He Ting, Yang Xiao Ling, Yuan Li, Li Rao, Lv Jing, Wang Yi
Department of Pancreatic Surgery, Sichuan University, West China Hospital, Chengdu, China.
Sichuan University, West China Hospital, School of Nursing, Chengdu, Sichuan, China.
BMJ Open. 2025 Apr 17;15(4):e091921. doi: 10.1136/bmjopen-2024-091921.
The development of mobile health (mHealth) in China has tremendous potential, especially for diabetes, which is one of the major chronic diseases affecting hundreds of millions of people. However, research on the current use of mHealth by patients with diabetes and the factors influencing their decision-making is insufficient. Most existing studies have approached the subject from a technological perspective and often overlooked the identity of patients as users of mHealth services. Based on the Andersen behavioural model, this study aimed to investigate the factors affecting patients' adoption of mHealth, with a special emphasis on individual patient characteristics, and provided recommendations for the promotion of mHealth and the management of diabetes.
This was a cross-sectional study. A convenience sample survey was conducted in one tertiary hospital and two community health service centres, and an anonymous self-administered questionnaire survey was conducted among patients with diabetes. Based on Andersen's behavioural model, the questionnaire divided the influencing factors into predisposing factors, enabling factors and need factors. Multivariate logistic regression analysis was used to explore the factors influencing the utilisation of mHealth.
A total of 533 questionnaires were valid. In this study, 36.8% of patients with diabetes used mHealth services. Among the predisposing factors, having better education and mHealth knowledge were found to be facilitators of mHealth utilisation, and employment status was a factor associated with mHealth utilisation. Among the enabling factors, patients with internet access and living in urban areas were more likely to have access to mHealth, and higher health literacy positively influenced mHealth utilisation. Among the need factors, self-assessed health status was linked to mHealth utilisation, and diabetes duration had a negative impact on mobile health utilisation.
The rate of mobile health utilisation remained low. In the future, improvements can be made in multiple aspects, such as policy, promotion, infrastructure and health education, to advance the development of mobile health and the management and control of diabetes.
移动健康（mHealth）在中国的发展具有巨大潜力，尤其是对于糖尿病而言，糖尿病是影响数亿人的主要慢性病之一。然而，关于糖尿病患者当前对移动健康的使用情况以及影响其决策的因素的研究并不充分。大多数现有研究从技术角度探讨该主题，常常忽视患者作为移动健康服务使用者的身份。基于安德森行为模型，本研究旨在调查影响患者采用移动健康的因素，特别强调个体患者特征，并为促进移动健康及糖尿病管理提供建议。
这是一项横断面研究。在一家三级医院和两家社区卫生服务中心进行了便利抽样调查，并对糖尿病患者进行了匿名自填式问卷调查。基于安德森模型，问卷将影响因素分为易患因素、促成因素和需求因素。采用多因素逻辑回归分析来探索影响移动健康利用的因素。
共533份问卷有效。在本研究中，36.8%的糖尿病患者使用移动健康服务。在易患因素中，受教育程度较高和具备移动健康知识被发现是移动健康利用的促进因素，就业状况是与移动健康利用相关的因素。在促成因素中，有互联网接入且居住在城市地区的患者更有可能使用移动健康，较高的健康素养对移动健康利用有积极影响。在需求因素中，自我评估的健康状况与移动健康利用有关，糖尿病病程对移动健康利用有负面影响。
移动健康利用率仍然较低。未来，可以在政策、推广、基础设施和健康教育等多个方面进行改进，以推动移动健康的发展以及糖尿病的管理和控制。
