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      Barriers for User Acceptance of Mobile Health Applications for Diabetic Patients: Applying the UTAUT Model

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          Abstract

          The literature illustrates that technology will widen health disparity if its use is restricted to patients who are already motivated and demonstrate good self-management behaviours. Additionally, despite the availability of free mobile health (m-health) applications for diabetes self-management, usage is low. There are also limited studies of m-health acceptance in South Africa. This research is delineated to the Western Cape, South Africa. The populace suffers from increasing numbers of diabetic patients. Segments of the population also suffer from technological forms of exclusion, such as limited internet access. Therefore, the objective of this study was to identify challenges for user acceptance that discourages the use of m-health applications. This study analysed 130 semi-structured interviews, using thematic content analysis. Respondents were predominantly female with type 2 diabetes, older than 50, residing in the Western Cape. It used key constructs from the Unified Theory of Acceptance and Use of Technology (UTAUT) model. The results confirmed that all four UTAUT constructs; performance expectancy (“the degree to which an individual believes that using the system will help him or her to attain gains in performance”), effort expectancy (“the degree of ease associated with the use of the system”, social influence (“the degree to which an individual perceives that important others believe he or she should use the new system”) and facilitating conditions (“the degree to which an individual believes that an organisational and technical infrastructure exists to support the use of the system”), explains the challenges for m-health acceptance in low socio-economic areas. Factors such as technology anxiety, resistance to change and a lack of trust in the use of devices for self-management need to be considered when implementing future interventions.

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          Understanding factors influencing the adoption of mHealth by the elderly: An extension of the UTAUT model.

          mHealth (mobile health) services are becoming an increasingly important form of information and communication technology (ICT) enabled delivery for healthcare, especially in low-resource environments such as developing countries like Bangladesh. Despite widespread adoption of mobile phones and the acknowledged potential of using them to improve healthcare services, the adoption and acceptance of this technology among the elderly is significantly low. However, little research has been done to draw any systematic study of the elderly's intention to adopt mHealth services.
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            Qualitative Research in Information Systems

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              Barriers and facilitators to health information exchange in low- and middle-income country settings: a systematic review.

              The exchange and use of health information can help healthcare professionals and policymakers make informed decisions on ways of improving patient and population health. Many low- and middle-income countries (LMICs) have however failed to embrace the approaches and technologies to facilitate health information exchange (HIE). We sought to understand the barriers and facilitators to the implementation and adoption of HIE in LMICs. Two reviewers independently searched 11 academic databases for published and on-going qualitative, quantitative and mixed-method studies and searched for unpublished work through the Google search engine. The searches covered the period from January 1990 to July 2014 and were not restricted by language. Eligible studies were independently, critically appraised and then thematically analysed. The searches yielded 5461 citations after de-duplication of results. Of these, 56 articles, three conference abstracts and four technical reports met the inclusion criteria. The lack of importance given to data in decision making, corruption and insecurity, lack of training and poor infrastructure were considered to be major challenges to implementing HIE, but strong leadership and clear policy direction coupled with the financial support to acquire essential technology, improve the communication network, and provide training for staff all helped to promote implementation. The body of work also highlighted how implementers of HIE needed to take into account local needs to ensure that stakeholders saw HIE as relevant and advantageous. HIE interventions implemented through leapfrog technologies such as telehealth/telemedicine and mHealth in Brazil, Kenya, and South Africa, provided successful examples of exchanging health information in LMICs despite limited resources and capability. It is important that implementation of HIE is aligned with national priorities and local needs.
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                Author and article information

                Contributors
                marie.hattingh@up.ac.za
                machdel.matthee@up.ac.za
                hanlie.smuts@up.ac.za
                ilias.pappas@uia.no
                ykdwivedi@gmail.com
                matti.mantymaki@utu.fi
                fapetersen@uwc.ac.za
                3462668@myuwc.ac.za
                spather@uwc.ac.za
                Journal
                978-3-030-45002-1
                10.1007/978-3-030-45002-1
                Responsible Design, Implementation and Use of Information and Communication Technology
                Responsible Design, Implementation and Use of Information and Communication Technology
                19th IFIP WG 6.11 Conference on e-Business, e-Services, and e-Society, I3E 2020, Skukuza, South Africa, April 6–8, 2020, Proceedings, Part II
                978-3-030-45001-4
                978-3-030-45002-1
                10 March 2020
                : 12067
                : 61-72
                Affiliations
                [8 ]GRID grid.49697.35, ISNI 0000 0001 2107 2298, University of Pretoria, ; Pretoria, South Africa
                [9 ]GRID grid.49697.35, ISNI 0000 0001 2107 2298, University of Pretoria, ; Pretoria, South Africa
                [10 ]GRID grid.49697.35, ISNI 0000 0001 2107 2298, University of Pretoria, ; Pretoria, South Africa
                [11 ]GRID grid.23048.3d, ISNI 0000 0004 0417 6230, University of Agder, ; Kristiansand, Norway
                [12 ]GRID grid.4827.9, ISNI 0000 0001 0658 8800, Swansea University, ; Swansea, UK
                [13 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, University of Turku, ; Turku, Finland
                GRID grid.8974.2, ISNI 0000 0001 2156 8226, University of the Western Cape, ; Bellville, South Africa
                Author information
                http://orcid.org/0000-0003-4592-2861
                http://orcid.org/0000-0003-4177-550X
                http://orcid.org/0000-0002-4667-222X
                Article
                6
                10.1007/978-3-030-45002-1_6
                7134297
                daaf11c3-1f9d-427c-8de0-764994ff8493
                © IFIP International Federation for Information Processing 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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                © IFIP International Federation for Information Processing 2020

                unified theory of acceptance and use of technology (utaut),challenges for user acceptance,mobile health (m-health),diabetes self-management,low socio-economic areas,south africa

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