Previously submitted to: JMIR Cardio (no longer under consideration since Sep 18, 2023)
Date Submitted: Nov 15, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Pathways to usage intention of mobile health apps among hypertensive patients: a fuzzy-set qualitative comparative analysis
ABSTRACT
Background:
Previous usage intention models have focused on the net effect of a single factor based on variance, such as the unified theory of acceptance and use of technology model. However, the intention to use digital and mobile health services is a complex behavioral decision influenced by numerous factors. The assumption of uniform symmetry between independent and dependent variables in the existing literature limits consideration of promotion pathways. It is important to study from the perspective of qualitative comparative analysis (QCA), which suggests several different combinations of conditional variables may lead to the same outcome under the asymmetrical causal model.
Objective:
This study aimed to explore the combination of different conditional variables resulting in high usage intention of mobile health apps among individuals with hypertension in China.
Methods:
We took the unified theory of acceptance and use of technology model as the theoretical framework, with three new variances: health belief, time preference, and compliance of hypertensive patients. We then constructed a fuzzy-set qualitative comparative analysis model based on in-depth analysis of the influence factors of usage intention for mobile health apps. The study was conducted in August 2022, and 98 middle-aged and elderly hypertensive individuals without diabetes were included.
Results:
Four different configurations for the pathway of high usage intention were generated. The results showed that perceived severity of disease, behavioral cues, and performance expectancy appeared in all four configurations. Perceived barriers, social influence, and compliance of hypertensive patients were the core conditions, but under certain combination of influencing factors, high usage intention could be achieved without one of these core conditions. The solution consistency and solution coverage were 0.93 and 0.36, respectively.
Conclusions:
The findings suggest that when formulating intervention approaches, medical and health departments should consider that the path of usage intention is not a one-way system; instead, multiple pathways can lead to high usage intention.
Citation
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