ArticleDigital health
Healthcare professionals' intention to adopt a smart diabetic foot screening system: A UTAUT-informed mixed-methods study.
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Abstract
Background: Diabetic foot ulcers are serious but potentially preventable diabetes complications. Although smart screening technologies may support early detection, their routine clinical uptake remains limited, and factors shaping healthcare professionals' willingness to adopt such tools are insufficiently understood. Objective: This study examined determinants of healthcare professionals' behavioral intention to adopt FootHow, a smart diabetic foot screening system, using the Unified Theory of Acceptance and Use of Technology (UTAUT). Because participants evaluated FootHow after a standardized demonstration rather than hands-on clinical use, the outcome represents anticipated adoption intention, not observed adoption behavior. Methods: We conducted a cross-sectional survey of 80 healthcare professionals from two medical centers in Taiwan. Seven UTAUT-related constructs and behavioral intention were measured using a structured questionnaire. Quantitative data were analyzed using descriptive statistics, bivariate correlations, and multiple linear regression. Optional semi-structured interviews with a subset of participants were analyzed using inductive content analysis to contextualize the quantitative findings. Results: Participants reported generally favorable perceptions of FootHow. In bivariate analyses, attitude, effort expectancy, self-efficacy, and social influence were significantly associated with behavioral intention. In the multivariable model, attitude was the only independent predictor of behavioral intention (β=0.605, P<.01), and the model explained 36% of the variance in intention. Qualitative findings suggested that FootHow was perceived as valuable for early detection, patient awareness, and workflow efficiency, but concerns remained regarding accessibility for older adults, device reliability and hygiene, and affordability. Conclusions: Provider attitude was the strongest independent determinant of anticipated intention to adopt FootHow. Implementation strategies for preventive digital health technologies should therefore address provider attitudes while also strengthening workflow fit, usability, affordability, and transparent evidence regarding model performance and operational reliability. Longitudinal and pilot implementation studies are needed to determine whether these intentions translate into sustained clinical adoption.
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