A study on students' acceptance of mobile phone use to seek health information in South Africa

An acceptance analysis of a sexual health education digital tool in resource-poor regions of Kenya: an UTAUT based survey study

BACKGROUND

Unplanned pregnancies and sexually transmitted diseases are a concern in Sub-Saharan Africa, particularly in low-income areas. Access to sexual health information is limited, partly due to the absence of comprehensive sex education in the national school curriculum and social taboos. In response to these challenges, this study introduces a web-based prototype, designed to provide essential sexual health information, targeting 18 to 35-year-old Kenyans, focusing on contraception, menstruation, and female genital mutilation.

METHOD

Aiming to investigate young adults' behavioral intention to use a digital tool for sexuality education, by analyzing factors affecting acceptance and usability in low-income and resource-poor regions in Kenya. To explore the acceptability and use of the developed digital tool, this study used a modified version of the Unified Theory of Acceptance and Use of Technology (UTAUT), complemented by the System Usability Scale (SUS) questionnaire. For statistical analysis, a Structural Equation Model (SEM) including Confirmatory Factor Analysis (CFA) and Linear Regression was used. Regarding the reporting of the E-survey results, the Checklist for Reporting Results of Internet E-surveys (CHERRIES), was considered.

RESULTS

Survey information from 77 persons (69 female, 7 male, 1 diverse) were collected. A modified UTAUT appears as an appropriate model for measuring the constructs and integrating evidence-based approaches to advanced and safe sexual healthcare information. Results from the SEM showed perceived usefulness, attitude towards healthcare integrated evidence technology, and usability as well as having a significant positive impact on the acceptance, the intention to use as well as wellbeing. Having the resources and knowledge necessary for the usage of a digital tool turns out to have a significant negative impact. A SUS score of 67.3 indicates the usability of the tool for sexual health information, assessed as okay.

CONCLUSIONS

The study adopts validated methods to assess the acceptability and usability of a digital sexual health education tool in Kenya. Emphasizing its potential effectiveness and highlighting the influence of cultural and contextual factors on technology adoption.

Exploring factors that influence the behavioural intention of medical students to use 3D gastroscopic model to learn how to operate gastroscope using UTAUT Model

BACKGROUND

The application of virtual reality (VR) in gastroscopic operation teaching can be safe and effective, but the advantages can be realized only when students accept and use it. This study aims to identify the factors influencing Chinese clinical medical postgraduates on their intention to use the 3D gastroscopic model constructed based on VR technology using Unified Theory of Acceptance and Use of Technology (UTAUT) model. Students' demographic factors are also taken into consideration.

METHODS

All methods were carried out in accordance with relevant guidelines. Data were collected from clinical medical postgraduates students in China using stratified sampling. A total of 292 questionnaires including valid responses were used in this study. Data were processed using Amos 24.0 and SPSS 26.0 software and the statistical analysis technique was based on structural equation modeling (SEM).

RESULTS

The results showed that different from the mediator of home location and year of clinical learning, mediator of gender, university kind and graduate degree did not affect the behavioral intention. In addition, performance expectancy, facilitating condition, and social influence directly and indirectly have effect on behavioral intention. Also, the significance between social influence and performance expectancy, social influence and effort expectancy were verified.

CONCLUSIONS

This study manifested that the proposed framework based on the UTAUT had explanatory power to identify the factors influencing the students' behavioral intention to use the 3D gastroscopic model constructed based on VR technology. Whereas, an important variable of effort expectancy in the frame of the SEM were not certified, thereby indicating that particular attention should be paid to this variable by universities and teachers before applying 3D gastroscopic model constructed based on VR technology in teaching. Added preparatory work is required such as explaining the basic knowledge of the operating steps of VR model and make students adequately understand its accessibility, which can probably improve the intentions of them to use it. The positive effects of social influence on performance expectancy and effort expectancy we proposed was also verified in this study, which provided a direction for future research.

Factors Affecting Customer Intention to Adopt a Mobile Chronic Disease Management Service

The Mobile Chronic Disease Management Service (MCDMS) is an emerging medical service for chronic disease prevention and treatment, but limited attention has been paid to the factors that affect users’ intention to adopt the service. Based on the unified theory of acceptance and use of technology 2 and the protection motivation theory, the authors built an MCDMS adoption model. The authors also verified the differentiating age effect on the service adoption intention from experiential distance perspective of the construal level theory. Empirical results showed that the young group focused more on the impact of effort expectancy, whereas the elderly group focused more on performance expectancy, imitating others, and perceived severity. Furthermore, the young group, however, focused more on the impact of perceived vulnerability, and offline medical habits showed no significant influence on either group’s intention to adopt, which were not consistent with the original hypotheses. The findings can aid MCDMS providers in selecting marketing strategies targeted toward different age groups.

Attitudes and use patterns for mobile technology and upper extremity home exercises in stroke survivors in the United States

Introduction

The use of mobile technology (MT) in home-based occupational therapy is expected to continue growing. This study describes daily use patterns for MT and upper extremity (UE) home exercise programs (HEPs) for community-dwelling stroke survivors in the United States.

Method

Cross-sectional survey. Data were analyzed using descriptive statistics and bivariate comparisons.

Results

N = 61 (30 stroke and 31 controls). Individuals with stroke had similar levels of knowledge, skill, and use of MT compared with non-disabled age-matched adults. Stroke participants used MT more frequently for information searching, social media, and reminders compared to control participants. Stroke participants were motivated to improve UE function (93.3%) and reported a need for additional HEP training (56.7%). Perceived facilitators to improve UE use included talking to peers (73.3%), getting more information (73.3%), and talking to a therapist (63.3%).

Conclusions

MT may have multiple potential benefits when integrated into occupational therapy practice including supporting instrumental ADLs, facilitating social connection, and increasing adherence to UE HEPs. Future work should focus on maximizing adherence and providing performance feedback through the use of social media to promote peer support and consistent remote communication using text messaging, phone calls, or video calls to deliver information and reminders on exercises.

Drivers for Teleconsultation Acceptance in Brazil: Patients’ Perspective during the COVID-19 Pandemic

ABSTRACT Context: teleconsultation can be a strategic technological tool for patients to access quality healthcare while dealing with resource challenges within health industry. It can be particularly relevant during and after the COVID-19 pandemic, when the social distancing world had to scramble for new technological solutions to offer quality healthcare services with reduced personal contact. Objective: our research proposes an integrative technology acceptance model to evaluate the drivers of teleconsultation adoption by patients, aligning constructs from the technology acceptance model with other drivers, such as technology readiness, trust, and self-efficacy. Methods: analyses included descriptive statistics and structural equations modeling based on survey’s data from a sample of 415 consumers. Results: results indicate significant relationships between the assessed constructs, with particular relevance on the effects of perceived usefulness, anteceded by trust and technology readiness, on attitude and intention to use teleconsultation. Conclusion: our findings provide helpful insights for health organizations and regulators associated with the diffusion of teleconsultation. The study findings also indicate that the challenging COVID-19 pandemic context may be affecting patients’ intention to adopt teleconsultation.

Factors Related to Internet Adoption and Its Use to Seek Health Information in Mexico

The Internet has the potential to be a valuable resource for the dissemination of health promotion information to the general population, mainly in conditions with well-developed health and digital literacy. Few studies have been undertaken on the adoption of the Internet by the Mexican population and its use to seek health information. The aim of this paper was to identify the factors that determine Internet adoption and its use by the heads of Mexican households for obtaining health information. This study used data taken from a probabilistic and cross-sectional national survey (National Survey on the Availability and Use of Information Technologies in Households, or ENDUTIH), applying an economic approach based on utility maximization theory. We estimated a univariate probit model for Internet adoption and a consecutive bivariate probit model with sample selection for the use of the Internet to seek health information. The software package was used to adjust and estimate the proposed models. The first model (Internet adoption) identified several factors related to digital divides in the country, while the second (Internet use to seek health information) identified various factors influencing online searches for health information, such as the following: being a woman; being an adult; having a higher level of education; having a higher income; having superior digital skills; and, living in an urban area. This study highlights the need to strengthen digital policy in order to improve access to and the adoption and efficient use of the Internet, particularly in terms of improving an individual's engagement with their own health.

Implementation of Online Hospitals and Factors Influencing the Adoption of Mobile Medical Services in China: Cross-Sectional Survey Study

Background

Online hospitals are part of an innovative model that allows China to explore telemedicine services based on national conditions with large populations, uneven distribution of medical resources, and lack of quality medical resources, especially among residents needing to be protected from COVID-19 infection.

Objective

In this study, we built a hypothesis model based on the Unified Theory of Acceptance and Use of Technology (UTAUT) in order to analyze the factors that may influence patients’ willingness to use mobile medical services. This research was designed to assist in the development of mobile medical services. Residents who do not live in urban areas and cannot access medical assistance would greatly benefit from this research, as they could immediately go to the online hospital when needed.

Methods

A cross-sectional study based at the West China Hospital, Sichuan University, was conducted in July 2020. A total of 407 respondents, 18 to 59 years old, in Western China were recruited by convenience sampling. We also conducted an empirical test for the hypothesis model and applied structural equation modeling to estimate the significance of path coefficients so that we could better understand the influencing factors.

Results

Out of 407 respondents, 95 (23.3%) were aware of online hospitals, while 312 (76.7%) indicated that they have never heard of online hospitals before. Gender (P=.048) and education level (P=.04) affected people’s willingness to use online hospitals, and both of these factors promoted the use of online hospitals (odds ratio [OR] 2.844, 95% CI 1.010-8.003, and OR 2.187, 95% CI 1.031-4.636, respectively). According to structural equation modeling, the results of the path coefficient analysis indicated that performance expectancy, effort expectancy, and facilitating conditions have positive effects on patients’ willingness to use online hospitals.

Conclusions

The goal of our research was to determine the factors that influence patients’ awareness and willingness to use online hospitals. Currently, the public’s awareness and usage of online hospitals is low. In fact, effort expectancy was the most important factor that influenced the use of online hospitals; being female and having a high education also played positive roles toward the use of mobile medical services.

Adoption of Mobile Health Apps in Dietetic Practice: Case Study of Diyetkolik

Background

Dietetics mobile health apps provide lifestyle tracking and support on demand. Mobile health has become a new trend for health service providers through which they have been shifting their services from clinical consultations to online apps. These apps usually offer basic features at no cost and charge a premium for advanced features. Although diet apps are now more common and have a larger user base, in general, there is a gap in literature addressing why users intend to use diet apps. We used Diyetkolik, Turkey’s most widely used online dietetics platform for 7 years, as a case study to understand the behavioral intentions of users.

Objective

The aim of this study was to investigate the factors that influence the behavioral intentions of users to adopt and use mobile health apps. We used the Technology Acceptance Model and extended it by exploring other factors such as price-value, perceived risk, and trust factors in order to assess the technology acceptance of users.

Methods

We conducted quantitative research on the Diyetkolik app users by using random sampling. Valid data samples gathered from 658 app users were analyzed statistically by applying structural equation modeling.

Results

Statistical findings suggested that perceived usefulness (P<.001), perceived ease of use (P<.001), trust (P<.001), and price-value (P<.001) had significant relationships with behavioral intention to use. However, no relationship between perceived risk and behavioral intention was found (P=.99). Additionally, there was no statistical significance for age (P=.09), gender (P=.98), or previous app use experience (P=.14) on the intention to use the app.

Conclusions

This research is an invaluable addition to Technology Acceptance Model literature. The results indicated that 2 external factors (trust and price-value) in addition to Technology Acceptance Model factors showed statistical relevance with behavioral intention to use and improved our understanding of user acceptance of a mobile health app. The third external factor (perceived risk) did not show any statistical relevance regarding behavioral intention to use. Most users of the Diyetkolik dietetics app were hesitant in purchasing dietitian services online. Users should be frequently reassured about the security of the platform and the authenticity of the platform’s dietitians to ensure that users’ interactions with the dietitians are based on trust for the platform and the brand.

Implementation of a national electronic health information system in Gabon: a survey of healthcare providers' perceptions

BACKGROUND

The Health Information System (HIS) is a set of computerized tools for the collection, storage, management, and transmission of health data. The role of such tools in supporting the modernization of health systems, improving access to quality healthcare, and reducing costs in developing countries is unquestionable, but their implementation faces several challenges. In Gabon, a unique national electronic HIS has been launched. It will connect healthcare institutions and providers at all levels in the whole country.

OBJECTIVE

This study aims to explore and identify the factors influencing healthcare providers' perceptions of the national electronic HIS in Gabon.

METHODS

A 44-item questionnaire based on the Information System Success Model (ISSM) was administered between February and April 2018 among 2600 healthcare providers across the country. The questions assessed the different aspects of the HIS that could influence its perceived impact on a 5-level Likert scale (from fully agree to totally disagree). The reliability and construct validity of the questionnaire were checked using Cronbach alpha and congeneric reliability coefficients. A logistic regression was used to identify the factors influencing healthcare providers' perceptions of the system.

RESULTS

A total of 2327 questionnaires were completed (i.e. 89.5% response rate). The logistic regression identified five elements that significantly influenced perceived system impact: System Quality (Odds Ratio-OR = 1.70), Information Quality (OR = 1.69), Actual Use (OR = 1.41), Support Quality (OR = 1.37), and Useful Functions (OR = 1.14). The model explained 30% of the variance in providers' perception that the national HIS leads to positive impacts.

DISCUSSION

The results show that healthcare providers' perceptions regarding the positive impact of the national HIS in Gabon are influenced by their previous use of an HIS, the scope of their usage, and the quality of the system, information, and support provided to users. These results could inform the development of strategies to ensure adequate change of management and user experience for the implementation of the national HIS in Gabon, and eventually in other low resource environments.

Informal mobile phone use by marginalised groups in a plural health system to bridge healthcare gaps in Sierra Leone

The possibility to use mobile phones to provide affordable, effective and accessible healthcare solutions has continued to attract significant investments in the application of formal m-health schemes in Africa. However, while the formal m-health schemes in Africa are limited and benefited only a handful of people, a majority of individuals are using their own phones to create an informal m-health ecosystem in an attempt to bridge primary healthcare access gaps. This paper draws on qualitative data from a four-year (2012-2016) anthropological study involving marginalised groups in Sierra Leone to document these health-seeking practices along with the benefits and challenges they create in a complex plural health system. It argues that the informal integration of mobile phones into the plural health system offers opportunities for marginalised individuals to search and secure primary healthcare of their choices, but poor network connectivity, high out of pocket maintenance costs, low digital literacy skills, and the lack of policy to streamline and regulate the practices can promise the effectiveness of the informal m-health system. It concludes by offering suggestions for addressing these challenges in the Sierra Leone context.

Wearable devices in healthcare: Privacy and information security issues

BACKGROUND

Mobile health has provided new and exciting ways for patients to partake in their healthcare. Wearable devices are designed to collect the user's health data, which can be analysed to provide information about the user's health status. However, little research has been conducted that addresses privacy and information security issues of these devices.

OBJECTIVE

To investigate the privacy and information security issues to which users are exposed when using wearable health devices.

METHOD

The study used a cross-sectional survey approach to collect data from a convenience sample of 106 respondents.

RESULTS

Half of the respondents did not understand the need to protect health information. There also appeared to be a general lack of awareness among respondents about the information security issues surrounding their data collected by wearable devices.

CONCLUSION

Users were not knowledgeable about the privacy risks that their data are exposed to or how these data are protected once collected.

IMPLICATIONS

Users of wearable devices that collect personal information about health need to be educated about privacy and information security issues to which they are exposed when using these devices.

Acceptability and Attitude towards a Mobile-Based Home Exercise Program among Stroke Survivors and Caregivers: A Cross-Sectional Study

Background

Stroke is a leading cause of disability and requires continued care after hospital discharge. Mobile-based interventions are suitable to reduce the cost of stroke rehabilitation and facilitate self-management among stroke survivors. However, before attempting to use mobile-based home exercise program, it is crucial to recognize the readiness of stroke survivors and their caregivers to opt for such interventions.

Objective

To assess the acceptability and attitude towards a mobile-based home exercise program among stroke survivors and their primary caregivers.

Methods

A cross-sectional study was conducted among 102 participants to understand their attitude and acceptability towards mobile-based home exercise program. A validated 10-item questionnaire was adapted for the study. The questions which assessed the attitude were rated on a three-point Likert scale, with three denoting agree and one denoting disagree. The acceptability was assessed by their willingness to opt for a mobile-based home program services. A Chi-square analysis and cross-tabulation were performed to test differences between caregivers and patients. A logistic regression was performed to determine the effects of age, gender, and mobile phone on acceptability.

Results

Ninety-two percent of caregivers and 90% of patients showed willingness to opt for mobile-based intervention. Majority of the participants showed a positive attitude towards this mode of treatment. There was no difference in the attitude noted among caregivers and patients (p>0.05) towards mobile-based intervention.

Conclusion

The stroke survivors and caregivers welcomed the concept of mobile-based home exercise program even in a low-resource settings, but further studies to understand treatment and cost-effectiveness of this technology among the stroke survivors would lead to better implementation.