Toward a Better Understanding of the Intention to Use mHealth Apps: Exploratory Study

Background: An increasing number of mobile health (mHealth) apps are becoming available for download and use on mobile devices. Even with the increase in availability and use of mHealth apps, there has still not been a lot of research into understanding the intention to use this kind of apps. Objective: The purpose of this study was to investigate a technology acceptance model (TAM) that has been specially designed for primary health care applications. Methods: The proposed model is an extension of the TAM, and was empirically tested using data obtained from a survey of mHealth app users (n=310). The research analyzed 2 additional external factors: promotion of health and health benefits. Data were analyzed with a PLS–SEM software and confirmed that gender moderates the adoption of mHealth apps in Spain. The explanatory capacity (R2 for behavioral intention to use) of the proposed model was 76.4%. Likewise, the relationships of the external constructs of the extended TAM were found to be significant. Results: The results show the importance of healthy habits developed by using mHealth apps. In addition, communication campaigns for these apps should be aimed at transferring the usefulness of eHealth as an agent for transforming attitudes; additionally, as more health benefits are obtained, ease of use becomes greater. Perceived usefulness (PU; β=.415, t0.001;4999=3.442, P=.001), attitude toward using (β=.301, t0.01;499=2.299, P=.02), and promotion of health (β=.210, t0.05;499=2.108, P=.03) were found to have a statistically significant impact on behavior intention to use eHealth apps (R2=76.4%). Perceived ease of use (PEOU; β=.179, t0.01;499=2.623, P=.009) and PU (β=.755, t0.001;499=12.888, P=78.2%). Furthermore, PEOU (β=.203, t0.01;499=2.810, P=.005), health benefits (β=.448, t0.001;499=4.010, P<.001), and promotion of health (β=.281, t0.01;499=2.393, P=.01) exerted a significant impact on PU (R2=72.7%). Finally, health benefits (β=.640, t0.001;499=14.948, P<.001) had a statistically significant impact on PEOU (R2=40.9%), while promotion of health (β=.865, t0.001;499=29.943, P<.001) significantly influenced health benefits (R2=74.7%). Conclusions: mHealth apps could be used to predict the behavior of patients in the face of recommendations to prevent pandemics, such as COVID-19 or SARS, and to track users’symptoms while they stay at home. Gender is a determining factor that influences the intention to use mHealth apps, so perhaps different interfaces and utilities could be designed according to gender

Investigating the adoption and use of smartphones in the UK : a silver-surfers perspective

Copyright and all rights therein are retained by the authors. All persons copying this information are expected to adhere to the terms and conditions invoked by each author's copyright. These works may not be re-posted without the explicit permission of the copyright holdersSmart phones are innovations that currently provide immense benefits and convenience to users in society. However, not all members of society are accepting and using smart phones; more specifically, for this research study silver-surfers or older adults (50+) are a demographic group displaying such an attitude. Currently, there is minimal knowledge of the reasons for older adults adopting and using smartphones. Bearing this in mind, this research study aims to investigate the adoption and usage behaviours of silver-surfers. For this purpose, the conceptual framework applied to this research draws factors from the following theories: Unified Theory of Acceptance and Use of Technology (UTAUT), the Diffusion of Innovations theory (DoI), and TAM3 (Technology Acceptance Model). From the online survey of 204 completed replies it was found that observability, compatibility, social influence, facilitating conditions, effort expectancy and enjoyment are important to the adoption and use of smartphones within silver-surfers. The contributions of this research are an identification and understanding of the factors that encourage or inhibit smartphone use within the older adult population. Second, this research can inform the design of computing devices and applications used for silver-surfers. Finally, this research can enlighten policy makers when forming decisions that encourage adoption and use of smartphones among silver surfersFinal Published versio

Re-thinking technology and its growing role in enabling patient empowerment

© The Author(s) 2018. The presence and increase of challenges to eHealth in today’s society have begun to generate doubts about the capability of technology in patient empowerment, especially within the frameworks supporting empowerment. Through the review of existing frameworks and articulation of patient demands, weaknesses in the current application of technology to support empowerment are explored, and key constituents of a technology-driven framework for patient empowerment are determined. This article argues that existing usage of technology in the design, development and implementation of patient empowerment in the healthcare system, although well intentioned, is insufficiently constituted, primarily as a result of fragmentation. Systems theory concepts such as holism and iteration are considered vital in improving the role of technology in enabling patient empowerment

Predicting Nursing Graduates’ Intention for Continuous Usage of OCP- MALL App: A Benchmark Analysis

Introduction: M- learning has become a great source for nurses to up-skill their practice. Many localized asynchronous m-learning apps are emerging to fill the lacunae in nursing education, which require features to trigger and sustain self-regulated e learning behaviour. The present study takes an inventory of the engaging factors of OCP (Oral case Presentation) MALL app that support continued m - learning Method: The OCP -MALL was analysed with three determiners of continued m-learning engaging qualities bench marked by various m- learning theories I. Cognitive Engagement Quality (Perceived Usefulness, perceived Relevance of Learning, User Satisfaction Quality); II. User Satisfaction Quality (M-learning satisfaction, Perceived level of m-learning Anxiety, Ease of M- Learning App usage); Motivational Engagement Quality (Intrinsic Motivation, Extrinsic Motivation and Game Elements) by comparing the pre-and postusers’ feedback. Results: The analysis indicate that all 57 participants considered OCP - MALL as a useful app with English language training for OCP perceived as a felt need. A significant change in the confidence perceived in the use of vocabulary and fluency to present the case. The user perception survey elicited responses showed a satisfaction in using online resources (z=-4.042b, P =&lt; 0.001), e learning support for academic performance (Z = -2.887b, P= &lt; 0.003) and improved interaction during e - learning (Z=-3.729d, P = &lt; 0.001), satisfaction ( z= -3.834b, P = 0.000) and peer interactions (Z= -4.417d, P = 0.000). A consistent everyday progress on OCP learning observed through the administrator’s progress tracker mode indicated a self-determined regulation to learn, a sign of intrinsic motivation.While employing digital gaming elements ‘unlocking levels of learning and assessment’, ‘receiving rewards, score points’ and ‘badges’ enhanced the extrinsic motivational quality of the app. Conclusion:The findings support that OCP - MALL app has the potential engaging qualities to influence the users’ continued learning. It is evident that asynchronous MALL applications that are developed in local regions could effective provide language learning if developed using the continuous learning factors as antecedents. Further, the identified check list of engaging factors could serve as guide post to the nursing educators who are desirous to develop need-based m- learning applications

Influential Factors of Undergraduate Students’ Behavioral Intention toward Mobile Reading Software: A Case of A Public University in Sichuan, China

Purpose: The main purpose of this study is to analyze the behavioral intention of college students using mobile reading apps in Sichuan Normal University through a questionnaire survey. This study mainly used system quality, information quality, service quality, perceived usefulness, perceived ease of use, and other methods to determine the influencing factors and behavioral intention of college students' use of mobile reading apps in Sichuan Normal University. Research design, data, and methodology: The target population of this study is college students at Sichuan Normal University. The total sample size is 500 undergraduates from the first to the third year in Sichuan Normal University. The researchers used three steps to collect target samples: purpose or judgment sampling, quota sampling, and convenience sampling. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to analyze the reliability of study variables and conceptual frameworks. Results: System quality, service quality and perceived ease of use significantly impact perceived usefulness. Perceived usefulness significantly impacts behavioral intention. In contrast, information quality has no significant impact on perceived usefulness. Conclusions: This research offers valuable insights that can guide educational institutions, app developers, policymakers, and researchers in fostering effective technology integration for educational enhancement

Digital technology adaptation and initiatives: a systematic review of teaching and learning during COVID-19

COVID-19 dramatically influenced students’ and staff’s learning and teaching experiences and approaches to learning. While many papers examined individual experiences in the context of higher education, synthesising these papers to determine enabling and hindering influences of digital adaptation was needed to guide the next phase of online learning reforms. This study explored the main dimensions of digital technology adaptation in higher education during the COVID-19 pandemic. The consequences for student and staff experiences and what aspects should be sustained and developed were discussed in this review. A total of 90 articles (published between 1st January 2020 and 30th June 2021) were identified and analysed based on the preferred reporting items for systematic reviews and meta-analyses framework. Four dimensions (with associated sub-factors) were found to influence student and staff experiences: techno-economic; personal and psychological; teaching, learning and assessment; and social. The findings highlighted that an integrated approach, across institutional, technical platforms, and individuals would be required to sustain digital learning initiatives during the crisis time

Application of Mobile Health Services to Support Patient Self-Management of Chronic Conditions

Background: Chronic conditions are the leading cause of ill-health, disability and premature death, adding huge health and socioeconomic burden to the healthcare system. Although mobile health (mHealth) services have the potential to provide patients with a timely, ubiquitous, and cost-effective means to access healthcare services, to date, much remains to be revealed for their application in chronic condition management. Aim: This doctoral project aims to comprehensively understand the application of mHealth services to support patient self-management of chronic conditions. This aim is achieved through four objectives: (1) to synthesise research evidence about health outcomes of applying mHealth services to support patient self-management of chronic conditions and the essential components to achieve these outcomes, (2) to determine the mechanism for applying mHealth services to support patient self-management of chronic conditions, (3) to explore critical factors and how these factors influence patients\u27 intention to continuously use mHealth services, and (4) to apply the above findings to guide the design of a prototype mHealth service. Methods: To increase the generalisability of the findings, three chronic conditions that could benefit from mHealth services were purposively studied to address the research objectives within the feasibility of available study sites and resources at different stages of the project. First, two literature review studies were conducted to achieve Objective 1. One was a systematic review to investigate health outcomes of mHealth services to support patient self-management of one chronic condition, unhealthy alcohol use, and the essential components to achieve these outcomes. The other was a rapid review on using behavioural theory to guide the design of mHealth services that support patient self-management of another chronic condition, hypertension. Second, two field studies were conducted to achieve Objectives 2 and 3, respectively. One was an interview study that explored patients\u27 perceptions of a mHealth service to support their self-management of hypertension in China. The other was a questionnaire survey study conducted on the same site that explored critical factors influencing patients\u27 intention to continuously use the mHealth service. Third, a clinician-led, experience-based co-design approach was implemented to apply the above-mentioned learning experience to the development practice of a mHealth service that supports patient self-management of obesity before elective surgery in Australia, achieving Objective 4. Results: Literature reviews identify five structural components - context, theory, content, delivery mode, and implementation procedure - which are essential for mHealth services to achieve three health outcomes - behavioural, physiological, and cognitive outcomes. Inductive synthesis of the interview findings lead to a 6A framework that summarises the mechanisms for mHealth services: access, assessment, assistance, awareness, ability, and activation. Mobile health services provide patients with easy access to health assessment and healthcare assistance to increase their self-management awareness and ability, thereby activating their self-management behaviours. Questionnaire survey study finds that patients\u27 intention to continuously use mHealth services can be influenced by the information quality, system quality and service quality by influencing their perceived usefulness and satisfaction with the mHealth services. Guided by Social Cognitive Theory, the developed prototype mHealth service provide patients with functions of automatic push notifications, online resources, goal setting and monitoring, and interactive health-related exchanges that encourage their physical activity, healthy eating, psychological preparation, and a positive outlook for elective surgery. The patients\u27 requirements in two focus group discussions enabled the research team to improve the mHealth service design. Conclusion: Mobile health services guided by behavioural theories can provide patients with easy access to health assessment and healthcare assistance to increase their self-management awareness and ability, thereby activating their self-management behaviours. The effort for designing mHealth services needs to be placed on crafting content (to improve information quality), developing useful functions and selecting a proper delivery mode (to improve system quality), and establishing effective implementation procedures (to improve service quality). These will ensure patients\u27 perceived usefulness and satisfaction with mHealth services, increase their intention to continuously use such services, thus supporting long-term patient self-management of chronic conditions. As demonstrated by the design case, the findings of this PhD project can be generalised to guide the design of other mHealth services that aim to support patient self-management of chronic conditions

DESIGN PRINCIPLES FOR APP-BASED HEALTHCARE INTERVENTIONS: A MIXED METHOD APPROACH

Despite the ubiquity of mobile health applications (apps), the practical use and success of the apps have been questionable. Design Principles (DP) can affect chronic health app user satisfaction and have been studied for ensuring favorable app usage. However, there is no consensual definition of DP within the preceding literature, which has a technical rather than an end-user-centric focus and lacks a rigorous theoretical basis. Moreover, different levels of DPs’ application can lead to differential user satisfaction as influenced by the user-contextual environment, warranting a quantitative assessment. Accordingly, the overarching question to be addressed is which DP for the self-management of chronic conditions contributes to better user satisfaction outcomes. The research focuses on Multiple Sclerosis (MS) as a representative condition. This research uses a mixed methods, with a qualitative approach for DP identification and a quantitative approach for the studying the DP-Satisfaction relationship. The DP identification is achieved through - 1) An in depth review of foundational theory for greater validity, 2) A Systematic Literature Review (SLR), for DP themes grounded in theory, and 3) Manually coded user reviews for MS apps. The theoretical underpinnings of the empirical approach are established through a composite theoretical lens, based on technologically, behaviorally, and cognitively oriented frameworks. The DP extracted from theory, SLR, and manual coding methods are found to be largely consistent with each other, namely ‘Communication with Clinicians’, ‘Compatibility, ‘Education’, ‘Notifications’, ‘Tracking’, ‘Social Support’, ‘Ease of Use’, ‘Technical Support’, ‘Usefulness’, ‘Privacy and Security’, and Quality. An ordinal logistic regression analysis is conducted to understand the relationship between DP and User Satisfaction outcomes based on the manually coded DP scores of the user reviews. All DP have a significant impact on User Satisfaction. From a theoretical perspective, the research improves our understanding of key design principles for the self-management of chronic conditions such as MS and the impact of such principles on user satisfaction. From a practical perspective, the findings provide guidance to the user requirement elicitation process, potentially leading to the development of more successful, sustainable, and responsive healthcare interventions