Research on the sustainability of information collection APP in rural basic public health services based on mixed-method_Chinese Journal of Evidence-Based Medicine

Authors：

LI Jiachang ¹ , CHEN Hui ¹ , SHEN Minghui ² , ZHANG Zhisheng ³ , LI Xu ¹ , DIAO Sha ¹ , MIAO Yunqi ¹ ,  LI Jiayuan ¹ , YANG Min ⁴

1. Department of Epidemiology and Statistics, West China School of Public Health and West China Fourth Hospital of Sichuan University, Chengdu 610041, P.R.China;
2. Health Information Centre of Sichuan Province, Chengdu 610041, P.R.China;
3. Health Bureau of Renshou County, Sichuan Province, Meishan 620010, P.R.China;
4. West China Research Center for Rural Health Development, Chengdu 610041, P.R.China;

Corresponding author：

LI Jiayuan, Email: lijiayuan73@163.com

Keywords：

Mixed-method research; Rural basic public health; APP; Information collection; Sustainability

DOI：

10.7507/1672-2531.202006164

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Abstract Full text Figures/Tables Video References Cited by

Objective Public health information collection is critical in improving the capacity of basic public health services. Our study took the "Wei Jian E Tong" APP as an example to evaluate the willingness and influencing factors of rural public health service personnel to continue using such APPs.Methods We applied exploratory sequential design in mixed-method research and chose Renshou county in Sichuan province as the representative region. Firstly, we used the personal in-depth interview to initially explore the status quo, applicability, continued willingness to use APP and other issues. Secondly, we used unified theory of acceptance and use of technology (UTAUT) and expectation confirmation theory (ECT) to construct a hypothetical model of influencing factors of user satisfaction. We then designed a structured questionnaire covering 7 measurement dimensions to survey all users of the APP at the survey site. Finally, we used structural equation model to verify the research hypothesis.Results A total of 21 individuals were interviewed in this survey, including leaders of township health centers, public health doctors, and rural doctors. Qualitative results showed the major defects were insufficient funds and policy support in the promotion and application, additionally lack of software functionalities and system incompatibility. A total of 593 valid questionnaires were collected from the quantitative survey on the satisfaction of township doctors and village doctors. Structural equation model results showed that seven direct hypotheses were established, of which compatibility had the largest effect value user satisfaction with a total effect value of 0.617, followed by facilitating condition (r=0.211), performance expectancy (r=0.137), effort expectancy (r=0.091) and social influence (r=0.068).Conclusions To promote the application of information collection apps in primary public health services and improve user satisfaction, the focus should be on solving software incompatibility and create interconnection among all levels of medical systems. At the same time, it is necessary to solve funding problems as a whole, optimize software functions, improve the performance evaluation system, and improve software training and promotion.

Citation： LI Jiachang, CHEN Hui, SHEN Minghui, ZHANG Zhisheng, LI Xu, DIAO Sha, MIAO Yunqi, LI Jiayuan, YANG Min. Research on the sustainability of information collection APP in rural basic public health services based on mixed-method. Chinese Journal of Evidence-Based Medicine, 2021, 21(1): 15-20. doi: 10.7507/1672-2531.202006164 Copy

1.	中共中央国务院. 中共中央国务院关于深化医药卫生体制改革的意见. 中国药房, 2010, 21(4): 289-294.
2.	Medhanyie AA, Spigt M, Yebyo H, et al. Quality of routine health data collected by health workers using smartphone at primary health care in Ethiopia. Int J Med Inform, 2017, 101: 9-14.
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8.	Bawack RE, Kala Kamdjoug JR. Adequacy of UTAUT in clinician adoption of health information systems in developing countries: The case of Cameroon. Int J Med Inform, 2018, 109: 15-22.
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10.	Venkatesh V, Morris MG, Davis GB, et al. User acceptance of information technology: toward a unified view. MIS Quarterly, 2003, 27(3): 425-478.
11.	任聪. 基于TAM和感知风险理论的移动医疗服务用户采纳模型及其实证研究. 武汉: 华中科技大学, 2017.
12.	陶方金. 基于UTAUT与感知风险性的PaaS使用意愿影响因素研究. 合肥: 合肥工业大学, 2016.
13.	Wright E, Marvel J. Electronic health records: postadoption physician satisfaction and continued use. Health Care Manag (Frederick), 2012, 31(3): 259-267.
14.	Parthasarathy M, Bhattacherjee A. Understanding post-adoption behavior in the context of online services. Information Systems Research, 1998, 9(4): 362-379.
15.	Oliver RL. A cognitive model of the antecedents and consequences of satisfaction decisions. J Market Res, 1980, 17(4): 460-469.
16.	Karahanna E, Agarwal R, Angst CM. Reconceptualizing compatibility beliefs in technology acceptance research. MIS Quarterly, 2006, 30(4): 781-804.
17.	Maillet É, Mathieu L, Sicotte C. Modeling factors explaining the acceptance, actual use and satisfaction of nurses using an Electronic Patient Record in acute care settings: an extension of the UTAUT. Int J Med Inform, 2015, 84(1): 36-47.
18.	吴明隆. 结构方程模型: AMOS的操作与应用. 重庆: 重庆大学出版社, 2010.
19.	Gu D, Yang X, Li X, et al. Understanding the role of mobile internet-based health services on patient satisfaction and word-of-mouth. Int J Environ Res Public Health, 2018, 15(9): 1972.
20.	Yuan S, Ma W, Kanthawala S, et al. Keep using my health apps: discover users' perception of health and fitness apps with the UTAUT2 model. Telemed J E Health, 2015, 21(9): 735-741.

1. 中共中央国务院. 中共中央国务院关于深化医药卫生体制改革的意见. 中国药房, 2010, 21(4): 289-294.
2. Medhanyie AA, Spigt M, Yebyo H, et al. Quality of routine health data collected by health workers using smartphone at primary health care in Ethiopia. Int J Med Inform, 2017, 101: 9-14.
3. Schoen J, Mallett JW, Grossman-Kahn R, et al. Perspectives and experiences of community health workers in Brazilian primary care centers using m-health tools in home visits with community members. Hum Resour Health. 2017, 15(1): 71.
4. Svoronos T, Mjungu D, Dhadialla P, et al. CommCare: automated quality improvement to strengthen community-based health. Available from: https://www.researchgate.net/publication/268198360_CommCare_Automated_Quality_Improvement_To_Strengthen_Community-Based_Health.
5. 吕姝, 景秀红, 吴擢春. 定性研究与定量研究相结合的方法在卫生领域中的应用. 医学与社会, 2013, 26(12): 21-24, 27.
6. Creswell JW. A concise introduction to mixed methods research. California: SAGE Publication, 2015.
7. 张敏, 罗梅芬, 张艳. 国内外移动医疗用户采纳行为的系统综述−知识基础, 影响因素与前沿展望. 现代情报, 2018, (8): 154-162.
8. Bawack RE, Kala Kamdjoug JR. Adequacy of UTAUT in clinician adoption of health information systems in developing countries: The case of Cameroon. Int J Med Inform, 2018, 109: 15-22.
9. Zhang Y, Liu C, Luo S, et al. Factors influencing patients' intentions to use diabetes management apps based on an extended unified theory of acceptance and use of technology model: web-based survey. J Med Internet Res, 2019, 21(8): e15023.
10. Venkatesh V, Morris MG, Davis GB, et al. User acceptance of information technology: toward a unified view. MIS Quarterly, 2003, 27(3): 425-478.
11. 任聪. 基于TAM和感知风险理论的移动医疗服务用户采纳模型及其实证研究. 武汉: 华中科技大学, 2017.
12. 陶方金. 基于UTAUT与感知风险性的PaaS使用意愿影响因素研究. 合肥: 合肥工业大学, 2016.
13. Wright E, Marvel J. Electronic health records: postadoption physician satisfaction and continued use. Health Care Manag (Frederick), 2012, 31(3): 259-267.
14. Parthasarathy M, Bhattacherjee A. Understanding post-adoption behavior in the context of online services. Information Systems Research, 1998, 9(4): 362-379.
15. Oliver RL. A cognitive model of the antecedents and consequences of satisfaction decisions. J Market Res, 1980, 17(4): 460-469.
16. Karahanna E, Agarwal R, Angst CM. Reconceptualizing compatibility beliefs in technology acceptance research. MIS Quarterly, 2006, 30(4): 781-804.
17. Maillet É, Mathieu L, Sicotte C. Modeling factors explaining the acceptance, actual use and satisfaction of nurses using an Electronic Patient Record in acute care settings: an extension of the UTAUT. Int J Med Inform, 2015, 84(1): 36-47.
18. 吴明隆. 结构方程模型: AMOS的操作与应用. 重庆: 重庆大学出版社, 2010.
19. Gu D, Yang X, Li X, et al. Understanding the role of mobile internet-based health services on patient satisfaction and word-of-mouth. Int J Environ Res Public Health, 2018, 15(9): 1972.
20. Yuan S, Ma W, Kanthawala S, et al. Keep using my health apps: discover users' perception of health and fitness apps with the UTAUT2 model. Telemed J E Health, 2015, 21(9): 735-741.

Chinese Journal of Evidence-Based Medicine

Research on the sustainability of information collection APP in rural basic public health services based on mixed-method

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