Middle-aged and elderly users' continuous usage intention of health maintenance-oriented WeChat official accounts: empirical study based on a hybrid model in China

Lin Xu; Pengfei Li; Xiaorong Hou; Hongfan Yu; Tingting Tang; Ting Liu; Shoushu Xiang; Xiaoqian Wu; Cheng Huang

doi:10.1186/s12911-021-01625-4

Middle-aged and elderly users' continuous usage intention of health maintenance-oriented WeChat official accounts: empirical study based on a hybrid model in China

BMC Med Inform Decis Mak. 2021 Sep 3;21(1):257. doi: 10.1186/s12911-021-01625-4.

Authors

Lin Xu¹, Pengfei Li¹, Xiaorong Hou¹, Hongfan Yu², Tingting Tang³, Ting Liu⁴, Shoushu Xiang⁴, Xiaoqian Wu¹, Cheng Huang⁵

Affiliations

¹ College of Medical Informatics, Chongqing Medical University, Chongqing, China.
² College of Public Health and Management, Chongqing Medical University, Chongqing, China.
³ The Children's Hospital of Chongqing Medical University, Chongqing, China.
⁴ Medical Data Science Academy, Chongqing Medical University, Chongqing, China.
⁵ College of Medical Informatics, Chongqing Medical University, Chongqing, China. huangcheng@cqmu.edu.cn.

Abstract

Background: Although middle-aged and elderly users are the main group targeted by health maintenance-oriented WeChat official accounts (HM-WOAs), few studies have explored the relationship of these accounts and their users. Exploring the factors that influence the continuous adoption of WOAs is helpful to strengthen the health education of middle-aged and elderly individuals.

Objective: We developed a new theoretical model and explored the factors that influence middle-aged and elderly individuals' continuous usage intention for HM-WOA. Performance expectancy mediated the effects of the model in explaining continuous usage intention and introduced health literacy into the model.

Methods: We established a hybrid theoretical model on the basis of the unified theory of acceptance and use of technology 2 model (UTAUT2), the health belief model (BHM), protection motivation theory (PMT), and health literacy. We collected valid responses from 396 middle-aged and elderly users aged ≥ 45 years in China. To verify our hypotheses, we analyzed the data using structural equation modeling.

Results: Performance expectancy (β = 0.383, P < 0.001), hedonic motivation (β = 0.502, P < 0.001), social influence (β = 0.134, P = 0.049), and threat appraisal (β = 0.136, P < 0.001) positively influenced middle-aged and elderly users' continuous usage intention. Perceived health threat (β = - 0.065, P = 0.053) did not have a significant effect on continuous usage intention. Both threat appraisal (β = 0.579, P < 0.001) and health literacy (β = 0.579, P < 0.001) positively affected performance expectancy. Threat appraisal indirectly affected continuous usage intention through performance expectancy mediation.

Conclusions: Our new theoretical model is useful for understanding middle-aged and elderly users' continuous usage intention for HM-WOA. Performance expectancy plays a mediation role between threat appraisal and continuous usage intention, and health literacy positively affects performance expectancy.

Keywords: Continuous usage intention; Health maintenance; Middle aged and elderly; Structural equation model; WeChat official accounts.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
China
Humans
Intention*
Latent Class Analysis
Middle Aged
Motivation*
Surveys and Questionnaires