Does gender matter? Exploring perceptions regarding health technologies among employees and students at a medical university

Analysis of willingness to use health management APP for female college students: application of UTAUT model based on Fogg theory

Introduction

As the development process of medical industry informatization has entered the stage of smart healthcare, health management applications (apps) have played an important role in improving people's health and preventing diseases, especially among female college students.

Methods

This study combines the UTAUT model and the Fogg behavioral model (FBM) as a theoretical framework to investigate the factors affecting female college students' willingness to use health management apps. A survey was conducted with 624 female college students regarding their usage of AI health management mobile applications.

Results

The analysis reveals that social influence (β = 0.497, p < 0.001), performance expectancy (β = 0.268, p < 0.001), effort expectancy (β = 0.359, p < 0.001), and facilitating conditions (β = 0.603, p < 0.001) positively predict attitude; social influence (β = 0.36, p < 0.001) and effort expectancy (β = 0.183, p < 0.001) positively predict perceived risk, while facilitating conditions negatively predict perceived risk (β = -0.108, p < 0.01). Additionally, performance expectancy (β = 0.231, p < 0.001), effort expectancy (β = 0.285, p < 0.001), facilitating conditions (β = 0.25, p < 0.01), and attitude (β = 0.291, p < 0.05) positively predict an individual's intention to use such applications, which in turn affects actual behavior (β = 0.804, p < 0.001).

Discussion

This study develops a comprehensive theoretical framework to explore the psychological and social factors influencing female college students' utilization of health management applications. The findings underscore the significant roles of social influence, performance expectancy, effort expectancy, and facilitating conditions in shaping user attitudes and intentions. These insights offer valuable guidance for formulating effective interventions to enhance the adoption of these applications.

Exploring female fitness app users' motivations and perceptions: A qualitative study

BACKGROUND

Women make up nearly 60% of fitness App users and play an important role in the operation and development of these Apps. Despite the widespread adoption of fitness Apps in recent years due to their many physical and mental benefits, the use of Apps tends to be short-term, and user engagement is relatively low. Little is known about the factors that motivate female users to consistently use fitness Apps. This study aimed to study attributes of fitness Apps that are most likely to influence female users during their use of Apps.

METHODS

The means-ends chain theory and the soft-laddering interview technique were used to analyze the attributes that influenced females' perceptions of fitness apps, focusing on the features most likely to provide them with benefits and value.

RESULT

The results of the study indicated that instructiveness, interaction, personalization, ease of use, and convenience were the most important attributes valued by female fitness App users; peer support, entertainment, and exercise adherence were the most important consequences; and health, self-fulfillment, enjoyment of life and sense of achievement were the most important values.

CONCLUSION

The findings provide researchers and management of fitness Apps and women's sports with valuable insights from the means-ends chain theory, as well as suggestions for applying App design and promotion.

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.

Effect of m-Health-Based Interventions on Blood Pressure: An Updated Systematic Review with Meta-Analysis

Background: In recent years, the integration of mobile health (m-Health) interventions has garnered increasing attention as a potential means to improve blood pressure (BP) management in adults. This updated systematic review with meta-analysis aimed to identify the effect of m-Health-based interventions on BP in adults and to evaluate the effect of m-Health on BP according to the characteristics of subjects, interventions, and countries. Methods: The search was carried out in PubMed, Embase, ResearchGate, and Cochrane databases in January 2022. Study selection and data extraction were performed by two independent reviewers. For analysis, random effects models were used with a confidence interval (CI) of 95% and p < 0.05. Results: Fifty studies were included in this review and in the meta-analysis. Interventions with m-Health reduced systolic BP in 3.5 mmHg (95% CI -4.3; -2.7; p < 0.001; I2 = 85.8%) and diastolic BP in 1.8 mmHg (95% CI -2.3; -1.4; p < 0.001; I2 = 78.9%) compared to usual care. The effects of m-Health interventions on BP were more evident in men and in older adults, in interventions lasting 6-8 weeks, with medication reminders, with the possibility of insertion of BP values (p < 0.05). Conclusion: The results of this study support the effectiveness of m-Health in reducing BP when compared to standard care. However, these effects are dependent on the characteristics of the subjects and interventions. Given the substantial heterogeneity among the results of this systematic review with meta-analysis, its interpretation should be cautious. Future research on this topic is warranted.

How to Encourage Continuous Use of Fitness Apps among Female Users?

The proportion of women engaging in insufficient physical activity is higher than that of men, and they may face greater barriers. Fitness apps, as effective tools for behavior change, can significantly promote active physical activity among women. Notably, women constitute over 60% of fitness app users. However, few studies have focused on the reasons behind the continuous use of fitness apps by female users. This study investigates the impact of different perceived values on the satisfaction and continuance intention of female fitness app users. A total of 395 female fitness app users from Guangzhou, China, participated in this study. The results indicate that hedonic value (β = 0.190, p < 0.001), utilitarian value (β = 0.171, p = 0.007), and health value (β = 0.440, p < 0.001) significantly and positively influence the satisfaction of female fitness app users. However, only utilitarian value (β = 0.135, p = 0.018) and health value (β = 0.436, p < 0.001) have a significant positive impact on the continuance intention, while hedonic value (β = 0.028, p = 0.547) does not. Additionally, satisfaction mediates the relationship between utilitarian and health values and continuance intention. Therefore, the design of fitness apps should prioritize helping female users achieve utilitarian and health values rather than overemphasizing hedonic-value-related content.

The Appropriateness of Medical Devices Is Strongly Influenced by Sex and Gender

Until now, research has been performed mainly in men, with a low recruitment of women; consequentially, biological, physiological, and physio-pathological mechanisms are less understood in women. Obviously, without data obtained on women, it is impossible to apply the results of research appropriately to women. This issue also applies to medical devices (MDs), and numerous problems linked to scarce pre-market research and clinical trials on MDs were evidenced after their introduction to the market. Globally, some MDs are less efficient in women than in men and sometimes MDs are less safe for women than men, although recently there has been a small but significant decrease in the sex and gender gap. As an example, cardiac resynchronization defibrillators seem to produce more beneficial effects in women than in men. It is also important to remember that MDs can impact the health of healthcare providers and this could occur in a sex- and gender-dependent manner. Recently, MDs' complexity is rising, and to ensure their appropriate use they must have a sex-gender-sensitive approach. Unfortunately, the majority of physicians, healthcare providers, and developers of MDs still believe that the human population is only constituted by men. Therefore, to overcome the gender gap, a real collaboration between the inventors of MDs, health researchers, and health providers should be established to test MDs in female and male tissues, animals, and women.

Designing Telemedicine for Older Adults With Multimorbidity: Content Analysis Study

BACKGROUND

Telemedicine is a potential option for caring for older adults with multimorbidity. There is a need to explore the perceptions about telemedicine among older adults with multimorbidity to tailor it to the needs of older adults with multiple chronic conditions.

OBJECTIVE

This study aims to explore the perceptions about telemedicine among older patients with multimorbidity.

METHODS

A qualitative study was conducted using semistructured interviews. The interview questions examined older adults' perspectives about telemedicine, including their expectations regarding telemedicine services and the factors that affect its use. Thematic analysis was performed using NVivo (version 12; Lumivero). The study was reported using the Standards for Reporting Qualitative Research guidelines.

RESULTS

In total, 29 patients with multimorbidity-21 (72%) female patients and 8 (28%) male patients with a mean age of 69 (SD 10.39) years-were included. Overall, 4 themes and 7 subthemes emerged: theme 1-perceived benefit of telemedicine among older adults with multimorbidities, theme 2-appropriate use of telemedicine for multimorbid care, theme 3-telemedicine system catering to the needs of older patients, and theme 4-respect patients' decision to decline to use telemedicine.

CONCLUSIONS

Telemedicine for older adults with multimorbidity should focus on those with stable conditions. This can help increase access to care for those requiring continuous condition monitoring. A structured telemedicine program and patient-centered services can help increase patient acceptance of telemedicine. However, health care providers must accept the limitations of older patients that may prevent them from receiving telemedicine services.

Awareness and level of digital literacy among students receiving health-based education

BACKGROUND

Being digitally literate allows health-based science students to access reliable, up-to-date information efficiently and expands the capacity for continuous learning. Digital literacy facilitates effective communication and collaboration among other healthcare providers. It helps to navigate the ethical implications of using digital technologies and aids the use of digital tools in managing healthcare processes. Our aim in this study is to determine the digital literacy level and awareness of our students receiving health-based education in our university and to pave the way for supporting the current curriculum with courses on digital literacy when necessary.

METHOD

Students from Acibadem University who were registered undergraduate education for at least four years of health-based education, School of Medicine, Nutrition and Dietetics, Nursing, Physiotherapy and Rehabilitation, Psychology, Biomedical Engineering, Molecular Biology, and Genetics were included. The questionnaire consisted of 24 queries evaluating digital literacy in 7 fields: software and multimedia, hardware and technical problem solving, network and communication/collaboration, ethics, security, artificial intelligence (A.I.), and interest/knowledge. Two student groups representing all departments were invited for interviews according to the Delphi method.

RESULTS

The survey was completed by 476 students. Female students had less computer knowledge and previous coding education. Spearman correlation test showed that there were weak positive correlations between the years and the "software and multimedia," "ethics," "interest and knowledge" domains, and the average score. The students from Nursing scored lowest in the query after those from the Nutrition and Dietetics department. The highest scores were obtained by Biomedical Engineering students, followed by the School of Medicine. Participants scored the highest in "network" and "A.I." and lowest in "interest-knowledge" domains.

CONCLUSION

It is necessary to define the level of computer skills who start health-based education and shape the curriculum by determining which domains are weak. Creating an educational environment that fosters females' digital knowledge is recommended. Elective courses across faculties may be offered to enable students to progress and discuss various digital literacy topics. The extent to which students benefit from the digital literacy-supported curriculum may be evaluated. Thus, health-based university students are encouraged to acquire the computer skills required by today's clinical settings.

REGISTRATION

This study was approved by Acıbadem University and Acıbadem Healthcare Institutions Medical Research Ethics Committee (ATADEK) (11 November 2022, ATADEK registration: 2022-17-138) All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from the participants.

Factors Associated with Avoiding Referrals by Dental Teleconsulting Sessions in Brazil

This cross-sectional analytical study assessed the frequency of avoided referrals of primary care to other care levels by dental teleconsulting and its association with individual and contextual variables using a multilevel approach. It appraised asynchronous dental teleconsulting sessions from the secondary database of the Monitoring and Evaluation System of the Telehealth Results during 2020, during the COVID-19 pandemic. The outcome was "whether referral to secondary care was avoided". Individual variables were related to teleconsulting and professionals that requested it: sex, dental specialty, and dentistry field. Contextual variables were related to each municipality that requested responses: Municipal Human Development Index, oral health teams (OHTs) in primary health care coverage, dental specialty centers coverage, illiteracy rate, Gini index, longevity, and per capita income. A descriptive analysis was made using the Statistical Package for the Social Sciences. Hierarchical Linear and Nonlinear Modeling software was used to perform multilevel analyses to assess the association of individual and contextual variables with avoiding patient referral to other care levels. Most teleconsulting sessions avoided patient referral to other care levels (65.1%). Contextual variables explained 44.23% of the variance in the outcome. Female dentists were more likely to avoid patient referrals than male dentists (OR = 1.74; CI = 0.99-3.44; p = 0.055). In addition, an increase of one percentage point in OHT/PHC coverage of municipalities increased the likelihood of avoiding patient referral by 1% (OR = 1.01; CI = 1.00-1.02; p = 0.02). Teleconsulting sessions efficiently avoided patient referral to other care levels. Both contextual and individual factors were associated with avoided referrals by teleconsulting sessions.

Teleconsultation management in healthcare during the COVID-19 pandemic: The impact of Perceived Justice on satisfaction and Word-Of-Mouth

Following the restrictions on movement imposed during the COVID-19 pandemic, the greater demands placed on physicians and many healthcare infrastructures, a large number of health teleconsultation platforms have emerged around the world. The aim of this paper is to obtain a better understanding of the acceptance of teleconsultation platforms by patients. To this end, a survey of 1273 patients was carried out using a teleconsultation platform during the pandemic period in France (from 9 July to 29 October 2020). The questionnaire mobilized existing scales to measure Satisfaction, Perceived Justice and, finally, the intention to disseminate by Word-Of-Mouth (WOM). Data were analysed using a Partial Least Squares approach. The study confirms the impact of Distributive, Informational and Procedural Justice on Satisfaction and the impact of Distributive and Informational Justice on WOM. The findings emphasize the influence of Satisfaction on WOM. The results detect a mediating effect of Satisfaction on WOM and moderating effects of gender, age and long-standing use. This research contributes to both theoretical and practical COVID-19 research and may be used by healthcare professionals to develop teleconsultation services, one of the means of supporting interaction and satisfying patients’ treatment requirements during the pandemic.

Medical Students and Their Perceptions of Digital Medicine: a Question of Gender?

Digital technologies play an essential role in the medical sector of today and the future. In a cross-sectional online survey at a German medical university, male students more frequently reported keeping themselves informed about digital medicine outside of their studies across all clinical years of study. While female students self-assessed their knowledge in different fields of digital medicine as worse than their male peers in the first clinical years of study, no more gender differences could be found towards the final year. However, students of both genders showed a strong desire for further education on the topic of digital medicine.

The Drivers of Acceptance of Artificial Intelligence–Powered Care Pathways Among Medical Professionals: Web-Based Survey Study

Background

The emergence of Artificial Intelligence (AI) has been proven beneficial in several health care areas. Nevertheless, the uptake of AI in health care delivery remains poor. Despite the fact that the acceptance of AI-based technologies among medical professionals is a key barrier to their implementation, knowledge about what informs such attitudes is scarce.

Objective

The aim of this study was to identify and examine factors that influence the acceptability of AI-based technologies among medical professionals.

Methods

A survey was developed based on the Unified Theory of Acceptance and Use of Technology model, which was extended by adding the predictor variables perceived trust, anxiety and innovativeness, and the moderator profession. The web-based survey was completed by 67 medical professionals in the Netherlands. The data were analyzed by performing a multiple linear regression analysis followed by a moderating analysis using the Hayes PROCESS macro (SPSS; version 26.0, IBM Corp).

Results

Multiple linear regression showed that the model explained 75.4% of the variance in the acceptance of AI-powered care pathways (adjusted R2=0.754; F9,0=22.548; P<.001). The variables medical performance expectancy (β=.465; P<.001), effort expectancy (β=–.215; P=.005), perceived trust (β=.221; P=.007), nonmedical performance expectancy (β=.172; P=.08), facilitating conditions (β=–.160; P=.005), and professional identity (β=.156; P=.06) were identified as significant predictors of acceptance. Social influence of patients (β=.042; P=.63), anxiety (β=.021; P=.84), and innovativeness (β=.078; P=.30) were not identified as significant predictors. A moderating effect by gender was found between the relationship of facilitating conditions and acceptance (β=–.406; P=.09).

Conclusions

Medical performance expectancy was the most significant predictor of AI-powered care pathway acceptance among medical professionals. Nonmedical performance expectancy, effort expectancy, perceived trust, and professional identity were also found to significantly influence the acceptance of AI-powered care pathways. These factors should be addressed for successful implementation of AI-powered care pathways in health care delivery. The study was limited to medical professionals in the Netherlands, where uptake of AI technologies is still in an early stage. Follow-up multinational studies should further explore the predictors of acceptance of AI-powered care pathways over time, in different geographies, and with bigger samples.

Willingness of French General Practitioners to Prescribe mHealth Apps and Devices: Quantitative Study

Background

The field of mobile health (mHealth) is constantly expanding. Integrating mHealth apps and devices in clinical practice is a major and complex challenge. General practitioners (GPs) are an essential link in a patient’s care pathway. As they are patients’ preferred health care intermediaries, GPs play an important role in supporting patients’ transition to mHealth.

Objective

This study aims to identify the factors associated with the willingness of French GPs to prescribe mHealth apps and devices to their patients.

Methods

This study was part of the ApiAppS project whose overall objective was to help remove barriers GPs face when prescribing mHealth apps and devices by developing a custom-built platform to aid them. The study included GPs recruited from the general practice department of several medical faculties in France (Lyon, Nice, and Rouen) and mailing lists of academic GPs, health care professional associations, and social and professional networks. Participants were asked to complete a web-based questionnaire that collected data on various sociodemographic variables, indicators of their involvement in continued education programs and the amount of time they dedicated to promoting healthy behaviors during patient consultations, and indicators characterizing their patient population. Data on their perceptions of mHealth apps and devices were also collected. Finally, the questionnaire included items to measure GPs’ acceptability of prescribing mHealth apps and devices for several health-related dimensions.

Results

Of the 174 GPs, 129 (74.1%) declared their willingness to prescribe mHealth apps and devices to their patients. In multivariate analysis, involvement in continued education programs (odds ratio [OR] 6.17, 95% CI 1.52-28.72), a better patient base command of the French language (OR 1.45, 95% CI 1.13-1.88), GP-perceived benefits of mHealth apps and devices for both patients and their medical practice and GP-perceived drivers for mHealth apps and device implementation in their medical practice (OR 1.04, 95% CI 1.01-1.07), and validation of mHealth apps and devices through randomized clinical trials (OR 1.02, 95% CI 1.00-1.04) were all associated with GPs’ willingness to prescribe mHealth apps and devices. In contrast, older GPs (OR 0.95, 95% CI 0.91-0.98), female GPs (OR 0.26, 95% CI 0.09-0.69), and those who perceived risks for the patient or their medical practice (OR 0.96, 95% CI 0.94-0.99) were less inclined to prescribe mHealth apps and devices.

Conclusions

mHealth apps and devices were generally seen by GPs as useful in general medicine and were, for the most part, favorable to prescribing them. Their full integration in general medicine will be conditioned by the need for conclusive certification, transparency (reliable and precise data concerning mHealth app and device methods of construction and clinical validation), software aids to assist GPs prescribe them, and dedicated training programs.

Electronic healthcare applications and programs among healthcare workers in Riyadh and conflict management

Objective

Electronic healthcare applications and programmes enable the use of computers, networks, and information technology to improve healthcare quality and patient safety, and secure confidential access to health information in order to enable individuals and communities to make the best possible health decisions. We study conflicts challenging users of e-health electronic applications and programmes in Riyadh.

Methods

We use a cross-sectional descriptive design to target all healthcare professionals who interact with e-health applications and programmes. Healthcare providers took a questionnaire survey online.

Results

Of the 169 responses to our questionnaire, 78.1% are female, and 46.2% are aged between 31 and 40 years. As many as 59.2% always use these applications, and 33.7% use them occasionally. Only 7.10% of the participants rarely or never use them. As many as 31.4% recognized that these applications led to conflicts at the workplace. Of these, 50.6%, 13.6%, and 35.8% stated that they caused decision-related, ethical, and other types of conflicts, respectively.

Conclusion

We conducted this study among healthcare providers in Riyadh, KSA, and found that the use of e-health applications and programmes encountered some difficulties.

Medical students’ intention to integrate digital health into their medical practice: A pre-peri COVID-19 survey study in Canada

Objective

We aimed to explore the factors that influence medical students’ intention to integrate dHealth technologies in their practice and analyze the influence of the COVID-19 pandemic on their perceptions and intention.

Methods

We conducted a two-phased survey study at the University of Montreal's medical school in Canada. The study population consisted of 1367 medical students. The survey questionnaire was administered in two phases, that is, an initial survey (t₀) in February 2020, before the Covid-19 pandemic, and a replication survey (t₁) in January 2021, during the pandemic. Component-based structural equation modeling (SEM) was used to test seven research hypotheses.

Results

A total of 184 students responded to the survey at t₀ (13%), whereas 138 responded to the survey at t₁ (10%). Findings reveal that students, especially those who are in their preclinical years, had little occasion to experiment with dHealth technologies during their degree. This lack of exposure may explain why a vast majority felt that dHealth should be integrated into medical education. Most respondents declared an intention to integrate dHealth, including AI-based tools, into their future medical practice. One of the most salient differences observed between t₀ and t₁ brings telemedicine to the forefront of medical education. SEM results confirm the explanatory power of the proposed research model.

Conclusions

The present study unveils the specific dHealth technologies that could be integrated into existing medical curricula. Formal training would increase students’ competencies with these technologies which, in turn, could ease their adoption and effective use in their practice.

Fitness and the Crisis: Impacts of COVID-19 on Active Living and Life Satisfaction in Austria

The COVID-19 pandemic has dramatically impacted human lifestyles across the world. Lockdowns and home confinement decreased prior opportunities for everyday physical activity. To retrospectively assess how the Austrian population coped with these aspects of the crisis, we conducted a cross-sectional online survey from March to September 2021 using a structured questionnaire in German. In total, 1214 participants (56.9% females, mean age 37.0 years) living across Austria shared self-reported information on sociodemographic characteristics, indoor and outdoor physical activity, reasons for being outdoors, and life satisfaction before and after the emergence of the virus. As a result, overall indoor physical activity significantly decreased in a before–during COVID-19 crisis comparison, although exercising at home with online instructions increased by about 63%. Exercising outdoors increased overall, specifically in periurban forests and rural areas, both by about 9%. Life satisfaction decreased significantly by 19.7% (p < 0.001). Outdoor public places and natural environments gained importance due to restrictions affecting access to sport facilities. Further research is needed to evaluate benefits and therapeutic values of outdoor nature for physical and mental health in times of a global pandemic to maintain resilient societies, as it might impact future active living and life satisfaction.

Insights Into the Older Adults' World: Concepts of Aging, Care, and Using Assistive Technology in Late Adulthood

The ongoing demographic change forces different stakeholders to cope with increasing needs in nursing care and the economic costs. Consequences arising from the population aging can be supported by assistive technologies to maintain older individuals' autonomy. However, older adults' opinions on the assistance of health-related technologies and their attitudes toward aging and care largely remain underexplored. This paper provides a geriatric and socio-technical perspective, investigating individual perceptions of (a) aging, (b) nursing care, and (c) the adoption of assistive technologies in a cross-national subject group. For this purpose, N = 384 individuals (60+ years) participated in an online survey. Findings indicate that most older adults are open to assistive technologies and that individual care preferences contribute to a successful adoption of these technologies. Among individual factors, health status, and gender affect respondents' opinions the most. Our findings help to understand older adults' acceptance of assistive technologies and contribute to the research on the nursing care in private and professional environments.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Evaluation of e-health (Seha) application: a cross-sectional study in Saudi Arabia

BACKGROUND

The Ministry of Health in Saudi Arabia is expanding the country's telemedicine services by using advanced technology in health services. In doing so, an e-health application (app), Seha, was introduced in 2018 that allows individuals to have face-to-face visual medical consultations with their doctors on their smartphones.

OBJECTIVE

This study evaluated the effectiveness of the app in improving healthcare delivery by ensuring patient satisfaction with the care given, increasing access to care, and improving efficiency in the healthcare system.

METHODS

A cross-sectional study design was used to assess the perceptions of users of the Seha app and non-users who continued with traditional health services. The data were collected using an online survey via Google Forms between June 2020 and September 2020. Independent t tests and chi-square (χ2) tests were conducted to answer the research questions.

RESULTS

There was a significant difference between users and non-users in terms of ease of access to health services (t =  - 9.38, p < 0.05), with app users having a higher mean score (4.19 ± 0.91) than non-users (3.41 ± 1.00); satisfaction with health services (t =  - 6.33, p < 0.05), with users having a higher mean score (3.96 ± 0.91) than non-users (3.45 ± 0.94); and efficiency (only one visit needed for treatment) (t =  - 3.20, p < 0.05), with users having a higher mean score (3.71 ± 0.93) than non-users (3.45 ± 0.93). There were significant associations between the use of the Seha app and age (χ2 = 8.79, p < 0.05), gender (χ2 = 22.19, p < 0.05), region (χ2 = 19.74, p < 0.05), and occupation (χ2 = 22.05, p < 0.05). There were significant relationships between the three items (on access, satisfaction, and efficiency) and experiencing technical issues (t = 4.47, t = 8.11, and t = 3.24, respectively, p < 0.05), with users who faced technical problems having significantly lower mean scores for all three items.

CONCLUSION

This study provided evidence that the Seha app improved the delivery of healthcare in Saudi Arabia. Users of the app had a better health experience in terms of their perceived ease of access to healthcare services; their satisfaction with healthcare services; and the efficiency of the system, measured by the number of required doctor visits. Other factors that appeared to influence the use of the app included age, gender, usual source of care, and technical difficulties.

Medical Students Respond: Question Precision and Gender Differentiation. Comment on "Understanding Medical Students' Attitudes Toward Learning eHealth: Questionnaire Study"

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Perceptions of Practitioners on Telehealth and App Use for Smoking Cessation and COPD Care-An Exploratory Study

Background and objectives: With the digitalization of modern healthcare delivery, digital media adoption in clinical practice is increasing. Also, healthcare professionals are more and more confronted with patients using smartphone-based health applications (apps). This exploratory study aimed at surveying perceptions on such apps in the context of lung health among a cross section of Austrian practitioners involved in pulmonary care. Materials and Methods: The online questionnaire in German assessed socio-demographic characteristics, telehealth readiness as well as opinions on smoke-free and COPD (chronic obstructive pulmonary disease) apps. We used descriptive statistics to report the finding. Results: We received valid responses from 55 participants (mean age 52.3 years, 69.1% males). Telehealth readiness was medium, indicating existence of certain barriers adversely impacting telehealth use. As for apps targeting smoking cessation and COPD, respondents indicated high relevance for visualization aspects for patients and control/overview features for the treating doctors. Only 40% of participants indicated that they would recommend a COPD app to an older patient. Conclusions: In smoking cessation therapy, doctors commonly adhere to the “5 A’s”: Ask, Advise, Assess, Assist, and Arrange. We suggest adding “App” as sixth A, assuming that in patient follow-up most of the other A’s could also be supported or even replaced by app features in the challenging task to tackle smoking-associated non-communicable diseases.

The Quantified Woman: Exploring Perceptions on Health App Use among Austrian Females of Reproductive Age

Smartphones have become the most important commodity for today’s digitalized society. Besides direct interpersonal communication, their most used features are third-party applications (apps). Apps for monitoring health parameters (health apps) are extremely popular, and their users are part of the Quantified Self movement. Little knowledge is available on how health apps are perceived by a female target audience, the Quantified Woman. We conducted a study among Austrian females of reproductive age (n = 150) to analyze prevalence, perceived benefits, and readiness for health app use. In the cross-sectional online German survey, nearly all participants used these apps (98.0%), predominantly for monitoring physical activity and female health (both 31.3%). For the latter, participants used a large variety of different apps for monitoring contraception and menstruation. Perceived benefits and readiness of health app use were only of medium range. Our study assessed aspects of health app use in an understudied segment of the general population. From a Public Health perspective, the Quantified Woman could be empowered by health data collection by enabling her to take active control over how her health graphs develop. We suggest assuring data security and privacy for sensitive female health data collected by health apps.

Mobile and Online Health Information: Exploring Digital Media Use among Austrian Parents

In today’s digitalized world, most parents are Internet-savvy and use online sources for child health information, mainly due to the 24/7 availability of advice. However, parents are often not specifically trained to identify reliable, evidence-based sources of information. In this cross-sectional online survey among a purposive, non-probabilistic sample of Austrian parents (n = 90, 81.1% females), we assessed aspects of health app use and family policy benefits-related and scenario-based Internet seeking behavior. We found that the surveyed parents showed a high health app use. The participants indicated that they prefer online information seeking to any other option in a scenario describing that their child would be sick at after-work hours, with social media channels being the least preferred source of online information. Mothers and younger parents were more likely to retrieve online information on family policy benefits. With the smartphone in everybody’s pocket, parents seemed to rely on mobile and online content when searching for child health information. Pediatricians are best suited to decide what treatment fits the child or their current medical condition, but nowadays they face increasing numbers of pre-informed parents seeking health information online. Provision of targeted parental education and guidance through the online information jungle could effectively empower parents and smooth personal and digital contacts in the delicate doctor–parent–child triangle.

Dentists’ Self-perception on Teledentistry: The Changing Landscape Driven by Technological Booming in the 21stCentury

Aim:

Teledentistry has gained popularity worldwide because it is cost-effective and increase accessibility to dental healthcare. This study assessed the self-perceptions of teledentistry among dental practitioners in Saudi Arabia and examinedany gender-related differences.

Methods:

This cross-sectional study was conducted between January and December 2017 and recruited a convenience sample of dental practitioners, whose self-perceptions of the practice-related use of teledentistry were assessed viaateledentistry survey (TDS). The TDS consisted off our sections:efficiency in patient care, cost reduction,capabilities forimproving practice, and security and confidentiality.Data analyseswere conducted throughdescriptive statistics,internalreliability tests(Cronbach’s alpha), andchi-squaredtests of the TDS.

Results:

The response rate was 620/800(78%). Most respondents were female (62%), and 58% of themworked in the public sector. The internal reliability of the TDS was 0.85 for the whole sampleand 0.85 and 0.90 for males and females, respectively. Among the entire sample, 51% agreed that teledentistry reduced potential cost, and 65% reported shortened waitlists. More females (42%, p<0.001) than males (22%) agreed that teledentistry could help monitor a patient’s condition.More females (35%) than males (13%, p<0.001) considered that teledentistry would require additional appointments for imaging. More females(29%, p=0.0001) than males (22%) expressed great concern aboutpotential violations of confidentiality.

Conclusion:

These findings suggest thatteledentistry in dental practiceis well perceived by practitioners in Saudi Arabia. Gender differences in perceptions are linked to certain aspects of teledentistry.

Willingness of Patients Prescribed Medications for Lifestyle-Related Diseases to Use Personal Health Records: Questionnaire Study

Background

Personal health record (PHR) systems let individuals utilize their own health information to maintain and improve quality of life. Using PHRs is expected to support self-management in patients with lifestyle-related diseases.

Objective

The aim of this study was to identify predictors of the willingness to use PHRs among patients who are prescribed medications for lifestyle-related diseases.

Methods

We recruited pharmacy patrons, aged 20 years or older, who had received at least one medication indicated for hypertension, dyslipidemia, or diabetes. Participants completed self-administered questionnaires regarding their previous diseases, awareness of health care, experience in using PHRs, willingness to use PHRs, and barriers to using PHRs. Data were analyzed using multivariate logistic regression models.

Results

Of the 3708 subjects meeting eligibility criteria, 2307 replies (62.22%) were collected. While only 174 (7.54%) participants had previous PHR experience, 853 (36.97%) expressed willingness to use PHRs. In the multivariate analysis, considering exercise to be important for health management (odds ratio [OR] 1.57, 95% CI 1.12-2.21; P=.009), obtaining medical information from books or magazines (OR 1.23, 95% CI 0.96-1.59; P=.10), and obtaining medical information from the internet (OR 1.45, 95% CI 1.13-1.87; P=.004) were newly identified predictors. These were in addition to known predictors, such as being employed, owning information terminals, and previous PHR experience.

Conclusions

Patients who have an active and positive attitude toward health seem to be more willing to use PHRs. Investigating willingness should contribute to the development of more useful PHRs for self-management among patients prescribed medications for lifestyle-related diseases.

Telemonitoring readiness among Austrian diabetic patients: A cross-sectional validation study

Digitalized healthcare services offer remote and cost-effective treatment of diabetes patients. Thus, the present online study analyzed the readiness to use telemonitoring among Austrian diabetes patients. We developed and validated a German version of the patient telehealth readiness assessment tool and performed quantitative context analysis of free-text comments on perceived barriers and benefits of telemonitoring. Participants (n = 41, 42.6% females) achieved a medium average readiness level for telemonitoring. The three top benefits were intensified care, shorter travel and waiting times, and better therapy adjustment. The top three barriers were data privacy issues, loss of personal communication and focus on blood sugar, and teledoctor competence. Diabetes patients represent a suitable target group for remote treatment opportunities. However, a shift from traditional face-to-face medical care to exclusive telemonitoring treatment from diagnosis to consultation and treatment requires fundamental new legal framework conditions.

Exploring perceptions on medical app use in clinical communication among Austrian physicians: Results of a validation study

Physicians increasingly use medical applications to facilitate clinical information management. The respective effect on clinical communication and quality of healthcare provision has not been studied in the Austrian context so far. Thus, the current cross-sectional online study analyzed prevalent medical applications use and views on clinical communication competence in everyday medical practice among Austrian physicians (n = 151) and validated the survey tool. More than half of the participants used medical applications in daily clinical practice. The top three benefits of medical applications use were higher quality of healthcare, location-independent health service access, and higher efficiency in healthcare resource allocation. Moreover, study participants felt that communication competence acquired during medical studies inadequately prepared them for daily clinical practices. Medical applications use certainly affects the therapeutic alliance between patients and physician. This study supports the importance of initiating an open, constructive discussion among healthcare stakeholders and developing according to evidence-based guidelines.