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A Novel Instrument for Measuring Older People's Attitudes Toward Technology (TechPH): Development and Validation
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0001-9870-8477
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0002-0316-548x
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0003-4312-2246
2019 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 21, no 5, article id e13951Article in journal (Refereed) Published
Abstract [en]

Background: The use of health technology by older people is coming increasingly in focus with the demographic changes. Health information technology is generally perceived as an important factor in enabling increased quality of life and reducing the cost of care for this group. Age-appropriate design and facilitation of technology adoption are important to ensure functionality and removal of various barriers to usage. Development of assessment tools and instruments for evaluating older persons' technology adoption and usage as well as measuring the effects of the interventions are of high priority. Both usability and acceptance of a specific technology or service are important factors in evaluating the impact of a health information technology intervention. Psychometric measures are seldom included in evaluations of health technology. However, basic attitudes and sentiments toward technology (eg, technophilia) could be argued to influence both the level of satisfaction with the technology itself as well as the perception of the health intervention outcome. Objective: The purpose of this study is to develop a reduced and refined instrument for measuring older people's attitudes and enthusiasm for technology based on relevant existing instruments for measuring technophilia A requirement of the new instrument is that it should be short and simple to make it usable for evaluation of health technology for older people. Methods: Initial items for the TechPH questionnaire were drawn from a content analysis of relevant existing technophilia measure instruments. An exploratory factor analysis was conducted in a random selection of persons aged 65 years or older (N=374) on eight initial items. The scale was reduced to six items, and the internal consistency and reliability of the scale were examined. Further validation was made by a confirmatory factor analysis (CFA). Results: The exploratory factor analysis resulted in two factors. These factors were analyzed and labeled techEnthusiasm and techAnxiety. They demonstrated relatively good internal consistency (Cronbach alpha=.72 and .68, respectively). The factors were confirmed in the CFA and showed good model fit (chi(2)(8)=21.2, chi(2)/df=2.65, comparative fit index=0.97, adjusted goodness-of-fit index=0.95, root mean square error of approximation=0.067, standardized root mean square residual=0.036). Conclusions: The construed TechPH score showed expected relations to external real-world criteria, and the two factors showed interesting internal relations. Different technophilia personality traits distinguish clusters with different behaviors of adaptation as well as usage of new technology. Whether there is an independent association with the TechPH score against outcomes in health technology projects needs to be shown in further studies. The instrument must also be validated in different contexts, such as other countries.

Place, publisher, year, edition, pages
JMIR PUBLICATIONS, INC , 2019. Vol. 21, no 5, article id e13951
Keywords [en]
technophilia, aging, internet, health technology, eHealth
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:bth-18031DOI: 10.2196/13951ISI: 000469099700001PubMedID: 31124467OAI: oai:DiVA.org:bth-18031DiVA, id: diva2:1324996
Note

open access

Available from: 2019-06-14 Created: 2019-06-14 Last updated: 2019-10-29Bibliographically approved
In thesis
1. Evaluating Success Factors of Health Information Systems
Open this publication in new window or tab >>Evaluating Success Factors of Health Information Systems
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Health information systems are our technological response to the growing demand for health care. However, their success in their mission can be challenging due to the complexity of evaluating technological interventions in health care. In the series of studies compiled in this dissertation, we looked at the evaluation of these systems. We focused on the evaluation of factors that lead to success, where success is indicated by user satisfaction and can be induced by both intervention-specific and individual-specific factors.

Study 1 developed a method, called UVON, to elicit and organise the user-demanded qualities in the outcomes of the health information system intervention. Through the application of the UVON method in the FI-STAR project, an EU project which developed and deployed seven e-health applications in seven member countries, ten categories of quality and their subcategories were identified. These qualities formed two questionnaires, specific to the patient and health professional users. Through the questionnaires, the patients and health-professionals users evaluated and graded both the occurrence of those demanded qualities in the project outcomes and their general satisfaction.

Study 2 analysed the survey results to find out which of those ten qualities have the highest impact on satisfaction or can predict it better. Two partial least squares structural equation modelling (PLS-SEM) models were constructed, for the patient and health professionals, based on the Unified eValuation using ONtology (UVON) and survey outputs. The models showed that effectiveness is an important quality in creating satisfaction for both user groups. Besides, affordability for the health professionals and efficiency plus safety for the patients were the most influential. A satisfaction index is also introduced for simple and fast inferring of the changes in the outcome qualities.

Study 5 recruited outputs and learnings from studies 1 and 2 to design a system that partially automates the process of evaluating success factors in health information systems, making it continuous and real-time, and replacing hard-to-run surveys with automatically captured indicators and analytics.

Study 3 focused on individual-specific factors in using health information systems, particularly the technophilia personality trait. A short six-items instrument, called TechPH, was designed to measure technophilia in users, tuned for older users. The study recruited empirical data from the Swedish National Study on Aging and Care (SNAC) project. Two factors, labelled techAnxiety and techEnthusiams, are identified by the factor analysis method. A TechPH score was introduced as a scalar measurement of technophilia.

Study 4 elicited and discussed the ethical challenges of evaluating and researching health information systems. Both a scoping review and a novel systematic postulation approach were recruited to identify twenty ethical challenges. The identified ethical challenges were discussed and mapped into a three-dimensional space of evaluation stages, demanded qualities, and major involving entities (stakeholder and artefacts), which fosters further postulation of ethical challenges.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2019. p. 340
Series
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 14
Keywords
Health Information Systems, Health Information Technology, Health Informatics, eHealth, Digital Health, Evaluation, Information Systems Evaluation, Health Technology Assessment, User Satisfaction, Technophilia, Evaluation and Research Ethics, System Design
National Category
Other Electrical Engineering, Electronic Engineering, Information Engineering
Identifiers
urn:nbn:se:bth-18799 (URN)978-91-7295-387-1 (ISBN)
Public defence
2019-12-17, J1640, Campus Gräsvik, Karlskrona, 14:00 (English)
Opponent
Supervisors
Available from: 2019-10-29 Created: 2019-10-29 Last updated: 2019-12-12Bibliographically approved

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Anderberg, PeterEivazzadeh, ShahryarSanmartin Berglund, Johan

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