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. 2021 Sep 20:26:100459.
doi: 10.1016/j.invent.2021.100459. eCollection 2021 Dec.

Acceptance towards digital health interventions - Model validation and further development of the Unified Theory of Acceptance and Use of Technology

Paula Philippi  1 , Harald Baumeister  1 , Jennifer Apolinário-Hagen  2 , David Daniel Ebert  3 , Severin Hennemann  4 , Leonie Kott  1 , Jiaxi Lin  5 , Eva-Maria Messner  1 , Yannik Terhorst  1   6
Affiliations

Acceptance towards digital health interventions - Model validation and further development of the Unified Theory of Acceptance and Use of Technology

Paula Philippi et al. Internet Interv. .

Abstract

Internet- and mobile-based interventions (IMI) offer an effective way to complement health care. Acceptance of IMI, a key facilitator of their implementation in routine care, is often low. Based on the Unified Theory of Acceptance and Use of Technology (UTAUT), this study validates and adapts the UTAUT to digital health care. Following a systematic literature search, 10 UTAUT-grounded original studies (N = 1588) assessing patients' and health professionals' acceptance of IMI for different somatic and mental health conditions were included. All included studies assessed Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions and acceptance as well as age, gender, internet experience, and internet anxiety via self-report questionnaires. For the model validation primary data was obtained and analyzed using structural equation modeling. The best fitting model (RMSEA = 0.035, SRMR = 0.029) replicated the basic structure of UTAUT's core predictors of acceptance. Performance Expectancy was the strongest predictor (γ = 0.68, p < .001). Internet anxiety was identified as an additional determinant of acceptance (γ = -0.07, p < .05) and moderated the effects of Social Influence (γ = 0.07, p < .05) and Effort Expectancy (γ = -0.05, p < .05). Age, gender and experience had no moderating effects. Acceptance is a fundamental prerequisite for harnessing the full potential of IMI. The adapted UTAUT provides a powerful model identifying important factors - primarily Performance Expectancy - to increase the acceptance across patient populations and health professionals.

Keywords: Acceptance; Digital health; Implementation science; Internet-and mobile-based interventions; Unified Theory of Acceptance and Use of Technology; eHealth.

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Conflict of interest statement

HB and EMM received consultancy fees, reimbursement of congress attendance and travel costs as well as payments for lectures from Psychotherapy and Psychiatry Associations as well as Psychotherapy Training Institutes in the context of E-Mental-Health topics. SH received payments from psychotherapy training institutes in the context of E-Mental-Health topics. DDE possess shares in the GET.On Institut GmbH, which works to transfer research findings on internet- and mobile-phone-based health interventions into routine care. DDE has received payments from several companies and health insurance providers for advice on the use of Internet-based interventions. He has received payments for lectures from Psychotherapy and Psychiatry Associations and has been the beneficiary of third-party funding from health insurance providers. All other authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Model 1.
Fig. 2
Fig. 2
Study flow diagram.
Fig. 3
Fig. 3
Estimates of Model 1b. Note. Estimates are standardized. Error terms are omitted for means of readability. All paths are significant.
Fig. 4
Fig. 4
Estimates of the adapted Model. Note. Estimates are standardized. Error terms are omitted for means of readability. All paths are significant.
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