埃塞俄比亚西北部农村地区卫生推广工作者使用电子社区卫生信息系统的意向：基于技术接受与使用统一理论2模型的横断面研究
Intention to Use an Electronic Community Health Information System Among Health Extension Workers in Rural Northwest Ethiopia: Cross-Sectional Study Using the Unified Theory of Acceptance and Use of Technology 2 Model.
作者信息
Hailemariam Tesfahun, Atnafu Asmamaw, Gezie Lemma, Kaasbøll Jens, Klein Jorn, Tilahun Binyam
机构信息
Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
JMIR Hum Factors. 2024 Mar 4;11:e47081. doi: 10.2196/47081.
BACKGROUND
IT has brought remarkable change in bridging the digital gap in resource-constrained regions and advancing the health care system worldwide. Community-based information systems and mobile apps have been extensively developed and deployed to quantify and support health services delivered by community health workers. The success and failure of a digital health information system depends on whether and how it is used. Ethiopia is scaling up its electronic community health information system (eCHIS) to support the work of health extension workers (HEWs). For successful implementation, more evidence was required about the factors that may affect the willingness of HEWs to use the eCHIS.
OBJECTIVE
This study aimed to assess HEWs' intentions to use the eCHIS for health data management and service provision.
METHODS
A cross-sectional study design was conducted among 456 HEWs in 6 pilot districts of the Central Gondar zone, Northwest Ethiopia. A Unified Theory of Acceptance and Use of Technology model was used to investigate HEWs' intention to use the eCHIS. Data were cleaned, entered into Epi-data (version 4.02; EpiData Association), and exported to SPSS (version 26; IBM Corp) for analysis using the AMOS 23 Structural Equation Model. The statistical significance of dependent and independent variables in the model was reported using a 95% CI with a corresponding P value of <.05.
RESULTS
A total of 456 HEWs participated in the study, with a response rate of 99%. The mean age of the study participants was 28 (SD 4.8) years. Our study revealed that about 179 (39.3%; 95% CI 34.7%-43.9%) participants intended to use the eCHIS for community health data generation, use, and service provision. Effort expectancy (β=0.256; P=.007), self-expectancy (β=0.096; P=.04), social influence (β=0.203; P=.02), and hedonic motivation (β=0.217; P=.03) were significantly associated with HEWs' intention to use the eCHIS.
CONCLUSIONS
HEWs need to be computer literate and understand their role with the eCHIS. Ensuring that the system is easy and enjoyable for them to use is important for implementation and effective health data management.
背景
信息技术在弥合资源匮乏地区的数字鸿沟以及推动全球医疗保健系统发展方面带来了显著变化。基于社区的信息系统和移动应用程序已得到广泛开发和部署，以量化并支持社区卫生工作者提供的卫生服务。数字健康信息系统的成败取决于其是否被使用以及如何被使用。埃塞俄比亚正在扩大其电子社区卫生信息系统（eCHIS），以支持卫生推广工作者（HEW）的工作。为了成功实施该系统，需要更多关于可能影响卫生推广工作者使用eCHIS意愿的因素的证据。
目的
本研究旨在评估卫生推广工作者使用eCHIS进行健康数据管理和服务提供的意愿。
方法
在埃塞俄比亚西北部贡德尔中部地区的6个试点地区对456名卫生推广工作者进行了横断面研究设计。使用技术接受与使用统一理论模型来调查卫生推广工作者使用eCHIS的意愿。数据经过清理，录入Epi-data（版本4.02；EpiData协会），并导出到SPSS（版本26；IBM公司），使用AMOS 23结构方程模型进行分析。使用95%置信区间和相应的P值<0.05来报告模型中因变量和自变量的统计显著性。
结果
共有456名卫生推广工作者参与了该研究，回复率为99%。研究参与者的平均年龄为28（标准差4.8）岁。我们的研究表明，约179名（39.3%；95%置信区间34.7%-43.9%）参与者打算使用eCHIS进行社区健康数据生成、使用和服务提供。努力期望（β=0.256；P=0.007）、自我期望（β=0.096；P=0.04）、社会影响（β=0.203；P=0.02）和享乐动机（β=0.217；P=0.03）与卫生推广工作者使用eCHIS的意愿显著相关。
结论
卫生推广工作者需要具备计算机知识，并了解他们在eCHIS中的作用。确保该系统对他们来说易于使用且令人愉悦对于实施和有效的健康数据管理很重要。
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