JMIR Publications

ABSTRACT

Background:

Digital health technologies, including electronic personal health records (e-PHRs), have emerged globally as pivotal tools for enhancing health management, patient autonomy, and healthcare accessibility. Despite the growing significance, people with disabilities (PWDs) often face considerable barriers to digital health adoption due to accessibility issues, limited technological literacy, and inadequate social support. A comprehensive understanding of the factors influencing technology acceptance among PWDs is essential for effectively integrating these digital solutions into healthcare practices.

Objective:

The objective of this study was to identify the factors influencing the intention to use digital health technologies among PWDs based on the Technology Acceptance Model (TAM). Specifically, this study aimed to analyze the structural relationships among perceived ease of use, perceived usefulness, usage intention, and external factors, including health consciousness, health information consent, content characteristics, information security, eHealth literacy, and effectiveness.

Methods:

A nationwide survey was conducted in South Korea, reaching a total of 800 PWDs who utilized rehabilitation hospitals, disability welfare centers, public health centers, and other institutions related to disability. Participants were recruited using proportionate stratified sampling and systematic stratified cluster sampling methods. The survey questionnaire was designed based on validated instruments from previous studies and modified to suit the context of e-PHR adoption among PWDs. Data were collected from August 30 to September 30, 2023. Statistical analyses included descriptive statistics, correlation analysis, exploratory factor analysis, and structural equation modeling (SEM) to test hypotheses and examine causal relationships among variables.

Results:

Perceived usefulness and perceived ease of use significantly influenced participants’ intentions to adopt e-PHR services. The structural model revealed significant paths from external factors to perceived ease of use, including health consciousness, content characteristics, health information consent, information security, and effectiveness. Conversely, eHealth literacy did not significantly impact perceived ease of use. For perceived usefulness, significant influencing factors included content characteristics, health information consent, eHealth literacy, and effectiveness, while health consciousness and information security showed no significant effects. The model demonstrated good overall fit.

Conclusions:

This study highlights that perceived usefulness and ease of use are crucial mediators driving the adoption of e-PHR among PWDs. Social support, content quality, and consent regarding health information significantly shape technology acceptance. These findings suggest the need for designing user-friendly digital health solutions that integrate robust support systems, address privacy concerns, and deliver high-quality, relevant content tailored to this population. Future research should incorporate longitudinal and mixed-methods studies to further explore the sustained adoption of digital health technologies and validate these results across diverse disability groups and contexts.