Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 26, 2020
Date Accepted: Apr 8, 2021
Warning: This is an author submission that is not peer-reviewed or edited.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.
Influence Mechanism of The Affordances of Chronic Disease Management Apps on Continuance Intention: Mediating Role of Health Empowerment
ABSTRACT
Background:
Mobile health apps are becoming increasingly popular, and they provide opportunities for effective health management. The existing chronic disease management (CDM) apps cannot meet users’ practical and urgent needs, and user adhesion is poor. Few, however, have investigated the factors that influence the continuance intention (CI) of CDM app users.
Objective:
Starting from the affordances of CDM apps, this study aimed to analyze how such apps can influence CI through the role of health empowerment (HE).
Methods:
Adopting a stimulus-organism-response framework, an antecedent model was established for CI from the perspective of perceived affordances, uses and gratifications theory, and HE. Perceived affordances were used as the “stimulus,” users’ gratifications and HE were used as the “organism,” and CI was used as the “response.” Data were collected online through a well-known questionnaire survey platform in China. 323 valid questionnaires were obtained. The theoretical model was tested using structural equation modeling.
Results:
Perceived connection affordances (PCA) were found to have significant positive effects on social interactivity gratification (SIG) (t=6.201, P<.001) and informativeness gratification (IG) (t=5.068, P<.001). Perceived utilitarian affordances (PUA) had significant positive effects on IG (t=7.029, P<.001), technology gratification (TG) (t=8.404, P<.001), and functions gratification (FG) (t=9.812, P<.001). Perceived hedonic affordances (PHA) had significant positive effects on FG (t=5.305, P<.001) and enjoyment gratification (EG) (t=13.768, P<.001). Five gratifications (t=2.767, P<.01; t=4.632, P<.001; t=7.608, P<.001; t=2.496, P<.05; t=5.088, P<.001) had significant positive effect on HE. SIG, IG, and FG had significant positive effects on CI. TG and EG had no significant effect on CI. HE had a significant positive effect on CI. HE and gratifications play mediating roles in the influence of affordances on CI.
Conclusions:
HE and gratifications of users' needs are effective ways to promote CI. The gratifications of users' needs can realize HE and then inspire CI. Affordances are key antecedents that affects gratifications of users' needs, HE and CI.
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