ArticleJMIR human factors2025
Understanding the Behavioral Determinants of First Responder App Adoption by Integrating Perspectives From the Unified Theory of Acceptance and Use of Technology and Health Belief Model: Cross-Sectional Survey.
Article in JMIR human factors, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Unified Theory of Acceptance and Use of Technology Questionnaire in Swedish Prehospital Care: Translation, Cross-Cultural Adaptation, and Pilot Psychometric Study.JMIR formative research · 2026Article
- User Acceptance of Remote Care Assist, a Telecare System for Home Care Among Care and Nursing Staff: Cross-Sectional Pilot Study.JMIR rehabilitation and assistive technologies · 2026Article
- Determinants of off-label drug acceptance in pregnancy: insights from an extended UTAUT model.Frontiers in pharmacology · 2026Article
- Knowledge and training willingness toward cardiopulmonary resuscitation among healthcare professionals in a tertiary rehabilitation hospital: a cross-sectional study.Frontiers in medicine · 2025Article
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Abstract
backgroundOut-of-hospital cardiac arrests (OHCAs) are a leading cause of death worldwide, yet first responder apps can significantly improve outcomes by mobilizing citizens to perform cardiopulmonary resuscitation before professional help arrives. Despite their importance, limited research has examined the psychological and behavioral factors that influence individuals' willingness to adopt these apps.
objectiveGiven that first responder app use involves elements of both technology adoption and preventive health behavior, it is essential to examine this behavior from multiple theoretical perspectives. Building on the unified theory of acceptance and use of technology (UTAUT) and health belief model (HBM), this study therefore developed an integrative framework to explain which behavioral determinants and demographic and health-related factors drive an individual's willingness to install a first responder app for OHCA.
methodsWe conducted a web-based cross-sectional survey (N=3660; mean age 49.95, SD 16.75 years; n=1909, 52.2% women) in June 2024 among Belgian adults. Behavioral determinants (UTAUT and HBM constructs), demographic (eg, age), and health-related (eg, cardiopulmonary resuscitation training experience) variables were measured using (multi-item) scales. Willingness to install the app served as the outcome variable. We developed a structural equation model using the Lavaan package in R and specified regression paths, on the one hand, between the behavioral determinants and willingness to install the app, and on the other hand, between the demographic and health-related factors and the behavioral determinants. Additionally, we conducted multiple group analyses to examine the moderating role of demographic and health-related factors on the relationships between the behavioral determinants and the willingness to install the app.
resultsOur results revealed that 2 UTAUT variables (ie, facilitating conditions: β=.07; P=.003 and social influence: β=.16; P<.001) and 3 HBM variables (ie, perceived susceptibility: β=.06; P=.003, perceived barriers: β=-.29; P<.001, and perceived benefits: β=.38; P<.001) were associated with willingness to install a first responder app for OHCA. Additionally, most demographic and health-related factors were indirectly related to willingness via behavioral determinants, with age being the sole moderator. Specifically, a negative association between perceived severity and willingness was only observed among older adults. In addition, the positive relationship between perceived benefits and willingness was stronger for older adults compared to younger ones.
conclusionsOverall, the results of this study have both theoretical and practical implications. Theoretically, this study finds its relevance in extending the UTAUT and HBM to altruistic mobile health apps and advancing our understanding of technology adoption in health contexts. Practically, the study's findings could inform real-life health campaigns aimed at enhancing citizen participation in first responder systems.
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