@Article{info:doi/10.2196/27926,
author="Mendez, Kyra Jennifer Waligora
and Budhathoki, Chakra
and Labrique, Alain Bernard
and Sadak, Tatiana
and Tanner, Elizabeth K
and Han, Hae Ra",
title="Factors Associated With Intention to Adopt mHealth Apps Among Dementia Caregivers With a Chronic Condition: Cross-sectional, Correlational Study",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Aug",
day="31",
volume="9",
number="8",
pages="e27926",
keywords="mHealth applications; mobile health; intention to adopt mHealth applications; dementia caregivers; family caregiving; chronic disease self-management; mobile phone",
abstract="Background: In the United States, nearly 80{\%} of family caregivers of people with dementia have at least one chronic condition. Dementia caregivers experience high stress and burden that adversely affect their health and self-management. mHealth apps can improve health and self-management among dementia caregivers with a chronic condition. However, mHealth app adoption by dementia caregivers is low, and reasons for this are not well understood. Objective: The purpose of this study is to explore factors associated with dementia caregivers' intention to adopt mHealth apps for chronic disease self-management. Methods: We conducted a cross-sectional, correlational study and recruited a convenience sample of dementia caregivers. We created a survey using validated instruments and collected data through computer-assisted telephone interviews and web-based surveys. Before the COVID-19 pandemic, we recruited dementia caregivers through community-based strategies, such as attending community events. After nationwide closures due to the pandemic, the team focused on web-based recruitment. Multiple logistic regression analyses were used to test the relationships between the independent and dependent variables. Results: Our sample of 117 caregivers had an average age of 53 (SD 17.4) years, 16 (SD 3.3) years of education, and 4 (SD 2.5) chronic conditions. The caregivers were predominantly women (92/117, 78.6{\%}) and minorities (63/117, 53.8{\%}), experienced some to extreme income difficulties (64/117, 54.7{\%}), and were the child or child-in-law (53/117, 45.3{\%}) of the person with dementia. In logistic regression models adjusting for the control variables, caregiver burden (odds ratio [OR] 1.3, 95{\%} CI 0.57-2.8; P=.57), time spent caregiving per week (OR 1.7, 95{\%} CI 0.77-3.9; P=.18), and burden of chronic disease and treatment (OR 2.3, 95{\%} CI 0.91-5.7; P=.08) were not significantly associated with the intention to adopt mHealth apps. In the final multiple logistic regression model, only perceived usefulness (OR 23, 95{\%} CI 5.6-97; P<.001) and the interaction term for caregivers' education and burden of chronic disease and treatment (OR 31, 95{\%} CI 2.2-430; P=.01) were significantly associated with their intention to adopt mHealth apps. Perceived ease of use (OR 2.4, 95{\%} CI 0.67-8.7; P=.18) and social influence (OR 1.8, 95{\%} CI 0.58-5.7; P=.31) were not significantly associated with the intention to adopt mHealth apps. Conclusions: When designing mHealth app interventions for dementia caregivers with a chronic condition, it is important to consider caregivers' perceptions about how well mHealth apps can help their self-management and which app features would be most useful for self-management. Caregiving factors may not be relevant to caregivers' intention to adopt mHealth apps. This is promising because mHealth strategies may overcome barriers to caregivers' self-management. Future research should investigate reasons why caregivers with a low education level and low burden of chronic disease and treatment have significantly lower intention to adopt mHealth apps for self-management. ",
issn="2291-5222",
doi="10.2196/27926",
url="https://mhealth.jmir.org/2021/8/e27926",
url="https://doi.org/10.2196/27926",
url="http://www.ncbi.nlm.nih.gov/pubmed/34463637"
}