a high behavioral intention to use another technology (ie, active video game, n=4; mobile app, n=1; telehealth, n=7). All the constructs of the UTAUT2 emerged during the qualitative interviews and were specified through subcategories. Additional constructs also emerged, especially other motivational factors.

CONCLUSIONS

This study showed that, in the context of technology-based PA interventions for postbariatric patients, the UTAUT2 is suitable, although additional motivational factors (which were not considered by the UTAUT2 model) should be considered.

A readiness assessment framework for the adoption of 5G based smart-living services

The subject of this article is to analyze the users’ attitude towards new, 5G-enabled smart living services before their commercial launch. The goal is to offer a framework for the analysis and evaluation of influential factors in the early adoption of 5G residential services. Additionally, the paper examines how mobile operators can leverage their existing infrastructure and services to boost the acceptance of both 5G as a technology and the provided smart-living services. To ascertain the potential impact that mobile operators can have on the adoption of such services, loyalty programs were taken into account as a separate factor in the acceptance study. The study was conducted in Serbia in the form of a survey. The analysis of the results yielded some notable conclusions such as trust in technology playing the leading role in influencing the behavior intention, while loyalty programs showed that they can influence attitudes towards individual smart living services. The presented results can be used to shape any future implementation of 5G-based services in Serbia, or any other country whose 5G infrastructure and services for the residential customer segment are yet to be established.

A study on the effects of perceived playfulness and emotional support in interactive learning environments for German language acquisition-A role-playing library system case

Introduction

This study examines the emotional support offered by the non-player characters (NPCs) in an interactive learning environment, as well as the effects of the perceived playfulness of the interactive system on German language learning.

Method

We developed a role-playing library system to serve this purpose. 2,377 Chinese Internet users were surveyed using online questionnaire.

Results

A theoretical model of emotion- driven learning (ELM) was proposed based on the analysis results of valid recovered data. Additionally, NPCs were found to be effective in improving learning outcomes through emotional support.

Discussion

An interactive education system may be able to enhance the perceived playfulness of learning in order to enhance the learning experience.

Determining factors affecting the perceived usability of air pollution detection mobile application "AirVisual" in Thailand: A structural equation model forest classifier approach

Air pollution has been evident worldwide. It presented numerous pieces of evidence that affect health-related adverse effects causing diseases and even death and the development of technology has helped monitor the exposure of people to air pollution. This research analyzed factors affecting the perceived usability of air pollution detection on the 'AirVisual' mobile application based on the integrated model of Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT2). A total of 416 participants voluntarily answered a self-administered survey consisting of adapted constructs covering factors such as Performance expectancy (PE), Effort expectancy (EE), Social influence (SI), Facilitating conditions (FC), Habit (HB), Perceived risk (PR), Perceived trust (PT), Intention to use (IU), and Perceived usability (PU). Structural Equation Modeling and Random Forest Classifier were utilized to determine factors affecting perceived usability of the 'AirVisual' mobile application. The results showed that PE, EE, SI, and FC were key factors leading to very high PU among users. Moreover, IU was seen to be the most significant factor affecting PU, followed by PT, PR, and HB. This study is one of the first studies that considered the evaluation of usability among health-related mobile applications covering air pollution. The results and the framework utilized in this model may be applied to evaluate other factors and applications related to health among people. Lastly, this study can also be extended to evaluate other mobile applications worldwide.

Resistance of Traditional SMEs in Using Digital Payments: Development of Innovation Resistance Theory

The impact of the pandemic has also affected the sustainability of traditional traders. One of the merchants’ efforts in overcoming the effect of COVID-19 is to make transactions with digital payments, both in-store purchases and through online media. This study is aimed at determining user resistance with the innovation resistance theory (IRT) approach based on two main approaches, namely, functional and psychological barriers. The unit of analysis in this study is a traditional clothing market trader who uses digital payments to process transactions. This study uses a qualitative method with a case study approach in Indonesia’s traditional clothing market through in-depth interviews of eight respondents. The results of this study prove that the clothing market sword uses digital payments when conducting transactions directly to consumers and for the needs of traders in supporting their business activities such as bill payments and purchases to suppliers. Most buyers complain about the risk barrier on the security and privacy factor, especially when they experience delays in information when processing transactions, causing more efforts to make complaints. The research contributes to the development of IRT theory, especially in the context of technology such as digital payments. The results of this study can also be helpful for service providers and the government in making strategies and policies that can protect users, especially buyers and sellers, in adopting digital payments.

Modelling the intention and adoption of cashless payment methods among the young adults in Malaysia

Purpose

Cashless payment is gradually replacing physical currency in almost every financial transaction across the world. Even though cashless payment methods have been available in Malaysia since a decade ago, their usage has remained relatively low in comparison to other countries. This study aims to analyse the elements that affect the Malaysian youth’s adoption intention and actual use of cashless payment by extending the unified theory of acceptance and use of technology (UTAUT) model with two key factors (perceived security [PS] and lifestyle compatibility [LC]).

Design/methodology/approach

Data were gathered online from 364 Malaysian youths and processed using partial least squares structural equation modelling.

Findings

The findings revealed that performance expectancy (PE), LC and PS had a positive and substantial effect on the intention to use cashless payment (ICP). In contrast, effort expectancy (EE) and social influence did not have any considerable influence on ICP. Furthermore, ICP had substantial mediating effects between the adoption of cashless payment (ACP) and PE, LC and PS. In the analysis of the moderating effect of age, gender, experience and voluntariness, only experience had moderating effects on the associations between PE and ICP and between FC and ACP.

Research limitations/implications

This study’s findings will be highly useful for marketers and the management as they plan their promotional and marketing tactics, with a focus on the factors that inspire customers to adopt cashless payments. Besides, architects and designers can benefit from the study results while designing and updating their services by consolidating consumers’ lifestyle standards as well as enhancing security features. Finally, governments may support service providers with security building through legislative measures and policy campaigns to strengthen the trustworthiness and mass adoption of contactless payment.

Originality/value

This study extended the UTAUT model with two new variables, i.e. PS and LC.

The Role of Personality and Top Management Support in Continuance Intention to Use Electronic Health Record Systems among Nurses

This study examines nurses' Continuance Intention (CI) to use electronic health records (EHRs) through a combination of three conceptual frameworks: the Unified Theory of Acceptance and Use of Technology (UTAUT), the theory of expectation-confirmation (ECT), and the Five-Factor Model (FFM). A model is developed to examine and predict the determinants of nurses' CI to use EHRs, including top management support (TMS) and the FFM's five personality domains. Data were collected from a survey of 497 nurses, which were analyzed using partial least squares. No significant relationship was found between TMS and CI. The study revealed that performance expectancy significantly mediated the influences of two different hypotheses of two predictors: agreeableness and openness to testing CI. A significant moderating impact of conscientiousness was found on the relationship between performance expectancy and CI and the relationship between social influence and CI. The findings of this study indicated that rigorous attention to the personality of individual nurses and substantial TMS could improve nurses' CI to use EHRs. A literature gap was filled concerning the mediating effects of performance expectancy on the FFM-CI relationship, and the moderation effects of Conscientiousness on UTAUT constructs and CI are another addition to the literature. The results are expected to assist government agencies, health policymakers, and health institutions all over the globe in their attempts to understand the post-adoption use of EHRs.

Understanding the determinants of ePharmacy services: the moderating effect of technology discomfort

Purpose

The purpose of this study is to understand the determinants affecting behavioral intention (BI) to use ePharmacy services. The moderating role of technology discomfort in the relationship between BI and the actual use of ePharmacies in the context of Bangladesh is also examined.

Design/methodology/approach

A descriptive, quantitative approach was used to consider the UTAUT-2 model. Using the convenience sampling method, 255 responses were collected. The data were analyzed using Smart-PLS 3.2 software to investigate the hypothesized relationships.

Findings

The findings reveal that website information, doctors’ services, performance expectancy, return policy, social influence, perceived reliability and facilitating conditions are significantly related to the BI to use ePharmacy services. Interestingly, the structural equation modeling results also confirmed that technology discomfort has no moderating effect on the relationship between BI and actual usage behavior.

Research limitations/implications

This research provides theoretical contribution by extending the practical knowledge focusing on the relationship of ePharmacy, BI and actual usage behavior by using UTAUT-2 model – a relevant and unexplored issue in the easting literature, offering several research opportunities as the future avenue.

Practical implications

The result highlights the economic and social relevance from the perspective of a developing country. As people are showing their intention toward ePharmacy, managers and decision-makers need to take strategic decision to overcome any difficulties. Policymakers need to improve their services for the expansion of ePharmacy through different development projects.

Originality/value

This study advances past studies on the use of ecommerce in the pharmaceutical industry and provides a general understanding of customers in developing countries.

Two of a Kind? Similarities and Differences between Runners and Walkers in Sociodemographic Characteristics, Sports Related Characteristics and Wearable Usage

As the two prime examples of sport light, running and walking have become very popular sports activities in the past decades. There are references in the literature of similarities between both sports, however these parallels have never been studied. In addition, the current digitalisation of society can have important influences on the further diversification of profiles. Data of a large-scale population survey among runners and walkers (n = 4913) in Flanders (Belgium) were used to study their sociodemographic, sports related and attitudinal characteristics, and wearable usage. The results showed that walkers are more often female, older, lower educated, and less often use wearables. To predict wearable usage, sports-related and attitudinal characteristics are important among runners but not among walkers. Motivational variables to use wearables are important to predict wearable usage among both runners and walkers. Additionally, whether or not the runner or walker registers the heart rate is the most important predictor. The present study highlights similarities and differences between runners and walkers. By adding attitudinal characteristics and including walkers this article provides new insights to the literature, which can be used by policymakers and professionals in the field of sport, exercise and health, and technology developers to shape their services accordingly.

An Analysis of the Learning Effects and Differences of College Students Using English Vocabulary APP

With the gradual popularization of mobile learning, it has become a trend for college students to use learning applications (APPs) for learning, but the learning effect has always been a concern. Since college students have different learning purposes, strategies, skills, and habits, responses to these differences have been an urgent problem. This paper takes college students using an English vocabulary APP to study as the survey object. It sets up the influencing factors model of the English vocabulary learning effect based on UTAUT2. Then, we analyzed the factors influencing the learning effect of using an English vocabulary APP and studied its mechanism. The results show that on the one hand, the influence degree of influencing factors is habit, facilitation condition, price value, effort expectancy, and performance expectancy from high to low, and all the above factors have a significant positive impact on the learning effect of college students using English vocabulary APP. On the other hand, gender, grade, and major have a moderating effect on English vocabulary learning, and there are differences among different genders, grades, and majors. Finally, suggestions are put forward from the perspective of APP construction and students’ differences to enhance and improve the learning effect of English vocabulary.

Utilizing Structural Equation Modeling-Artificial Neural Network Hybrid Approach in Determining Factors Affecting Perceived Usability of Mobile Mental Health Application in the Philippines

Mental health problems have emerged as one of the biggest problems in the world and one of the countries that has been seen to be highly impacted is the Philippines. Despite the increasing number of mentally ill Filipinos, it is one of the most neglected problems in the country. The purpose of this study was to determine the factors affecting the perceived usability of mobile mental health applications. A total of 251 respondents voluntarily participated in the online survey we conducted. A structural equation modeling and artificial neural network hybrid was applied to determine the perceived usability (PRU) such as the social influence (SI), service awareness (SA), technology self-efficacy (SE), perceived usefulness (PU), perceived ease of use (PEOU), convenience (CO), voluntariness (VO), user resistance (UR), intention to use (IU), and actual use (AU). Results indicate that VO had the highest score of importance, followed by CO, PEOU, SA, SE, SI, IU, PU, and ASU. Having the mobile application available and accessible made the users perceive it as highly beneficial and advantageous. This would lead to the continuous usage and patronage of the application. This result highlights the insignificance of UR. This study was the first study that considered the evaluation of mobile mental health applications. This study can be beneficial to people who have mental health disorders and symptoms, even to health government agencies. Finally, the results of this study could be applied and extended among other health-related mobile applications worldwide.

Comparative analysis of variables that influence behavioral intention to use MOOCs

The purpose of this research was to investigate the key factors that influence behavioral intention to adopt MOOCs. The study was conducted in three countries namely, Poland, Thailand, and Pakistan. The study was considered significant considering the advancements in technology that have had an unprecedented impact on education, and the need to conduct learning online due to the COVID-19 to pandemics. The research adopted the Unified Theory of Acceptance and Use of Technology (UTAUT2) and extended it by including other variables including culture, social distancing, and absorptive capacity. The study was conducted using the quantitative methodology, where the data was collected using a structured questionnaire. The data was collected from a sample from each of the three countries, and sample sizes were 455, 490, and 513 for Poland, Thailand, and Pakistan respectively. The data were analyzed using Structural Equation Modeling (SEM) and multi-group SEM analysis. The results of the study indicated that effort expectancy and culture significantly and positively influenced behavioral intention to use MOOCs in all three countries. As well, absorptive capacity is mediated significantly by performance expectancy and effort expectancy. Facilitating conditions have a significant influence on MOOCs in both Thailand and Pakistan. Social influence has a significant influence on behavioral intention to use MOOCs in Thailand, hedonic motivation and price value have a significant influence on behavioral intention to use MOOCs in Poland, and the habit has a significant factor in Pakistan. The keys aspects influencing behavioral intention to Use MOOCs were different in Poland, Thailand, and Pakistan, in various factors which are performance expectancy, social distancing, price value, facilitating conditions, and social influence. The research recommended that it is important to evaluate the situation and prevailing conditions of the concerned country, before implementing the MOOCs and the associated online learning practices.

Factors influencing graduate students' behavioral intention to use Google Classroom: Case study-mixed methods research

Blended learning combines face-to-face instruction and online learning experiences. It capitalizes on online learning management systems, one of which is Google Classroom (GC). Nevertheless, empirical investigations have mirrored literature gaps in understanding how the GC platform affects students' behavioral intention to harness it for web-based learning. Therefore, this case study applied a modified version of the extended unified theory of acceptance and use of technology (UTAUT2) as a theoretical underpinning to examine factors influencing graduate students' behavioral intention to utilize the GC platform. Employing mixed methods explanatory sequential design, the study first analyzed survey data from 23 EFL graduate students implementing partial least squares structural equation modeling (PLS-SEM). Subsequently, it conducted a qualitative stage carrying out semi-structured interviews for data collection and thematic analysis for its evaluation. The study through PLS-SEM results revealed that the most crucial determinant of students' behavioral intention toward the GC platform was habit, which hung on facilitating conditions and hedonic motivation. Besides, it evinced facilitating conditions as the most important performing interaction factor in determining graduate students' behavioral intention. Nonetheless, it indicated that performance expectancy, effort expectancy, social influence, facilitating conditions, and hedonic motivation had no direct effect on behavioral intention. The follow-up qualitative findings explained that since the students mainly used the GC platform off-campus, the GC App on their smartphones and the interesting content on the GC platform sustained their habitual tendencies toward employing the GC platform. Accordingly, the study explicates implications and recommendations for theory, policy, and practice.

Facebook/Meta usage in higher education: A deep learning-based dual-stage SEM-ANN analysis

The paper's main aim is to investigate and predict major factors in students' behavioral intentions toward academic use of Facebook/Meta as a virtual classroom, taking into account its adoption level, purpose, and education usage. In contrast to earlier social network research, this one utilized a novel technique that comprised a two-phase analysis and an upcoming the Artificial Neural Network (ANN) analysis approach known as deep learning was engaged to sort out relatively significant predictors acquired from Structural Equation Modeling (SEM). This study has confirmed that perceived task-technology fit is the most affirmative and meaningful effect on Facebook/Meta usage in higher education. Moreover, facilitating conditions, collaboration, subjective norms, and perceived ease of use has strong influence on Facebook usage in higher education. The study's findings can be utilized to improve the usage of social media tools for teaching and learning, such as Facebook/Meta. There is a discussion of both theoretical and practical implications.

Value and Sustainability of Emerging Social Commerce Professions: An Exploratory Study

Recent advances in social commerce and mobile technology have led to the emergence of new professions such as vlogging, blogging and virtual pop-up store owning. Starting initially as hobbies, the services provided by these ‘new professionals’ have become ubiquitous and are being used by customers from many different countries and backgrounds. This paper reports on a study that first explored the views and opinions of new professionals from several fields (using a qualitative approach), and then the views of their potential customers (a quantitative study informed by UTAUT2—the extended Unified Theory of Acceptance and Use of Technology). The results indicated that new professionals both create and co-create value with their customers, peers, and some existing, traditionally established professions. The results also indicated that the intended audience/customers of the new professional businesses had a positive perception of their long-term commercial sustainability. Customers’ intention to use the new professional services in the future were predicted mostly by the behavioral characteristics of hedonic motivation and habit. The research contributes by empirically investigating the value creation and co-creation processes in a context that is yet to attract academic interest. It proposes a value creation and co-creation framework that draws on the interactions of the main players.

Mindful Application of Digitalization for Sustainable Development: The Digitainability Assessment Framework

Digitalization is widely recognized as a transformative power for sustainable development. Careful alignment of progress made by digitalization with the globally acknowledged Sustainable Development Goals (SDGs) is crucial for inclusive and holistic sustainable development in the digital era. However, limited reference has been made in SDGs about harnessing the opportunities offered by digitalization capabilities. Moreover, research on inhibiting or enabling effects of digitalization considering its multi-faceted interlinkages with the SDGs and their targets is fragmented. There are only limited instances in the literature examining and categorizing the impact of digitalization on sustainable development. To overcome this gap, this paper introduces a new Digitainability Assessment Framework (DAF) for context-aware practical assessment of the impact of the digitalization intervention on the SDGs. The DAF facilitates in-depth assessment of the many diverse technical, social, ethical, and environmental aspects of a digital intervention by systematically examining its impact on the SDG indicators. Our approach draws on and adapts concepts of the Theory of Change (ToC). The DAF should support developers, users as well policymakers by providing a 360-degree perspective on the impact of digital services or products, as well as providing hints for its possible improvement. We demonstrate the application of the DAF with the three test case studies illustrating how it supports in providing a holistic view of the relation between digitalization and SDGs.

Teaching Evolution: The Use of Social Networking Sites

Online schooling has been adopted worldwide due to the COVID-19 pandemic. During quarantine, people go online for all kind of purposes, especially for amusement such as via social networking sites (SNSs). This study examined university physical education (PE) students’ SNSs usage intention using the Unified Theory of Acceptance and Use of Technology model II (UTAUT2) in Taiwan. Research respondents were selected from PE departments of 19 universities through purposive sampling method. A total of 707 questionnaires were collected, with a returning rate of 93%. Using Warp PLS 7.0 as the main instrument for data analysis, this research finds that performance expectancy, facilitating conditions, hedonic motivation, price value, and habit within the UTAUT2 model have significant positive effects on students’ intention to use social networking sites, and the model explains 63.4% of the variance in their intention to use SNSs. Among those variables, hedonic motivation had the highest impact (β = 0.24). Moreover, intention, facilitating conditions and habit have significant positive effects on students’ use of social networking sites, and the model explains 13.4% of the variance in their use of social networking sites. The moderating effects of gender, age and experience are found in some path analyses. These findings provide future university instructors a with better understanding of students using SNSs. We thus recommend for university PE instructors to create interesting and pleasant classroom learning experiences to attract students’ attention, and recommend that they may even manage a SNS as an aid for teaching to enhance students’ interests in learning.

Applying an Extended UTAUT2 Model to Explain User Acceptance of Lifestyle and Therapy Mobile Health Apps: Survey Study

Background

Mobile health (mHealth) care apps are a promising technology to monitor and control health individually and cost-effectively with a technology that is widely used, affordable, and ubiquitous in many people’s lives. Download statistics show that lifestyle apps are widely used by young and healthy users to improve fitness, nutrition, and more. While this is an important aspect for the prevention of future chronic diseases, the burdened health care systems worldwide may directly profit from the use of therapy apps by those patients already in need of medical treatment and monitoring.

Objective

We aimed to compare the factors influencing the acceptance of lifestyle and therapy apps to better understand what drives and hinders the use of mHealth apps.

Methods

We applied the established unified theory of acceptance and use of technology 2 (UTAUT2) technology acceptance model to evaluate mHealth apps via an online questionnaire with 707 German participants. Moreover, trust and privacy concerns were added to the model and, in a between-subject study design, the influence of these predictors on behavioral intention to use apps was compared between lifestyle and therapy apps.

Results

The results show that the model only weakly predicted the intention to use mHealth apps (R²=0.019). Only hedonic motivation was a significant predictor of behavioral intentions regarding both app types, as determined by path coefficients of the model (lifestyle: 0.196, P=.004; therapy: 0.344, P<.001). Habit influenced the behavioral intention to use lifestyle apps (0.272, P<.001), while social influence (0.185, P<.001) and trust (0.273, P<.001) predicted the intention to use therapy apps. A further exploratory correlation analysis of the relationship between user factors on behavioral intention was calculated. Health app familiarity showed the strongest correlation to the intention to use (r=0.469, P<.001), stressing the importance of experience. Also, age (r=–0.15, P=.004), gender (r=–0.075, P=.048), education level (r=0.088, P=.02), app familiarity (r=0.142, P=.007), digital health literacy (r=0.215, P<.001), privacy disposition (r=–0.194, P>.001), and the propensity to trust apps (r=0.191, P>.001) correlated weakly with behavioral intention to use mHealth apps.

Conclusions

The results indicate that, rather than by utilitarian factors like usefulness, mHealth app acceptance is influenced by emotional factors like hedonic motivation and partly by habit, social influence, and trust. Overall, the findings give evidence that for the health care context, new and extended acceptance models need to be developed with an integration of user diversity, especially individuals’ prior experience with apps and mHealth.

Antecedents to the Adoption of Mobile Payment in China and Italy: an Integration of UTAUT2 and Innovation Resistance Theory

This research aims to investigate the adoption gap in mobile payment systems between Italy and China, focusing on users' intention to adopt mobile payment. The theoretical framing considers both drivers and barriers when combines the unified theory of acceptance and use of technology 2 (UTAUT2) with innovation resistance theory (IRT). To empirically verify the proposed model, this study gathers primary data through a web-based, self-administered survey. To analyze the data, we use structural equation modeling, and to test for significant differences between the two groups we run multi-group analysis. The respondents in Italy and China present different behaviors. Social influence plays a significant role in cultures with high uncertainty avoidance, such as Italy. The tradition barrier is the only significant barrier to the adoption of mobile payment.

Digital Exclusion During the COVID-19 Pandemic

During the COVID-19 pandemic, the reliance on digital services increased in most developed countries leaving many communities who are digitally excluded cut-off from vital services such as health and social care. Globally, digital exclusion is proposed to be one of the largest issues on discrimination within countries where smart cities and digital-by-default policies have been promoted, preventing certain groups of society from having access to public services. Addressing why people are being digitally excluded is important in improving the access people have to healthcare and other services that improve a person’s quality of life. Through a focused review of literature and publicly available secondary information, this paper examines the impact of Covid-19 on digital exclusion in Europe, Scandinavia, North America and Asia Pacific region and the methods that have been successful in limiting digital exclusion. Results show that while some countries handled the COVID 19 pandemic well, other countries’ attempts widened the gap with more people becoming digitally excluded.

Exploring Quality Differences in Telemedicine Between Hospital Outpatient Departments and Community Clinics: A Cross-Sectional Study

Background

Telemedicine is a care delivery modality that has the potential to broaden the reach and flexibility of health care services. In the United Arab Emirates, telemedicine services are mainly delivered through either integrated hospital outpatient department (OPDs) or community clinics. However, it is unknown if patients’ perceptions of, and satisfaction with, telemedicine services differ between these two types of health care systems during the COVID-19 pandemic.

Objective

We aimed to explore the differences in patients’ perceptions of, and satisfaction with, telemedicine between hospital OPDs and community clinics during the COVID-19 pandemic. We also aimed to identify patient- or visit-related characteristics contributing to patient satisfaction with telemedicine.

Methods

In this cross-sectional study that was conducted at Abu Dhabi health care centers, we invited outpatients aged 18 years or over, who completed a telemedicine visit during the COVID-19 pandemic, to participate in our study. Patients’ perceptions of, and satisfaction with, telemedicine regarding the two system types (ie, hospital OPDs and community clinics) were assessed using an online survey that was sent as a link through the SMS system. Regression models were used to describe the association between patient- and visit-related characteristics, as well as the perception of, and satisfaction with, telemedicine services.

Results

A total of 515 patients participated in this survey. Patients’ satisfaction with telemedicine services was equally high among the settings, with no statistically significant difference between the two setting types (hospital OPDs: 253/343, 73.8%; community clinics: 114/172, 66.3%; P=.19). Video consultation was significantly associated with increased patient satisfaction (odds ratio [OR] 2.57, 95% CI 1.04-6.33; P=.04) and patients’ support of the transition to telemedicine use during and after the pandemic (OR 2.88, 95% CI 1.18-7.07; P=.02). Patients who used video consultations were more likely to report that telemedicine improved access to health care services (OR 3.06, 95% CI 1.71-8.03; P=.02), reduced waiting times and travel costs (OR 4.94, 95% CI 1.15-21.19; P=.03), addressed patients’ needs (OR 2.63, 95% CI 1.13-6.11; P=.03), and eased expression of patients’ medical concerns during the COVID-19 pandemic (OR 2.19, 95% CI 0.89-5.38; P=.09). Surprisingly, middle-aged patients were two times more likely to be satisfied with telemedicine services (OR 2.12, 95% CI 1.09-4.14; P=.03), as compared to any other age group in this study.

Conclusions

These findings suggest that patient satisfaction was unaffected by the health system setting in which patients received the teleconsultations, whether they were at hospitals or community clinics. Video consultation was associated with increased patient satisfaction with telemedicine services. Efforts should be focused on strategic planning for enhanced telemedicine services, video consultation in particular, for both emergent circumstances, such as the COVID-19 pandemic, and day-to-day health care delivery.

Research Trend of the Unified Theory of Acceptance and Use of Technology Theory: A Bibliometric Analysis

Information technology-acceptance research has always been a research hotspot. In 2003, Venkatesh established the unified theory of acceptance and use of technology (UTAUT), which pushed information technology-acceptance research to a new climax. This study uses bibliometrics, Bibliometrix, and CiteSpace software to conduct data mining and quantitative analysis on 1694 research papers in the UTAUT in the Web of Science core collection database from 2003 to 2021 (the data update time is 13 August 2021). Combined with a visual bibliometric analysis, this paper makes an in-depth discussion on the UTAUT model from the aspects of research trends, research fields, main research journals, authors/institutions, national or regional cooperation networks, etc. This study comprehensively and systematically shows the evolution track and characteristics of the UTAUT. On this basis, the future development trend of the UTAUT is put forward.

Understanding nurses' perceptions of barriers and enablers to use of a new electronic medical record system in Australia: A qualitative study

BACKGROUND

Electronic medical record system implementations impact nurses, their work and workflows. The aim of this study was to understand nurses' perceptions of barriers and enablers to using a new electronic medical record in an acute hospital environment.

METHODS

Data were collected just prior to an organisation-wide new electronic medical record implementation at a large tertiary healthcare organization in Victoria, Australia. Sixty-three nurses from five hospital sites participated in 12 focus group interviews. Transcripts were transcribed and deductive content analysis used the 14-domain Theoretical Domains Framework to identify barriers and enablers.

RESULTS

Coded data mapped to 13 of the 14 domains. Nurse motivation emerged as a dominant theme among both barriers and enablers. Nurses' most common perceived barriers related to emotions (24.1%) and environmental context and resources (21.3%). Conversely, the most common enablers related to social influences (21%) and reinforcement (20.8%).

DISCUSSION

In addition to effecting changes in their work and workflows, the dominance of nurses' emotional responses reveals the potential for implementation of a new electronic medical record to negatively affect nurses' psychological well-being. Using data aligned to the Theoretical Domains Framework assisted identification of behavior change strategies to target the barriers and enablers perceived by nurses. Strategies aligned with nine behavioral intervention categories are recommended for successful implementation and optimization of an electronic medical record by nurses.

CONCLUSIONS

Multifaceted strategies targeting multiple behaviors are required to support adoption of the electronic medical record by nurses, and reduce the risk for nurse attrition in the workforce.

Adoption of electronic commerce by individuals in Bangladesh

With increased use of Internet and information technology platforms, e-commerce has experienced tremendous growth worldwide in the recent years. Although growing steadily in various digital services, Bangladesh has not been able to gain full advantages and benefits of e-commerce due to its poor adoption rate. This study aims at exploring the factors affecting e-commerce adoption in Bangladesh by applying an extended version of Unified Theory of Acceptance and Use of Technology (UTAUT) model which includes perceived risk, perceived cost and personal awareness with perceived usefulness, perceived ease of use, social influence, and facilitating conditions. This study applies a mixed methods research approach by combining qualitative field study and quantitative survey. A PLS based structural equation modeling is employed to a dataset of 253 individuals which are collected by applying a convenient sampling technique. The study results reveals that perceived usefulness, perceived cost, personal awareness and facilitating conditions affect consumer behavioral intention while facilitating conditions as well as behavioral intention have positive influence on actual use of e-commerce. This study also provides several implications that might be useful for the academic proponents, decision makers, and various stakeholders.

Enhancing Consumer Experience through Development of Implicit Attitudes Using Food Delivery Applications

In the context created by the COVID-19 pandemic, the aim of the research in this article is to highlight how the consumer experience is constructed, starting from the consumer’s attitudes—which we consider to be implicitly positive—and from the formation of habits of using mobile applications for food supply. Data were collected from 610 people—users of applications for food delivery in urban areas—in the spring of 2021, using a quantitative type of research in the form of a field survey based on questionnaire completion; for the model validation, we used confirmatory factor analysis. The online questionnaire link was sent out in April 2021, followed by the consumers’ completion of the questionnaire in the same month. The proposed theoretical model highlights the influence of variables that are specific for technology acceptance models on the perceived utility and development of implicit attitudes based on it, as well as the habits of using the application. The results of the research validate the proposed model, showing that attitudes in the form of an implicit-type attitudes developed in time are influencing habits and aid the development of a certain usage behavior depicted by a consumption experience that has specific content. Our paper contributes to a better understanding of the consumer experience development process within the context of technology acceptance in the field of food delivery services, emphasizing the importance of satisfying hedonic motivations as an integral part of the compensatory mechanisms determined by the effects of the pandemic.

Factors Influencing the Acceptance of Pediatric Telemedicine Services in China: A Cross-Sectional Study

Background: Pediatrician workforce shortages have aroused great attention from health authorities in China. Telemedicine services have been known to enhance the management of children's health, yet the rate of adoption and usage in Chinese hospitals still at a quite low level, and the factors influencing the acceptance of telemedicine services remains unclear. Objective: The purpose of this empirical study was to evaluate the reliability and validity of a technology acceptance measurement instrument applied in healthcare, to investigate the perception of telemedicine services on the provider-side and demand-side, and to determine the factors that may drive individuals to adopt telemedicine services. Methods: A cross-sectional survey study based at Shanghai Children's Hospital, Shanghai Jiao Tong University, was conducted in March 2020. A total of 456 valid responses were obtained by convenience sampling. The internal consistency of items was assessed by Cronbach's alpha (α), composite reliability (CR) and average variance extracted (AVE) to evaluate both the reliability and validity of the questionnaire. Structural equation modeling analysis was used to test and verify the interrelationships among relevant variables. Results: Price value is the strongest predictor (β = 0.30, p = 0.02), facilitating conditions (β = 0.28, p = 0.01) and hedonic motivation (β = 0.13, p = 0.04) also have significantly positive direct effects on telemedicine acceptance. The results showed the perception of child patients' families were significantly more acceptable to telemedicine services than pediatricians (t = -2.99, p < 0.01). Participants with no prior experience and lower education may be more willing to adopt telemedicine. Conclusion: Telemedicine will likely continue to have an integral role in pediatric health care delivery, and the findings can assist policy makers and hospital administrators in determining the more valued characteristics of telemedicine services from a behavioral perspective. Future attention will be paid to the pricing, training and service quality of telemedicine in China.

Advancing the Understanding of the Role of Responsible AI in the Continued Use of IoMT in Healthcare

This paper examines the continuous intention by healthcare professionals to use the Internet of Medical Things (IoMT) in combination with responsible artificial intelligence (AI). Using the theory of Diffusion of Innovation (DOI), a model was developed to determine the continuous intention to use IoMT taking into account the risks and complexity involved in using AI. Data was gathered from 276 healthcare professionals through a survey questionnaire across hospitals in Bahrain. Empirical outcomes reveal nine significant relationships amongst the constructs. The findings show that despite contradictions associated with AI, continuous intention to use behaviour can be predicted during the diffusion of IoMT. This study advances the understanding of the role of responsible AI in the continued use of IoMT in healthcare and extends DOI to address the diffusion of two innovations concurrently.

Where’s the tech in sex research? A brief critique and call for research

Internet and data-based technologies are ubiquitous in most societies around the world. People use online technologies (i.e., devices, software, platforms, applications, etc., that connect to the Internet through wired or wireless means) in almost all aspects of their daily lives, including sexuality. Yet, researchers have been slow to integrate online technologies in sexuality studies. The purpose of this paper is to briefly review the opportunities and challenges associated with integrating research about online technology with research about human sexuality. We argue that researchers focused on (almost) all topics of human sexuality would benefit from considering online technologies in their studies. We describe how people’s online and in-person experiences do not exist in separate vacuums; rather, they influence and are influenced by one another in an ongoing and dynamic fashion. We propose three ways that sexuality researchers can integrate technology and technology-informed research in their future studies that address some of the opportunities and challenges: adding variables and constructs, using technology-focused theories, and collaboration.

Social Media Use of Small Wineries in Alsace: Resources and Motivations Analysis

Social media (SM) plays an increasingly important role in small and medium businesses, including wineries. However, little is known about the managerial adoption and use of SM by wineries. This study aims to understand wineries’ SM usage by analysing their strategic objectives of SM usage and main differences in relation to their SM usage, as well as establishing factors contributing to SM usage. The unified theory of acceptance and use of technology (UTAUT) framework (performance expectancy, effort expectancy, social influence, and facilitating conditions) is discussed together with additional explanatory factors relevant in the studied context (attitude toward SM, self-efficacy, and anxiety). A quantitative survey of 78 wineries from the Alsace wine region of France was conducted. The results show that SM is currently used by a majority of wineries, but that strategic alignment is missing. There are significant differences in SM usage according to winery size, export orientation, and winemakers’ profiles. The results also confirm that wineries need resources and knowledge to use SM more extensively.