User Acceptance of Wireless Text Messaging in Telehealth: A Case for Adherence

Abstract

<p> This work is an investigation of user acceptance of a prototype solution utilizing wireless text messaging (or SMS - i.e., short messaging service) to improve people's adherence. Insufficient adherence, also known as medical non-compliance, is a major cause of failure in self-management programs, causing significant losses to all healthcare stakeholders.</p> <p> Innovative mobile healthcare solutions, based on portable devices like cell phones, may address some non-adherence aspects by helping outpatients to follow treatments agreed with their health providers. Although this seems a win-win situation, a verdict on the overall usefulness of such an approach cannot be formulated before exploring outpatient acceptance, as this is a novel technology that targets a new area of implementation. Accordingly, this research investigates key factors that may influence the acceptance of a mobile healthcare solution based on SMS to support improved adherence to healthy behaviour, with special attention to motivation (the 'pro' factors) and perceived risk (the 'con' factors).</p> <p> As a means of investigation, a one-month longitudinal experiment with two groups of subjects (an intervention group and a control group) was utilized. Data were analyzed with quantitative and qualitative techniques: descriptive statistics, partial least squares modelling, and content analysis.</p> <p> Findings show that users are aware of the potential usefulness of such a pioneering application. However, enjoyment is the unique reason for adopting, and perceived financial and psychological risks the main obstacles against adopting, an SMS-based solution for improving adherence to healthy behaviour. Furthermore, a business analysis shows that users are concerned about usefulness features, even when asked about financial aspects.</p> <p> These results, together with encouraging findings about the effectiveness of the application, open the way for medical-led research to investigate if long-term mobile healthcare initiatives customized to patient needs are also beneficial for outpatient adherence and health outcomes.</p>