The Technology Acceptance Model for Resource-Limited Settings (TAM-RLS): A Novel Framework for Mobile Health Interventions Targeted to Low-Literacy End-Users in Resource-Limited Settings
The Technology Acceptance Model for Resource-Limited Settings (TAM-RLS): A Novel Framework for Mobile Health Interventions Targeted to Low-Literacy End-Users in Resource-Limited Settings
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DOI：
10.1007/s10461-017-1765-y
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发表时间：
2017-11-01
影响因子：
4.4
通讯作者：
Siedner, Mark J.
中科院分区：
文献类型：
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作者：
Campbell, Jeffrey I.;Aturinda, Isaac;Siedner, Mark J.
虽然移动的健康（mHealth）技术在改善资源有限环境（RLS）中的临床护理方面显示出了希望，但它们很少被大规模应用。许多移动保健干预措施取得成功的一个限制是不注意最终用户的可接受性，这是技术采用的一个重要预测因素。我们对乌干达农村的43名艾滋病毒感染者进行了深入采访，他们参加了一项基于短信系统（SMS）的干预措施的临床试验，旨在在实验室检测异常后迅速返回诊所。访谈的重点是技术接受模式的既定特征，包括感知易用性和感知有用性，并包括开放式问题，以深入了解与干预措施的可接受性有关的未探讨问题。我们使用传统的（归纳）和直接的内容分析来获得描述使用行为和可接受性的类别。访谈指导了一个拟议的概念框架，技术接受模型资源有限的设置（TAM-RLS）的发展。该框架既包含了经典的技术接受模型类别，也包含了影响该环境中使用的新因素。与会者描述了SMS消息语言、电话特性和类似技术的经验如何有助于系统的易用性。人们认为，这一系统扩大了艾滋病毒护理服务，改善了从家人和同事那里获得社会支持的机会，从而形成了对有用性的认识。与乌干达艾滋病病毒携带者接受移动医疗具体相关的新兴主题包括：（1）保密、披露和污名的重要性，以及（2）影响系统目标成果实现的干预措施下游的障碍和促进因素。TAM-RLS是根据乌干达农村地区的最终用户经验提出的移动医疗技术接受模式。虽然所提出的模型需要验证，TAM-RLS可以作为一个有用的工具，以指导设计和实施mHealth干预措施。
Although mobile health (mHealth) technologies have shown promise in improving clinical care in resource-limited settings (RLS), they are infrequently brought to scale. One limitation to the success of many mHealth interventions is inattention to end-user acceptability, which is an important predictor of technology adoption. We conducted in-depth interviews with 43 people living with HIV in rural Uganda who had participated in a clinical trial of a short messaging system (SMS)-based intervention designed to prompt return to clinic after an abnormal laboratory test. Interviews focused on established features of technology acceptance models, including perceived ease of use and perceived usefulness, and included open-ended questions to gain insight into unexplored issues related to the intervention's acceptability. We used conventional (inductive) and direct content analysis to derive categories describing use behaviors and acceptability. Interviews guided development of a proposed conceptual framework, the technology acceptance model for resource-limited settings (TAM-RLS). This framework incorporates both classic technology acceptance model categories as well as novel factors affecting use in this setting. Participants described how SMS message language, phone characteristics, and experience with similar technologies contributed to the system's ease of use. Perceived usefulness was shaped by the perception that the system led to augmented HIV care services and improved access to social support from family and colleagues. Emergent themes specifically related to mHealth acceptance among PLWH in Uganda included (1) the importance of confidentiality, disclosure, and stigma, and (2) the barriers and facilitators downstream from the intervention that impacted achievement of the system's target outcome. The TAM-RLS is a proposed model of mHealth technology acceptance based upon end-user experiences in rural Uganda. Although the proposed model requires validation, the TAM-RLS may serve as a useful tool to guide design and implementation of mHealth interventions.