移动医疗环境下慢性病自我护理行为决策机制及其演变规律研究

The prevalence of chronic diseases has become one of the important threats to human health. The outline of the 2030 health plan issued by the State Council of China calls for strengthening the prevention and control of chronic diseases and promoting the establishment of the health information service system. Much interest and investment have been put into the eHealth industry, which brings new opportunities for the development of chronic disease prevention and control. However, consumer acceptance of eHealth and long-term adherence to the technology-augmented interventions remain one of the key challenges. This project aims to study the potential influencing factors affecting individuals’ health-related behaviors and propose a theoretical model that helps to explain the behavioral decision-making and evolution mechanism that governing chronic disease self-care. The hierarchical PLS regression will be employed for model testing using observations generated by pooling the panel data across multiple time points. The overall goodness of fit of the model will be assessed using covariance-based structural equation modeling to cross-validate the accuracy, parsimony, and generalizability of the model. This project focuses on the field of interdisciplinary research, which not only provides a scientific reference for exploring new methods of chronic disease self-care but also provides theoretical support for the effective implementation of eHealth interventions.

慢性病是威胁人类健康的重要因素之一，最新的“健康中国”战略明确提出加强慢性病防控并推进健康信息化服务体系建设。移动医疗产业已引起了市场参与者的浓厚兴趣并吸引了大量投资，这给慢性病防控带来了新的发展契机。然而，在提高医疗消费者科技接受水平、确保干预长期依从性方面仍然存在巨大挑战。本项目针对慢性病自我护理行为，研究移动医疗实施过程中的潜在影响因素，构建符合我国医疗环境的个体健康行为理论模型，揭示消费者基于移动医疗的慢性病自我护理行为决策机制及其演变规律。采用分层式PLS回归建模对纵向多时间节点面板数据进行整合分析，对复杂结构方程进行探索性求解；采用基于协方差的结构方程建模对前期理论模型进行验证性拟合评估，确保其准确性、简约性和普适性。本项目聚焦多学科交叉领域，不仅为探索新型慢性病自我护理模式提供方法借鉴，也为移动医疗落地应用提供理论支持。

移动医疗作为新兴的信息技术服务广受关注，突如其来的新冠肺炎疫情使其用户规模快速增长。然而，该类信息技术在终端用户中的采纳与实施仍面临巨大挑战。本项目紧密结合移动医疗发展趋势，围绕慢性病自我护理面临的科技接受度低和干预依从性差两大难题，采用混合研究方法对慢性病患者、患者家属和医护人员开展理论和实证研究，揭示健康消费者在移动医疗环境下的个体健康行为决策机制及演变规律。项目研究发现健康消费者在移动医疗干预初期具有较高的使用意愿，然而随时间推移而降低，提高和维护用户在移动医疗使用初期的整体态度对于该类信息技术的实施至关重要。研究结果表明个体健康行为决策与其所处的物理和认知环境中的人机交互过程息息相关，移动医疗的实施应同时关注用户个人属性（例如年龄、疾病状况）、科技属性（例如感知有用性、感知易用性）和环境属性（例如主观规范、网络外部性），研究结果同时强调信任在线上个体健康行为决策机制中的重要作用。本项目从管理、技术和运营的视角为移动医疗实施策略提供理论依据，为应对我国人口老龄化、慢性病年轻化等棘手问题提供了解决思路。