Assessing Determinants of Online Medical Services Adoption Willingness of General Hospital Physicians Using the Information-Motivation-Behavioral Skills Model: A Multi-Group Structural Equation Modeling Approach

Xueqing Peng; Zhiguang Li; Chi Zhang; Qifeng Wu; Jinghong Gu; Hua You

doi:10.2147/JMDH.S346675

Assessing Determinants of Online Medical Services Adoption Willingness of General Hospital Physicians Using the Information-Motivation-Behavioral Skills Model: A Multi-Group Structural Equation Modeling Approach

J Multidiscip Healthc. 2021 Dec 21:14:3453-3462. doi: 10.2147/JMDH.S346675. eCollection 2021.

Authors

Xueqing Peng¹, Zhiguang Li², Chi Zhang³, Qifeng Wu¹, Jinghong Gu⁴, Hua You^{1

3

5}

Affiliations

¹ School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China.
² The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China.
³ School of Nursing, Nanjing Medical University, Nanjing, 211166, People's Republic of China.
⁴ College of Art and Sciences, University of Washington, Seattle, WA, 98195, USA.
⁵ Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, 211166, People's Republic of China.

Abstract

Purpose: Physician adoption of online medical services (OMS) has been hastened by the COVID-19 pandemic, but their adoption willingness still requires to be improved. This study aims to construct a physician's OMS adoption willingness model based on the information-motivation-behavioral skill (IMB) theory, explore the determinants affecting adoption willingness and its influencing pathways, and evaluate the moderating effects of OMS use experience on willingness through multi-group analysis.

Participants and methods: A cross-sectional survey was conducted among physicians in three public hospitals of Jiangsu province, China, from June to July 2020, using a multi-stage sampling method. Structural equation modeling was applied to analyze the valid data from 531 respondents.

Results: Physicians' willingness to adopt OMS was at a moderate level, with an average score of 14.27±3.34 (range: 4-20). The behavior model for physician's OMS adoption willingness fitted well. Information (In), motivation (Mo), and behavioral skill (BS) explained 69% of the variance in adoption willingness (AW). Information could only exert completely indirect effect on willingness via behavioral skills (b = 0.202, 95% CI[0.122, 0.314]); motivation could both generate direct effect (β=0.368, p < 0.001) and partial indirect effect on willingness via behavioral skills (b = 0.160, 95% CI[0.092, 0.248]); and behavioral skills had a positive effect on willingness (β=0.424, p < 0.001). Furthermore, OMS use experience showed a significant moderating effect on the Mo → AW pathway, with inexperienced physicians' willingness being significantly stronger influenced by motivation compared to experienced ones.

Conclusion: Findings from this study revealed the role of IMB model in interpreting and predicting physicians' willingness to adopt OMS and the moderating effect of uptake experience, providing practitioners with a theoretical foundation and intervention framework for supporting OMS development efforts.

Keywords: information-motivation-behavioral skills (IMB) model; online medical services; physician; structural equation modeling.

Grants and funding

This work was supported by the National Natural Science Foundation of China [grant number 72074122]; and Cultivation Project of Decision-making Consultation, Institute of Healthy Jiangsu Development, Nanjing Medical University.