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Zhang Q, Zhang R, Lu X, Zhang X. What drives the adoption of online health communities? An empirical study from patient-centric perspective. BMC Health Serv Res 2023; 23:524. [PMID: 37221504 DOI: 10.1186/s12913-023-09469-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 04/28/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Online health communities (OHCs) provide platforms for patients to seek advice from physicians and receive professional suggestions online. It can improve the efficiency of patients' diagnosis of simple diseases and alleviate hospital congestion. However, few empirical studies have comprehensively explored the factors influencing patients' intention to use OHCs through objective data. This study aims to fill this gap by identifying key factors that influence patients' acceptance of OHCs and proposing effective ways to promote the applications of OHCs in China. METHODS Based on the Unified Theory of Acceptance and Usage of Technology (UTAUT), extended with additional constructs identified with patients' information demands in OHCs, this study developed a research model and proposed nine hypotheses. An online survey involving 783 valid responses was conducted in China to collect data to validate the proposed model. Confirmatory factor analysis and partial least squares (PLS) path model were conducted for instrument validation and hypothesis testing. RESULTS Price value, eHealth literacy, and performance expectancy are the most prominent constructs in the study context. Interestingly, relation quality was also found to have a significant positive relationship with behavioral intention. CONCLUSIONS Based on these findings, OHC operators need to create a user-friendly platform, improve information quality, set reasonable prices, and establish consummate security systems. Physicians and related organizations can raise awareness and assist patients in developing the skills to appropriately comprehend and utilize information in OHCs. This study contributes to both technology adoption theory and practice.
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Affiliation(s)
- Qianyao Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing, 100044, China
| | - Runtong Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing, 100044, China.
| | - Xinyi Lu
- School of Management and E-business, Zhejiang Gongshang University, Hangzhou, Zhejiang, China
| | - Xijing Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing, 100044, China
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Yan M, Zhang M, Kwok APK, Zeng H, Li Y. The Roles of Trust and Its Antecedent Variables in Healthcare Consumers' Acceptance of Online Medical Consultation during the COVID-19 Pandemic in China. Healthcare (Basel) 2023; 11:healthcare11091232. [PMID: 37174774 PMCID: PMC10177990 DOI: 10.3390/healthcare11091232] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/09/2023] [Accepted: 03/11/2023] [Indexed: 05/15/2023] Open
Abstract
Online medical consultation (OMC) is generating considerable interest among researchers and practitioners due to the mandatory quarantine measures implemented during the COVID-19 pandemic in China. However, the acceptance rate of OMC has declined over time. This paper aims to empirically investigate OMC acceptance using a proposed research model by integrating the technology acceptance model (TAM) with trust and its antecedent variables. A quantitative self-administered cross-sectional survey was conducted to collect data from 260 healthcare consumers. A partial least squares structural equation modeling method was used to examine the data. Results revealed that healthcare consumers' behavioral intention was influenced by attitudes, while perceived usefulness and trust significantly influenced behavioral intention through attitude as a mediator. In addition, perceived risk, perceived privacy protection, network externalities, cognitive reputation, and interactivity directly influenced trust. Overall, the research model explained 50% of the variance in attitude and 71% of the variance in behavioral intention. The study's findings should provide useful insights into making effective design, development, and implementation decisions for OMC services.
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Affiliation(s)
- Mian Yan
- School of Intelligent Systems Science and Engineering, Jinan University, Zhuhai 519070, China
- GBA and B&R International Joint Research Center for Smart Logistics, Jinan University, Zhuhai 519070, China
| | - Meijuan Zhang
- School of Management, Jinan University, Guangzhou 510000, China
| | - Alex Pak Ki Kwok
- Data Science and Policy Studies Programme, Faculty of Social Science, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Haoyan Zeng
- School of Intelligent Systems Science and Engineering, Jinan University, Zhuhai 519070, China
| | - Yanfeng Li
- School of Intelligent Systems Science and Engineering, Jinan University, Zhuhai 519070, China
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Jiang Y, Lau AKW. Understanding Post-Adoption Behavioral Intentions of Mobile Health Service Users: An Empirical Study during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3907. [PMID: 36900918 PMCID: PMC10001414 DOI: 10.3390/ijerph20053907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
This study aims to understand the post-adoption behaviors of mobile health (m-Health) service users during the COVID-19 pandemic. Drawing on the stimulus-organism-response framework, we examined the effects of user personality traits, doctor characteristics, and perceived risks on user continuance intentions and positive word of mouth (WOM) when using m-Health, as mediated by cognitive and emotional trust. The empirical data were collected via an online survey questionnaire from 621 m-Health service users in China and were verified with partial least squares structural equation modeling. The results showed that personal traits and doctor characteristics were positively associated and the perceived risks were negatively associated with both cognitive and emotional trust. Both cognitive and emotional trust significantly influenced users' post-adoption behavioral intentions in terms of continuance intentions and positive WOM, with different magnitudes. This study provides new insights for the promotion of the sustainable development of m-Health businesses after or during the pandemic.
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Affiliation(s)
- Yanmei Jiang
- The School of Business, Anhui University of Technology, Ma’anshan 243032, China
- Key Laboratory of Multidisciplinary Management and Control of Complex Systems of Anhui Higher Education Institutes, Anhui University of Technology, Ma’anshan 243032, China
| | - Antonio K. W. Lau
- The School of Management, Kyung Hee University, Seoul 02447, Republic of Korea
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Wang W, Sun L, Liu T, Lai T. The use of E-health during the COVID-19 pandemic: a case study in China's Hubei province. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:215-231. [PMID: 34161186 DOI: 10.1080/14461242.2021.1941184] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 05/29/2021] [Indexed: 06/13/2023]
Abstract
Globally, the use of e-health has accelerated dramatically during the coronavirus pandemic. Based on both quantitative and qualitative data collected in China's Hubei province (i.e. the first epicentre of COVID-19), this research explores how the pandemic influences the practices of e-health from the perspective of users. Through analysis of 1,033 surveys and 14 in-depth interviews, we find that e-health has played a crucial role in residents' healthcare during the COVID-19 pandemic. Certain external factors influence the choice of digital health, including the high risk of infection outdoors, the shutting down of transport systems, and dysfunctional healthcare facilities that neglect non-COVID-19 patients' clinical demands. Against this backdrop, we argue digital health acts as a functional equivalent to traditional medical treatment and has largely satisfied patients and users in the crisis period. Additionally, the COVID-19 pandemic has unintentionally sped up the diffusion of digital medicine over the long term as respondents expressed their willingness to continue use of e-health in the post-COVID-19 phase. However, we assert that despite the increasing use of e-health, it cannot fully substitute traditional offline treatment. Thus, we suggest a combination of online and offline healthcare will be more commonly practiced in the future.
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Affiliation(s)
- Weiquan Wang
- School of Political Science and Public Administration, East China University of Political Science and Law, Shanghai, People's Republic of China
| | - Li Sun
- School of Sociology and Social Policy, University of Leeds, Leeds, UK
| | - Tao Liu
- School of Public Affairs, Zhejiang University, Hangzhou, People's Republic of China
- Center for Social Welfare and Governance, Zhejiang University, Hangzhou, People's Republic of China
| | - Tian Lai
- School of Political Science and Public Administration, East China University of Political Science and Law, Shanghai, People's Republic of China
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Qi M, Cui J, Li X, Han Y. Perceived Factors Influencing the Public Intention to Use E-Consultation: Analysis of Web-Based Survey Data. J Med Internet Res 2021; 23:e21834. [PMID: 33470934 PMCID: PMC7857952 DOI: 10.2196/21834] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/24/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022] Open
Abstract
Background Unbalanced distribution of medical resources is becoming a major challenge, particularly in the selection of doctors. e-Consultation could provide patients with more choices of doctors and break the constraints of time and space. However, the acceptance of e-consultation is still poor and the mechanism of adoption is unclear. Objective The aim of this study was to identify the factors influencing the public intention to use e-consultation and explore the effect path of the factors and behavior intention. Methods The hypotheses of our research model were developed based on the technology acceptance model and perceived risk theory. A web-based survey was conducted by an electronic questionnaire collection platform; this survey that consisted of a 29-item questionnaire with 5-point Likert scales was completed by 934 respondents. Structural equation modeling was used to analyze the data. Item evaluation and reliability, validity, path loading, goodness of fit, and multiple group analysis were used to check the moderation effects. Results The standardized factor loadings of the items were between 0.551 and 0.873. The composite reliability of 9 constructs ranged from 0.706 to 0.840. The average variance extracted ranged from 0.387 to 0.640. The fitness indices showed that the collected data fitted well with the research model. Perceived usefulness was the strongest positive factor effecting behavior intention (β=.399, P<.001). Perceived ease of use had a positive effect on behavior intention but it was not statistically significant (β=.117, P=.07) and it had a positive effect on perceived usefulness (β=.537, P<.001). Perceived risk could be well explained by financial risk (β=.972, P<.001), privacy risk (β=.774, P<.001), social risk (β=.871, P<.001), time risk (β=.894, P<0.001), and psychological risk (β=.774, P<.001). Perceived risk had negative effects on perceived usefulness (β=–.375, P<.001) and behavior intention (β=–.297, P<.001). Personal innovativeness had a positive influence on perceived ease of use (β=.241, P<.001) and a slight effect on behavior intention (β=.124, P=.001). Age (χ258=133.5, P<.001) and usage experience (χ258=82.5, P=.02) had a slight moderation effect on the paths. Conclusions Perceived usefulness and perceived risk have significant effects on public intention to use e-consultation. Therefore, platform and manufacturer must improve the function of e-consultation, which will promote the public intention to use e-consultation fundamentally. In order to control the perceived risk of public, government should play an important role in enforcing management of e-consultation markets and approving corresponding medical insurance policies. Besides, personal innovativeness had an effect on behavior intention. Moreover, the paths of factors had some heterogeneity among people with different characteristics. Therefore, it is necessary to adjust the strategies to fit more groups better.
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Affiliation(s)
- Miaojie Qi
- School of Public Health, Capital Medical University, Beijing, China
| | - Jiyu Cui
- School of Public Health, Capital Medical University, Beijing, China
| | - Xing Li
- School of Public Health, Capital Medical University, Beijing, China
| | - Youli Han
- School of Public Health, Capital Medical University, Beijing, China
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Wang Y, Liu Y, Shi Y, Yu Y, Yang J. User Perceptions of Virtual Hospital Apps in China: Systematic Search. JMIR Mhealth Uhealth 2020; 8:e19487. [PMID: 32687480 PMCID: PMC7450379 DOI: 10.2196/19487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/17/2020] [Accepted: 06/25/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Virtual hospital apps are mobile apps that offer functionalities of online consultation, medical guidance, health community forums, referrals, outpatient appointments or virtual hospital-to-home care services. With an increasing number of online medical and health care consulting services, virtual hospital apps have made health care more accessible and fairer for all, especially in China. However, they have occurred without control or regulation. User evaluation can provide directions to help apps optimize identification, lower risks, and guarantee service quality. OBJECTIVE We aimed to conduct a systematic search for virtual hospital apps in China. To get a global view, virtual hospital apps were assessed and characterized by means of quantitative analysis. To get a local view, we conducted a content feedback analysis to explore user requirements, expectations, and preferences. METHODS A search was conducted of the most popular Apple and Android app stores in China. We characterized and verified virtual hospital apps and grouped apps according to quantification analysis. We then crawled apps and paid attention to corresponding reviews to incorporate users' involvement, and then performed aspect-based content labeling and analysis using an inductive approach. RESULTS A total of 239 apps were identified in the virtual hospital app markets in China, and 2686 informative corresponding reviews were analyzed. The evidence showed that usefulness and ease of use were vital facts for engagement. Users were likely to trust a consulting service with a high number of downloads. Furthermore, users expected frequently used apps with more optimization to improve virtual service. We characterized apps according to 4 key features: (1) app functionalities, including online doctor consultation, in-app purchases, tailored education, and community forums; (2) security and privacy, including user data management and user privacy; (3) health management, including health tracking, reminders, and notifications; and (4) technical aspects, including user interface and equipment connection. CONCLUSIONS Virtual hospitals relying on the mobile internet are growing rapidly. A large number of virtual hospital apps are available and accessible to a growing number of people. Evidence from this systematic search can help various types of virtual hospital models enhance virtual health care experiences, go beyond offline hospitals, and continuously meet the needs of individual end users.
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Affiliation(s)
- Yuan Wang
- College of Artificial Intelligence, Tianjin University of Science and Technology, Tianjin, China
| | - Yuqiao Liu
- College of Artificial Intelligence, Tianjin University of Science and Technology, Tianjin, China
| | - Yancui Shi
- College of Artificial Intelligence, Tianjin University of Science and Technology, Tianjin, China
| | - Yanjun Yu
- College of Artificial Intelligence, Tianjin University of Science and Technology, Tianjin, China
| | - Jucheng Yang
- College of Artificial Intelligence, Tianjin University of Science and Technology, Tianjin, China
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Special Issue on E-Health Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082885. [PMID: 32331273 PMCID: PMC7215852 DOI: 10.3390/ijerph17082885] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/16/2020] [Indexed: 12/15/2022]
Abstract
The importance of e-health to citizens, patients, health providers, governments, and other stakeholders is rapidly increasing. E-health services have a range of advantages. For instance, e-health may improve access to services, reduce costs, and improve self-management. E-health may allow previously underserved populations to gain access to services. Services utilizing apps, social media, or online video are rapidly gaining ground in most countries. In this special issue, we present a range of up-to-date studies from around the world, providing important insights into central topics relating to e-health services.
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Yan M, Tan H, Jia L, Akram U. The Antecedents of Poor Doctor-Patient Relationship in Mobile Consultation: A Perspective from Computer-Mediated Communication. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2579. [PMID: 32283741 PMCID: PMC7178203 DOI: 10.3390/ijerph17072579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 11/23/2022]
Abstract
This study aims to understand the underlying reasons for poor doctor-patient relationships (DPR). While extant studies on antecedents of poor DPR mainly focus on the offline context and often adopt the patients' perspective, this work focuses on the mobile context and take both doctors' and mobile consultation users' perspectives into consideration. To fulfill this purpose, we first construct a theoretical framework based on the Computer-Mediated Communication (CMC) literature. Then we coded 592 doctor-user communication records to validate and elaborate the proposed theoretical model. This work reveals that characteristics of mobile technologies pose potential challenges on both doctors' and patients' information providing, informative interpreting, and relationship maintaining behaviors, resulting in 10 and 6 types of inappropriate behaviors of doctors and users, respectively, that trigger poor DPR in the mobile context. The findings enrich the research on online DPR and provide insights for improving DPR in the mobile context.
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Affiliation(s)
- Mengling Yan
- School of Economics and Management, Beijing University of Posts and Telecommunications, Beijing 100876, China; (M.Y.); (L.J.)
| | - Hongying Tan
- School of Economics and Management, Beijing University of Posts and Telecommunications, Beijing 100876, China; (M.Y.); (L.J.)
| | - Luxue Jia
- School of Economics and Management, Beijing University of Posts and Telecommunications, Beijing 100876, China; (M.Y.); (L.J.)
| | - Umair Akram
- Guanghua School of Management, Peking University, Beijing 100871, China;
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Li Z, Xu X. Analysis of Network Structure and Doctor Behaviors in E-Health Communities from a Social-Capital Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1136. [PMID: 32053913 PMCID: PMC7068535 DOI: 10.3390/ijerph17041136] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/02/2022]
Abstract
In tandem with internet development and widespread social media use, e-health communities have begun to emerge in recent years. These communities allow doctors to access forums anywhere, anytime, seek or exchange medical information online, find literature, and so on. This is convenient and can solve some problems for doctors while also promoting doctor communication. This study collected and collated 102 doctors in the "Lilac Forum" and used social network tools to quantify the overall network density, centrality, core-periphery structure, and structural hole indicators of doctors' information exchange from a social-capital perspective. The results showed that the frequency of interaction between doctors differed because of differences in the identities and participation of doctors in the e-health community. The density of the doctors' information dissemination network (0.228) and network cohesion (0.610) were relatively high. Thus, the doctors were more closely connected, and information was easily spread. At the same time, doctors with higher professional titles had obvious location characteristics, familiarity and trust, and high levels of reciprocity. They could obtain redundant information in the network and were more likely to influence the behavior of other doctors. This study's findings provide support for improving information exchange among doctors in e-health communities and improving the service levels of the platforms.
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Affiliation(s)
- Zhigang Li
- School of Management Science, Chengdu University of Technology, No. 1, Dongsan Road, Erxian Bridge, Chenghua District, Chengdu 610059, China;
| | - Xu Xu
- Chengdu University of Technology, No.1, Dongsan Road, Erxian Bridge, Chenghua District, Chengdu 610059, China
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Exploring Doctors' Willingness to Provide Online Counseling Services: The Roles of Motivations and Costs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010110. [PMID: 31877861 PMCID: PMC6981478 DOI: 10.3390/ijerph17010110] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 12/12/2019] [Accepted: 12/19/2019] [Indexed: 01/10/2023]
Abstract
With the impetus of information communication technology (ICT), emerging eHealth has attracted increasing number of doctors' participation in online health platforms, which provide various potential benefits to doctors. However, previous studies on eHealth have seldom distinguished different service modes provided by doctors. In addition, the bulk of the literature has considered doctors' motivations based solely on online environments. To fill this gap, this study combines expectancy theory and the Bagozzi, Dholakia, and Basuroy (BDB) model to examine the relationships between anticipated outcomes, performance expectations, and effort intentions from online and offline perspectives. Doctors' behavioral intentions are further divided into two categories: the willingness to offer free services and paid services. Using SmartPLS, this study conducts structural equation modeling (SEM) to analyze 311 sample data. The results show that extrinsic motivations (i.e., extrinsic rewards, expected relationships, and image) and intrinsic motivation (i.e., a sense of self-worth) significantly influence the desire to serve patients well, which in turn positively affects the willingness to offer free services and the willingness to offer paid services. Moreover, counseling time is confirmed as the main cost, which negatively moderates the relationships between desire and behavioral intentions. The findings provide theoretical insights for eHealth and provide practical suggestions to develop marketing strategies for online health platform providers.
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