Measuring Success of Patients' Continuous Use of Mobile Health Services for Self-management of Chronic Conditions: Model Development and Validation

Abstract

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 the self-management of chronic conditions.

Methods: The proposed model was derived from the information systems continuance model and the information systems success model. This model contains 7 theoretical constructs: information quality, system quality, service quality, perceived usefulness, user satisfaction, perceived health status, and continuous use intention. A web-based 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 validated instruments and were measured using a 5-point Likert scale. The partial least squares modelling method was used to test the theoretical model.

Results: The model accounted for 58.5% of the variance in perceived usefulness (R²=0.585), 52.3% of the variance in user satisfaction (R²=0.523), and 41.4% of the variance in patients' intention to make continuous use of mobile health services (R²=0.414). The continuous use intention was significantly influenced by their perceived health status (β=.195, P=.03), perceived usefulness (β=.307, P=.004), and user satisfaction (β=.254, P=.04) with the mobile health service. Information quality (β=.235, P=.005), system quality (β=.192, P=.02), and service quality (β=.494, P<.001) had a significantly positive influence on perceived usefulness but not on user satisfaction. Perceived usefulness had a significantly 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 significantly 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.

Keywords: PLS; chronic disease; continuous use; high blood pressure; mobile application; mobile health; service; smartphone.