Doll Moritz, Chandrakumar Ranujan, Jahre Lisa Maria, Skoda Eva-Maria, Dinse Hannah, Führer Dagmar, Lampropoulou Eleni, Teufel Martin, Bäuerle Alexander
Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, Essen, 45147, Germany, 0049 201438755203.
Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.
JMIR Form Res. 2025 Aug 8;9:e67317. doi: 10.2196/67317.
Hypothyroidism is a common chronic disease that can substantially impair physical and mental well-being and is associated with lower quality of life, a trend that interventions delivered by mobile health (mHealth) apps could ameliorate.
The objective of this study was to evaluate the acceptance and its influencing predictors of mHealth interventions in female patients affected by hypothyroidism to improve their quality of life. The focus on female patients reflects the significantly higher prevalence of hypothyroidism in women and their underrepresentation in many prior studies on technology acceptance and mHealth use.
A survey-based, cross-sectional study, which included 318 female patients affected by hypothyroidism (assessed via self-reported diagnosis according to International Classification of Diseases-10 criteria, aged 18 y or older), was conducted online between April 2023 and April 2024 in Germany. Participants were recruited via local and online self-help groups, social media platforms, and medical practices using flyers. Sociodemographic, health, and eHealth-related data were assessed. To determine acceptance and its drivers and barriers, an extended version of the unified theory of acceptance and use of technology (UTAUT) model was applied. Group comparisons (t tests, ANOVAs) and multiple hierarchical regression analyses were conducted. Only complete datasets were included in the analysis.
Acceptance of mHealth apps was high (mean 4.10, SD 0.91), with 76.1% (n=242) of the participants reporting high acceptance, 18.6% (n=59) reporting moderate acceptance, and only 5.3% (n=17) reporting low acceptance. Significant predictors of acceptance were place of residence: medium-sized city (β=0.34; P=.02) and small town or rural area (β=0.28; P=.003), fatigue (β=0.54; P<.001), internet anxiety (β=-0.20; P=.002), and the UTAUT predictors effort expectancy (β=0.37; P<.001), performance expectancy (β=0.32; P<.001), and social influence (β=0.20; P<.001). The extended model explained 56.1% of the variance in acceptance.
The high level of acceptance of mHealth apps observed among female patients affected by hypothyroidism indicates that mHealth interventions can provide such patients with valuable support to manage the disease and improve their quality of life. Addressing drivers and barriers of acceptance will be crucial for the successful implementation of mHealth interventions in hypothyroidism management, for example, by mHealth developers, clinicians, or policy makers. These include intuitive and accessible design (effort expectancy), clear communication of app benefits (performance expectancy), and fostering health care professional support (social influence), while addressing barriers such as internet anxiety. The study also contributes to advancing gender-sensitive mHealth research by applying the UTAUT model to this patient group.
甲状腺功能减退是一种常见的慢性病，会严重损害身心健康，并与生活质量下降相关，而移动健康（mHealth）应用程序提供的干预措施可能会改善这种趋势。
本研究的目的是评估受甲状腺功能减退影响的女性患者对mHealth干预措施的接受度及其影响因素，以改善她们的生活质量。关注女性患者反映了甲状腺功能减退在女性中的患病率显著更高，且她们在许多先前关于技术接受和mHealth使用的研究中代表性不足。
2023年4月至2024年4月在德国进行了一项基于调查的横断面研究，纳入了318名受甲状腺功能减退影响的女性患者（根据国际疾病分类第10版标准通过自我报告诊断评估，年龄在18岁及以上）。通过当地和在线自助小组、社交媒体平台以及使用传单的医疗实践招募参与者。评估了社会人口统计学、健康和电子健康相关数据。为了确定接受度及其驱动因素和障碍，应用了技术接受与使用统一理论（UTAUT）模型的扩展版本。进行了组间比较（t检验、方差分析）和多元层次回归分析。分析仅纳入完整数据集。
mHealth应用程序的接受度较高（均值4.10，标准差0.91），76.1%（n = 242）的参与者报告接受度高，18.6%（n = 59）报告接受度中等，只有5.3%（n = 17）报告接受度低。接受度的显著预测因素包括居住地：中型城市（β = 0.34；P = 0.02）和小镇或农村地区（β = 0.28；P = 0.003）、疲劳（β = 0.54；P < 0.001）、网络焦虑（β = -0.20；P = 0.002）以及UTAUT预测因素努力期望（β = 0.37；P < 0.001）、绩效期望（β = 0.32；P < 0.001）和社会影响（β = 0.20；P < 0.001）。扩展模型解释了接受度方差的56.1%。
在受甲状腺功能减退影响的女性患者中观察到的mHealth应用程序的高接受度表明，mHealth干预措施可以为这些患者提供有价值的支持，以管理疾病并改善生活质量。解决接受度的驱动因素和障碍对于mHealth干预措施在甲状腺功能减退管理中的成功实施至关重要，例如对于mHealth开发者、临床医生或政策制定者。这些包括直观且易于使用的设计（努力期望）、清晰传达应用程序的益处（绩效期望）以及促进医疗保健专业人员的支持（社会影响），同时解决诸如网络焦虑等障碍。该研究还通过将UTAUT模型应用于该患者群体，为推进对性别敏感的mHealth研究做出了贡献。
