Community health workers’ continuance of mobile health applications: An extended expectation confirmation model

Abstract

Mobile health applications (MHAs) have been widely used by community health workers (CHWs) in primary care to facilitate their workflow, but the continuance of these applications by CHWs remains inadequate. This article employs expectation confirmation theory as the overarching theory, complemented by the information system success model and the consumer expectations model, to propose a research model aimed at examining the factors influencing CHWs’ MHA continuance. To validate this research model, a survey was conducted involving 459 CHWs who used MHAs. The analysis results confirm many hypothetical relationships within the research model. First, we propose an extended expectation confirmation model remedying deficiency of the expectation confirmation theory. Second, this study uncovers an inverted U-shaped relationship between CHWs’ expectations and expectation confirmation. Third, we study continuance from a novel perspective – that of CHWs. Fourth, we reveal one boundary condition of our research model by considering the moderating role of health institution type. In addition, practical implications for both policymakers in healthcare systems and MHA providers are delivered.