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. 2023 Jan 27;47(1):14.
doi: 10.1007/s10916-023-01910-x.

Patient Acceptance of Prescribed and Fully Reimbursed mHealth Apps in Germany: An UTAUT2-based Online Survey Study

Marie Uncovska  1 , Bettina Freitag  1 , Sven Meister  2   3 , Leonard Fehring  4   5
Affiliations

Patient Acceptance of Prescribed and Fully Reimbursed mHealth Apps in Germany: An UTAUT2-based Online Survey Study

Marie Uncovska et al. J Med Syst. .

Abstract

The study aims to (1) investigate current levels of patient acceptance of mHealth in Germany; (2) determine the influencing factors of patients' intention to use, and (3) test the influence of prescription and reimbursement status on patient acceptance. Online survey with 1349 participants, of which 1051 were complete and included for statistical analysis, from a broad cross-section of the German population, addressing both users of mobile health (mHealth) applications and people without prior experience. SEM modeling based on a combination of two theoretical frameworks: the extended Unified Theory of Acceptance and Use of Technology and Health Protective Behavior Theories were used to assess acceptance. Users of mHealth in Germany are mostly patients between the ages of 30 - 50 with mental health or endocrine conditions. General willingness to use mHealth apps / DiGAs (mHealth apps fully reimbursed by social health insurance) is high at 76%, especially if they are governmentally certified, however only 27% of respondents were willing to pay out of pocket. With the exception of a spike in performance expectancy and data security, DiGAs lack a clear differentiation from mHealth apps. Perceived self-efficacy and performance expectancy are significant predictors of willingness to use digital health interventions; with age, attitude, and e-literacy being key demographic predictors. A key takeaway for regulators, providers of mHealth apps/ DiGAs, and other stakeholders involved in mHealth adoption is the importance of addressing negative beliefs early on, targeted communication around effortless usage of mHealth services across age groups and demographics, and focus on highlighting expected benefits of mHealth app/ DiGA usage.

Keywords: Digital health; Mobile health; Technology acceptance; UTAUT2; mHealth.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/ or or publication of this article.

Figures

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Article selection process
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Demographics
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Selected ANOVA and post-hoc analyses results
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Response spread along model dimensions and comparative scoring DiGAs and mHealth apps
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SEM model with standardized path coefficients & conceptual framework of the study
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Construct reliabilities, model fit indices and SEM model output
See this image and copyright information in PMC

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References

    1. C. Ernsting et al., “Using Smartphones and Health Apps to Change and Manage Health Behaviors: A Population-Based Survey,” J Med Internet Res 2017;19(4):e101 https://www.jmir.org/2017/4/e101, vol. 19, no. 4, p. e6838, Apr. 2017, 10.2196/JMIR.6838. - PMC - PubMed
    1. M. Lingg and V. Lütschg, “Health system stakeholders’ perspective on the role of mobile health and its adoption in the swiss health system: Qualitative study,” JMIR Mhealth Uhealth, vol. 8, no. 5, May 2020, 10.2196/17315. - PMC - PubMed
    1. K. Morton et al., “Using digital interventions for self-management of chronic physical health conditions: A meta-ethnography review of published studies,” Patient Education and Counseling, vol. 100, no. 4. Elsevier Ireland Ltd, pp. 616–635, Apr. 01, 2017. 10.1016/j.pec.2016.10.019. - PMC - PubMed
    1. Keehan SP, et al. National health expenditure projections, 2014–24: spending growth faster than recent trends. Health Aff (Millwood) 2015;34(8):1407–1417. doi: 10.1377/HLTHAFF.2015.0600. - DOI - PubMed
    1. Suzman R, Beard JR, Boerma T, Chatterji S. Health in an ageing world - What do we know? The Lancet. 2015;385(9967):484–486. doi: 10.1016/S0140-6736(14)61597-X. - DOI - PubMed