{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:59:03Z","timestamp":1790330343394,"version":"4.1.0"},"reference-count":76,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2025QC758"],"award-info":[{"award-number":["ZR2025QC758"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2024MG002"],"award-info":[{"award-number":["ZR2024MG002"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2025MS1116"],"award-info":[{"award-number":["ZR2025MS1116"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>AI-powered medical chatbots are increasingly used in healthcare, yet the mechanisms underlying users' continued engagement remain unclear. This study examines how AI use influences continuance intention through cognitive trust and emotional attachment and whether technology anxiety differentially moderates these pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from 233 users of AI medical services in China. The proposed model was tested using partial least squares structural equation modeling (PLS-SEM) and bootstrapping in SmartPLS 4.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AI use positively influences both cognitive trust and emotional attachment, which in turn enhance continuance intention. Both mechanisms significantly mediate the relationship between AI use and continuance intention, with emotional attachment showing a stronger mediating effect. Technology anxiety significantly moderates the AI use\u2013cognitive trust relationship but not the AI use\u2013emotional attachment relationship, revealing an asymmetric moderating pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study extends cognitive-affective processing theory by revealing dual cognitive and emotional pathways linking AI use to continuance intention. It further identifies technology anxiety as a boundary condition that selectively shapes the cognitive pathway while leaving the emotional pathway relatively unaffected. The findings offer implications for designing anxiety-sensitive AI healthcare services and differentiated user engagement strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1956063","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:49:27Z","timestamp":1788932967000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Trusting and staying with AI doctors: cognitive and emotional pathways driving continuance intention toward AI healthcare chatbots"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhanyou","family":"Wang","sequence":"first","affiliation":[{"name":"School of Business Administration, Shandong Management University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoran","family":"Han","sequence":"additional","affiliation":[{"name":"School of Labor Relations, Shandong Management University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongmei","family":"Han","sequence":"additional","affiliation":[{"name":"School of Information Engineering, Shandong Management University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Ma","sequence":"additional","affiliation":[{"name":"School of Management Science and Engineering, Shandong University of Finance and Economics","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifei","family":"Hao","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1637270","DOI":"10.3389\/fpubh.2025.1637270","article-title":"Factors influencing the acceptance of medical AI chat assistants among healthcare professionals and patients: a survey-based study in China","volume":"13","author":"Zhang","year":"2025","journal-title":"Front Public Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"101109","DOI":"10.1016\/j.jadr.2026.101109","article-title":"Constructing trust and distrust in AI therapists: a grounded theory study of public online narratives","volume":"25","author":"Naeim","year":"2026","journal-title":"J Affect Disord Rep."},{"key":"B3","doi-asserted-by":"publisher","first-page":"10591478231225891","DOI":"10.1111\/poms.13785","article-title":"Rationally trust, but emotionally? 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