An Exploration and Confirmation of the Factors Influencing Adoption of IoT-Based Wearable Fitness Trackers

Modelling the significance of value-belief-norm framework to predict mass adoption potentials of internet of things-enabled wearable fitness devices

Self-health monitoring technologies have become increasingly popular in averting unanticipated health complications. However, the adoption rate of such technologies in developing countries is surprisingly low. Furthermore, empirical studies on the application of the value-belief-norm (VBN) model to elucidate intention to use IoT-enabled wearable fitness devices (IoT-enabled WFDs) are scarce. This study aimed to expand the VBN model by integrating health values, health consciousness, health knowledge-seeking, and social norms as influencing constructs. The proposed holistic framework was empirically tested to examine these constructs on users' decision-making process of adopting IoT-enabled WFDs. A web-based survey involving 866 adults in China aged 18-30 years was conducted. The gathered data were analysed using partial least squares-structural equation modeling. The results revealed the significant influence of health consciousness and health knowledge-seeking on personal health beliefs, as well as the favourable impact of personal health beliefs on personal norms and awareness of consequences. The results further demonstrated the substantial influence of awareness of consequences and ascription of responsibilities on personal norms. Besides that, personal norms and societal norms were found to have strong influence on the intention to adopt IoT-enabled WFDs, which was revealed to have significant influence on the actual usage. This study's findings offer novel theoretical insights on the behavioural characteristics of adopting IoT-enabled WFDs and serve as a practical guideline for industry experts and marketers to establish appropriate marketing strategies to support the IoT-enabled wearable sector. The findings also benefit policymakers in their efforts of developing strategies that emphasise the unique benefits of self-healthcare monitoring to encourage active lifestyle and decrease obesity and overweight-related health risks.

Iterative Patient Testing of a Stimuli-Responsive Swallowing Activity Sensor to Promote Extended User Engagement During the First Year After Radiation: Multiphase Remote and In-Person Observational Cohort Study

BACKGROUND

Frequent sensor-assisted monitoring of changes in swallowing function may help improve detection of radiation-associated dysphagia before it becomes permanent. While our group has prototyped an epidermal strain/surface electromyography sensor that can detect minute changes in swallowing muscle movement, it is unknown whether patients with head and neck cancer would be willing to wear such a device at home after radiation for several months.

OBJECTIVE

We iteratively assessed patients' design preferences and perceived barriers to long-term use of the prototype sensor.

METHODS

In study 1 (questionnaire only), survivors of pharyngeal cancer who were 3-5 years post treatment and part of a larger prospective study were asked their design preferences for a hypothetical throat sensor and rated their willingness to use the sensor at home during the first year after radiation. In studies 2 and 3 (iterative user testing), patients with and survivors of head and neck cancer attending visits at MD Anderson's Head and Neck Cancer Center were recruited for two rounds of on-throat testing with prototype sensors while completing a series of swallowing tasks. Afterward, participants were asked about their willingness to use the sensor during the first year post radiation. In study 2, patients also rated the sensor's ease of use and comfort, whereas in study 3, preferences were elicited regarding haptic feedback.

RESULTS

The majority of respondents in study 1 (116/138, 84%) were willing to wear the sensor 9 months after radiation, and participant willingness rates were similar in studies 2 (10/14, 71.4%) and 3 (12/14, 85.7%). The most prevalent reasons for participants' unwillingness to wear the sensor were 9 months being excessive, unwanted increase in responsibility, and feeling self-conscious. Across all three studies, the sensor's ability to detect developing dysphagia increased willingness the most compared to its appearance and ability to increase adherence to preventive speech pathology exercises. Direct haptic signaling was also rated highly, especially to indicate correct sensor placement and swallowing exercise performance.

CONCLUSIONS

Patients and survivors were receptive to the idea of wearing a personalized risk sensor for an extended period during the first year after radiation, although this may have been limited to well-educated non-Hispanic participants. A significant minority of patients expressed concern with various aspects of the sensor's burden and its appearance.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03010150; https://clinicaltrials.gov/study/NCT03010150.

Haptic Nudging Using a Wearable Device to Promote Upper Limb Activity during Stroke Rehabilitation: Exploring Diurnal Variation, Repetition, and Duration of Effect

Haptic nudging via wearable devices promotes physical activity and may increase upper limb movement in stroke rehabilitation. This study investigated the optimal approach to haptic nudging by examining diurnal variation, duration of effect, and repeated nudging. The study analysed data from a multiple-period randomised crossover study. A 12 h inpatient rehabilitation day was divided into 72 intervals in which participants with stroke (n = 20) randomly received either a 'nudge' or 'no nudge'. Upper limb movement was observed, classified, and analysed using longitudinal mixed models. The odds of affected upper limb movement following a nudge compared with no nudge were significantly higher during active periods such as breakfast, lunch, and morning and afternoon activities (odds ratios (ORs) 2.01-4.63, 95% CIs [1.27-2.67, 3.17-8.01]), but not dinner (OR 1.36, 95% CI [0.86, 2.16]). The effect of nudging was no longer statistically significant at 50-60 s post-nudge. Consecutive delays in nudging significantly decreased the odds of moving when a nudge was eventually delivered. Contrary to expectations, people with stroke appear more responsive to haptic nudging during active periods rather than periods of inactivity. By understanding the optimal timing and frequency of haptic nudging, the design of wearable devices can be optimised to maximise their therapeutic benefits.

Security Risks and User Perception towards Adopting Wearable Internet of Medical Things

The Wearable Internet of Medical Things (WIoMT) is a collective term for all wearable medical devices connected to the internet to facilitate the collection and sharing of health data such as blood pressure, heart rate, oxygen level, and more. Standard wearable devices include smartwatches and fitness bands. This evolving phenomenon due to the IoT has become prevalent in managing health and poses severe security and privacy risks to personal information. For better implementation, performance, adoption, and secured wearable medical devices, observing users' perception is crucial. This study examined users' perspectives of trust in the WIoMT while also exploring the associated security risks. Data analysed from 189 participants indicated a significant variance (R² = 0.553) on intention to use WIoMT devices, which was determined by the significant predictors (95% Confidence Interval; p < 0.05) perceived usefulness, perceived ease of use, and perceived security and privacy. These were found to have important consequences, with WIoMT users intending to use the devices based on the trust factors of usefulness, easy to use, and security and privacy features. Further outcomes of the study identified how users' security matters while adopting the WIoMT and provided implications for the healthcare industry to ensure regulated devices that secure confidential data.

Technology Roadmap for Flexible Sensors

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.

Exploring the mass adoption potential of wearable fitness devices in Malaysia

Objective

The current study explores the formation of an intention to use wearable fitness devices (WFDs) with wearable fitness attributes and health consciousness (HCS). Moreover, the research examines the use of WFDs with the health motivation (HMT) and intention to use WFDs. The study also exposes the moderating effect of HMT between the intention to use WFDs and the use of WFDs.

Methods

Five hundred and twenty-five adults participated in the current study, and data were collected from January 2021 to March 2021 through the online survey of Malaysian respondents. The cross-sectional data was analyzed using the second-generation statistical method of partial least square structural equation modeling.

Results

HCS is insignificantly associated with the intention to use WFDs. Perceived compatibility, perceived product value, perceived usefulness, and perceived technology accuracy significantly influence the intention to use WFDs. HMT significantly impacts the adoption of WFDs; however, the intention to use WFDs negatively but significantly influences the use of WFDs. Lastly, the association between the intention to use WFDs and the adoption of WFDs is significantly moderated by HMT.

Conclusions

Our study findings illuminate the significant impact of technology-level attributes of WFDs on the intention to use WFDs. However, an insignificant impact of HCS on the intention to use WFDs was reported. Our result confirms that HMT plays a significant role in the use of WFDs. Such as the moderating role of HMT is vital to transform the intention to use WFDs into the adoption of WFDs.

Factors Affecting the Adoption of IoT-Based Smart Campus: An Investigation Using Analytical Hierarchical Process (AHP)

The advancement of technology is making university campuses smarter every single day. Despite the benefits of these advanced technologies, the literature concerning the adoption of smart campuses is significantly lacking increased knowledge to provide effective smart campus solutions. This study aims to prioritize the adoption factors of an IoT-based smart campus. The study applied an analytical hierarchical process (AHP) on 25 factors drawn from the literature. The factors were classified into technology specific factors (TSF), organizational specific factors (OSF), environmental specific factors (ESF), and end-user specific factors (USF). Based on the results obtained, the most significant contributing factors were government support, privacy concerns, social influence, facilitating conditions, and service collaboration, whereas the least significant contributing factors were enjoyment, availability, reliability, mobility, and compatibility. Moreover, based on the global ranking computation, 12 factors from the OSF, ESF, and USF categories appeared to be more significant than TSF. The findings of this study could help university administrators, manufacturers, and policy-makers to understand the critical factors of smart campuses in order to improve the adoption and utilization of these solutions effectively.

Veteran and Staff Experience from a Pilot Program of Health Care System-Distributed Wearable Devices and Data Sharing

OBJECTIVE

 The growing trend to use wearable devices to track activity and health data has the potential to positively impact the patient experience with their health care at home and with their care team. As part of a pilot program, the U.S. Department of Veterans Affairs (VA) distributed Fitbits to Veterans through four VA medical centers. Our objective was to assess the program from both Veterans' and clinicians' viewpoints. Specifically, we aimed to understand barriers to Fitbit setup and use for Veterans, including syncing devices with a VA mobile application (app) to share data, and assess the perceived value of the device functions and ability to share information from the Fitbit with their care team. In addition, we explored the clinicians' perspective, including how they expected to use the patient-generated health data (PGHD).

METHODS

 We performed semi-structured interviews with 26 Veterans and 16 VA clinicians to assess the program. Responses to each question were summarized in order of frequency of occurrence across participants and audited by an independent analyst for accuracy.

RESULTS

 Our findings reveal that despite setup challenges, there is support for the use of Fitbits to engage Veterans and help manage their health. Clinicians believed there were benefits for having Veterans use the Fitbits and expected to use the PGHD in a variety of ways as part of the Veterans' care plans, including monitoring progress toward health behavior goals. Veterans were overwhelmingly enthusiastic about using the Fitbits; this enthusiasm seems to extend beyond the 3 month "novelty period."

CONCLUSION

 The pilot program for distributing Fitbits to Veterans appears to be successful from both Veterans' and clinicians' perspectives and suggests that expanded use of wearable devices should be considered. Future studies will need to carefully consider how to incorporate the PGHD into the electronic health record and clinical workflow.

Revising Technology Adoption Factors for IoT-Based Smart Campuses: A Systematic Review

Smart education and the sustainable development of smart campuses have drawn significant research attention. This is enabled by intelligent devices that are widely attracting massive applicability in personal and big business contexts and can increase efficiency and convenience. This paper aims to present a solution to address the lack of a proper adoption model for smart campus initiatives. The evaluation and synthesis of the literature were conducted by following the systematic literature review (SLR) procedure. The study’s findings revealed the taxonomy and IoT technologies leading to the wide adoption of IoT-based smart campuses. The technology adoption models and their corresponding variables help the authors identify and classify a suitable adoption framework for smart campuses. The limitations and challenges of adoption theories as they pertain to smart campuses are discussed. Finally, the study adapts perceived scalability, perceived replicability, perceived reliability, perceived privacy and security, perceived trust, the cost of deployment, usefulness, enjoyment, and technicality as adoption factors of sustainable smart campuses. This study offers practical and theoretical implications regarding the adoption and propagation of emerging smart campuses.

Is health consciousness and perceived privacy protection critical to use wearable health devices? Extending the model of goal-directed behavior

Purpose

The present study is an attempt to extend the Model of Goal-directed Behavior (MGB) to consider health consciousness and perceived privacy protection as two critical factors to predict desire and intention by individuals to adopt and use wearable health devices (WHDs).

Design/methodology/approach

Based on the literature review hypotheses were framed and tested using data collected through a questionnaire survey. A total of 418 self-reported complete responses were considered to analyze the hypotheses proposed in the study. Structural equation modeling, effects analysis and model comparison (MGB and extended MGB) were performed to understand the predictability of the suggested model.

Findings

The results of the study corroborate that along with MGB, health consciousness and perceived privacy protection also induces the intention of users toward using WHDs. Health-consciousness is found to have a positive and significant direct and indirect impact on intention to use WHDs. Further, the model comparison exhibits that the proposed extended MGB is a better predictor of intention to use WHDs.

Practical implications

Apart from the conventional framework of MGB, health consciousness and perceived privacy protection promote desire and intention to use WHDs. This research provides a framework for marketers to promote health consciousness among consumers by motivating them to adopt WHDs. Further, privacy protection features should be showcased in order to induce trust in consumers which in turn will trigger their intention to use WHDs to lead a healthy lifestyle.

Originality/value

The current study incorporates health consciousness and perceived privacy protection in MGB to fit into the context of healthcare intention study, which enhances the predictability of intention behavior of consumers and adds to the existing body of MGB and healthcare literature.

Association between behavioral phenotypes and sustained use of smartphones and wearable devices to remotely monitor physical activity

Smartphones and wearable devices can be used to remotely monitor health behaviors, but little is known about how individual characteristics influence sustained use of these devices. Leveraging data on baseline activity levels and demographic, behavioral, and psychosocial traits, we used latent class analysis to identify behavioral phenotypes among participants randomized to track physical activity using a smartphone or wearable device for 6 months following hospital discharge. Four phenotypes were identified: (1) more agreeable and conscientious; (2) more active, social, and motivated; (3) more risk-taking and less supported; and (4) less active, social, and risk-taking. We found that duration and consistency of device use differed by phenotype for wearables, but not smartphones. Additionally, "at-risk" phenotypes 3 and 4 were more likely to discontinue use of a wearable device than a smartphone, while activity monitoring in phenotypes 1 and 2 did not differ by device type. These findings could help to better target remote-monitoring interventions for hospitalized patients.

Adoption Intention and Factors Influencing the Use of Gerontechnology in Chinese Community-Dwelling Older Adults: A Mixed-Methods Study

Objective: To explore the Chinese community-dwelling intention of older adults to adopt gerontechnology and its influencing factors.

Design: A mixed-methods sequential explanatory design with an inductive approach was employed. In phase 1, a self-made questionnaire was administered from August 2018 to December 2019. Multifactor logistic regression was used to analyze the adoption intention and factors influencing the use of gerontechnology. In phase 2, participants completed a semistructured interview to explore the adoption intention of a specific form of gerontechnology, Smart Aged Care Platform, from May to July 2020.

Setting: Twelve communities in three districts of Chongqing, China.

Participants: Community-dwelling older adults were included.

Results: A total of 1,180 older adults completed the quantitative study; two-thirds of them (68.7%) showed adoption intention toward gerontechnology. Nineteen participants (10 users and nine nonusers) completed the qualitative study and four themes were explored. Through a summarized understanding of the qualitative and quantitative data, a conceptual model of influencing factors, namely, predictive, enabling, and need factors, was constructed.

Conclusions: This study reveals that most Chinese community-dwelling older adults welcome the emergence of new technologies. However, there was a significant difference in the adoption intention of gerontechnology in Chinese community-dwelling older adults based on their sociodemographic and psychographic characteristics. Our findings extend previous technology acceptance models and theories and contribute to the existing resource base.

Analyzing the Adoption Challenges of the Internet of Things (IoT) and Artificial Intelligence (AI) for Smart Cities in China

Smart cities play a vital role in the growth of a nation. In recent years, several countries have made huge investments in developing smart cities to offer sustainable living. However, there are some challenges to overcome in smart city development, such as traffic and transportation management, energy and water distribution and management, air quality and waste management monitoring, etc. The capabilities of the Internet of Things (IoT) and artificial intelligence (AI) can help to achieve some goals of smart cities, and there are proven examples from some cities like Singapore, Copenhagen, etc. However, the adoption of AI and the IoT in developing countries has some challenges. The analysis of challenges hindering the adoption of AI and the IoT are very limited. This study aims to fill this research gap by analyzing the causal relationships among the challenges in smart city development, and contains several parts that conclude the previous scholars’ work, as well as independent research and investigation, such as data collection and analysis based on DEMATEL. In this paper, we have reviewed the literature to extract key challenges for the adoption of AI and the IoT. These helped us to proceed with the investigation and analyze the adoption status. Therefore, using the PRISMA method, 10 challenges were identified from the literature review. Subsequently, determination of the causal inter-relationships among the key challenges based on expert opinions using DEMATEL is performed. This study explored the driving and dependent power of the challenges, and causal relationships between the barriers were established. The results of the study indicated that “lack of infrastructure (C1)”, ”insufficient funds (C2)”, “cybersecurity risks (C3)”, and “lack of trust in AI, IoT” are the causal factors that are slowing down the adoption of AI and IoT in smart city development. The inter-relationships between the various challenges are presented using a network relationship map, cause–effect diagram. The study’s findings can help regulatory bodies, policymakers, and researchers to make better decisions to overcome the challenges for developing sustainable smart cities.

Factors affecting adoption of digital payments by semi-rural Indian women: extension of UTAUT-2 with self-determination theory and perceived credibility

Purpose

The aim of this research is to investigate the factors influencing the adoption of digital payments by the semi-rural women in India.

Design/methodology/approach

The study extended the factors of unified theory of acceptance and use of technology UTAUT-2, with perceived credibility and self-determination theory to understand the use behaviour of the rural Indian women. The study checked the mediating role of some constructs besides testing the direct relationship. The study was conducted in the rural parts of the adjoining areas of Delhi, where the women from different states, education and financial background live. The research model was empirically tested on 568 respondents using structural equation modelling (SEM) technique.

Findings

The research model was able to explain 72.6% variance in the user behaviour variable. Effort expectancy, habit, facilitating conditions as well as perceived competence emerged out to be significant determinants of use behaviour. Besides these direct relationships, two constructs, habit as well as facilitating conditions were found to partially mediate the relationship between behavioural intention and behaviour.

Originality/value

This study provides some very critical clues for the companies providing digital payment services, by highlighting the significant factors explaining the technology adoption by semi-rural women. The companies must devise suitable marketing strategies to inculcate trust in mind of perspective customers towards their companies as well as the service provided by them. The role of simple digital platform, that is easy to learn and use, is also an important element in determining the technology adoption.

Important Factors Affecting User Experience Design and Satisfaction of a Mobile Health App-A Case Study of Daily Yoga App

In recent years, mobile health (mHealth) has gained popularity. Yoga apps help users to exercise at home and improve their health. It is worth discussing how to give yogis a better experience and higher satisfaction to improve their willingness to keep using yoga apps. In this study, the Daily Yoga app was selected as the research object to explore important factors related to its user experience design and user satisfaction. Through a literature review and Delphi method composed of eight experts, this study put forward the important criteria framework of user experience design for the Daily Yoga app and then, used the DEMATEL (Decision Making and Trial Evaluation Laboratory)-based ANP (Analytic Network Process) method to determine the factors’ importance order and the causal relationships among them. Finally, combined with the results of an importance–performance analysis of 16 real users, we discuss the improvement measures. The research results show that the yoga class is the most critical factor in the user experience design of the Daily Yoga app, the target plan is a factor that is in great need of improvement, and having an attractive interface can improve user experience. The evaluation model of the study can act as a reference for improving user experience with the Daily Yoga app, and can also be widely used in the process of user experience design, questionnaire production, and evaluation optimization of mHealth app and related applications.

Strategies for Heterogeneous R&D Alliances of In Vitro Diagnostics Firms in Rapidly Catching-Up Economies

Most developed countries already have high-quality in vitro diagnostic (IVD) techniques for diseases, but developing countries often do not have access to these technologies and cannot afford them. Enabling firms to leverage external resources to optimize their research and development (R&D) performance has become one of the most critical issues for small and medium-sized late-coming IVD firms. R&D alliances, especially heterogeneous alliances, are necessary for releasing the resource limitations of late-coming small and medium-sized enterprises (SMEs) and reaching the metaoptimum of the R&D performances. However, to the authors’ knowledge, a few, if any, previous studies have investigated the key success factors and strategies of heterogeneous alliances in the IVD industry. Therefore, the authors aim to define the critical factors for evaluating and selecting strategies for heterogeneous alliances in the IVD industry. A Decision-Making Trial and Evaluation Laboratory (DEMATEL)-based analytic network process (DANP) was proposed to prioritize the weights associated with the evaluation criteria. Then, a heterogeneous R&D alliance strategy was derived from the compromise ranking based on the modified VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method. An empirical study of major Taiwanese IVD firms’ evaluation and selection of heterogeneous R&D alliance strategies will be used to reveal the practicability of the analytic framework. Based on the analytic results, the joint venture strategy is the most suitable heterogeneous R&D alliance strategy for IVD firms in rapidly catching-up economies. These results can serve as the basis for heterogeneous R&D alliance strategy definitions in the IVD industry in the future.

Factors Influencing the Application of Connected Health in Remote Areas, Taiwan: A Qualitative Pilot Study

This pilot study investigated factors influencing the application of connected health (CH) in Taiwanese remote areas. These factors cover issues of cost, infrastructure, technology, business sustainability, business model, collaboration, and communication. It aimed to explore the significance and to assess the feasibility of researching CH in Taiwan. A qualitative exploratory study was conducted by interviewing relevant stakeholders (n = 18). The majority were healthcare providers as most of them are the CH end users. Their feedback was essential in reflecting the effectiveness of CH products and services. Therefore, understanding their views is significant in the design of a successful and user-friendly interactive system. A theoretical framework on the introduction of innovations in healthcare was employed to guide data collection and thematic analysis. Additionally, stakeholders proposed strategies for enhancing the implementation of CH in remote areas. This pilot study also contributed to identifying future directions and information for conducting the multi-stage interviews for collecting the data more effectively. Although the results reveal that the study of CH is meaningful, there is an issue of business sustainability which is obscured by some barriers that need to be addressed. These barriers will be further investigated in the first-stage interview and second-stage interview in future research. The research findings also suggest that strategies and sustainability for CH implementation should be included from the planning phase to benefit all the stakeholders in the CH ecosystem.

Advanced Technology Use by Care Professionals

Advanced technology is a primary solution for the shortage of care professionals and increasing demand for care, and thus acceptance of such technology is paramount. This study investigates factors that increase use of advanced technology during elderly care, focusing on current use of advanced technology, factors that influence its use, and care professionals’ experiences with the use. This study uses a mixed-method design. Logfiles were used (longitudinal design) to determine current use of advanced technology, questionnaires assessed which factors increase such use, and in-depth interviews were administered to retrieve care professionals’ experiences. Findings suggest that 73% of care professionals use advanced technology, such as camera monitoring, and consult clients’ records electronically. Six of nine hypotheses tested in this study were supported, with correlations strongest between performance expectancy and attitudes toward use, attitudes toward use and satisfaction, and effort expectancy and performance expectancy. Suggested improvements for advanced technology include expanding client information, adding report functionality, solving log-in problems, and increasing speed. Moreover, the quickest way to increase acceptance is by improving performance expectancy. Care professionals scored performance expectancy of advanced technology lowest, though it had the strongest effect on attitudes toward the technology.