Peng Xueqing, Li Zhiguang, Zhang Chi, Wu Qifeng, Gu Jinghong, You Hua
School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China.
The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China.
J Multidiscip Healthc. 2021 Dec 21;14:3453-3462. doi: 10.2147/JMDH.S346675. eCollection 2021.
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.
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.
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.
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.
新冠疫情加速了医生对在线医疗服务（OMS）的采用，但他们的采用意愿仍有待提高。本研究旨在基于信息-动机-行为技能（IMB）理论构建医生OMS采用意愿模型，探讨影响采用意愿的决定因素及其影响路径，并通过多组分析评估OMS使用经验对意愿的调节作用。
2020年6月至7月，采用多阶段抽样方法，对中国江苏省三家公立医院的医生进行了横断面调查。应用结构方程模型分析了531名受访者的有效数据。
医生采用OMS的意愿处于中等水平，平均得分为14.27±3.34（范围：4-20）。医生OMS采用意愿的行为模型拟合良好。信息（In）、动机（Mo）和行为技能（BS）解释了采用意愿（AW）中69%的方差。信息只能通过行为技能对意愿产生完全间接影响（b = 0.202，95%CI[0.122, 0.314]）；动机既能产生直接影响（β=0.368，p < 0.001），又能通过行为技能对意愿产生部分间接影响（b = 0.160，95%CI[0.092, 0.2,48]）；行为技能对意愿有正向影响（β=0.424，p < 0.001）。此外，OMS使用经验对Mo→AW路径显示出显著的调节作用，与有经验的医生相比，无经验的医生的意愿受动机的影响显著更强。
本研究结果揭示了IMB模型在解释和预测医生采用OMS意愿方面的作用以及采用经验的调节作用，为从业者支持OMS发展提供了理论基础和干预框架。
