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

Abstract

Xueqing Peng,1 Zhiguang Li,2 Chi Zhang,3 Qifeng Wu,1 Jinghong Gu,4 Hua You1,3,5 1School of Public Health, Nanjing Medical University, Nanjing, 211166, People’s Republic of China; 2The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People’s Republic of China; 3School of Nursing, Nanjing Medical University, Nanjing, 211166, People’s Republic of China; 4College of Art and Sciences, University of Washington, Seattle, WA, 98195, USA; 5Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, 211166, People’s Republic of ChinaCorrespondence: Hua YouInstitute of Healthy Jiangsu Development, Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, People’s Republic of ChinaTel [phone]Email [email protected]: 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: online medical services, physician, information-motivation-behavioral skills (IMB) model, structural equation modeling

Keywords

• online medical services
• physician
• information-motivation-behavioral skills (imb) model
• structural equation modeling