Accepted for/Published in: JMIR Human Factors
Date Submitted: Dec 11, 2024
Date Accepted: Jul 10, 2025
Understanding the Behavioral Determinants of First Responder App Adoption by Integrating UTAUT and Health Belief Model Perspectives: A Cross-Sectional Survey
ABSTRACT
Background:
Out-of-hospital cardiac arrests (OHCA) are a leading cause of death worldwide, yet first responder apps can significantly improve outcomes by mobilizing citizens to perform CPR before professional help arrives. Despite their importance, understanding of these apps' societal integration remains limited.
Objective:
Given that first responder app use involves elements of both technology adoption and preventive health behavior, it is essential to examine this behavior from multiple theoretical perspectives. Building on the UTAUT and Health Belief Model (HBM), this study therefore developed an integrative framework to explain which behavioral determinants and individual factors drive individual’s willingness to install a first responder app for OHCA.
Methods:
We conducted an online cross-sectional survey (N=3660, Mage=49.95, SDage=16.75, 52.2% female) in June 2024 among [country blinded] adults. To test our hypotheses and address our research questions, we developed a Structural Equation Model (SEM) using the Lavaan package in R.
Results:
Our results revealed that two UTAUT variables (i.e. facilitating conditions and social influence) and three HBM variables (i.e. perceived susceptibility, perceived barriers and perceived benefits) were associated with willingness to install a first responder app for OHCA. Additionally, most demographic and health factors indirectly related to willingness via behavioral determinants, with age being the sole moderator.
Conclusions:
Overall, the results of this study have both theoretical and practical implications. Theoretically, this study finds its relevance in extending the UTAUT and HBM to altruistic mobile health apps and advancing our understanding of technology adoption in health contexts. Practically, the study’s findings could inform real-life health campaigns aimed at enhancing citizen participation in first responder systems.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© 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.