Acceptance Of Services Research Articles

Factors influencing demand and acceptance of hospice care among Chinese older adults: A meta-analysis

ABSTRACT This study aimed to systematically integrate existing research findings on relevant factors influencing Chinese older adults to choose hospice care, thus providing targeted theoretical support and a basis for the promotion of hospice care services in China. The literature on factors affecting the older adults’ choice of hospice care services were retrieved from nine databases, including PubMed, Embase, Web of Science, The Cochrane Library, CNKI, Wanfang Data, VIP, CBM, and SinoMed. The data were extracted and analyzed using Revman5.3 and Stata17.0. A total of 11 articles are incorporated, and 13 related factors are extracted. The meta-analysis results show that the demand and acceptance of hospice care services in the older adults are related to age (RR = 1.39, 95% CI (1.17,1.65), p = 0.0002), education level (RR = 1.94, 95% CI (1.42,2.63), p < 0.001), marital status (RR = 1.21, 95% CI (1.05,1.40), P = 0.007), death attitude (RR = 1.21, 95% CI (1.53,9.45), p = 0.004), having experienced or witnessed emergency treatment (RR = 2.07, 95% CI (1.51,2.85), p < 0.001), and living condition (RR = 1.32, 95% CI (1.00,1.73), P = 0.05). The elders who are at an advanced age, well educated, unmarried in solitude, and have experienced or witnessed emergency treatment have a high demand and acceptance of hospice care services

The impact of smart elderly care service acceptance on elderly service usage behavior in Xi’an: An analysis of mediating effects based on the UTAUT model and the moderating role of digital literacy

As the aging trend intensifies, the Chinese government prioritizes technological innovation in smart elderly care services to enhance quality and efficiency, catering to the diverse needs of the elderly. This study examines the acceptance and usage behavior of smart elderly care services among elderly individuals in Xi’an, using a modified Unified Theory of Acceptance and Use of Technology (UTAUT) model that includes digital literacy as a moderating variable. Data were collected via a survey of 299 elderly individuals aged 60 and above in Xi’an. The study aims to identify factors influencing the acceptance and usage behavior of smart elderly care services and to understand how digital literacy moderates the relationship between these factors and usage behavior. Regression analysis assessed the direct effects of Performance Expectancy (PE), Effort Expectancy (EE), Social Influence (SI), and Facilitating Conditions (FC) on usage behavior. These dimensions were then integrated into a comprehensive index Service Acceptance to evaluate their overall impact on usage behavior, with behavioral intention examined as a potential mediating variable. Results indicate that EE and SI significantly impact the adoption of smart elderly care services, whereas PE and FC do not. Behavioral intention mediates the relationship between these variables and usage behavior. Additionally, gender, age, and digital literacy significantly moderate the impact of service acceptance on usage behavior. This study provides valuable theoretical and practical insights for designing and promoting smart elderly care services, emphasizing the importance of usability and social promotion to enhance the quality of life for the elderly.

AHP SO08 - Weekend physiotherapy pilot for patients on hepatobiliary enhanced recovery pathways: Examining the impact of a 7-day service

Abstract Background Enhanced recovery after surgery (ERAS) is a safe, multi-disciplinary, evidenced-based approach to optimise the perioperative management and outcomes after hepatobiliary (HPB) surgery. Despite the adoption of the ERAS mobilisation protocols to improve recovery time, one limitation is a traditional 5-day service model (Monday-Friday). This can result in an inequality of service provision for those patients operated Thursday or Friday and lead to increased length of stay (LOS) in hospital. Mobilisation across 7 days can ensure improved compliance with ERAS mobilisation protocols, better continuity of care, facilitate improved outcomes and timely discharge from hospital. Method Data was collected pre-introduction of the 7-day physiotherapy service from May-October 2022. During November 2022 – April 2023 a 7-day physiotherapy service was piloted. This service included 1 qualified physiotherapist and 1 non-qualified physiotherapist on Saturday and Sunday. This 7-day service provided continuity of care for patients from intensive care or post-anaesthesia care unit to the ward, facilitating discharges and accelerating return to independence. Data was collected during the 7-day service as well as 6 months post intervention (May 2023-October 2023). Acceptability of the intervention was assessed among the HPB multi-disciplinary team (MDT) using a survey consisting of 5 qualitative questions. Results The table illustrates that a reduction in mean LOS was seen in all 4 HPB surgeries that follow ERAS protocols during the 7-day physiotherapy service. It was also shown that 6-months post intervention (returning to a 5-day service) all 4 HPB ERAS surgeries mean LOS increased. To determine the acceptability of the 7-day physiotherapy service, 22 members of the MDT responded to a survey (5 consultants, 4 physiotherapy staff, 4 sisters, 5 staff nurses, 1 nursing assistant, 2 healthcare assistants). All 22 members of the MDT agreed that a 7-day physiotherapy service was acceptable and improves recovery. Conclusion A 7-day physiotherapy service has shown to reduce mean LOS in comparison to a 5-day physiotherapy service within HPB ERAS pathways. From an MDT perspective the 7-day physiotherapy service was also deemed to be beneficial and improves patient recovery.

Abstract 4126893: Feasibility and Acceptability of a Nurse-Pharmacist Post-Discharge Telehealth Model of Care for Heart Failure Patients

Background: Suboptimal medication management is common in patients with heart failure (HF), particularly during transitions-of-care. To date, there are few studies assessing the feasibility of a nurse-pharmacist post-discharge telehealth service for medication optimisation in patients with HF. We performed a feasibility study to determine service uptake and acceptability, and ability to identify medication-related issues for HF patients as they transition from hospital to home. Methods: HF patients were referred to an existing post-discharge telehealth service and offered medication reconciliation and education in addition to their usual care; a service we termed ‘MedRec’ (MR). Primary outcomes were feasibility, measured through recruitment and successful MR completion, and acceptability, measured by an investigator-developed survey. Secondary outcomes were medication-related issues detected during MR. Results: A total of 100 HF patients were offered a post-discharge MR. Mean age of patients was 68.5 ±14.2 years, and mostly male sex (62%). Pharmacist MRs were requested by 80% of patients. In total 62 MRs (77.5%) were performed; 9 patients declined MR during follow-up and an additional 9 patients were uncontactable. Mean time to MR following nurse referral was 10.98 ±9.74 days. Drug-related toxicity or adverse effect presentation was identified in 25 (40.3%) MR recipients at the time of consultation and subsequently required general practitioner follow-up. Medication compliance issues were detected by the pharmacist in 13 (20.9%) patients; forgotten doses being the most common concern. Undertreated medical conditions, such as symptomatic HF and chronic pain, were identified in 12 (19.3%) MR recipients. Medications prescribed without any apparent indication were found in 8 (12.9%) patients. Drug or disease management information was requested by 35 (56.4%) MR recipients. A total of 35 (56.5%) post-MR surveys were successfully completed. All participants who completed a post-MR survey agreed that a post-discharge telehealth MR was an acceptable form of education provision. Engagement with a pharmacist MR was perceived to ease anxiety associated with understanding medication-related changes and empowered greater medication self-management. Conclusions: A post-discharge nurse-pharmacist telehealth service is a feasible and acceptable model of care. Inclusion of a routine MR post-discharge may be an effective means of maintaining continuity of care for HF patients.

From Function to Relation: Exploring the Dual Influences of Warmth and Competence on Generative Artificial Intelligence Services in the Hospitality Industry

Generative artificial intelligence (GenAI) has emerged as a transformative force in the rapidly-evolving hospitality industry. This study examined the correlation of acceptance of GenAI services with perceived warmth and competence, and the consequent correlations with customer outcomes in the hospitality industry. Employing a Hospitality Service Dialogue System prototype, this study collected responses from 1,306 hotel guests. Perceptions of warmth and competence correlated with increased customer intention to use GenAI services and satisfaction. Satisfaction correlated significantly with customer–brand identification and attachment. The Technology Readiness Index moderated the relationships of warmth and competence with the acceptance of GenAI services. This investigation extends the stereotype content model and the behaviors from intergroup affect and stereotypes map framework by integrating them with the technology acceptance literature, unveiling service innovations enabled by technology in the hospitality industry. This study provides hotel managers, technology developers, and marketers with strategic directions for implementing GenAI.

Incorporating personality traits for the study of user acceptance of electric micromobility-sharing services

Incorporating personality traits for the study of user acceptance of electric micromobility-sharing services

“Us versus Them”: is the voice of the community heard when planning communication screening programmes for preschoolers?

ObjectivesCommunity consultation is necessary to ensure the uptake and use of community-based screening intervention to detect early childhood disabilities, as its absence can result in poor service acceptance and usage. To document stakeholders' perspectives regarding planning a community-based communication disorder (an impairment in the ability to receive, send, process and comprehend concepts or verbal, non-verbal and graphic symbol systems) screening programmes for pre-schoolers. Study designThis qualitative research design used purposive and random sampling to recruit 46 participants from eThekwini Municipality, South Africa. These stakeholders consisted of caregivers/parents of children who underwent screening for communication disorders, People who are Deaf, their parents, early childhood development practitioners, health professionals and government officials involved with children with disabilities. All participants were adults aged between 19 and 79 years, with an average age of 39.7 years. MethodsData was collected through focus group discussions and individual interviews, which were thematically analysed. ResultsThe four emergent themes were screening approaches, methods, location and personnel. Service users expected greater access to screening and reliable tests to identify problems by trained personnel at sites within the community. Service providers preferred a targeted approach to screening with parental input. Task shifting and sharing were seen as a solution to address staff shortages and provide services at health facilities, as resource constraints made it challenging to provide outreach services. ConclusionStakeholder engagement revealed diverging views between service users and providers, with implications for programme provision and uptake. There is a need for ongoing, inclusive discussion to ensure consensus during the planning stage, in order to render services that address issues of equity and accessibility for people with disabilities in marginalised communities.

Analysis of factors affecting telemedicine use satisfaction: A literature review

In the digital era, the role of telemedicine is increasingly vital in ensuring equitable and quality health access for all without being hindered by geography or economy. This literature aims to identify indicators of telemedicine service user satisfaction that impact the effectiveness and acceptance of telemedicine services. This study involved PubMed and Google Scholar. Inclusion criteria were published in the last 5 years, including studies that explore and analyze telemedicine user satisfaction indicators, through both quantitative and qualitative approaches, providing an understanding of the factors that influence users' perceptions of telemedicine quality. User satisfaction is an important indicator of telemedicine success. So that service providers must consider these factors in improving telemedicine services. From this literature, factors that influence user satisfaction were identified, including the availability of technology, the quality of telemedicine services, the level of trust in the security of personal data, the ease of use of telemedicine, and the interaction between patients and telemedicine service providersopulation.

Co-designing postpartum contraceptive services with and for immigrant women in Sweden: lessons learned from the IMPROVE-it project

Background and aimImmigrant women in many high-income countries including Sweden, report unmet need of sexual and reproductive health and rights, and face worse pregnancy outcomes and higher risk of unintended pregnancies. Postpartum contraceptive services are often inadequate to meet their needs. Co-design has shown to reduce health inequities, yet little is known about using this method for postpartum contraceptive service development and even less in collaborating with immigrant populations. The aim of this paper is to describe the co-design process and the strategies that were developed to help develop tailored and acceptable postpartum contraceptive services for immigrant women in Sweden.MethodsThe paper describes a co-design process that took place during 2022–2023, including the cyclical digital consultations with Arabic and Somali speaking immigrant women, midwives and researchers, as well as the outputs from the process. The theoretical framework for the co-design process was the ‘Double Diamond’ Design Process Model. Data analysis included qualitative content analysis.ResultsThe co-design process led to the joint development of intervention materials and strategies to improve postpartum contraceptive services. Specifically, the process revealed ideas on how to improve contraceptive counseling within three pre-identified areas of change: improve physical access to contraceptive services; improved communication strategies using visual aids and information charts; and empowerment strategies that focus on reflective practice without assumptions about what a group of women might expect. We found that participants contributed actively to the process with ideas and suggestions, and that the co-design process facilitated positive reflections on ongoing counseling practices.ConclusionThe co-design process resulted in the successful and participative development of innovative tools and activities to improve contraceptive counseling services. This approach is original because it involves both immigrant women, often left behind, and midwives delivering the services. Whilst this interplay allowed for careful refinement of services and tools by using an iterative process, it also facilitated reflective midwifery practice.

Rethinking electronic health records implementation in Germany: a value-based health system approach

Abstract Problem The Digital Act (Digital-Gesetz) in Germany stipulates that electronic health records (elektronische Patientenakte; ePA) will be set up for all persons under the statutory health insurance (SHI) in 2025; those who do not wish to use ePA can object. This opt-out approach aims to increase the coverage of ePA among the SHI population to 80%, which has been ca. 1.5% since its launch in 2021. According to law, ePA is managed solely by the patient and does not replace the conventional patient file stored in the medical practice management system. Without appropriate measures, it is likely that multiple parallel patient files are created, with the risk of ePA being side-lined over time. Description The Ministry of Health aims to make ePA the central platform for patients’ healthcare provision throughout their life. With ePA, patients should receive useful information about their healthcare as well as reminders and tailor-made medical advice. For healthcare providers, ePA should become an essential part of the healthcare process with containing reliable information and supporting the treatment. However, understanding ePA as more than a digital health solution, factors beyond technical interoperability must be considered for its successful implementation. Results The full potential of ePA and its positive impact on healthcare to tackle the fragmentation issue can only be realised when it is viewed as a helpful tool of collaboration for all involved parties. The existing regulatory frameworks in Germany create disincentives for greater integration, coordination, and interconnection, with each sector following its own reimbursement system and reinforcing the division between them. This contradicts with the idea of ePA fostering patient-centredness and inter-sectoral collaboration. Lessons How a health system functions and how health services are governed and remunerated have a substantial impact on the healthcare providers’ acceptance of digital services. Key messages • Changes in the governance of health systems may be necessary when implementing electronic health records to bring person-centred care and overcome the separation of in-patient and out-patient sectors. • Rather than a paternalistic approach, the relationship between the patient and healthcare provider should move towards a partnership model, based on the motivation of keeping individuals healthy.

A Conceptual Framework of Navigating Digital Banking: How Gender Impacts Adoption Intentions in Klang Valley

Malaysian banking users have encountered negative experiences while adopting traditional bank services. Several customers and businesses face limited access to traditional banking products and services due to factors such as low or irregular income, bad credit, or a lack of conveniently located banks. The acceptability of digital banking products and services in Malaysia is currently unknown and inadequate due to the general lack of familiarity among Malaysians with the notion of digital banking. Conventional methods of analyzing consumer behavior, which primarily consider historical data and current resources, will not result in the achievement of branchless banking in the future. This paper presents a framework that examines how various factors such as performance expectancy, effort expectancy, social influence, facilitating condition, hedonic motivation, price value, and habit may influence behavioral intention. Additionally, the framework considers gender as a moderator variable. The results of this study are anticipated to expand the existing body of knowledge on behavioral intention and bring advantages to marketers and digital banking providers.

"We're Not Gonna Aid You in Shooting Up": Stigma's Relationship to Harm Reduction in People Who Inject Drugs.

Harm reduction, when applied to drug use, prioritizes improving patient-centered health outcomes and reducing drug-related harm. In order for harm reduction strategies to be adopted by people who inject drugs (PWID), they need to be promoted, accessible, and accepted in that population and the community-at-large. While PWID face stigma at multiple levels, less is known about how stigma influences uptake and acceptance of harm reduction services and strategies among PWID. We aim to characterize the stigmatizing experiences PWID have had related to harm reduction and the role of stigma in influencing their acceptance and adoption of harm reduction services and strategies. A qualitative study using in-person, semi-structured interviews. We recruited hospitalized participants, age 18 and over, with a history of injection drug use. We developed an interview guide asking about various aspects of stigma and participants' experiences with naloxone, syringe service programs, fentanyl test strips, HIV and hepatitis C testing, and any other harm reduction strategies. Key themes were generated using a thematic analysis. We reached thematic saturation at 16 participants. PWID reported multi-level stigma related to harm reduction from themselves, the public, the healthcare system, and the legal and carceral systems. Themes were grouped into four main categories: internalized, interpersonal, intervention, and structural stigma. Stigma across all of these domains negatively impacted the ability of PWID to access harm reduction resources. Positive, non-stigmatizing experiences from others, such as syringe service programs and peer navigators, countered historically negative experiences and promoted greater education and comfort about using harm reduction resources among PWID. To expand the reach of harm reduction services, it is critical to develop interventions that can reduce the stigma against PWID and harm reduction.

Recommendations for permanent sleep telehealth: an American Academy of Sleep Medicine position statement.

Telehealth use greatly expanded under the Centers for Medicare and Medicaid Services (CMS) waivers at the start of the COVID-19 pandemic; however, the uncertainty and limitations of continued coverage risks loss of this momentum. Permanent coverage with adequate reimbursement is essential for the long-term acceptance and expansion of telehealth services. Telehealth supports both the current and future need for sleep health management by expanding patient access, increasing clinician efficiency, improving patient safety, and addressing health care equity. Sleep medicine is an ideal field for telehealth due to limited provider access, safety concerns with sleepy patients, availability of remote patient monitoring for treatment management, and the minimal need for repeated physical examinations. Telehealth is non-inferior for delivery of cognitive behavioral therapy for insomnia (CBT-I) and can enhance obstructive sleep apnea (OSA) treatment adherence. It is the position of the American Academy of Sleep Medicine (AASM) that telehealth is an essential tool for the provision of high quality, patient-centered care for patients with sleep disorders. We encourage all stakeholders including legislators, policymakers, clinicians, and patients to work together to address payment models, interstate care, technology access, prescribing practices, and ongoing research to ensure that sleep telehealth services are permanently available and accessible for all patients seeking sleep medicine care.

A comparison Study on User Acceptance of Digital Healthcare Services Among M40 and B40 Community in Selangor: A Study on SELangkah Application

Over time, the global digital healthcare industry has started to take shape with the aim of offering benefits to all residents. Much effort has been put into improving the effectiveness and accessibility of the healthcare system in Malaysia for the benefit of its people. The Selangor state government is working to make all communities safer and healthier places, and one of its initiatives is the SELangkah application. Nonetheless, there are still concern over the take up of digital healthcare services among citizens especially those in the low-income and middle-income communities; B40 and M40. Previous study has shown that different economic status has an impact towards the acceptance level in technology services. Therefore, this study utilises qualitative research method to investigate the state of user acceptance in digital healthcare services among B40 and M40 users in Selangor through the case study of SELangkah application. Focus group discussion was conducted with over 10 participants from Selangor to evaluate and compare the acceptance level of digital healthcare services between both income group with the instrument development were guided by the Extended Technology Acceptance Model (ETAM). The area of group discussion covers users’ perceived usefulness, perceived ease of use, attitude, behaviour, external challenges, and actual use. The findings show that both M40 and B40 group find the application to be beneficial; in addition, they believe there should be more awareness campaign to promote the application to the public. A few clear differences between the acceptance level of the two groups would be the simplicity of the language used in the application, the recommended features, and future needs between the two groups. M40 group find no difficulties to navigate the application but B40 group mention that the used words can be simplify. While M40 group recommended for gamification and high engagement features; the B40 group is looking more at practicality such as more information or linkages to nearby clinic. Nevertheless, both groups did not find major difficulties and they see a lot of benefit of the application. This will form the fundamental basis for future research efforts aimed at closing the technology acceptance gap and enabling a wider population to use technology as a tool to have a healthier life.

At the opinion crossroads: Kuibyshev in the days of the Great Patriotic War (1941–1943)

The article considers Kuibyshev city (Samara nowadays) in the wartime (1941–1943), the features of its life activity and development. The solving of the large-scale tasks raised in connection with the unprecedented evacuation of the government departments, diplomatic body, people’s commissariats, factories and population to the city deeply changed the city life. Kuibyshev was the regionally governed city, but it performed many specific functions typical for the soviet capital city of Moscow. The circumstance gave occasion to call the city of Kuibyshev unofficially «alternate capital». The research task is to analyze the various aspects of the Kuibyshev city life in the wartime: to show the different interpretations of its status perception by the historians in 1941–1943; to specify the data concerning the specified All-Union people’s commissariats being on evacuation in the city of Kuibyshev and its quantitative composition; to raise the question of the final date of the acceptance of the «special objects» No. 1 (Stalin’s bunker) and No. 2 (for General Staff of the Red Army) of the Building of Metrostroi (Soviet subway construction company); to qualify the questions about the zoning of the city in the wartime; to cite new data about Bezymyanka district of the prewar time using comparative-historical, analytical and retrospective methods. The article introduces a new document material of the central archives of the Russian Federation into scientific discourse. It is proved that Kuibyshev was neither «alternate» nor «military» capital. It tasted the peak of its «capital city status» during 2–3 months while solving many issues of the All-Union scale and performing capital functions. The conclusion that the acceptance of the city services in the analyzed period was the rating of the city of Kuibyshev to the cities of republican subordination on 21st August 1943 is drawn.

Understanding the drivers of consumers’ acceptance and use of service robots in the hotel industry

Purpose This study aims to discover factors and configurations that influence customers’ acceptance behaviors to investigate the current hospitality industry using service robots. Design/methodology/approach A mix of symmetrical and asymmetrical modeling methods was used for the data analysis. The symmetrical modeling was used to find the net effects, whereas asymmetrical modeling was adopted to find the combined configurations for hotel guests’ robot service acceptance behaviors. Findings The results revealed the significant effect of innovativeness, willingness to be a lighthouse customer, personal norms and concern about service robot performance on acceptance behaviors. In addition, the complex solution models using characteristics of tech-forward consumers, norms and attitude and uncertainty and concern were found. Practical implications The study shows directions to hotel marketers, to help them make customers adopt service robots. Originality/value The study explored customer service robot acceptance behaviors based on comprehensive theoretical backgrounds, including the technology acceptance model, theory of planned behavior, norm activation model and service robot acceptance model.

Factors influencing the acceptability of the test, treat and refer practice for malaria among caregivers of under 5 children at community pharmacies and drug shops in Nigeria

BackgroundMalaria affects children under the age of five and pregnant women, leading to high morbidity and mortality rates. In sub-Saharan Africa, Patent and Proprietary Medicine Vendors (PPMVs) have been identified as key players in the provision of malaria treatment due to their accessibility and availability in communities, but PPMVs are not usually tested before fever cases are treated as malaria or refer clients. The aim of this study was to explore the factors influencing caregivers’ acceptance of the test, treatment and referral practices for malaria management provided by CPs and PPMVs in Kaduna and Lagos states, Nigeria.MethodsA cross-sectional quantitative telephone survey was conducted among 150 caregivers of children under five years old who received malaria services from trained CPs and PPMVs between May and July 2022. Descriptive and bivariate analyses were performed to identify factors significantly associated with the acceptability of malaria management services. All statistically significant factors from the bivariate analysis were explored using logistic regression models, and odds ratios (ORs) with confidence intervals (CIs) were calculated to predict acceptability. The 95% level was used to define statistically significant associations (p ≤ 0.05).ResultsAll caregivers were asked questions that aided in obtaining a diagnosis of malaria. More than two-thirds of the caregivers (68%) reported that the child was tested by a CP/PPMV. Among those treated (148), 89% reported that the child was administered artemisinin combination therapy (ACT) irrespective of whether the child tested positive or negative for malaria. At the bivariate level, acceptability was greater among caregivers of children aged 13 months and older than among caregivers of children aged 0–12 months (93% vs. 76%, p = 0.004). Caregivers of children who prescribed ACT had greater acceptance than did those not prescribing ACT (92% vs. 69%, p = 0.010). Multivariate analysis revealed that these relationships held.ConclusionsThe adoption of the test, treat, and refer practice as a standard approach by CPs and PPMVs could replace the widespread practice of prescribing medications without conducting tests. This shift has the potential to improve the quality of malaria management services and enhance patient outcomes.

How Time, Living Situation, and Stress Related to Technology Influence User Acceptance and Usability of a Socialization Service for Older Adults and Their Formal and Informal Caregivers: Six-Month Pilot Study.

Considering the growing population of older adults, addressing the influence of loneliness among this demographic group has become imperative, especially due to the link between social isolation and deterioration of mental and physical well-being. Technology has the potential to be used to create innovative solutions to increase socialization and potentially promote healthy aging. This 6-month study examined the usability and acceptability of a technology-based socialization service and explored how stress and living situation affect older adults' and their ecosystem's perceptions of technology, investigating cross-sectional and longitudinal differences among and across user groups. Participants were recruited in Tuscany and Apulia (Italy) through a network of social cooperatives and a research hospital, respectively. A total of 20 older adults were provided with the same technology installed on a tablet and on a smart television. The technology has three functionalities: video calling, playing games, and sharing news. Additionally, 20 informal caregivers (IC) and 13 formal caregivers (FC) connected to the older adults were included in the study. After both initial training in the use of the system (T0) and 6 months of using the system (T6), questionnaires on usability, acceptability, and technostress were filled in by older adults, IC, and FC. Nonparametric or parametric tests were conducted to investigate group differences at both time points and changes over time. Additional analyses on older adults were done to assess whether differences in usability and acceptability were related to living situation (ie, alone or with someone). Furthermore, correlation analyses were performed between usability, acceptability, and stress toward technology at T0 and T6. At both T0 and T6, older adults had lower usability scores than IC and FC and higher anxiety than IC. Over time, there was a significant decrease in older adults' attitudes toward technology score, depicting a negative attitude over time (T0 median 4.2, IQR 0.5; T6 median 3.7, IQR 0.8; Cohen d=0.7), while there was no change for IC and FC. At T0, those living alone had lower acceptability than those living with someone but this difference disappeared at T6. People or participants living with someone had a decline in anxiety, attitudes toward technology, enjoyment, and perceived usefulness. Stress toward technology affected usability and acceptability in the older adult group entering the study (ρ=-.85) but this was not observed after 6 months. In the IC group, stress affected trust at T0 (ρ=-.23) but not at T6. At the start of the study, older adults judged the system to be less usable and more stressful than did the caregivers. Indeed, at first, technostress was correlated with usability and acceptability; however, with repeated use, technostress did not influence the perception of technology. Overall, getting accustomed to technology decreased anxiety and stress toward technology.

A scoping review of barriers to accessing aged care services for older adults from culturally and linguistically diverse communities in Australia

The ageing population of the culturally and linguistically diverse (CALD) population is increasing in Australia. This is because the number of early migrants in Australia is ageing, coupled with increasing family reunification. This scoping review aimed to describe the nature and extent of research on the barriers to aged care services for CALD older adults in Australia using Penchansky and Thomas’s Access to Care Framework of five A's dimensions: availability, accessibility, accommodation, affordability, and acceptability. Arksey and O’Malley’s five-step scoping review framework was adopted to search 6 databases from inception till August 2024. Title/abstract and full-text screening were conducted using predefined inclusion and exclusion criteria, with supplementary search of references from included articles to identify additional articles. Findings show that while all the five A's of access to care services were barriers for CALD older adults, accommodation and acceptability of services were the major areas of concern due to the lack of cultural sensitivity of such services in Australia. An additional barrier captured and termed as Awareness was noted in some of the included studies, highlighting the need to expand the five A's to 6 A’s. Researchers, practitioners, and policymakers on ageing could leverage these findings to improve cultural practice sensitivities when supporting these populations.

Managerial practices for app-based primary care telemedicine service acceptance in South Africa

Purpose: This study addresses the qualitative research phase of a mixed methods study conducted to investigate patient acceptance of an app-based telemedicine service for primary care aimed at South African public health care sector patients.Design/methodology/approach: Qualitative data were collected by means of semi-structured individual interviews with patients who had exposure to an existing app-based primary care telemedicine service in South Africa named Kena Health. Thematic analysis of the qualitative data using ATLAS.ti software was conducted to identify the relevant antecedents of telemedicine service acceptance in the study’s context.Findings/results: Eight antecedents of app-based primary care telemedicine service acceptance among South African patients (who are predominantly reliant on public health care sector services to receive medical care) were identified, namely, perceived compatibility, perceived ease of use, relative advantage, price value, trust, innovativeness, privacy perception and care perception.Practical implications: To date, prior literature has not yet identified the specific antecedents that would apply to the acceptance of an app-based telemedicine service for primary care among South African individuals who are predominantly reliant on the country’s public health care system to receive medical care.Originality/value: Our study contributes to the literature by identifying which existing factors of technology acceptance apply to primary care telemedicine service acceptance, predominantly in the South African public health care sector context. Furthermore, additional antecedents of telemedicine service acceptance that have not been included in technology acceptance theory until present, that is, (positive) privacy perception and care perception are identified.