scholarly journals Explaining Differences in the Acceptability of 99DOTS, a Cell Phone–Based Strategy for Monitoring Adherence to Tuberculosis Medications: Qualitative Study of Patients and Health Care Providers (Preprint)

2019 ◽  
Author(s):  
Beena E Thomas ◽  
J Vignesh Kumar ◽  
Chidiebere Onongaya ◽  
Spurthi N Bhatt ◽  
Amith Galivanche ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Text Messaging ◽  
Cell Phone ◽  
Social Influences ◽  
Patient Acceptance ◽  
Care Providers ◽  
Performance Expectancy ◽  
Effort Expectancy ◽  
Related Stigma ◽  
Facilitating Conditions

BACKGROUND 99DOTS is a cell phone–based strategy for monitoring tuberculosis (TB) medication adherence that has been rolled out to more than 150,000 patients in India’s public health sector. A considerable proportion of patients stop using 99DOTS during therapy. OBJECTIVE This study aims to understand reasons for variability in the acceptance and use of 99DOTS by TB patients and health care providers (HCPs). METHODS We conducted qualitative interviews with individuals taking TB therapy in the government program in Chennai and Vellore (HIV-coinfected patients) and Mumbai (HIV-uninfected patients) across intensive and continuation treatment phases. We conducted interviews with HCPs who provide TB care, all of whom were involved in implementing 99DOTS. Interviews were transcribed, coded using a deductive approach, and analyzed with Dedoose 8.0.35 software (SocioCultural Research Consultants, LLC). The findings of the study were interpreted using the unified theory of acceptance and use of technology, which highlights 4 constructs associated with technology acceptance: performance expectancy, effort expectancy, social influences, and facilitating conditions. RESULTS We conducted 62 interviews with patients with TB, of whom 30 (48%) were HIV coinfected, and 31 interviews with HCPs. Acceptance of 99DOTS by patients was variable. Greater patient acceptance was related to perceptions of improved patient-HCP relationships from increased phone communication, TB pill-taking habit formation due to SMS text messaging reminders, and reduced need to visit health facilities (performance expectancy); improved family involvement in TB care (social influences); and from 99DOTS leading HCPs to engage positively in patients’ care through increased outreach (facilitating conditions). Lower patient acceptance was related to perceptions of reduced face-to-face contact with HCPs (performance expectancy); problems with cell phone access, literacy, cellular signal, or technology fatigue (effort expectancy); high TB- and HIV-related stigma within the family (social influences); and poor counseling in 99DOTS by HCPs or perceptions that HCPs were not acting upon adherence data (facilitating conditions). Acceptance of 99DOTS by HCPs was generally high and related to perceptions that the 99DOTS adherence dashboard and patient-related SMS text messaging alerts improve quality of care, the efficiency of care, and the patient-HCP relationship (performance expectancy); that the dashboard is easy to use (effort expectancy); and that 99DOTS leads to better coordination among HCPs (social influences). However, HCPs described suboptimal facilitating conditions, including inadequate training of HCPs in 99DOTS, unequal changes in workload, and shortages of 99DOTS medication envelopes. CONCLUSIONS In India’s government TB program, 99DOTS had high acceptance by HCPs but variable acceptance by patients. Although some factors contributing to suboptimal patient acceptance are modifiable, other factors such as TB- and HIV-related stigma and poor cell phone accessibility, cellular signal, and literacy are more difficult to address. Screening for these barriers may facilitate targeting of 99DOTS to patients more likely to use this technology.

scholarly journals Explaining Differences in the Acceptability of 99DOTS, a Cell Phone–Based Strategy for Monitoring Adherence to Tuberculosis Medications: Qualitative Study of Patients and Health Care Providers

10.2196/16634 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e16634 ◽  
Author(s):  
Beena E Thomas ◽  
J Vignesh Kumar ◽  
Chidiebere Onongaya ◽  
Spurthi N Bhatt ◽  
Amith Galivanche ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Text Messaging ◽  
Cell Phone ◽  
Social Influences ◽  
Patient Acceptance ◽  
Care Providers ◽  
Performance Expectancy ◽  
Effort Expectancy ◽  
Related Stigma ◽  
Facilitating Conditions

Background 99DOTS is a cell phone–based strategy for monitoring tuberculosis (TB) medication adherence that has been rolled out to more than 150,000 patients in India’s public health sector. A considerable proportion of patients stop using 99DOTS during therapy. Objective This study aims to understand reasons for variability in the acceptance and use of 99DOTS by TB patients and health care providers (HCPs). Methods We conducted qualitative interviews with individuals taking TB therapy in the government program in Chennai and Vellore (HIV-coinfected patients) and Mumbai (HIV-uninfected patients) across intensive and continuation treatment phases. We conducted interviews with HCPs who provide TB care, all of whom were involved in implementing 99DOTS. Interviews were transcribed, coded using a deductive approach, and analyzed with Dedoose 8.0.35 software (SocioCultural Research Consultants, LLC). The findings of the study were interpreted using the unified theory of acceptance and use of technology, which highlights 4 constructs associated with technology acceptance: performance expectancy, effort expectancy, social influences, and facilitating conditions. Results We conducted 62 interviews with patients with TB, of whom 30 (48%) were HIV coinfected, and 31 interviews with HCPs. Acceptance of 99DOTS by patients was variable. Greater patient acceptance was related to perceptions of improved patient-HCP relationships from increased phone communication, TB pill-taking habit formation due to SMS text messaging reminders, and reduced need to visit health facilities (performance expectancy); improved family involvement in TB care (social influences); and from 99DOTS leading HCPs to engage positively in patients’ care through increased outreach (facilitating conditions). Lower patient acceptance was related to perceptions of reduced face-to-face contact with HCPs (performance expectancy); problems with cell phone access, literacy, cellular signal, or technology fatigue (effort expectancy); high TB- and HIV-related stigma within the family (social influences); and poor counseling in 99DOTS by HCPs or perceptions that HCPs were not acting upon adherence data (facilitating conditions). Acceptance of 99DOTS by HCPs was generally high and related to perceptions that the 99DOTS adherence dashboard and patient-related SMS text messaging alerts improve quality of care, the efficiency of care, and the patient-HCP relationship (performance expectancy); that the dashboard is easy to use (effort expectancy); and that 99DOTS leads to better coordination among HCPs (social influences). However, HCPs described suboptimal facilitating conditions, including inadequate training of HCPs in 99DOTS, unequal changes in workload, and shortages of 99DOTS medication envelopes. Conclusions In India’s government TB program, 99DOTS had high acceptance by HCPs but variable acceptance by patients. Although some factors contributing to suboptimal patient acceptance are modifiable, other factors such as TB- and HIV-related stigma and poor cell phone accessibility, cellular signal, and literacy are more difficult to address. Screening for these barriers may facilitate targeting of 99DOTS to patients more likely to use this technology.

scholarly journals Evaluation of the Acceptability of the Medication Event Reminder Monitor for Promoting Adherence to Multidrug-Resistant Tuberculosis Therapy in India: Qualitative Study of Patients and Healthcare Providers (Preprint)

2020 ◽  
Author(s):  
Beena E Thomas ◽  
J. Vignesh Kumar ◽  
Murugesan Periyasamy ◽  
Amit Subhash Khandewale ◽  
J. Hephzibah Mercy ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Remote Monitoring ◽  
Social Influences ◽  
Healthcare Providers ◽  
Multidrug Resistant ◽  
Performance Expectancy ◽  
Effort Expectancy ◽  
Mdr Tb ◽  
Facilitating Conditions ◽  
Patient Use

BACKGROUND Multidrug-resistant TB (MDR TB) patients face challenges adhering to medications, given that treatment is prolonged and has a high rate of adverse effects. The Medication Event Reminder Monitor (MERM) is a digital pillbox that provides daily pill-taking reminders and facilitates remote monitoring of medication adherence. OBJECTIVE We assessed the MERM’s acceptability to patients and healthcare providers (HCPs) during pilot implementation in India’s public sector MDR TB program. METHODS From October 2017 to September 2018, we conducted qualitative interviews with patients taking MDR TB therapy, who were being monitored with the MERM, and HCPs in the government program in Chennai and Mumbai. Interviews transcripts were independently coded by two researchers and analyzed to identify emergent themes. We organized findings using the unified theory of acceptance and use of technology (UTAUT), which outlines four constructs that predict technology acceptance: performance expectancy, effort expectancy, social influences, and facilitating conditions. RESULTS We interviewed 65 MDR TB patients and 10 HCPs. In patient interviews, greater acceptance of the MERM was related to perceptions that the audible and visual reminders improved medication adherence and that remote monitoring reduced the frequency of clinic visits (performance expectancy); that the device’s organization and labeling made it easier to take medications correctly (effort expectancy); that the device facilitated positive family involvement in the patient’s care (social influences); and that remote monitoring made patients feel more “cared for” by the health system (facilitating conditions). Lower patient acceptance was related to problems with the durability of the MERM’s cardboard construction and difficulties with portability and storage due to its large size (effort expectancy); concerns regarding stigma and disclosure of patients’ MDR TB diagnoses (social influences); and incorrect understanding of the MERM due to suboptimal counseling (facilitating conditions). In their interviews, HCPs reported that MERM implementation resulted in reduced in-person interactions with patients, allowing HCPs to dedicate more time to other tasks, which improved job satisfaction. CONCLUSIONS Several features of the MERM support its acceptability among MDR TB patients and HCPs, and some barriers to patient use could be addressed with improved design of the device. However, some barriers to patient use—such as disease-related stigma—are more difficult to modify and may limit its use by some MDR TB patients. Further research is needed to assess the MERM’s accuracy for measuring adherence, its effectiveness for improving treatment outcomes, and patients’ sustained use of the device in larger-scale implementation.

scholarly journals Faktor Peramal Penerimaan Perkhidmatan e-Kerajaan

2021 ◽  
Vol 37 (1) ◽  
pp. 1-27
Author(s):  
Syafila Kamarudin ◽  
◽  
Siti Zobidah Omar ◽  
Keyword(s):  
Social Influences ◽  
Pearson Correlation ◽  
Performance Expectancy ◽  
Effort Expectancy ◽  
Regression Test ◽  
Pearson Correlation Test ◽  
Klang Valley ◽  
The Government ◽  
Facilitating Conditions ◽  
Predictor Factors

Predictor Factors Towards Acceptance of e-Government Services ABSTRACT The e-government application was developed to change the way the government operates in the online service delivery system. Thus, this study focused on one of the e-government platforms namely, the MyEG application. This study was aimed to determine the predictor factors that influence consumers’ acceptance using the MyEG application. The framework consisted of four main predictors namely, social influence, performance expectancy, effort expectancy and facilitating conditions, while the dependent variable was the acceptance of MyEG application. A quantitative approach was adopted, by using a questionnaire survey. A total of 396 MyEG application users in the Klang Valley were selected to participate in the survey. The data collected were analyzed using SPSS version 22. Two sampling techniques were used; simple random and purposive. Two statistics procedures were used; descriptive and inferential. The results displayed that the level of acceptance towards the MyEG application was at a moderate level. The Pearson correlation test also revealed a positive and significant correlation between performance expectancy, effort expectancy, facilities condition and social influences to the acceptance of MyEG application. The analysis showed that users had accepted the MyEG application because it was emphasized the predictor factors. Moreover, the multi regression test found that performance expectancy, facilities conditions, social influences and effort expectancy were among the variables that predicted the acceptance of the MyEG application. However, the overall result showed that performance expectancy was a major factor that contributed to the acceptance of the MyEG application among users. Keywords: e-government, online services, application, predictor factor, acceptance.

FAKTOR YANG MEMPENGARUHI BEHAVIOR INTENTION UNTUK PENGGUNAAN APLIKASI DOMPET DIGITAL MENGGUNAKAN MODEL UTAUT2

2020 ◽  
Vol 25 (2) ◽  
pp. 111-122
Author(s):  
Aries Andrianto
Keyword(s):  
Sem Analysis ◽  
Electronic Money ◽  
Analysis Techniques ◽  
Behavior Intention ◽  
The Past ◽  
Performance Expectancy ◽  
Effort Expectancy ◽  
Facilitating Conditions ◽  
Positive Effect ◽  
Digital Wallet

Based on Bank Indonesia data, electronic money transactions have grown rapidly in the past 10 years. Throughout 2018, the volume of electronic money transactions was 2.92 billion transactions, growing 16,600 times compared to 2009.This study aims to analyze the factors that influence interest in using the LinkAja digital wallet using the UTAUT 2 method. The object of this study is the LinkAja digital wallet user who is domiciled in Jakarta. The independent variables examined in this study were Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions, Hedonic Motivation, and Habit on Behavior Intention using PLS-SEM analysis techniques. The results of this study indicate that Price Value has a positive effect on Behavior Intention.

scholarly journals Investigating the Determinants of Students’ Intention to Use Business Simulation Games

2019 ◽  
Vol 58 (2) ◽  
pp. 433-458 ◽  
Author(s):  
Yu-Yin Wang ◽  
Yi-Shun Wang ◽  
Shi-En Jian
Keyword(s):  
Social Influence ◽  
Behavioral Intention ◽  
Partial Least Square ◽  
Intention To Use ◽  
Business Simulation ◽  
Simulation Games ◽  
Performance Expectancy ◽  
Effort Expectancy ◽  
Facilitating Conditions ◽  
Behavioral Intention To Use

Business simulation games (BSGs) are educational tools that help students develop business management knowledge and skills. However, to date, relatively little research has investigated the factors that influence students’ BSG usage intention. Grounded on the extended unified theory of acceptance and use of technology, this study helped to fill this gap by exploring intention to use BSGs. Specifically, this study investigated the influence of performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic motivation, and price value on behavioral intention to use BSGs. Data collected from 141 useful respondents were tested against the research model using partial least square approach. The results of this study indicated that behavioral intention to use BSGs was influenced by facilitating conditions, hedonic motivation, and price value. Unexpectedly, performance expectancy, effort expectancy, and social influence were not predictive of students’ behavioral intention to use BSGs. These findings enhanced our understanding of students’ BSG usage behavior and provided several important theoretical and practical implications for the application of BSG in the context of business and management education.

Modeling the Factors that Influence Ghanaian Entrepreneurs to Adopt e-Commerce

2021 ◽  
Vol 18 (06) ◽  
Author(s):  
Frederick Pobee
Keyword(s):  
Structural Equation ◽  
Partial Least Square ◽  
Least Square ◽  
Equation Modeling ◽  
Unified Theory ◽  
Cross Sectional ◽  
Performance Expectancy ◽  
Use Of Technology ◽  
Effort Expectancy ◽  
Facilitating Conditions

This study investigated the factors that influence Ghanaian entrepreneurs to adopt e-commerce. Cross-sectional data was gathered from 520 entrepreneurs in the most populous and industrious regions in Ghana. The unified theory of acceptance and use of technology (UTAUT) was employed to effectively understand the unexplored phenomenon of e-commerce adoption among Ghanaian entrepreneurs. Partial Least Square-Structural Equation Modeling (PLS-SEM) was used to test the hypothesized relationships. The findings indicate that performance expectancy, effort expectancy, and social influence (SI) positively and significantly influenced the behavioral intention (BI) to adopt e-commerce. Facilitating conditions (FC) and BI had a significant positive relationship with the adoption of e-commerce.

The Moderating Effects of Gender on E-Commerce Systems Adoption Factors

2018 ◽  
Vol 9 (4) ◽  
pp. 86-104
Author(s):  
Frederick Pobee ◽  
Daniel Opoku
Keyword(s):  
Behavioral Intention ◽  
Structural Equation ◽  
Equation Modeling ◽  
Moderating Effects ◽  
Performance Expectancy ◽  
Adoption Factors ◽  
Use Of Technology ◽  
Effort Expectancy ◽  
Actual Use ◽  
Facilitating Conditions

The purpose of this article was to investigate the moderating effects of gender on e-commerce systems adoption factors among university lecturers in Ghana. In order to achieve this purpose, the unified theory of acceptance and use of technology (UTAUT) was used as the theoretical lens for the study. Eight hypotheses were developed and tested. Data analysis was performed with a structural equation modeling (SEM) technique using SmartPLS Application. Using a survey of 223 respondents, the study showed that factors such as performance expectancy, effort expectancy, and facilitating conditions positively and significantly influenced Ghanaian lecturers' behavioral intention and ultimately the actual use of e-commerce systems. As for the moderating effects of gender, this study discovered that gender insignificantly moderated the effects of performance expectancy, effort expectancy and social influence on behavioral intention.

scholarly journals Analisis Penerimaan dan Penggunaan Aplikasi Gojek Menggunakan Model UTAUT

2020 ◽  
Vol 1 (1) ◽  
pp. 85-95
Author(s):  
Nadiyah Hidayati ◽  
Yudi Ramdhani
Keyword(s):  
Data Processing ◽  
Social Influence ◽  
Significant Influence ◽  
Behavioral Intention ◽  
Strong Relationship ◽  
Performance Expectancy ◽  
Use Of Technology ◽  
Data Processing Method ◽  
Effort Expectancy ◽  
Facilitating Conditions

Abstrak Objektif. Aplikasi Gojek merupakan aplikasi berbasis android yang menjadi pintu masuk bagi pelanggan untuk mendapatkan layanan yang disediakan PT Gojek Indonesia. Penelitian ini dilakukan untuk menganalisa faktor-faktor yang mempengaruhi penerimaan dan penggunaan aplikasi Gojek menggunakan model Unified Theory of Acceptance and Use of Technology (UTAUT) dengan 4 variabel bebas dan 1 variabel terikat yaitu ekspektasi kinerja, ekspektasi usaha, faktor sosial, kondisi-kondisi pemfasilitasi, dan niat perilaku. Penelitian ini dilakukan terhadap 100 responden pengguna aplikasi Gojek  pada SMK MVP Ars Internasional. Material and Metode. Model UTAUT digunakan untuk mengetahui tingkat keberhasilan penerimaan aplikasi Gojek agar dapat diterima oleh masyarakat. Metode pengolahan data yang digunakan adalah regresi linear berganda yang menggunakan software SPSS 22. Hasil. Dari pengolahan data tersebut didapatkan hasil bahwa variabel ekspektasi kinerja, ekspektasi usaha, faktor sosial dan kondisi-kondisi pemfasilitasi memiliki nilai korelasi sebesar 0,867 terhadap niat perilaku, artinya antara variabel independen dan dependen dalam penelitian ini memiliki hubungan yang sangat kuat, nilai R Square (R2) sebesar 75,2% sedangkan sisanya dipengaruhi variabel lain. Kesimpulan. Dengan demikian dapat disimpulkan bahwa secara simultan, variabel ekspektasi kinerja, ekspektasi usaha, faktor sosial, dan kondisi-kondisi pemfasilitasi berpengaruh secara positif dan signifikan terhadap niat perilaku aplikasi Gojek. Sedangkan secara parsial, hanya variabel ekspektasi kinerja dan faktor sosial yang memiliki pengaruh positif dan signifikan terhadap niat perilaku aplikasi Gojek. Sedangkan variabel ekspektasi usaha dan kondisi-kondisi pemfasilitasi tidak memiliki pengaruh positif dan signifikan terhadap niat perilaku dalam menggunakan aplikasi Gojek. Abstrack Objective. Gojek application is an android-based application that is the entrance for customers to get the services provided PT Gojek Indonesia. This study was conducted to analyze the factors that influence the acceptance of Gojek applications using the UTAU) method with 4 independent variables and 1 dependent variable namely Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions, and Behavioral Intention. This research was conducted on 100 respondents of the Gojek application SMK MVP Ars International. Materials and Methods. The UTAUT model is used to determine the level of success in accepting Gojek applications to be accepted by the community. The data processing method used is multiple linear regression using SPSS 22 software. Results From the data processing, the results show that the variables of performance expectancy, effort expectancy, social influence, and facilitating conditions have a correlation value of 0,867 to behavioral intention, meaning between independent and dependent variables in this study has a strong relationship, the value of R Square (R2) of 75,2% while the rest is influenced by other variables. Conclusion. Thus it can be concluded that simultaneously, the variable performance expectancy, effort expectancy, social influence, and facilitating conditions positively and significantly affect the behavioral intention of Gojek applications. While partially, only the performance expectancy and social influence variables that have a positive and significant influence on the behavioral intention of Gojek application. While the effort expectancy and facilitating conditions variable does not have a positive and significant influence on Behavioral Intentionin using the Gojek application.

scholarly journals Health care providers and HIV

2021 ◽  
Author(s):  
Anne C. Wagner
Keyword(s):  
Health Care ◽  
Factor Analysis ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Care Providers ◽  
Related Stigma ◽  
Convergent And Divergent Validity ◽  
Living With Hiv

The current investigation seeks to examine the attitudes and beliefs of health care providers in Canada about people living with HIV. The line of research consists of three studies. Study 1 was a qualitative study conducted with a critical lens. The critical lens was used in a series of four focus groups when qualitatively soliciting opinions about the range of attitudes, behaviours and cognitions health care providers may have towards people living with HIV. Study 2 used the information gathered from Study 1 to develop a scale to assess HIV stigma in health care providers. Items were created from examples and themes found in the qualitative study, and were tested via exploratory factor analysis, confirmatory factor analysis, test-retest reliability analysis, and assessed for convergent and divergent validity. Study 3 examined the newly developed scale’s relationship to proposed overlapping stigmas and attitudes, and tested the adapted intersectional model of HIV-related stigma with health care trainees using the newly developed HIV stigma scale as an outcome measure. The line of research found that HIV stigma continues to be a significant problem in the health care system. The scale developed in Study 2 demonstrates that HIV stigma can be conceptualized and assessed as a tripartite model of discrimination, stereotyping and prejudice, and that this conceptualization of HIV stigma supports an intersectional model of overlapping stigmas with homophobia, racism, stigma against injection drug use and stigma against sex work.

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