JMIR Publications

ABSTRACT

Background:

High blood pressure (hypertension) is a highly prevalent chronic condition that can, if untreated, contribute to several life-threatening secondary diseases and events, such as stroke. In addition to first-line medication, self-management in daily life is crucial for the long-term treatment which can be supported by mobile health apps. However, little attention has been paid to the determinant factors of acceptance of such medical apps among patients as users and physicians as potential prescribers in direct comparison.

Objective:

The present study aims to investigate subjectively influencing factors of the acceptance of health apps in terms of intentions to use by patients and physicians in German-speaking countries.

Methods:

Based on an extended model of the Unified Theory of Acceptance and Use of Technology (UTAUT2), we performed an online survey to explore the acceptance of health apps for the self-management of hypertension among patients and physicians in Germany. In addition to UTAUT2 variables, we considered self-efficacy, eHealth literacy, previous experience with health apps, the perceived threat to privacy, and protection motivation as potential determinants of app acceptance. Data from n=163 patients and n=46 physicians from a cross-sectional questionnaire study were analysed using hierarchical regression and mediation analyses.

Results:

As expected, a significant influence of the UTAUT predictors on intentions to use hypertension apps were confirmed, especially with regard to the factor performance expectancy (patients: ß = .42, P < .01, physicians: ß = .54, P = .01). Intention to use was moderate for patients (M=3.5, range 1-5) and physicians (M=3.4) and did not differ between both user groups. Among patients, a higher degree of self-reported self-efficacy and protection motivation contributed to an increase in explained variance in acceptance (increase R2 = .09), while perceived eHealth literacy was shown as a specific influencing factor among physicians (increase R2 = .10). Furthermore, our findings indicated mediating effects of performance expectancy on acceptance among patients but not among physicians.

Conclusions:

Taken together, this study has identified performance expectancy as most important determinant of the acceptance of mobile apps for the self-management of hypertension among patients and physicians. Concerning patients, we also identified mediating effects of performance expectancy in the relationships between both effort expectancy and social influence and the acceptance of apps. Self-efficacy and protection motivation also contributed to an increase in the explained variance in app acceptance among patients, while eHealth literacy was a predictor of acceptance among physicians. Such insights on the determinants of the acceptance of health apps can help tailor self-management intervention to the needs and preferences of future users, for instance, by emphasizing the benefits of hypertension apps in information campaigns.