Schinle Markus, Erler Christina, Kaliciak Mayumi, Milde Christopher, Stock Simon, Gerdes Marius, Stork Wilhelm
Medical Information Technology, Embedded Systems and Sensors Engineering, FZI Research Center for Information Technology, Karlsruhe, Germany.
Biological Psychology, Department of Psychology, University of Koblenz and Landau, Landau, Germany.
JMIR Form Res. 2022 Jun 22;6(6):e35961. doi: 10.2196/35961.
Age-related diseases such as dementia are playing an increasingly important role in global population development. Thus, prevention, diagnostics, and interventions require more accessibility, which can be realized through digital health apps. With the app on prescription, Germany made history by being the first country worldwide to offer physicians the possibility to prescribe and reimburse digital health apps as of the end of the year 2020.
Considering the lack of knowledge about correlations with the likelihood of use among physicians, this study aimed to address the question of what makes the use of a digital health app by physicians more likely.
We developed and validated a novel measurement tool-the Digital Health Compliance Questionnaire (DHCQ)-in an interdisciplinary collaboration of experts to assess the role of proposed factors in the likelihood of using a health app. Therefore, a web-based survey was conducted to evaluate the likelihood of using a digital app called DemPredict to screen for Alzheimer dementia. Within this survey, 5 latent dimensions (acceptance, attitude toward technology, technology experience, payment for time of use, and effort of collection), the dependent variable likelihood of use, and answers to exploratory questions were recorded and tested within directed correlations. Following a non-probability-sampling strategy, the study was completed by 331 physicians from Germany in the German language, of whom 301 (90.9%) fulfilled the study criteria (eg, being in regular contact with patients with dementia). These data were analyzed using a range of statistical methods to validate the dimensions of the DHCQ.
The DHCQ revealed good test theoretical measures-it showed excellent fit indexes (Tucker-Lewis index=0.98; comparative fit index=0.982; standardized root mean square residual=0.073; root mean square error of approximation=0.037), good internal consistency (Cronbach α=.83), and signs of moderate to large correlations between the DHCQ dimensions and the dependent variable. The correlations between the variables acceptance, attitude toward technology, technology experience, and payment for the time of use and the dependent variable likelihood of use ranged from 0.29 to 0.79, and the correlation between effort of the collection and likelihood of use was -0.80. In addition, we found high levels of skepticism regarding data protection, and the age of the participants was found to be negatively related to their technical experience and attitude toward technology.
In the context of the results, increased communication between the medical and technology sectors and significantly more awareness raising are recommended to make the use of digital health apps more attractive to physicians as they can be adjusted to their everyday needs. Further research could explore the connection between areas such as adherence on the patient side and its impact on the likelihood of use by physicians.
痴呆症等与年龄相关的疾病在全球人口发展中发挥着越来越重要的作用。因此，预防、诊断和干预需要更高的可及性，而这可以通过数字健康应用程序来实现。自2020年底起，德国通过将数字健康应用程序纳入处方，成为全球首个允许医生开具此类应用程序并予以报销的国家，创造了历史。
鉴于医生对与使用可能性相关因素的了解不足，本研究旨在探讨哪些因素会使医生更有可能使用数字健康应用程序。
我们通过专家的跨学科合作开发并验证了一种新型测量工具——数字健康合规问卷（DHCQ），以评估所提出的因素在使用健康应用程序可能性中的作用。为此，我们开展了一项基于网络的调查，以评估使用一款名为DemPredict的数字应用程序筛查阿尔茨海默病痴呆症的可能性。在这项调查中，记录了5个潜在维度（接受度、对技术的态度、技术经验、使用时间付费和收集工作量）、因变量使用可能性以及探索性问题的答案，并在定向相关性分析中进行了测试。遵循非概率抽样策略，331名来自德国的医生以德语完成了该研究，其中301名（90.9%）符合研究标准（如经常接触痴呆症患者）。使用一系列统计方法对这些数据进行分析，以验证DHCQ的维度。
DHCQ显示出良好的测试理论指标——其拟合指数极佳（塔克 - 刘易斯指数 = 0.98；比较拟合指数 = 0.982；标准化根均方残差 = 0.073；近似根均方误差 = 0.037），内部一致性良好（克朗巴哈α系数 = 0.83），且DHCQ维度与因变量之间存在中度至高度相关的迹象。接受度、对技术的态度、技术经验和使用时间付费与因变量使用可能性之间的相关性在0.29至0.79之间，而收集工作量与使用可能性之间的相关性为 -0.80。此外，我们发现医生对数据保护高度怀疑，且参与者的年龄与他们的技术经验和对技术的态度呈负相关。
基于研究结果，建议加强医疗和技术领域之间的沟通，并显著提高认知度，以使数字健康应用程序对医生更具吸引力，因为它们可以根据医生的日常需求进行调整。进一步的研究可以探索患者依从性等领域之间的联系及其对医生使用可能性的影响。
