Determinants of physicians' online medical services uptake: a cross-sectional study applying social ecosystem theory

Doctors' Personal Preference and Adoption of Mobile Apps to Communicate with Patients in China: Qualitative Study

BACKGROUND

Different kinds of mobile apps are used to promote communications between patients and doctors. Studies have investigated patients' mobile app adoption behavior; however, they offer limited insights into doctors' personal preferences among a variety of choices of mobile apps.

OBJECTIVE

This study aimed to investigate the nuanced adoption behaviors among doctors in China, which has a robust adoption of mobile apps in health care, and to explore the constraints influencing their selection of specific mobile apps. This paper addressed 3 research questions: (1) Which doctors opt to adopt mobile apps to communicate with patients? (2) What types of mobile apps do they choose? (3) To what degree do they exercise personal choice in adopting specific mobile apps?

METHODS

We used thematic content analysis of qualitative data gathered from semistructured interviews with 11 doctors in Hangzhou, which has been recognized for its advanced adoption of mobile technology in social services, including health care services. The selection of participants was purposive, encompassing diverse departments and hospitals.

RESULTS

In total, 5 themes emerged from the data analysis. First, the interviewees had a variety of options for communicating with patients via mobile apps, with the predominant ones being social networking apps (eg, WeChat) and medical platforms (eg, Haodf). Second, all interviewees used WeChat to facilitate communication with patients, although their willingness to share personal accounts varied (they are more likely to share with trusty intermediaries). Third, fewer than half of the doctors adopted medical platforms, and they were all from tertiary hospitals. Fourth, the preferences for in-person, WeChat, or medical platform communication reflected the interviewees' perceptions of different patient cohorts. Lastly, the selection of a particular kind of mobile app was significantly influenced by the doctors' affiliation with hospitals, driven by their professional obligations to fulfill multiple tasks assigned by the hospitals or the necessity of maintaining social connections with their colleagues.

CONCLUSIONS

Our findings contribute to a nuanced understanding of doctors' adoption behavior regarding specific types of mobile apps for patient communication, instead of addressing such adoption behavior of a wide range of mobile apps as equal. Their choices of a particular kind of app were positioned within a social context where health care policies (eg, limited funding for public hospitals, dominance of public health care institutions, and absence of robust referral systems) and traditional culture (eg, trust based on social connections) largely shape their behavioral patterns.

Associated factors of health-promoting lifestyle of the elderly based on the theory of social ecosystem

OBJECT

To explore the factors related to health-promoting lifestyles of the elderly based on social-ecosystem theory.

DESIGN

A cross-sectional survey study was carried out to include 627 elderly people in communities in three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou) from October 2021 to January 2022 for questionnaire survey (601 validly returned cases).

VENUE

Three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou).

PARTICIPANTS

627 elderly people.

INTERVENTIONS

A cross-sectional survey study.

MAIN MEASUREMENTS

The questionnaire survey was conducted by using the general demographic data, health promotion life scale, frailty scale, general self-efficacy scale, health engagement scale, General Self-Efficacy Scale, The family Adaptability, Partnership, Growth, Affection, and Resolve scale, and Perceived Social Support Scale.

RESULTS

The total health promotion lifestyle score for the elderly was 100.20±16.21, which was at the lower limit of the good level, with the highest mean score for nutrition (2.71±0.51) and the lowest mean score for physical activity (2.25±0.56). Stepwise linear regression showed that exercise frequency (95% confidence interval (CI) 1.304-3.885), smoking status (95% CI -4.190 to -1.556), self-efficacy (95% CI 0.071-0.185), health management (95% CI 0.306-0.590), frailty (95% CI -3.327 to -1.162) in the microsystem, marital status (95% CI 0.677-3.660), children's attention to the elderly health (95% CI 4.866-11.305), family care in the mesosystem (95% CI 1.365-4.968), and pre-retirement occupation (95% CI 2.065-3.894), living area (95% CI 0.813-3.912), whether receive community-based chronic disease prevention and management services (95% CI 2.035-8.149), social support (95% CI 1.667-6.493) in the macrosystem were the main factors affecting health promotion of life in the elderly (P<0.05). Hierarchical regression analysis showed the microsystem accounted for 17.2%, the mesosystem accounted for 7.1%, and the macrosystem accounted for 11.4%.

CONCLUSION

The health promotion lifestyle of the elderly in Hebei Province was at the lower limit of good level. Among them, exercise frequency, children's attention to the elderly health, and pre-retirement occupation played a major role in relation to the health-promoting lifestyle of the elderly. Hence, it needs the joint action of individuals, families, and society to promote the elderly to adopt the health promotion lifestyle and realize healthy aging.

What influences news learning and sharing on mobile platforms? An analysis of multi-level informational factors

Purpose

The purpose of the study is threefold: first, to identify what factors influence mobile users' willingness of news learning and sharing, second, to find out whether users' learning in the news platforms will affect their sharing behavior and third, to access the impact of sharing intention on actual sharing behavior on the mobile platform.

Design/methodology/approach

This study proposes an influence mechanism model for examining the relationship among the factors, news learning and news sharing. The proposed mechanism includes factors at three levels: personal, interpersonal and social level. To achieve this, researchers collected data from 474 mobile news users in China to test the hypotheses. The tools SPSS 26.0 and AMOS 23.0 were used to analysis the reliability, validity, model fits and structural equation modeling (SEM), respectively.

Findings

The findings indicate that news learning on the mobile platforms is affected by self-efficacy and self-enhancement. And news sharing intention is influenced by self-efficacy, interpersonal trust, interpersonal reciprocity, online community identity and social norms positively. News sharing intention has a significant effect on news sharing behavior, but news learning has an insignificant relationship with new sharing.

Originality/value

This study provides practical guidelines for mobile platform operators and news media managers by explicating the various factors of users' engagement on the news platforms. This paper also enriches the literature of news learning and news sharing on mobile by the integration of two theories: the social ecology theory and the interpersonal behavior theory.