Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Accepted for/Published in: JMIR Human Factors

Date Submitted: Feb 18, 2023
Open Peer Review Period: Feb 18, 2023 - Mar 6, 2023
Date Accepted: Oct 16, 2023
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Factors Influencing the Behavioral Intentions and Use Behaviors of Telemedicine in Patients With Diabetes: Web-Based Survey Study

Liu C, Shao H, Tang L, Wang B, Xie H, Zhang Y

Factors Influencing the Behavioral Intentions and Use Behaviors of Telemedicine in Patients With Diabetes: Web-Based Survey Study

JMIR Hum Factors 2023;10:e46624

DOI: 10.2196/46624

PMID: 38153781

PMCID: 10784981

Factors Influencing the Behavioral Intentions and Use Behaviors of Telemedicine in Patients with Diabetes: Web-Based Survey in China

  • Chaoyuan Liu; 
  • Huige Shao; 
  • Li Tang; 
  • Bian Wang; 
  • Hebin Xie; 
  • Yiyu Zhang

ABSTRACT

Background:

The outbreak of COVID-19 caused a major public health care crisis worldwide On December 7th, 2022, China lifted the “zero tolerance” policy, and the number of patients with COVID-19 infection rose rapidly. Diabetes is a risk factor for severe COVID-19 infection and increased mortality. Telemedicine shows great potential for diabetes management. However, the influencing factors of diabetic patients' behavioral intention to use telemedicine are not clear.

Objective:

We aimed to understand determinants of behavioral intention based on an extended Unified Theory of Acceptance and Use of Technology (UTAUT) model and to find factors associated with telemedicine use in patients with diabetes in China.

Methods:

Patients with diabetes aged >18 years were surveyed from February 1, 2023 to February 7, 2023. We distributed the survey link in three WeChat groups including a total of 988 patients with diabetes from the outpatient department or discharge of Changsha Central Hospital. Structural equation modeling was used to understand determinants of behavioral intention. A multivariate regression analysis was used to identify factors associated with telemedicine usage.

Results:

A total of 514 qualified questionnaires were collected. Of these respondents, 186 (36.2%) had been diagnosed with COVID-19. The results of the measurement model showed acceptable reliability, convergent validity, discriminant validity, and data fit indexes. The model explained 63.8% of the variance in behavioral intention. Social influence, performance expectancy and facilitating conditions positively influenced behavioral intention (β=0.467, P<.001; β=0.164, P=.016; and β=0.252, P=.005, respectively). Perceived susceptibility, perceived severity and effort expectancy had no significant impact on behavioral intention (all P>.05). The overall use of telemedicine was 104/514 (20.6%). After adjusting the behavioral intention score, the multivariate regression analysis showed that age, education and family income were associated with telemedicine usage. Compared with the patients aged ≥60, telemedicine usage in the 40-59 years group and 18-39 years group was higher (OR=4.35, 95% CI 1.84-10.29, P=.001; OR=9.20, 95% CI 3.40-24.88, P<.001, respectively). Compared with the patients with junior high school education and less, telemedicine usage in the senior high school group and the university and more group was higher (OR=2.45, 95% CI 1.05-5.73, P=.04; OR=2.63, 95% CI 1.11-6.23, P=.03, respectively). Compared with patients who had an annual family income less than 10000 ¥, patients with a higher family income used telemedicine more often (¥10,000-50,000 group, OR=3.90, 95% CI 1.21-12.51, P=.02; ¥50,000-100,000 group OR=3.91, 95% CI 1.19-12.79, P=.02; ¥>100,000 group OR=4.63, 95% CI 1.41-15.27, P=.01, respectively).

Conclusions:

Social influence, performance expectancy and facilitating conditions positively affect the behavioral intention of patients with diabetes to use telemedicine. Young patients, highly educated patients, and patients with high family income use telemedicine more often. Promoting behavioral intention and paying special attention to the needs of elderly patients, patients with low incomes and patients with low levels of education are needed to encourage telemedicine usage.


 Citation

Please cite as:

Liu C, Shao H, Tang L, Wang B, Xie H, Zhang Y

Factors Influencing the Behavioral Intentions and Use Behaviors of Telemedicine in Patients With Diabetes: Web-Based Survey Study

JMIR Hum Factors 2023;10:e46624

DOI: 10.2196/46624

PMID: 38153781

PMCID: 10784981

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.