← Back to all case studies
Health informatics · Acceptance research

Adoption of digital health apps

Healthcare / mHealth

An extension of the Technology Acceptance Model (TAM) to digital health apps. Alongside the classic TAM variables Perceived Ease of Use and Perceived Usefulness, we model Health Consciousness as a domain-specific motivator and Perceived Risk as a negative privacy path — a rarely so clearly delimited f² effect.

N
380
LVs
6
Effect
PR → BI negative

Cloning requires a free OpenPLS account.

Theoretical background

Davis (1989) established TAM, which to this day remains an extremely popular acceptance model with two core determinants: perceptions of usefulness (PU) and ease of use (PEOU). These shape attitude, which in turn drives intention.

For mHealth applications, the classic TAM is not enough: Sun et al. (2013) integrated Health Consciousness (positive) and Perceived Risk (negative) as domain-specific extensions. Privacy is particularly relevant in healthcare because sensitive data is shared.

The model is methodologically interesting because it contains a clearly negative path (PR → BI). Such effects are valuable in PLS-SEM teaching: they show that sign, significance, and f² effect sizes need to be interpreted separately.

Structural model

Classic TAM chain (PEOU → PU → Attitude → Intention) plus two domain-specific antecedents: Health Consciousness positive, Perceived Risk negative.

PEOU

Perceived Ease of Use

Perceived ease of operating the app.

PU

Perceived Usefulness

Expected health-related usefulness.

HC

Health Consciousness

Health awareness and personal responsibility.

PR

Perceived Risk

Perceived privacy and data-misuse risk.

ATT

Attitude

General attitude toward the app.

BI

Behavioral Intention

Intention to use the app regularly.

Hypotheses

H1 PEOU → PU + Ease of use raises perceived usefulness.
H2 PU → ATT + Usefulness raises attitude toward the app.
H3 HC → ATT + Health consciousness strengthens the positive attitude.
H4 PR → ATT - Perceived data risk undermines attitude.
H5 PU → BI + Usefulness directly raises usage intention.
H6 ATT → BI + A positive attitude leads to usage intention.

Methodology & data

N = 380 synthetic responses on 20 reflective indicators (seven-point Likert). Effect sizes are calibrated so the negative PR path is significant but smaller than the positive drivers — typical for real mHealth studies (Sun et al., 2013; Cocosila & Archer, 2010).

Expected results

R²(BI) ≈ 0.52
The five determinants explain about 52 % of variance in intention — solid for an extended TAM.
PR → BI ≈ −0.18
A clearly negative but moderate path. A teaching example for negative effects: report sign, significance, and effect size separately.
f²(PR)
The f² effect size for Perceived Risk typically lies in the small-to-medium range (≈ 0.06). Ideal for discussing Cohen thresholds.

Reproduce in 60 seconds

  1. 1

    Clone the project

    A single click in your OpenPLS workspace creates a fully editable copy: model, indicators, and dataset, all linked and ready to go.

  2. 2

    Run the computation

    OpenPLS solves outer weights, path coefficients, R², HTMT, SRMR, and bootstrap confidence intervals in a few seconds.

  3. 3

    Compare against expected metrics

    The key metrics documented below come from the published original. Your computed values should fall inside the bootstrap 95 % CIs.

References

  • Davis, F. D. (1989). Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology. MIS Quarterly, 13(3), 319–340. doi.org/10.2307/249008
  • Sun, Y., Wang, N., Guo, X., & Peng, Z. (2013). Understanding the acceptance of mobile health services: A comparison and integration of alternative models. Journal of Electronic Commerce Research, 14(2), 183–200. www.jecr.org/node/313
  • Cocosila, M., & Archer, N. (2010). Adoption of mobile ICT for health promotion: an empirical investigation. Electronic Markets, 20(3), 241–250. doi.org/10.1007/s12525-010-0042-y

Other case studies