Factors that influence the adoption of a school-based eHealth alcohol prevention program among Spanish personnel: a mixed methods study.

Abstract

Background: Evidence-based research has shown that using eHealth interventions effectively reduces risk behaviors such as alcohol consumption, a public health problem worldwide. However, despite its benefits, there has been a poor intention to adopt such innovations, and limited resources exist to understand factors influencing the uptake decision to use school-based eHealth alcohol prevention programs. This study aims to identify the factors that influence the adoption of a computer-tailored eHealth alcohol prevention program among school personnel in Spain.

Methods: A cross-sectional study employing an exploratory sequential mixed methods research design was carried out. First, interviews were conducted with ten Spanish school counselors to assess factors influencing the adoption of the school-based eHealth program by exploring participants' awareness and salient beliefs concerning attitudes, social influences, and self-efficacy. Second, an online quantitative questionnaire was developed based on the qualitative research findings. Third, the new questionnaire was administered to Spanish school personnel (N = 100), including the school management team, school counselors, and teachers. Rogers' Diffusion of Innovations theory and the Integrated Change Model frameworks were used as theoretical bases for understanding the adoption process.

Results: School personnel with a strong intention to adopt the program (intenders) perceived significantly more advantages and positive innovation attributes, than those participants with a weaker intention to adopt (non-intenders). Intenders perceived a higher personal relevance and responsibility towards using the program, more self-efficacy (e.g., ability to understand, manage time and incorporate the program) and positive social influences from their colleagues, as well as greater willingness in preparing action plans, such as monitor students' alcohol consumption and discussing the program with coworkers, than the non-intenders group. Advantages and social support were found to explain a significant portion of the variance in the adoption intention.

Conclusions: This study suggests that health intervention researchers should develop strategies to enhance educators' pro-innovation attitudes, personal relevance and responsibility, and perceived ease of use towards adopting an eHealth program. Furthermore, our results highlight that fostering school personnel's acceptance of the intervention and planning goal-oriented actions are crucial elements in optimizing adoption promotion of eHealth programs in school settings.