{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:44:24Z","timestamp":1791845064347,"version":"4.3.4"},"reference-count":80,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Hypothyroidism is a common chronic disease that can substantially impair physical and mental well-being and is associated with lower quality of life, a trend that interventions delivered by mobile health (mHealth) apps could ameliorate.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The objective of this study was to evaluate the acceptance and its influencing predictors of mHealth interventions in female patients affected by hypothyroidism to improve their quality of life. The focus on female patients reflects the significantly higher prevalence of hypothyroidism in women and their underrepresentation in many prior studies on technology acceptance and mHealth use.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A survey-based, cross-sectional study, which included 318 female patients affected by hypothyroidism (assessed via self-reported diagnosis according to International Classification of Diseases-10 criteria, aged 18 y or older), was conducted online between April 2023 and April 2024 in Germany. Participants were recruited via local and online self-help groups, social media platforms, and medical practices using flyers. Sociodemographic, health, and eHealth\u2013related data were assessed. To determine acceptance and its drivers and barriers, an extended version of the unified theory of acceptance and use of technology (UTAUT) model was applied. Group comparisons (\n t<\/jats:italic>\n tests, ANOVAs) and multiple hierarchical regression analyses were conducted. Only complete datasets were included in the analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Acceptance of mHealth apps was high (mean 4.10, SD 0.91), with 76.1% (n=242) of the participants reporting high acceptance, 18.6% (n=59) reporting moderate acceptance, and only 5.3% (n=17) reporting low acceptance. Significant predictors of acceptance were place of residence: medium-sized city (\u03b2=0.34;\n P<\/jats:italic>\n =.02) and small town or rural area (\u03b2=0.28;\n P<\/jats:italic>\n =.003), fatigue (\u03b2=0.54;\n P<\/jats:italic>\n <.001), internet anxiety (\u03b2=\u22120.20;\n P<\/jats:italic>\n =.002), and the UTAUT predictors effort expectancy (\u03b2=0.37;\n P<\/jats:italic>\n <.001), performance expectancy (\u03b2=0.32;\n P<\/jats:italic>\n <.001), and social influence (\u03b2=0.20;\n P<\/jats:italic>\n <.001). The extended model explained 56.1% of the variance in acceptance.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The high level of acceptance of mHealth apps observed among female patients affected by hypothyroidism indicates that mHealth interventions can provide such patients with valuable support to manage the disease and improve their quality of life. Addressing drivers and barriers of acceptance will be crucial for the successful implementation of mHealth interventions in hypothyroidism management, for example, by mHealth developers, clinicians, or policy makers. These include intuitive and accessible design (effort expectancy), clear communication of app benefits (performance expectancy), and fostering health care professional support (social influence), while addressing barriers such as internet anxiety. The study also contributes to advancing gender-sensitive mHealth research by applying the UTAUT model to this patient group.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/67317","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T23:45:06Z","timestamp":1750722306000},"page":"e67317-e67317","source":"Crossref","is-referenced-by-count":2,"title":["Acceptance, Drivers, and Barriers to Use of mHealth Apps to Improve Quality of Life in Female Patients Affected by Hypothyroidism: Cross-Sectional Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6487-3419","authenticated-orcid":false,"given":"Moritz","family":"Doll","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2101-8553","authenticated-orcid":false,"given":"Ranujan","family":"Chandrakumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2676-1345","authenticated-orcid":false,"given":"Lisa Maria","family":"Jahre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4667-5877","authenticated-orcid":false,"given":"Eva-Maria","family":"Skoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8855-2699","authenticated-orcid":false,"given":"Hannah","family":"Dinse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0357-4192","authenticated-orcid":false,"given":"Dagmar","family":"F\u00fchrer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5627-5750","authenticated-orcid":false,"given":"Eleni","family":"Lampropoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2120-1840","authenticated-orcid":false,"given":"Martin","family":"Teufel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1488-8592","authenticated-orcid":false,"given":"Alexander","family":"B\u00e4uerle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"issue":"39-51","key":"R1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1093\/bmb\/ldr030","article-title":"The epidemiology of thyroid disease","volume":"99","author":"Vanderpump","journal-title":"Br Med Bull"},{"issue":"3","key":"R2","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1210\/jc.2013-2409","article-title":"The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis","volume":"99","author":"Madariaga","journal-title":"J Clin Endocrinol Metab"},{"key":"R3","unstructured":"G\u00f6rsch B Melchert HU Thierfelder W . Schilddr\u00fcsenhormone und schilddr\u00fcsenmedikamente bei probanden in den nationalen gesundheitssurveys [thyroid hormones and thyroid medication in participants in the national health surveys] [Article in German]. Robert Koch Institut; 2002."},{"issue":"5","key":"R4","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1111\/j.1365-2265.2008.03338.x","article-title":"The incidence of autoimmune thyroid disease: a systematic review of the literature","volume":"69","author":"McGrogan","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"10","key":"R5","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1089\/105072502761016458","article-title":"Epidemiology and prevention of clinical and subclinical hypothyroidism","volume":"12","author":"Vanderpump","journal-title":"Thyroid"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3390\/biology11030394","article-title":"Epidemiology of hypothyroidism, hyperthyroidism and positive thyroid antibodies in the Croatian population","volume":"11","author":"\u0110ula","journal-title":"Biology (Basel)"},{"issue":"2","key":"R7","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1007\/s12020-012-9703-2","article-title":"The incidence and prevalence of thyroid autoimmunity","volume":"42","author":"McLeod","journal-title":"Endocrine"},{"issue":"10101","key":"R8","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.1016\/S0140-6736(17)30703-1","article-title":"Hypothyroidism","volume":"390","author":"Chaker","journal-title":"Lancet"},{"issue":"5","key":"R9","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1111\/cen.12787","article-title":"Gender differences in symptoms of hypothyroidism: a population-based DanThyr study","volume":"83","author":"Carl\u00e9","journal-title":"Clin Endocrinol (Oxf)"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/590648","article-title":"The link between thyroid function and depression","volume":"2012","author":"Hage","journal-title":"J Thyroid Res"},{"issue":"9","key":"R11","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1007\/s00127-015-1043-0","article-title":"Diagnosed thyroid disorders are associated with depression and anxiety","volume":"50","author":"Ittermann","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/0163-8343(86)90060-5","article-title":"The relationship of anxiety and depression to symptoms of hyperthyroidism using operational criteria","volume":"8","author":"Kathol","journal-title":"Gen Hosp Psychiatry"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/0163-8343(88)90084-9","article-title":"A psychiatric and neuropsychological study of patients with untreated Graves\u2019 disease","volume":"10","author":"Trzepacz","journal-title":"Gen Hosp Psychiatry"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1023\/B:QURE.0000015315.35184.66","article-title":"Health-related quality of life in patients with thyroid disorders","volume":"13","author":"Bianchi","journal-title":"Qual Life Res"},{"issue":"12","key":"R15","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1089\/thy.2014.0028","article-title":"Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on thyroid hormone replacement","volume":"24","author":"Jonklaas","journal-title":"Thyroid"},{"issue":"9821","key":"R16","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1016\/S0140-6736(11)60276-6","article-title":"Subclinical thyroid disease","volume":"379","author":"Cooper","journal-title":"Lancet"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","first-page":"50","DOI":"10.7326\/M15-1799","article-title":"The history and future of treatment of hypothyroidism","volume":"164","author":"McAninch","journal-title":"Ann Intern Med"},{"issue":"9","key":"R18","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1055\/a-1832-0644","article-title":"A questionnaire survey of German thyroidologists on the use of thyroid hormones in hypothyroid and euthyroid patients: the THESIS (Treatment of Hypothyroidism in Europe by Specialists: An International Survey) collaborative","volume":"130","author":"Vardarli","journal-title":"Exp Clin Endocrinol Diabetes"},{"issue":"11","key":"R19","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1038\/s41574-024-01022-7","article-title":"Medically not yet explained symptoms in hypothyroidism","volume":"20","author":"Heged\u00fcs","journal-title":"Nat Rev Endocrinol"},{"issue":"15","key":"R20","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11154296","article-title":"Long-term adherence to levothyroxine replacement therapy in thyroidectomized patients","volume":"11","author":"Bocale","journal-title":"J Clin Med"},{"issue":"514","key":"R21","first-page":"362","volume":"55","author":"Crilly","journal-title":"Br J Gen Pract"},{"issue":"62","key":"R22","first-page":"129","volume":"16","author":"Shrestha","journal-title":"Kathmandu Univ Med J (KUMJ)"},{"issue":"5","key":"R23","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.4624","article-title":"Adherence to levothyroxine tablet in patients with hypothyroidism","volume":"11","author":"Kumar","journal-title":"Cureus"},{"issue":"4","key":"R24","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-019-0206-x","article-title":"What is the clinical value of mHealth for patients?","volume":"3","author":"Rowland","journal-title":"NPJ Digital Med"},{"issue":"2","key":"R25","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.3328","article-title":"mHealth 2.0: experiences, possibilities, and perspectives","volume":"2","author":"Becker","journal-title":"JMIR Mhealth Uhealth"},{"key":"R26","unstructured":"Anzahl der smartphone-nutzer weltweit von 2016 bis 2022 und prognose bis 2028 (in milliarden) [number of smartphone users worldwide from 2016 to 2022 and forecast to 2028 (in billions)] [Article in German]. Statista GmbH. URL: https:\/\/de.statista.com\/statistik\/daten\/studie\/309656\/umfrage\/prognose-zur-anzahl-der-smartphone-nutzer-weltweit\/ [Accessed 17-09-2024]"},{"issue":"1","key":"R27","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012042.pub2","article-title":"Providing physicians with feedback on medication adherence for people with chronic diseases taking long-term medication","volume":"1","author":"Zaugg","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1089\/whr.2021.0010","article-title":"Improving the quality of life of patients with an underactive thyroid through mHealth: a patient-centered approach","volume":"2","author":"H\u00f6gqvist Tabor","journal-title":"Womens Health Rep (New Rochelle)"},{"key":"R29","volume":"205","author":"Gajanayake","journal-title":"Stud Health Technol Inform"},{"key":"R30","volume":"245","author":"Jiang","journal-title":"Stud Health Technol Inform"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1177\/2055207620905422","article-title":"Barriers to older adults\u2019 uptake of mobile-based mental health interventions","volume":"6","author":"Pywell","journal-title":"Digit Health"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1177\/014107680710000102","article-title":"Gender bias in research: how does it affect evidence based medicine?","volume":"100","author":"Holdcroft","journal-title":"J R Soc Med"},{"issue":"94","key":"R33","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s12905-015-0251-9","article-title":"Twenty years and still counting: including women as participants and studying sex and gender in biomedical research","volume":"15","author":"Mazure","journal-title":"BMC Womens Health"},{"key":"R34","unstructured":"The role of digital health technologies in women\u2019s health, empowerment and gender equality. World Health Organization. 2024. URL: https:\/\/iris.who.int\/bitstream\/handle\/10665\/376179\/WHO-EURO-2024-9293-49065-73153-eng.pdf?sequence=2 [Accessed 09-06-2025]"},{"issue":"3","key":"R35","doi-asserted-by":"publisher","first-page":"319","DOI":"10.2307\/249008","article-title":"Perceived usefulness, perceived ease of use, and user acceptance of information technology","volume":"13","author":"Davis","journal-title":"MIS Q"},{"issue":"3","key":"R36","doi-asserted-by":"publisher","first-page":"425","DOI":"10.2307\/30036540","article-title":"User acceptance of information technology: toward a unified view","volume":"27","journal-title":"MIS Q"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.3233\/SHTI190111","article-title":"Technology acceptance models in health informatics: TAM and UTAUT","volume":"263","author":"Ammenwerth","journal-title":"Stud Health Technol Inform"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2021.100459","article-title":"Acceptance towards digital health interventions\u2014model validation and further development of the unified theory of acceptance and use of technology","volume":"26","author":"Philippi","journal-title":"Internet Interv"},{"issue":"8","key":"R39","doi-asserted-by":"publisher","DOI":"10.2196\/15023","article-title":"Factors Influencing patients\u2019 intentions to use diabetes management apps based on an extended unified theory of acceptance and use of technology model: web-based survey","volume":"21","author":"Zhang","journal-title":"J Med Internet Res"},{"issue":"9","key":"R40","doi-asserted-by":"publisher","DOI":"10.3390\/nu14091968","article-title":"Determinants of acceptance of weight management applications in overweight and obese individuals: using an extended unified theory of acceptance and use of technology model","volume":"14","author":"B\u00e4uerle","journal-title":"Nutrients"},{"issue":"282-288","key":"R41","doi-asserted-by":"publisher","first-page":"282","DOI":"10.3233\/SHTI190839","article-title":"Acceptance of mHealth apps for self-management among people with hypertension","volume":"267","author":"Breil","journal-title":"Stud Health Technol Inform"},{"key":"R42","unstructured":"International statistical classification of diseases and related health problems 10th revision (ICD-10): chapter IV endocrine, nutritional and metabolic diseases (E00-E90). World Health Organization. 2019. URL: https:\/\/icd.who.int\/browse10\/2019\/en#\/E89.0 [Accessed 01-10-2024]"},{"issue":"9596","key":"R43","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","journal-title":"Lancet"},{"issue":"2","key":"R44","doi-asserted-by":"publisher","DOI":"10.2196\/28252","article-title":"Measuring electronic health literacy: development, validation, and test of measurement invariance of a revised German version of the eHealth Literacy Scale","volume":"24","author":"Marsall","journal-title":"J Med Internet Res"},{"issue":"4","key":"R45","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd10040174","article-title":"Determining the acceptance of digital cardiac rehabilitation and its influencing factors among patients affected by cardiac diseases","volume":"10","author":"B\u00e4uerle","journal-title":"J Cardiovasc Dev Dis"},{"issue":"8","key":"R46","doi-asserted-by":"publisher","DOI":"10.2196\/37682","article-title":"Determining the Influencing factors on acceptance of ehealth pain management interventions among patients with chronic pain using the unified theory of acceptance and use of technology: cross-sectional study","volume":"6","author":"Stoppok","journal-title":"JMIR Form Res"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1177\/20552076231222108","article-title":"Drivers and barriers of patients\u2019 acceptance of video consultation in cancer care","volume":"10","author":"Nurtsch","journal-title":"Digital Health"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.1177\/17562864231175730","article-title":"Acceptance, drivers, and barriers to use eHealth interventions in patients with post-COVID-19 syndrome for management of post-COVID-19 symptoms: a cross-sectional study","volume":"16","author":"Schr\u00f6der","journal-title":"Ther Adv Neurol Disord"},{"issue":"3","key":"R49","doi-asserted-by":"publisher","first-page":"215824402211143","DOI":"10.1177\/21582440221114320","article-title":"Examining the impact of technology overload at the workplace: a systematic review","volume":"12","author":"Rasool","journal-title":"SAGE Open"},{"issue":"7","key":"R50","doi-asserted-by":"publisher","DOI":"10.2196\/27436","article-title":"Determining acceptance of e-Mental health interventions in digital psychodiabetology using a quantitative web-based survey: cross-sectional study","volume":"5","author":"Damerau","journal-title":"JMIR Form Res"},{"key":"R51","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2023.1104653","article-title":"Employing the TAM in predicting the use of online learning during and beyond the COVID-19 pandemic","volume":"14","author":"Zobeidi","journal-title":"Front Psychol"},{"issue":"12","key":"R52","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6003","article-title":"Drivers and barriers to acceptance of web-based aftercare of patients in inpatient routine care: a cross-sectional survey","volume":"18","author":"Hennemann","journal-title":"J Med Internet Res"},{"key":"R53","unstructured":"Cohen J . Statistical Power Analysis for the Behavioral Sciences. Erlbaum; 1988. ISBN: 9781134742707"},{"issue":"9","key":"R54","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.45222","article-title":"Quality of life in thyroid cancer patients","volume":"15","author":"Alsaud","journal-title":"Cureus"},{"issue":"3","key":"R55","doi-asserted-by":"publisher","first-page":"243","DOI":"10.18203\/2349-3933.ijam20220425","article-title":"A study of gonadal dysfunction in women with thyroid disease","volume":"9","author":"Vasudevan","journal-title":"Int J Adv Med"},{"issue":"3","key":"R56","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1177\/0269215513503355","article-title":"Impact of fatigue on health-related quality of life in patients with Parkinson\u2019s disease: a prospective study","volume":"28","author":"Elbers","journal-title":"Clin Rehabil"},{"issue":"6","key":"R57","doi-asserted-by":"publisher","first-page":"371","DOI":"10.15406\/ijfcm.2018.02.00111","article-title":"Fatigue and physical performance in the elderly aged 65 and over living in a nursing home","volume":"2","author":"Soyuer","journal-title":"IJFCM"},{"issue":"23","key":"R58","doi-asserted-by":"publisher","DOI":"10.3390\/nu16234155","article-title":"Acceptance, needs, and demands for nutritional mhealth support in patients with cardiovascular disease","volume":"16","author":"Mohajeri","journal-title":"Nutrients"},{"issue":"22-31","key":"R59","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.ijmedinf.2016.03.002","article-title":"Analyzing older users\u2019 home telehealth services acceptance behavior-applying an Extended UTAUT model","volume":"90","author":"Cimperman","journal-title":"Int J Med Inform"},{"key":"R60","unstructured":"Faverio. Share of those 65 and older who are tech users has grown in the past decade. Pew Research Center; 2022. URL: https:\/\/www.pewresearch.org\/short-reads\/2022\/01\/13\/share-of-those-65-and-older-who-are-tech-users-has-grown-in-the-past-decade\/ [Accessed 10-07-2025]"},{"issue":"4","key":"R61","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16040645","article-title":"Sociodemographic factors influencing the use of eHealth in people with chronic diseases","volume":"16","author":"Reiners","journal-title":"Int J Environ Res Public Health"},{"key":"R62","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/790457","article-title":"Participating in online mental health interventions: who is most likely to sign up and why?","volume":"2014","author":"Crisp","journal-title":"Depress Res Treat"},{"issue":"2-3","key":"R63","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1080\/03601277.2018.1428145","article-title":"Technophobia among older Internet users","volume":"44","author":"Nimrod","journal-title":"Educ Gerontol"},{"issue":"6","key":"R64","doi-asserted-by":"publisher","first-page":"2337","DOI":"10.1016\/j.chb.2013.05.012","article-title":"Computer anxiety: comparison of research from the 1990s and 2000s","volume":"29","author":"Powell","journal-title":"Comput Human Behav"},{"issue":"3","key":"R65","doi-asserted-by":"publisher","DOI":"10.2196\/31229","article-title":"Predicting acceptance of e-Mental health interventions in patients with obesity by using an extended unified theory of acceptance model: cross-sectional study","volume":"6","author":"Rentrop","journal-title":"JMIR Form Res"},{"issue":"23","key":"R66","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192315643","article-title":"What determines the acceptance and use of eHealth by older adults in Poland?","volume":"19","author":"R\u00f3j","journal-title":"Int J Environ Res Public Health"},{"issue":"9","key":"R67","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9418","article-title":"Use and the users of a patient portal: cross-sectional study","volume":"20","author":"Hoogenbosch","journal-title":"J Med Internet Res"},{"issue":"1","key":"R68","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15644-5","article-title":"Using the unified theory of acceptance and use of technology (UTAUT) and e-health literacy(e-HL) to investigate the tobacco control intentions and behaviors of non-smoking college students in China: a cross-sectional investigation","volume":"23","author":"Ma","journal-title":"BMC Public Health"},{"issue":"3","key":"R69","doi-asserted-by":"publisher","first-page":"26","DOI":"10.3390\/mti7030026","article-title":"Developing usability guidelines for mHealth applications (UGmHA)","volume":"7","author":"Nasr","journal-title":"MTI"},{"issue":"1","key":"R70","doi-asserted-by":"publisher","DOI":"10.1038\/s44401-025-00017-4","article-title":"A systematic review of strategies in digital technologies for motivating adherence to chronic illness self-care","volume":"2","author":"Lu","journal-title":"npj Health Syst"},{"key":"R71","doi-asserted-by":"publisher","DOI":"10.1177\/23337214231162773","article-title":"Digital affinitiy and cognitive reserve: salience for resilient aging in pandemic","volume":"9","author":"Cilli","journal-title":"Gerontol Geriatr Med"},{"issue":"9","key":"R72","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1111\/spc3.12265","article-title":"The intention\u2013behavior gap","volume":"10","author":"Sheeran","journal-title":"Soc Pers Psych"},{"issue":"923464","key":"R73","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.923464","article-title":"Understanding the intention-behavior gap: the role of intention strength","volume":"13","author":"Conner","journal-title":"Front Psychol"},{"issue":"1","key":"R74","doi-asserted-by":"publisher","first-page":"51","DOI":"10.4236\/ojbm.2016.41006","article-title":"Gender differences in technology usage\u2014a literature review","volume":"04","author":"Goswami","journal-title":"OJBM"},{"issue":"10","key":"R75","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0000279","article-title":"Digital literacy as a new determinant of health: a scoping review","volume":"2","author":"L\u00f3pez","journal-title":"PLOS Digital Health"},{"key":"R76","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2024.105122","article-title":"Digital health technologies and inequalities: a scoping review of potential impacts and policy recommendations","volume":"146","author":"Badr","journal-title":"Health Policy"},{"issue":"7","key":"R77","doi-asserted-by":"publisher","DOI":"10.2196\/17616","article-title":"Digital divide in perceived benefits of online health care and social welfare services: national cross-sectional survey study","volume":"22","author":"Heponiemi","journal-title":"J Med Internet Res"},{"key":"R78","doi-asserted-by":"publisher","DOI":"10.2196\/45162","article-title":"Influencing factors to mHealth uptake with indigenous populations: qualitative systematic review","volume":"11","author":"Goodman","journal-title":"JMIR Mhealth Uhealth"},{"issue":"2","key":"R79","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1108\/EL-04-2019-0097","article-title":"Culture in the design of mHealth UI","volume":"38","author":"Alsswey","journal-title":"EL"},{"issue":"17","key":"R80","doi-asserted-by":"publisher","first-page":"5591","DOI":"10.3390\/s24175591","article-title":"Advancing mHealth research in low-resource settings: young women\u2019s insights and implementation challenges with wearable smartwatch devices in Uganda","volume":"24","author":"Swahn","journal-title":"Sensors (Basel)"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e67317","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:28:03Z","timestamp":1785536883000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e67317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,7]]},"references-count":80,"URL":"https:\/\/doi.org\/10.2196\/67317","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,7]]},"article-number":"v9i39-51e67317"}}