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Intention to Use Digital Health Among COPD Patients in Europe: A Cluster Analysis

2026-01-09Artigo científico Acesso aberto
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datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorAlem, Solomon Getachew
dc.contributor.authorNguyen, Le
dc.contributor.authorHipólito, Nádia
dc.contributor.authorSpiller, Maelle
dc.contributor.authorMetting, Esther
dc.date.accessioned2026-04-23T09:27:37Z
dc.date.available2026-04-23T09:27:37Z
dc.date.issued2026-01-09
dc.descriptionArticle number - 178
dc.descriptionThe authors would like to sincerely thank all participants for their valuable contributions to this study. We also acknowledgethesupportofcollaboratinginstitutions andresearch staff involved in data collection and management. The constructive feedback from colleagues during the development of the study design and analysis is gratefully recognized.
dc.description.abstractBackground: Chronic obstructive pulmonary disease (COPD) increasingly strains European health systems amid population ageing. Digital health interventions (DHIs) can reduce hospitalizations and support self-management, yet older patients hesitate to adopt them. Tailored interventions require understanding patient profiles. This study aimed to identify clusters by intention to use DHIs. Methods: Between July 2024 and February 2025, 232 COPD patients (mean age 65; 61% female) across seven European countries completed surveys covering sociodemographic and Unified Theory of Technology Acceptance (UTAUT) constructs. Intention to use DHIs was categorized as positive, neutral, or negative. Weighted UTAUT scores were clustered using Gower distance and Partitioning Around Medoids. Associations were visualized with multiple correspondence analysis and heat maps; differences were tested with the chi-square test. Results: Intention to adopt DHIs varied across countries, with the highest in the Netherlands. Two clusters emerged. Cluster 1, the ‘balanced hesitant’ group (n = 104), showed mixed intentions (38% positive, 40% neutral, 21% negative). Barriers included low performance expectancy and limited digital skills (both p < 0.05). Cluster 2, the ‘enthusiastic’ group (n = 128), demonstrated strong adoption intentions, with 84% positive intention. Enablers included low effort expectancy and complex disease (p < 0.01). Across both clusters, performance expectancy predicted intention. Conclusions: Digital health adoption among COPD patients is shaped by psychosocial and digital skill profiles. Hesitant users benefit from expectation-based information about DHIs, digital literacy training and peer support. Enthusiasts require ease of integration. Performance expectancy is a consistent driver of adoption, whereas country-specific factors should guide strategies.eng
dc.description.sponsorshipThe study was funded by the Dutch government through talent grants (ZonMw Veni Grant) and by the Early Career Prize from the Jantina Tammes School of Digital Society, Technology and AI.
dc.identifier.citationAlem, S.G.; Nguyen, L.; Hipólito, N.; Spiller, M.; Metting, E. Intention to Use Digital Health Among COPD Patients in Europe: A Cluster Analysis. Healthcare 2026, 14, 178. https://doi.org/10.3390/healthcare14020178
dc.identifier.doi10.3390/healthcare14020178
dc.identifier.issn2227-9032
dc.identifier.urihttp://hdl.handle.net/10400.8/16178
dc.language.isoeng
dc.peerreviewedyes
dc.publisherMDPI
dc.relation.hasversionhttps://www.mdpi.com/2227-9032/14/2/178
dc.relation.ispartofHealthcare
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectCOPD
dc.subjectDigital health
dc.subjectDigital health interventions
dc.subjectOlder adults
dc.subjectSelf-management
dc.subjectTechnology acceptance
dc.titleIntention to Use Digital Health Among COPD Patients in Europe: A Cluster Analysiseng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue2
oaire.citation.titleHealthcare
oaire.citation.volume14
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameHipólito
person.givenNameNádia
person.identifier.ciencia-id161D-76B4-3740
person.identifier.orcid0000-0003-1796-6218
relation.isAuthorOfPublication19bb0257-324b-4231-8fcb-b4b5655427c6
relation.isAuthorOfPublication.latestForDiscovery19bb0257-324b-4231-8fcb-b4b5655427c6

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