[Type 2 diabetes patients use E-health to manage disease willingness and influence mechanisms].

Abstract

Objective: To comprehensively investigate how the willingness of patients with type 2 diabetes mellitus to use E-health technologies, such as the application (APP) or Wechat mini-programs and the underlying influencing factors works for its mechanisms.

Methods: Based on the extended technology acceptance model, a cross-sectional questionnaire survey was conducted among 559 patients with type 2 diabetes from six provinces or municipalities in the eastern, central, and western regions of China from November to December 2024. The survey aimed to investigate the patients' willingness to use APP or Wechat mini-programs and the influencing factors. Correlation analysis and structural equation modeling methods were used to analyze the influencing factors of patients ' willingness to use and to explore the mechanisms.

Results: A total of 559 patients were surveyed, with an average willingness score of 10.68 (out of a total score of 15). Age and education level were found to be influencing factors of willingness to use, younger age and higher education (high school/college) were significantly associated with stronger willingness to use (P < 0.05). Spearman correlation analysis revealed that perceived usefulness, perceived ease of use, disease perception, social support, self-efficacy, and external cues were positively correlated with willingness to use, while perceived barriers were negatively correlated (all P < 0.05). Structural equation modeling demonstrated direct effects of perceived usefulness (β=0.375, P < 0.001), disease perception (β=-0.240, P < 0.001), self-efficacy (β=0.313, P=0.019), social support (β=-0.336, P=0.042), and external cues (β=0.609, P < 0.001) on willingness to use. Perceived ease of use indirectly influenced willingness through perceived usefulness (total effect=0.374). Self-efficacy affected usage intention partially mediated by disease perception, external cues influenced intention through perceived usefulness, and perceived barriers impacted intention via perceived usefulness, with external cues exhibiting the strongest total effect (β=0.672). All these effects were statistically significant (P < 0.05).

Conclusion: Patients with type 2 diabetes mellitus have a high willingness to use E-health technologies like APP or Wechat mini-programs, particularly younger individuals and those with high school/college education. Increasing perceived usefulness, self-efficacy, and external promotion can enhance willingness to use. However, higher disease perception and higher social support are associated with decreased willingness to use. Perceived ease of use and self-efficacy can also affect willingness to use through multiple mechanisms.