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Background Wearable technologies have the potential to support health promotion and disease prevention. However, it remains unclear how the role of social determinants of health (SDoH) and digital determinants of health (DDoH) plays in this context. Objective This study investigates differences in sociodemographic factors and digital health literacy between wearable users and non-users, whether the association with wearable use varies across age groups and its potential mediator. Methods A cross-sectional nationwide telephone survey was conducted in November 2022 in a panel of adult internet users in Germany. Assessments included self-reported wearable use, sociodemographic factors (sex, age, education, household size and income, and residence region), and digital health literacy (measured with the eHealth Literacy Scale, eHEALS). Associations between wearable use, sociodemographic factors and digital health literacy were analyzed using binomial logistic regression models in the total sample and with age group stratification, with a supplementary mediation analysis examining digital health literacy as a mediator in the relationship between age and wearable use. Results Overall, 24% (223/932) of participants (52% male, mean age 55.6 years) reported using wearables for health. Wearable use was lower among participants aged 65 and above, with lower educational attainment, living in 1–2 person households, with below-average household income, and residing in smaller cities or former East Germany. Wearable use prevalence is substantially lower in older age groups (18–40: 36%; 41–64: 26%; 65+:14%). Wearable users reported higher levels of digital health literacy (mean: 30.7, SD = 5) than non-users (mean: 28.3, SD = 6). Stratified analyses indicate that the association between digital health literacy and wearable use varies by age group, with significant positive association observed in older age groups (OR = 1.00, 95% CI: 0.94 to 1.07 in age group 18–40; OR = 1.07, 95% CI: 1.03 to 1.12 in age group 41–64; OR = 1.11, 95% CI: 1.04 to 1.19 in age group 65+). Mediation analysis indicated that digital health literacy partially mediates the relationship between age and wearable use (indirect effect: coefficient = -0.0156, 95% CI: -0.0244 to -0.00791, p <.001). Conclusions This study indicates sociodemographic disparities in wearable use among the German population and differences in digital health literacy between wearable users and non-users. A generational divide in wearable use was identified, with older adults being less likely to embrace this technology. This was especially true for older adults with lower digital health literacy. Future public health initiatives employing health technologies should take SDoH and DDoH into consideration to ensure effective and equitable impacts.
Background Wearable technologies have the potential to support health promotion and disease prevention. However, it remains unclear how the role of social determinants of health (SDoH) and digital determinants of health (DDoH) plays in this context. Objective This study investigates differences in sociodemographic factors and digital health literacy between wearable users and non-users, whether the association with wearable use varies across age groups and its potential mediator. Methods A cross-sectional nationwide telephone survey was conducted in November 2022 in a panel of adult internet users in Germany. Assessments included self-reported wearable use, sociodemographic factors (sex, age, education, household size and income, and residence region), and digital health literacy (measured with the eHealth Literacy Scale, eHEALS). Associations between wearable use, sociodemographic factors and digital health literacy were analyzed using binomial logistic regression models in the total sample and with age group stratification, with a supplementary mediation analysis examining digital health literacy as a mediator in the relationship between age and wearable use. Results Overall, 24% (223/932) of participants (52% male, mean age 55.6 years) reported using wearables for health. Wearable use was lower among participants aged 65 and above, with lower educational attainment, living in 1–2 person households, with below-average household income, and residing in smaller cities or former East Germany. Wearable use prevalence is substantially lower in older age groups (18–40: 36%; 41–64: 26%; 65+:14%). Wearable users reported higher levels of digital health literacy (mean: 30.7, SD = 5) than non-users (mean: 28.3, SD = 6). Stratified analyses indicate that the association between digital health literacy and wearable use varies by age group, with significant positive association observed in older age groups (OR = 1.00, 95% CI: 0.94 to 1.07 in age group 18–40; OR = 1.07, 95% CI: 1.03 to 1.12 in age group 41–64; OR = 1.11, 95% CI: 1.04 to 1.19 in age group 65+). Mediation analysis indicated that digital health literacy partially mediates the relationship between age and wearable use (indirect effect: coefficient = -0.0156, 95% CI: -0.0244 to -0.00791, p <.001). Conclusions This study indicates sociodemographic disparities in wearable use among the German population and differences in digital health literacy between wearable users and non-users. A generational divide in wearable use was identified, with older adults being less likely to embrace this technology. This was especially true for older adults with lower digital health literacy. Future public health initiatives employing health technologies should take SDoH and DDoH into consideration to ensure effective and equitable impacts.
PurposeAs the new frontier in online healthcare innovation, mobile health consultation (MHC) is transforming how traditional healthcare is delivered. Despite being known on a large scale for its benefits, MHC still faces consumer resistance. MHC is a technology-enabled service, so an in-depth analysis of consumer resistance from the perspective of technology is crucial to enhance service adoption. This study sought to determine the mechanism by which two information technology (IT)-specific traits – IT affordance and IT identity – influence consumer resistance to MHC during consumer–platform interactions.Design/methodology/approachWe used the Credamo platform to gather data from 786 users with medical consulting experience to validate the resulting relationships.FindingsBased on partial least squares structural equation modeling, three of the six IT affordances (visibility, searching and guidance shopping) exerted a significant positive influence on IT identity, while trigger attending and association affordance had no significant effect on IT identity. Persistence affordance was negatively associated with IT identity, and IT identity negatively influenced consumer resistance to MHC.Originality/valueAcademically, this empirical paper primarily contributes to the MHC literature and the theory of IT affordance and IT identity. Practically, several valuable guidance for MHC platforms is provided.
PurposeThe purpose of our research is to explore the role of employee AI identity in influencing employee proactive behavior and its boundary conditions in AI workplace.Design/methodology/approachBased on the IT identity theory and motivation theory, our research discusses the effects of employee AI identity on employee proactive behavior and regarded the proactive work intention as a mediating variable. Meanwhile, we considered organization inducement as a boundary condition and discussed the moderating effects of it and its two sub-dimensions (development rewards and material rewards). Data were collected from 326 employees and partial least squares structural equation modeling was used to analyzed and draw the conclusions.FindingsFindings showed that employee AI identity significantly affects employee proactive behavior, in which the proactive work intention play a mediating role. Moreover, three subdimensions (relatedness, emotional energy, dependence) of employee AI identity have different effects on formation of employee AI identity. And organization inducement acts as a positive moderating role, development rewards and material rewards play different roles in the formation of organization inducements.Originality/valueOur research explores the different paths that influence employee proactive behavior and their boundary moderation, while analyzing the results of these influences in different subdimensions, deepening the research on employee AI identity and organization inducement. Our research is conducive to the development of the identity theory and organizational behavior research and provide suggestions for managers to improve their organizational management level.
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