Virtual world continuance intention

Influence Mechanism of the Affordances of Chronic Disease Management Apps on Continuance Intention: Questionnaire Study

BACKGROUND

Mobile health apps are becoming increasingly popular, and they provide opportunities for effective health management. Existing chronic disease management (CDM) apps cannot meet users' practical and urgent needs, and user adhesion is poor. Few studies, however, have investigated the factors that influence the continuance intention of CDM app users.

OBJECTIVE

Starting from the affordances of CDM apps, this study aimed to analyze how such apps can influence continuance intention through the role of health empowerment.

METHODS

Adopting a stimulus-organism-response framework, an antecedent model was established for continuance intention from the perspective of perceived affordances, uses and gratifications theory, and health empowerment. Perceived affordances were used as the "stimulus," users' gratifications and health empowerment were used as the "organism," and continuance intention was used as the "response." Data were collected online through a well-known questionnaire survey platform in China, and 323 valid questionnaires were obtained. The theoretical model was tested using structural equation modeling.

RESULTS

Perceived connection affordances were found to have significant positive effects on social interactivity gratification (t₇₁₇=6.201, P<.001) and informativeness gratification (t₇₁₇=5.068, P<.001). Perceived utilitarian affordances had significant positive effects on informativeness gratification (t₇₁₇=7.029, P<.001), technology gratification (t₇₁₇=8.404, P<.001), and function gratification (t₇₁₇=9.812, P<.001). Perceived hedonic affordances had significant positive effects on function gratification (t₇₁₇=5.305, P<.001) and enjoyment gratification (t₇₁₇=13.768, P<.001). Five gratifications (t₇₁₇=2.767, P=.005; t₇₁₇=4.632, P<.001; t₇₁₇=7.608, P<.001; t₇₁₇=2.496, P=.012; t₇₁₇=5.088, P<.001) had significant positive effects on health empowerment. Social interactivity gratification, informativeness gratification, and function gratification had significant positive effects on continuance intention. Technology gratification and enjoyment gratification did not have a significant effect on continuance intention. Health empowerment had a significant positive effect on continuance intention. Health empowerment and gratifications play mediating roles in the influence of affordances on continuance intention.

CONCLUSIONS

Health empowerment and gratifications of users' needs are effective ways to promote continuance intention. The gratifications of users' needs can realize health empowerment and then inspire continuance intention. Affordances are key antecedents that affect gratifications of users' needs, health empowerment, and continuance intention.

Motivation and Continuance Intention towards Online Instruction among Teachers during the COVID-19 Pandemic: The Mediating Effect of Burnout and Technostress

In-service teachers have various emotional and motivational experiences that can influence their continuance intention towards online-only instruction during the COVID-19 pandemic, as a significant stress factor for their workplace. Derived from the Self-Determination Theory (SDT), Job Demands–Resources Model (JD–R), and Technology Acceptance Model (TAM), the present research model includes technological pedagogical knowledge (TPK) self-efficacy (SE), intrinsic (IM) and extrinsic (EM) work motivation, and occupational stress (OS) (i.e., burnout and technostress which have been examined in tandem) as key dimensions to explain the better continuance intention among in-service teachers to use online-only instruction (CI). Data for the research model were collected from 980 in-service teachers during the COVID-19 outbreak between April and May 2020. Overall, the structural model explained 70% of the variance in teachers’ CI. Motivational practices were directly and indirectly linked through OS with CI. The findings showed that IM has the most directly significant effect on teachers’ CI, followed by TPK-SE, and OS as significant, but lower predictors. IM was positively associated with TPK-SE and negatively associated with EM. The results offered valuable insights into how motivation constructs were related to OS and to a better understanding online instruction in an unstable work context, in order to support teachers in coping during working remotely.

Avatars and the Disease: Digital Customization as a Resource for Self-Perception Assessment in Breast Cancer Patients

Avatars, or users' renditions within digital environments, may change depending on modifications of users' self-conception. According to literature, chronic health conditions influence patients and survivors' identity, because living with a disease requires people to reconfigure their self-representation and their own daily life and future plans. This is especially true for breast cancer, whose treatment and surgery also affect patients' body image, sexual identity, and sense of womanhood. In this study, 22 breast cancer survivors were asked to create multiple avatars resembling their actual self (AS), their ideal self (IS), and their self connected to the disease experience; then, they were asked to rate their attitudes toward their three avatars. Results show that disease avatars are significantly different in patients' attitudes toward them from AS and IS avatars. In addition, attitudes toward one's own avatars appeared partially related to clinically relevant psychological states, such as anxiety and depression. Discussion explores suggestions for usage of avatars in interventions for assessment and quality-of-life promotion among chronic patients.