Mihail Cocosila

Can wireless text messaging improve adherence to preventive activities? Results of a randomised controlled trial

OBJECTIVE To determine the effectiveness of cell phone wireless text messaging for improving adherence to a healthy behaviour. DESIGN A randomised, unblinded, controlled trial was conducted with 102 subjects, 18 years or older, each having a cell phone and willing to take 1 vitamin C pill per day for 1 month for preventive reasons. Intervention group participants received text messaging reminders and were asked to acknowledge receiving their messages after taking the vitamins, whereas control group subjects had no text messaging activity. MEASUREMENTS Self-reported adherence and the number of participant text messages acknowledging vitamins taken. RESULTS Both groups reported an increased adherence after the trial: by 246% for the intervention group and by 131% for the control group. There was a non-significant difference between the two groups at endpoint: an average difference of 0.8 between the number of pills missed in the last week of the trial (2.5 out of 7 in the intervention and 3.3 out of 7 in the control group) with a power of 0.54. The study revealed a significant correlation (coefficient=-0.352, sig.=0.01) between the average number of text messaging acknowledgements sent by the intervention group participants and the number of pills they reported missed during the last week of the trial. CONCLUSION This was a small randomised controlled trial with inconclusive but encouraging results. It suggests a new approach in addressing insufficient adherence in outpatient conditions and shows that the use of information technology tools for compliance warrants further research.

Factors of adoption of mobile information technology by homecare nurses: a technology acceptance model 2 approach.

Pervasive healthcare support through mobile information technology solutions is playing an increasing role in the attempt to improve healthcare and reduce costs. Despite the apparent attractiveness, many mobile applications have failed or have not been implemented as predicted. Among factors possibly leading to such outcomes, technology adoption is a key problem. This must be investigated early in the development process because healthcare is a particularly sensitive area with vital social implications. Moreover, it is important to investigate technology acceptance using the support of scientific tools validated for relevant information systems research. This article presents an empirical study based on the Technology Acceptance Model 2 in mobile homecare nursing. The study elicited the perceptions of 91 Canadian nurses who used personal digital assistants for 1 month in their daily activities. A partial least squares modeling data analysis revealed that nurses perception of usefulness is the main factor in the adoption of mobile technology, having subjective norm and image within the organization as significant antecedents. Overall, this study was the first attempt at investigating scientifically, through a pertinent information systems research model, user adoption of mobile systems by homecare nursing personnel.

Adoption of mobile ICT for health promotion: an empirical investigation

This research is an unbiased empirical evaluation of user reasons to accept or resist a mobile information and communication technology (ICT) application for health promotion. This innovative use of mobile ICT consists of developing services that educate people to stay healthy, with clear benefits for both individuals and society. Receiving customized health advice through mobile devices may be an attractive service. However, despite their ability to support users, mobile services may sometimes irritate by being too intrusive. A 1-month experiment exposed participants to a health promotion application, delivered through their cell phones. This was the framework for the evaluation of an adoption model that included both positive and negative user adoption factors. Findings revealed intrinsic motivation to be a sufficient reason for adoption and a multi-faceted perceived overall risk factor as the main obstacle. Accordingly, when usefulness is less apparent, enjoyment may be a key factor for the adoption of mobile ICT for health promotion.

A comparison of physician pre-adoption and adoption views on electronic health records in Canadian medical practices.

Background There is a major campaign involving large expenditures of public money to increase the adoption rate of electronic health record (EHR) systems in Canada. To maximize the chances of success in this effort, physician views on EHRs must be addressed, since user perceptions are key to successful implementation of technology innovations. Objective We propose a theoretical model comprising behavioral factors either favoring or against EHR adoption and use in Canadian medical practices, from the physicians’ point of view. EHR perceptions of physicians already using EHR systems are compared with those not using one, through the lens of this model. Methods We conducted an online cross-sectional survey in both English and French among medical practitioners across Canada. Data were collected both from physicians using EHRs and those not using EHRs, and analyzed with structural equation modeling (SEM) techniques. Results We collected 119 responses from EHR users and 100 from nonusers, resulting in 2 valid samples of 102 and 83 participants, respectively. The theoretical adoption model explained 55.8% of the variance in behavioral intention to continue using EHRs for physicians already using them, and 66.8% of the variance in nonuser intention to adopt such systems. Perception of ease of use was found to be the strongest motivator for EHR users (total effect .525), while perceptions of usefulness and of ease of use were the key determinants for nonusers (total effect .538 and .519, respectively) to adopt the system. Users see perceived overall risk associated with EHR adoption as a major obstacle (total effect –.371), while nonusers perceive risk only as a weak indirect demotivator. Of the 13 paths of the SEM model, 5 showed significant differences between the 2 samples (at the .05 level): general doubts about using the system (P = .02), the necessity for the system to be relevant for their job (P < .001), and the necessity for the system to be useful (P = .049) are more important for EHR nonusers than for users, while perceptions of overall obstacles to adoption (P = .03) and system ease of use (P = .042) count more for EHR users than for nonusers. Conclusions Relatively few differences in perceptions about EHR system adoption and use exist between physicians already using such systems and those not yet using the systems. To maximize the chances of success for new EHR implementations from a behavioral point of view, general doubts about the rationale for such systems must be mitigated through improving design, stressing how EHRs are relevant to physician jobs, and providing substantiating evidence that EHRs are easier to use and more effective than nonusers might expect.

Exploring the management information systems discipline: a scientometric study of ICIS, PACIS and ASAC

This study examines the identity and development of the management information systems (MIS) field through a scientometric lens applied to three major global, regional and national conferences: International Conference on Information Systems (ICIS), Pacific Asia Conference on Information Systems (PACIS) and Administrative Sciences Association of Canada Annual Conference (ASAC). It adapts the conference stakeholder approach to the construction of the identity of the MIS discipline and analyzes the proceedings of these three conferences. The findings suggest that the MIS field has been evolving in terms of collaborative research and scholarly output and has been gradually moving towards academic maturity. The leading MIS conference contributors tend to establish loyalty to a limited number of academic meetings. At the same time, relatively low levels of repeat publication in the proceedings of ICIS, PACIS and ASAC were observed. It was suggested that Lotka’s and Yule-Simon’s bibliometric laws may be applied to measure and predict the degree of conference delegate loyalty.

Unplanned effects of intelligent agents on Internet use: a social informatics approach

This paper instigates a discourse on the unplanned effects of intelligent agents in the context of their use on the Internet. By utilizing a social informatics framework as a lens of analysis, the study identifies several unanticipated consequences of using intelligent agents for information- and commerce-based tasks on the Internet. The effects include those that transpire over time at the organizational level, such as e-commerce transformation, operational encumbrance and security overload, as well as those that emerge on a cultural level, such as trust affliction, skills erosion, privacy attrition and social detachment. Furthermore, three types of impacts are identified: economic, policy, and social. The discussion contends that economic impacts occur on the organizational level, social effects transpire on a cultural level, and policy impacts take place on both levels. These effects of the use of intelligent agents have seldom been predicted and discussed by visionaries, researchers, and practitioners in the field. The knowledge of these unplanned outcomes can improve our understanding of the overall impacts that innovative agent technologies may potentially have on organizations and individuals. Subsequently, this may help us develop better agent applications, facilitate the formulation of appropriate contingencies, and provide impetus for future research.

Role of user a priori attitude in the acceptance of mobile health: an empirical investigation

The objective of this research is to investigate the role of user attitude toward the activity supported by a mobile health application in the overall technology acceptance equation. For that, a perceived risk-motivation theoretical model integrating user attitude on quitting smoking was developed and tested empirically with 170 participants from the UK for the context of using cell phones to support smoking cessation interventions. Results show an attitude favourable to quitting smoking has a negative effect on the perceived risk, no significant effect on the motivation, and a small positive influence on the behavioural intention associated with using the mobile health service. Overall, having a positive a priori attitude toward a healthy activity is not a sufficient reason to make users accept a mobile service supporting that activity.

Perceived health risks of 3G cell phones: do users care?

Studying the perception of health risks associated with mobile phones and the implications for usage.

How important is the “social” in social networking? A perceived value empirical investigation

Purpose – The purpose of this paper is to report on a value-based empirical investigation of the adoption of Twitter social networking application. The unprecedented popularity of social networking applications in a short time period warrants exploring theory-based reasons of their success. Design/methodology/approach – A cross-sectional survey-based study to elicit user views on Twitter was conducted with participants recruited through the web site of a North-American university. Findings – All facets of perceived value considered in the study (utilitarian, hedonic and social) had a significant and relatively strong influence on consumer intent to use Twitter. Quite surprisingly for a social networking application, though, the social value facet had comparatively the weakest contribution in the use equation. Research limitations/implications – User value perception might have been influenced by the features of the actual social networking application under scrutiny (i.e. Twitter in this case). Practical ...

Would People Pay for Text Messaging Health Reminders

The aim of this study is to determine the time and financial limitations that people would accept for using a telehealth service consisting of wireless text messaging reminders to improve adherence to a recommended healthy regimen. An empirical study based on a 1-month trial of a prototype system that studied adherence to a specified healthy behaviour was conducted. Fifty-one participants received daily cell phone text messaging reminders on taking one vitamin C pill daily for preventive reasons. At the end of the trial they answered a survey regarding their willingness to pay for and to stay with such a service, if offered. If usage were free, only 45% of the participants would continue to use it for a long indefinite period of time. If the usage were for a fee, 29% of the participants would use the service just a few weeks; 28% would use it an indefinite period of time if they could see its usefulness and if the cost were reasonable. The median amount indicated by the participants as a reasonable monthly fee for such a service was