Measuring Success of Patients' Continuous Use of Mobile Health Services for Self-Management of Chronic Conditions: A Theoretical Model and Empirical Test with Hypertensive Patients (Preprint)
BACKGROUND Mobile health services are gradually being introduced to support patients' self-management of chronic conditions. The success of these services is contingent upon patients' continuous use of them. OBJECTIVE This study aims to develop a model to measure the success of patients' continuous use of mobile health services for self-management of chronic conditions. METHODS The proposed model was derived from the Information Systems Continuance Model and Information Systems Success Model. The model contained seven theoretical constructs: information quality, system quality, service quality, perceived usefulness, user satisfaction, perceived health status, and continuous use intention. An online questionnaire survey instrument was developed to test the model. The survey was conducted to collect data from 129 patients who used a mobile health app for hypertension management from 2017 to 2019. The questionnaire items were derived from the validated instruments and were measured by a five-point Likert Scale. The partial least square modelling method was used to test the theoretical model. RESULTS The model accounted for 58.5% of the variance in perceived usefulness (R2=.585), 52.3% of the variance in user satisfaction (R2=.523), and 41.4% of the variance in patients' intention to make continuous use of mobile health services (R2=.414). The continuous use intention was significantly influenced by their perceived health status (β=.195, P=.034), the perceived usefulness (β=.307, P=.004) and user satisfaction (β=.254, P=.037) with the mobile health service. Information quality (β=.235, P=.005), system quality (β=.192, P=.022) and service quality (β=.494, P<.001) had a significant positive influence on perceived usefulness, but not on user satisfaction. Perceived usefulness had a significant positive influence on user satisfaction (β=.664, P<.001). In a result opposite to the original hypothesis, perceived health status did not negatively influence patients' intention to continue using the mobile health service but showed a significant, positive correlation. CONCLUSIONS This study developed a theoretical model to predict and explain patients' continuous use of mobile health services for self-management of chronic conditions and empirically tested the model. Perceived usefulness, user satisfaction and health status contributed to patients' intention to make continuous use of mobile health services for self-managing their chronic conditions.