Understanding the determinants of mHealth apps adoption in Bangladesh: A SEM-Neural network approach

Due to the low adoption rate of mHealth apps, the apps designers need to understand the factors behind adoption. But understanding the determinants of mHealth apps adoption remains unclear. Comparatively less attention has been given to the factors affecting the adoption of mHealth apps among the young generation. This study aims to examine the factors influencing behavioral intention and actual usage behavior of mHealth apps among technology prone young generation. The research model has extracted variables from the widely accepted Unified Theory of Acceptance and Use of Technology (UTAUT2) alongside privacy, lifestyles, self-efficacy and trust. Required data were collected from mHealth apps users in Bangladesh. Firstly, this study confirmed that performance expectancy, social influence, hedonic motivation and privacy exerted a positive influence on behavioral intention whereas facilitating conditions, self-efficacy, trust and lifestyle had an influence on both behavioral intention and actual usage behavior. Secondly, the Neural Network Model was employed to rank relatively significant predictors obtained from structural equation modeling (SEM). This study contributes to the growing literature on the use of mHealth apps in trying to elevate the quality of patients' lives. The new methodology and findings from this study will significantly contribute to the extant literature of technology adoption and mHealth apps adoption intention especially. Therefore, for practitioners concerned with fostering mHealth apps adoption, the findings stress the importance of adopting an integrated approach centered on key findings of this study

ANTESEDEN NIAT PENGGUNAAN BERKELANJUTAN DAN PENGARUHNYA PADA NIAT MEREKOMENDASIKAN TELEMEDISIN PASCA-PANDEMI COVID-19

ABSTRACT The dramatic development of information and communication technology triggered by the Covid-19 pandemic situation has prompted changes in the patient's behavior in using health services. The purpose of this study was to determine whether, after the pandemic ended, patients still wanted to continue using telemedicine for their treatment. This study attempts to integrate the theory of attitude, ECM, UTAUT2, social media brand communication, and consumer trust models to predict post-Covid-19 telemedicine continuance use intentions. The antecedent variables used in this study are satisfaction, confirmation, initial trust in doctors, social media content, and UTAUT2, which are represented by performance expectations, effort expectations, social influences, facilitating conditions, price values, and habits. An online survey design was employed to collect data. A structured questionnaire was distributed to telemedicine users using google forms. The sampling method used in this study is purposive sampling. A total of 224 respondents were collected, and data were processed with SmartPLS. The study found that effort and confirmation expectations positively affect performance expectations. Whereas confirmation and performance expectations positively affect satisfaction. Price values and habits positively affect continuance usage intention in using telemedicine after the Covid-19 pandemic. The results also found that the continuance usage intention affects the intention to recommend. Meanwhile, four of the six variables in the UTAUT2 model (performance expectations, effort expectations, social influence, facilitating conditions) were not shown to affect the continuance usage intention. Likewise, satisfaction, initial trust in doctors, and social media content did not affect the continuance usage intention.  Keywords: UTAUT2; ECM; satisfaction; trust; social media content; continuance usage intention; intention to recommend.   ABSTRAK Perkembangan teknologi informasi dan komunikasi yang dramatis yang dipicu oleh situasi pandemi Covid-19 telah mendorong perubahan perilaku pasien dalam menggunakan layanan kesehatan. Tujuan dari penelitian ini adalah untuk mengetahui apakah, setelah pandemi berakhir, pasien masih ingin terus menggunakan telemedicine untuk pengobatannya. Penelitian ini mencoba mengintegrasikan teori sikap, ECM, UTAUT2, komunikasi merek media sosial, dan model kepercayaan konsumen untuk memprediksi niat penggunaan telemedicine pasca Covid-19. Variabel anteseden yang digunakan dalam penelitian ini adalah kepuasan, konfirmasi, kepercayaan awal pada dokter, konten media sosial, dan UTAUT2, yang diwakili oleh ekspektasi kinerja, ekspektasi usaha, pengaruh sosial, kondisi memfasilitasi, nilai harga, dan kebiasaan. Desain survei online digunakan untuk mengumpulkan data. Kuesioner terstruktur dibagikan kepada pengguna telemedicine dengan menggunakan google form. Metode pengambilan sampel yang digunakan dalam penelitian ini adalah purposive sampling. Sebanyak 224 responden dikumpulkan, dan data diolah dengan menggunakan SmartPLS. Studi ini menemukan bahwa ekspektasi usaha dan konfirmasi secara positif memengaruhi ekspektasi kinerja. Sedangkan konfirmasi dan ekspektasi kinerja berpengaruh positif terhadap kepuasan. Nilai harga dan kebiasaan berpengaruh positif pada penggunaan telemedicine berkelanjutan pasca pandemi Covid-19. Hasil penelitian juga menemukan bahwa niat penggunaan berkelanjutan memengaruhi niat untuk merekomendasikan. Sementara itu, empat dari enam variabel dalam model UTAUT2 (ekspektasi kinerja, ekspektasi usaha, pengaruh sosial, kondisi fasilitasi) tidak terbukti memengaruhi niat penggunaan berkelanjutan. Demikian juga kepuasan, kepercayaan awal pada dokter, dan konten media sosial tidak memengaruhi niat penggunaan berkelanjutan. Kata kunci: UTAUT2; ECM; kepuasan; kepercayaan; konten media sosial; niat penggunaan berkelanjutan; niat merekomendasikan.

The role of culture in mobile application adoption amongst diabetes patients in previously disadvantaged communities in the Western Cape

Magister Commercii - MComIntroduction: Diabetes mellitus is a global health problem with a high mortality rate. Self-management is an essential part of diabetes management and it includes self-care behaviour tasks such as healthy eating, being active and taking prescribed medication. In the current digital age, the use of technology for self- management of the disease is an important consideration. As a first step towards this, individuals have to first accept and use the technology. However, the literature indicates low levels of technology use amongst diabetic patients in environments with low socio- economic indicators and amongst minority groups. Previous studies suggest that there are many factors that influence technology acceptance such as economic, social and cultural factors. Mobile health (m-health) received recognition in healthcare literature in recent years and are known for delivering effective and efficient interventions to patients with chronic conditions such as diabetes. An investigation into m-health acceptance for diabetes management is vital as it impacts the achievement of development goals, including the United Nations’ SDG 3. This research posits that the culture of patients is a possible reason for the low acceptance and use of technology. Research based on the proliferation of culture as a determinant for diabetes self-management at an individual level is limited, especially in the South African context. The main research question pursued in the study reported in this thesis is How does culture influence m-health acceptance of diabetic patients in disadvantaged communities? Research design and methodology: Using an interpretivist paradigm, a case study research design provided the basis to collect data from 20 diabetes patients in Mitchells Plain and Strandfontein. The theoretical model that was used as a lens for investigation comprised a juxtaposition of Hofstede’s cultural dimensions and Unified- Theory of Acceptance and Use of Technology 2 (UTAUT2). The analysis of the qualitative data was undertaken with Atlas Ti, using a thematic content analysis process. Results: Eight themes emerged from the data and key results of the study indicate that opinions towards medical practitioners, which reflects power distance has a positive impact on users and non-users. Diabetic patients comply with the opinions of their doctors as they fear disagreeing with them. As such, this may result in having a positive influence on a participant’s ability to adopt and use mobile applications. Caregiver influence, which reflects femininity, has a negative influence on users as a result of diabetic patients being responsible for taking care of their family and others are both home carers and providers for their families. This indicates that patients are more concerned with the quality of their life and family than with the adoption mobile applications. Future work: It is recommended that research should be conducted in other areas in the Western Cape, specifically in the Cape flats to see whether the same sorts of results will be achieved in different communities. This could help policymakers and application developers tailor mobile applications for this target population

Using the UTAUT Model to Determine Factors Affecting Acceptance and Use of Mobile Health (mHealth) Services in Bangladesh

mHealth is one of the most promising technologies that has emerged in recent years and could prove to have considerable value to both health services providers and patients for achieving the sustainable development goals (SDGs). But, the adoption of mHealth faces many challenges and barriers, including cultural, technological, personal, organizational and social issues which must be addressed and treated carefully by mHealth services providers. The aim of this study is to identify the critical factors affecting the adoption of mHealth in healthcare system of Bangladesh by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) model to include perceived reliability and price value. A cross sectional survey questionnaire was used to collect data from 296 participants from different public and private hospitals in Dhaka city of Bangladesh. Result demonstrates that performance expectancy, effort expectancy, social influence, facilitating condition & perceived reliability had significant influence on the intention to adopt mHealth services in Bangladesh. Surprisingly, price value (p>0.05) had no significant influence on adoption of mHealth services. With the proposed model, it is possible to develop better mHealth services to meet the requirements of the common people based on widely available smartphone. The findings of this study will be beneficial for the government agencies, mobile phone operators, policy makers, healthcare providers and NGOs in developing countries

The role of culture in the adoption of mobile applications for the self‑management of diabetes in low resourced urban communities

Diabetes mellitus has been documented as a global health problem with a high mortality rate. In the current digital age, the use of technology to overcome such health problems in pursuance of Sustainable Development Goal 3 is widely recognised. The increased penetration of mobile devices provides one avenue to support the self-management of conditions such as diabetes. As a first step towards this, individuals have to first accept and use the technology. However, the literature indicates low levels of technology use amongst diabetic patients with low socio-economic indicators. We posit that the culture of patients is a contributory factor for the low acceptance and use of technology. This study assessed how culture influences mobile health (m-health) acceptance among diabetic patients from low-resourced urban communities through semi-structured interviews. The theoretical model that was used as a lens for the investigation comprised a juxtaposition of Hofstede's cultural dimensions and the Unified-Theory of Acceptance and Use of Technology 2 (UTAUT2)

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.Peer reviewe

Consumer’s acceptance of Mobile Health Technologies in Germany

As equipas de administração da industria farmacêutica acreditam que a digitalização da saúde criará novos segmentos de mercado no futuro, enquanto que a saúde móvel propulsará mudança. Embora a adoção de tecnologias por parte de médicos tenha sido já extensivamente analisada no passado, pouco avanço tem sido feito na identificação de fatores que determinam a intenção de adotar tecnologias móveis de saúde pelos consumidores. Após uma extensiva análise de investigações anteriores, a presente tese adota a Teoria Unificada de Aceitação e Uso de Tecnologia, estendendo o modelo referido para incluir determinantes de utilidade negativa que possam impedir a adoção de tecnologias móveis de saúde pelos consumidores. O presente estudo concentra-se no mercado alemão e consequentemente, os dados recolhidos por meio de um questionário online dizem respeito a um total de 289 consumidores alemães. Os resultados obtidos através de uma analise PLS-SEM indicam que autoeficácia antecede expectativa de esforço, e que expectativa de desempenho, influência social, condições de facilitação e receio de monitorização são fatores determinantes na intenção de adotar tecnologias móveis relacionadas à saúde por parte dos consumidores. O presente estudo contribui desta forma para a atual investigação da aceitação de tecnologias moveis relacionadas com a saúde por parte de utilizadores no continente Europeu. Os resultados apresentados pretendem ainda constituir uma fonte de informação útil para gestores, profissionais de marketing ou criadores de tecnologias moveis ligadas à saúde, para que possam compreender melhor os fatores mais relevantes na aceitação destas aplicações por parte dos consumidores. Conclui-se que as características utilitárias das aplicações em questão devem ser realçadas, alinhando a sua promoção aos segmentos de mercado adequados e promovendo uma receção positiva pelos consumidores, o que conduzirá a uma maior aceitação de intenção de adotar tecnologias moveis ligadas a saúde.Les cadres de l’industrie pharmaceutique attendent de la santé digitale qu’elle fasse apparaître de nouveaux segments de marché, et figurent que la santé sur téléphone mobile sera le vecteur de ce changement. Tandis que l’adoption de la santé mobile du point de vue physiologique a déjà été fréquemment étudiée, peu d’études ont cherché à identifier les facteurs déterminants de l’adoption de cette technologie de santé sur mobile par les consommateurs. Après une large revue de littérature, cette étude appliquera la ‘Unified Theory of Acceptance and Use of Technology’ (UTAUT) et étendra ce modèle aux concepts d'utilité négative qui pourrait empêcher l'adoption de cette technologie. Le marché allemand sera le domaine d’étude. Ainsi, des données issues de consommateurs allemands ont été récoltées grâce à un questionnaire en ligne (n=289). Les résultats tirés du PLS-SEM indiquent que la Self-Efficacy (auto efficacité) est un antécédent de l’Effort-Expectancy (effort attendu) et que les concepts de Performance Expectancy (performance attendue), Social Influence (influence sociale), Facilitating conditions (conditions favorables) et Surveillance Anxiety (anxiété de surveillance) affectent de manière significative l’intention d’adoption des technologies mobiles des consommateurs. L’étude apporte des éléments de recherche supplémentaires sur l’acceptation de la santé sur mobile par les utilisateurs européens. De plus, les résultats apportent des conclusions sur les déterminants de l’acceptation des technologies de m-santé utiles aux développeurs, aux marketeurs et aux managers du secteur de la santé sur mobile. Plus précisément, les paramètres utilitaristes des produits doivent être privilégiés tout en ciblant les early-adopters dans le but d’encourager le bouche-à-oreille qui, enfin, conduira à de plus fortes intentions d’adoption de ces technologies de santé sur mobile

Conceptualizing mobile health application use intention and adoption among Iraqian older adults: from the perspective of expanded technology acceptance model

The aim of this article is to discuss how different factors affect the decision of intention to use and adopt mobile health applications using the extended technology acceptance model (TAM) among older adults in Iraq. “Perceived usefulness (PU), perceived ease of use (PEU), subjective norm (SN), and facilitating conditions (FC)” were four key predictors. Gender and age were included as factors for moderating the impact of two key TAM components in the proposed model (PU and PEU) on intention to use and adoption behaviors. The results of the past studies indicated that PU, PEU and SN were important predictors of adoption of mobile health applications among older adults in Iraq, While PU, SN, and FC were important predictors of the intention to use mobile health applications. Previous studies highlighted a strong impact of PEU on the intention to use mobile health applications on older adults than for younger adults. Implications are discussed for future research and practices

Drivers of digital transformation adoption: A weight and meta-analysis

Cavalcanti, D. R., Oliveira, T., & Santini, F. D. O. (2022). Drivers of digital transformation adoption: A weight and meta-analysis. Heliyon, 8(2), 1-17. [e08911]. https://doi.org/10.1016/j.heliyon.2022.e08911 --------------------------- Funding: This work was supported by national funds through FCT (Fundação para a Ciência e a Tecnologia) under the project - UIDB/04152/2020 - Centro de Investigação em Gestão de Informação (MagIC).The advent of the global pandemic has accelerated the growing need for product and service transformation, highlighting the emerging importance of technology and creating the opportunity to update the digital transformation (DT) domain through empirical-quantitative research. This weight and meta-analysis enabled the synthesis and integration of previous literature on the scope of individual DT adoption, evaluating the state of the art and filling a void on the subject. Athwart 88 studies and 99 datasets by international sources, our results demonstrate that attitude and satisfaction are relevant predictors of behavioral intentions and promising outcomes, including compatibility and personal innovativeness. Behavioral intentions, satisfaction, and habit are the best predictors for DT use. Usefulness and ease of use are critical for DT adoption intention and use, being moderated by individualism, as a cultural factor, human capital, and knowledge-technology, as innovation indicators. We present a conceptual model of promising and best predictors for future research on DT individual adoption.publishersversionpublishe