Factors Influencing mHealth Acceptance: An Empirical Investigation from a Trust-Anxiety Perspective

Abstract

Mobile health (mHealth) is an emerging healthcare technology designed specifically for improving individuals’ quality of life. Despite mHealth purported benefits, its acceptance rates have fallen short of industry expectations. Lack of trust and anxiety have been identified as two long-term barriers to successful mHealth acceptance. Yet, little attention has been devoted to understand individuals’ acceptance of mHealth services from a trust and anxiety perspective in the current mHealth acceptance research. The virtuality of mHealth services and the sensitivity of health data are two major issues affecting individuals’ acceptance of mHealth services before the initial interaction stage with the service. In such situations, trust in mHealth service, trust in mHealth service provider, and mHealth use anxiety become central parts of the acceptance decisions formed around the use of mHealth services. Motivated by this fact, this study develops a trust-anxiety model to understand individuals’ acceptance behavior of mHealth services. The developed model draws on innovation attributes (trialability, visibility, relative advantage, and ease of use), external and interpersonal social influence, and facilitating conditions from information systems, innovation diffusion, and social psychology research to understand the factors affecting individuals trust and anxiety when accepting mHealth services from social, technological, and behavioral dimensions.

The developed model was empirically validated via a sample of 385 potential adopters in Saudi Arabia and 507 in the United Kingdom using online self-administrated surveys. Partial least squares structural equation modeling was used to assess the developed research model. The findings in Saudi Arabia and the United Kingdom showed that potential adopters mHealth acceptance was largely promoted by their level of trust in mHealth service followed by their level of trust in mHealth service provider. The results further indicated that in the United Kingdom, mHealth use anxiety can significantly reduce potential adopters’ acceptance of mHealth services. Moreover, the results in Saudi Arabia and the United Kingdom showed that trialability can increase individuals mHealth use anxiety, while ease of use can significantly reduce it when accepting mHealth services. However, in Saudi Arabia, the results further showed that trust in mHealth service can significantly reduce potential adopters mHealth use anxiety when accepting mHealth services. The results also suggested that trust in mHealth service can be promoted by relative advantage, ease of use, interpersonal social influence, and trust in mHealth service provider in both countries before the initial interaction stage with the service. On the other hand, the results revealed that trust in mHealth service provider was positively affected by external social influence, relative advantage, facilitating conditions, and visibility in Saudi Arabia. However, in the United Kingdom, trust in mHealth service provider has been found to be positively associated with external social influence, facilitating conditions, and relative advantage.

From a theoretical perspective, this study contributes to existing mHealth acceptance literature by providing a comprehensive understanding of mHealth acceptance behavior from a trust-anxiety perspective. From a practical perspective, the study offers valuable information for mHealth participants that can help them in promoting their mHealth services acceptance rates.