Acceptance and usage of mHealth technologies amid COVID-19 pandemic in a developing country: the UTAUT combined with situational constraint and health consciousness

Digital Health Intervention (SANGYAN Podcast) to Enhance Knowledge Related to COVID-19 and Other Health Conditions: Protocol for an Implementation and Evaluation Study

BACKGROUND

Podcasts are an unconventional method of disseminating information through audio to the masses. They are an emerging portable technology and a valuable resource that provides unlimited access for promoting health among participants. Podcasts related to health care have been used as a source of medical education, but there is a dearth of studies on the use of podcasts as a source of health information. This study will provide new perspectives by implementing the SANGYAN podcast, which contains information about COVID-19 and other health conditions.

OBJECTIVE

The study aims to determine the usefulness and effectiveness of the SANGYAN podcast as a digital health intervention to address misinformation related to COVID-19 and other health conditions among individuals in Chennai, Tamil Nadu, India.

METHODS

An implementation and evaluation study will be conducted with 500 participants from the Panimalar Medical College Hospital & Research Institute (PMCHRI) and Rural Health Training Centre in Chennai. Among individuals aged 18 years and older, those residing in the selected urban and rural settings who visit the outpatient department of the PMCHRI and Rural Health Training Centre will be recruited. For participants who consent to the study, their sociodemographic details will be noted and their health literacy will be assessed using the Rapid Estimate of Adult Literacy in Medicine scale. Once the participants have listened to the podcast, the usability, acceptance, and user satisfaction of the podcast will be assessed. Descriptive analysis will be used for continuous variables, and frequency analysis will be used for categorical variables. Bivariate analysis will be conducted to understand the correlation of sociodemographic features in response to perception, usefulness, acceptance, and user satisfaction of the podcast. All analysis will be performed using SPSS (version 24), and the results will be reported with 95% CIs and P<.05.

RESULTS

As of December 2024, the SANGYAN podcast has been launched for voluntary usage in the PMCHRI.

CONCLUSIONS

The finding from this research project will aid in the development and implementation of data-driven, evidence-based, and human-centered behavior change interventions using podcasts to address public health challenges among populations living in diverse settings. This would also help in enhancing the acceptability of podcasts as a source of health-related information.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/41175.

Factors driving the acceptance of COVID-19 pandemic mobile contact tracing apps: The influence of security and privacy concerns

The acceptance of COVID-19 mobile contact tracing apps (MCTA) is crucial to curb the spread of the virus and decrease the number of infections. However, the security and privacy concerns (SPC) of COVID-19 MCTA have been called into question. Thus this paper examines the drivers of the acceptance of the COVID-19 pandemic MCTA under the auspices of the influence of SPC from the Chinese perspective based on the modified Unified Theory of Acceptance and Usage of Technology (UTAUT) model. The data generated through a questionnaire based on the convenient sampling technique was analyzed with SPSS by performing hierarchical regression analysis. The results show that the core constructs of UTAUT such as performance expectancy (PE), facilitating conditions (FC), effort expectancy (EE), and social influence (SI) along with mobile self-efficacy (MSE) were significant predictors of individual user acceptance of COVID-19 MCTA. Additionally, the study confirmed that security and privacy concerns were significant in moderating the impact of PE, FC, EE, SI, and MSE on the acceptance of COVID-19 MCTA. The managerial and theoretical implications of these findings for policy-makers, governments, mobile app developers, and researchers are interrogated.

Nurses' continuance intention to use electronic health record systems: The antecedent role of personality and organisation support

Nurses play a crucial role in the adoption and continued use of Electronic Health Records (EHRs), especially in developing countries. Existing literature scarcely addresses how personality traits and organisational support influence nurses' decision to persist with EHR use in these regions. This study developed a model combining the Five-Factor Model (FFM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) to explore the impact of personality traits and organisational support on nurses' continuance intention to use EHR systems. Data were collected via a self-reported survey from 472 nurses across 10 public hospitals in Jordan and analyzed using a structural equation modeling approach (Smart PLS-SEM 4). The analysis revealed that personality traits, specifically Openness, Experience, and Conscientiousness, significantly influence nurses' decisions to continue using EHR systems. Furthermore, organisational support, enhanced by Performance Expectancy and Facilitating Conditions, positively affected their ongoing commitment to EHR use. The findings underscore the importance of considering individual personality traits and providing robust organisational support in promoting sustained EHR usage among nurses. These insights are vital for healthcare organisations aiming to foster a conducive environment for EHR system adoption, thereby enhancing patient care outcomes.

Social influence, performance expectancy, and price value as determinants of telemedicine services acceptance in Chile

Medicine is a discipline based on and nurtured by scientific research and technological development. The use of health services supported by information technology is increasing worldwide, and Latin America is no exception. Factors such as needing more specialists in peripheral cities, large geographic areas, and socio-cultural aspects limit the possibility of receiving timely and quality medical care services. Information Technology (IT) for health purposes, such as e-health, is a cost-effective solution for equitable access to quality healthcare services and optimization of the rising associated costs. As an e-health service, telemedicine facilitates and mediates distance communication between the patient and medical staff. Even though Latin America is at the beginning of the development of telemedicine, it would have a relevant impact, given the geographic and socioeconomic conditions of the population in this part of the world. Drawing on the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) theory, we developed a theoretical model to identify the latent factors influencing the public acceptance of telemedicine and examined their interrelationships. A survey questionnaire was designed and administered to 391 residents in Antofagasta, a mine region of Chile. After that, structural equation modeling was employed to analyze the survey data. The results reveal that the UTAUT2 factors' performance expectancy, social influence, and price value significantly impact the intention to use (R 2 = 0.693). Additionally, the model presented a good fit. This study enriches the existing theoretical research on the acceptance of telemedicine services and offers insights into understanding and managing technology in the Chilean health sector.

Examining Antecedents of Factual Knowledge and Perceived Familiarity of COVID-19 Contact Tracing App: A Modified Cognitive Mediation Model

This study employs a modified cognitive mediation model to investigate the role of health valuation and fear in shaping media attention, factual knowledge, and perceived familiarity with COVID-19 contact tracing apps. Data were collected from a national survey of 906 Singaporeans, and structural equation modeling was used to analyze the results. Findings indicated that both fear of COVID-19 and health valuation were positively associated with newspapers, television, and social media attention, with health valuation demonstrating a stronger association with each media type. This suggests that health valuation, as an intrinsic motivation, is more critical in information-seeking behavior related to emerging health technologies. However, media attention on all platforms did not correlate with factual knowledge of COVID-19 contact tracing apps, whereas attention to social media was positively associated with perceived familiarity with these apps. This result highlights the potential influence of social media in shaping public perceptions, warranting further investigation into the quality and accuracy of the information disseminated. News elaboration was found to have a positive association with both factual knowledge and perceived familiarity with COVID-19 contact tracing apps. This underscores the need for effective communication strategies to promote accurate understanding of health technologies and emphasizes the role of individual motivations in shaping media consumption and information processing.

Modeling the predictors of mobile health adoption by Rohingya Refugees in Bangladesh: An extension of UTAUT2 using combined SEM-Neural network approach

While the healthcare facilities for the people is questionable in Bangladesh, Rohingya refugees is a burning issue for both Bangladesh and global community. Integrating Rohingya refugees into the framework of mHealth could be beneficial for both Bangladesh and Rohingya refugees in general, and in specific situation like COVID-19 outbreak. However, no research has been found on what motivates Rohingya refugees to accept mHealth in Bangladesh. Drawing on the UTAUT2 model, this study investigates the predictors of acceptance of mHealth services technologies among Rohingya refugees. The study also seeks to clarify the roles of mHealth developers, the Bangladesh government, and non-governmental organizations working with the 1.1 million Rohingya refugees in Bangladesh. Quantitative data were collected from refugee camps with the permission of the Refugee Relief and Repatriation Commissioner (RRRC). The data were analyzed in two stages using a mixed approach that combines PLS-SEM and Artificial Neural Network (ANN). This study revealed that Effort expectancy (EE, with t = 5.629, β = 0.313) and facilitating conditions (FC with t = 4.442, β = 0.269) in PLS-SEM, and FC (with 100 percent importance) and Health consciousness (HC, with 94.88 percent importance) in ANN analysis were found to be the most substantial predictors of mHealth adoption. The study also revealed that EE and FC are more important for low education group, while PE and Situational Constraint (SC) are more important for the high education group of refugees. In addition to providing insights for mHealth developers, this study particularly focuses on the role of government institutions and non-governmental social workers in working with the subjects to increase FC and HC among Rohingya refugees and bring them under mHealth services.

The impact of e-government information quality (EGIQ) dimensions on the adoption of electronic government services

E-government's capacity to reform public service delivery is hinged on critical factors from the demand side of e-government. The demand side of e-government is the element that drives users’ behaviors to adopt e-government services and understanding these factors is fundamental to driving the realization of e-government targets. This study thus examined the extent to which e-government information quality dimensions can stimulate the acceptance and utilization of e-government services. The Unified Theory of Acceptance and Use of Technology (UTAUT) was used as the theoretical basis for this paper and the data congregated was evaluated with Analysis of Moment Structures (AMOS) statistical software using the structural equation modeling (SEM) approach. The results have revealed that both effort expectancy and facilitating conditions significantly drive the intention to use and recommend the adoption of e-government services. Also, e-government information quality dimensions such as availability, objectivity, utility, confidentiality, and integrity were all found to positively drive the intention to use e-government services. Additionally, people's intention to use e-government was significant in driving the recommendation behavior of e-government services to others. The practical and research repercussions of these discoveries on the development and deployment of e-government-empowered services are deliberated.

Digital transformation of healthcare during the COVID-19 pandemic: Patients’ teleconsultation acceptance and trusting beliefs

The COVID-19 pandemic boosted the digital transformation of many services, including healthcare, and access to medical care using teleconsultation has increased rapidly. Thus, a growing number of online platforms have been developed to accommodate patients’ needs. This paper examines the factors that predict the intention to use medical teleconsultation by extending the unified theory of acceptance and use of technology (UTAUT2) with the three dimensions of trusting beliefs and self-efficacy. A survey was administered to patients who had used a teleconsultation platform during the pandemic period. As one of the largest studies to date, a sample of 1233 respondents was collected and analyzed using a partial least squares approach, often mobilized in the information systems (IS) domain. Furthermore, a deep analysis using all recommended metrics was performed. The results highlight the significance of trusting beliefs, and self-efficacy in the adoption of digital healthcare services. These findings contribute to both theory and practice in COVID-19 research.

The Use of a Technology Acceptance Model (TAM) to Predict Patients' Usage of a Personal Health Record System: The Role of Security, Privacy, and Usability

Personal health records (PHR) systems are designed to ensure that individuals have access and control over their health information and to support them in being active participants rather than passive ones in their healthcare process. Yet, PHR systems have not yet been widely adopted or used by consumers despite their benefits. For these advantages to be realized, adoption of the system is necessary. In this study, we examined how self-determination of health management influences individuals' intention to implement a PHR system, i.e., their ability to actively manage their health. Using an extended technology acceptance model (TAM), the researchers developed and empirically tested a model explaining public adoption of PHRs. In total, 389 Saudi Arabian respondents were surveyed in a quantitative cross-sectional design. The hypotheses were analysed using structural equation modelling-partial least squares (SEM-PLS4). Results indicate that PHR system usage was influenced by three major factors: perceived ease of use (PEOU), perceived usefulness (PU), and security towards intention to use. PHR PEOU and PHR intention to use were also found to be moderated by privacy, whereas usability positively moderated PHR PEOU and PHR intention to use and negatively moderated PHR PU and PHR intention to use. For the first time, this study examined the use of personal health records in Saudi Arabia, including the extension of the TAM model as well as development of a context-driven model that examines the relationship between privacy, security, usability, and the use of PHRs. Furthermore, this study fills a gap in the literature regarding the moderating effects of privacy influence on PEOU and intention to use. Further, the moderating effects of usability on the relationship between PEOU, PU, and intention to use. Study findings are expected to assist government agencies, health policymakers, and health organizations around the world, including Saudi Arabia, in understanding the adoption of personal health records.

Usage and impact of the internet-of-things-based smart home technology: a quality-of-life perspective

The aim of this paper is to explore the usage and impact of the Internet-of-Things-based Smart Home Technology (IoT-SHT) in Malaysia. Face-to-face interviews were conducted with a total of eleven IoT-SHT users who had a minimum of 2-year usage experience. The semi-structured interview consisted of six questions which were compartmentalised into two sections. Common themes were identified through constant comparison of the inductive data in the coding process. The in-depth interview uncovered six uses of IoT-SHT. Mainly, it was used for real-time remote control, surveillance, sensing, home automation, entertainment, and family communication. It seems clear that the IoT-SHT helped people to save time, changed their lives, improved security, safety, environment condition, fun, convenience, and comfort within the home ground. It also facilitated better health tracking, family care, and energy conservation. Psychologically, the IoT-SHT also enhanced one's image, offered better companionship, and improved the sense of belongingness, and closeness within the family. This study fills the research gap by providing insights into how the IoT-SHT was used, thereby benefiting users in Malaysia. With the arrival of industrial revolution 4.0, a comprehensive knowledge on the usage of IoT is pertinent. The findings of this study may also serve as a foundation for future research in IoT-SHT adoption. Practically, this study accelerates IoT-SHT diffusion by providing insights to vendors in designing better IoT products and services, based on the popular usages and impactful benefits.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10209-022-00937-0.

End-users' perspectives on the quality and design of mHealth technologies during the COVID-19 pandemic in the Philippines: A Qualitative Study

BACKGROUND

The COVID-19 pandemic has expanded the use of mHealth technologies in contact tracing, communicating COVID-related information, and monitoring the health conditions of the general population in the Philippines. However, the limited end-user engagement in the features and feedback along the development cycle of mHealth technologies results to risks in adoption. The WHO recommends user-centric design and development of mHealth technologies to ensure responsiveness to the needs of the end-users.

OBJECTIVE

The goal of the study is to understand, using the end-users' perspectives, the design and quality of mHealth technology implementations in the Philippines during the COVID-19 pandemic with focus on areas identified by stakeholders: 1) utility, 2) technology readiness level, 3) design, 4) information, 5) usability, 6) features, and 7) security and privacy.

METHODS

Using a descriptive qualitative design, we conducted five interviews and three FGDs with a total of 16 participants, six males and ten females. Questions were based on the Mobile App Rating Scale (MARS). Utilizing the cyclical coding approach, transcripts were analyzed using NVivo 12. Domains and themes were identified.

RESULTS

The qualitative analysis identified eighteen themes that were organized under the seven focus areas: 1) utility: use of mHealth technologies; motivations in using mHealth; 2) technology readiness: mobile technology literacy, user segmentation; 3) design: user interface design, language and content accessibility, and technology design; 4) information: accuracy of information, use of information; 5) usability: design factors, dependency on human processes, and technical issues; 6) features: interoperability and data integration, other feature and design recommendations, and technology features and upgrades, and 7) privacy and security: trust that mHealth can secure data, lack of information, and policies. To highlight, accessibility, privacy and security, simple interface, and integration are some of the design and quality areas that end-users find important and consider in using mHealth tools.

CONCLUSIONS

Engaging end-users in the development and design of mHealth technologies ensures adoption and accessibility making it a valuable tool in curbing the pandemic. The six principles for developers, researchers, and implementers to consider when scaling up or developing new mHealth solutions in low resource settings are: 1) should be driven by value in its implementation; 2) should be inclusive; 3) addresses users' physical and cognitive restrictions; 4) ensures privacy and security; 5) designed in accordance to digital health systems' standards; and 6) should be trusted by the end-users.

CLINICALTRIAL

The behavioral intention to adopt mobile health services: The moderating impact of mobile self-efficacy

This study explored the moderating impact of mobile self-efficacy on the adoption of mobile health services. The UTAUT was used as the theoretical foundation for this study. The results have indicated that mobile self-efficacy was significant in moderating the impact of both performance expectancy (β = -0.005, p < 0.05) and effort expectancy (β = -010, p < 0.05) on the adoption of mobile health services. In addition, it was revealed to our surprise that both performance (β = 0.521, t = 9.311, p > 0.05) and effort expectancy (β = 0.406, t = 7.577, p > 0.05) do not determine the behavioral intention to use mobile health services. Effort expectancy and behavioral intention to use were also, respectively, not significant in influencing performance expectancy (β = 0.702, t = 12.601, p > 0.05) and intention to recommend the adoption of mobile health services (β = 0.866, t = 13.814, p > 0.05). Mobile self-efficacy, however, was found to significantly predict the citizen's intention to recommend the adoption of mobile health services (β = 0.139, t = 2.548, p < 0.05). The implications of these findings on mobile health are discussed.

COVID-19 Misinformation on Social Media and Public’s Health Behavior: Understanding the Moderating Role of Situational Motivation and Credibility Evaluations

The spread of misinformation on social networking conduit regarding COVID-19 pandemic poses deleterious consequences on public health. The author advance the body of knowledge on tackling misinformation to generate positive health behavior responses by proposing a conceptual framework based on the theory of persuasion and behavior change. Furthermore, as a belief antecedent, conspiracy theory is also used in this study. The author, using structural equation modeling technique, explored the three hundred seventy-three participants’ belief in conspiracy theory and religious misinformation and their influence on intention and behavior. Those direct relationships were tested by the joint moderating role of situational motivation and credibility evaluations. The study revealed that the situational motivation and credibility evaluation jointly and individually (in some cases) weaken the strong positive relationship between misinformation (conspiracy theory and religious misinformation) and health belief, health belief and intention, and intention and health behavior regarding COVID-19. The findings of this study offer guideline for policymakers to generate favorable health behavior regarding COVID-19 and any other epidemic or pandemic. Directions for researchers to any further extensions are also placed.

Demand for Mobile Health in Developing Countries During COVID-19: Vietnamese's Perspectives from Different Age Groups and Health Conditions

BACKGROUND

Vietnam's economy and intellectual standards have witnessed significant development, improving conditions for residents to acquire novel mHealth applications. Additionally, the outbreak of the COVID-19 pandemic has influenced Vietnamese awareness of healthcare; however, previous studies have only been clinician-centered rather than customer-centered.

METHODS

This study addresses this literature gap by interviewing 50 Vietnamese participants grouped by age, namely Generation X, Generation Y, and Generation Z, and health conditions, namely whether participants or family members have chronic illness. The study utilized semi-structured and in-depth interviews to collect the data and used thematic analysis to analyze the data under the unified theory of acceptance and use of technology framework.

RESULTS

Most participants were willing to adopt this technology and demanded a convenient and user-friendly one-stop-shop solution, endorsements from credible and authoritative sources, and professional customer services. However, each group also had distinctive demands and behaviors.

CONCLUSION

This study contributes theoretically by providing context-rich demand for Vietnamese customers across three generations and healthcare conditions during the COVID-19 pandemic and comparing their behavior with pre-COVID literature. While this research provides helpful information for potential app developers, this study also suggests that mHealth developers and policymakers should pay more attention to the differences in the demand of age groups and health conditions.