3.9 million older Americans have heart failure (HF) and this number is only expected to increase with the rapid growth of the =65 population. In 2012, the total cost of treating HF was $30.7 billion, 80% of which was spent on hospitalizations, and older HF patients made up over 70% of these HF-related hospitalizations. mHealth, or the use of mobile technologies to support the achievement of health objectives, has the potential to revolutionize HF self-management. In people with HF, mHealth has already been shown to improve HF self- management, decrease hospitalizations, improve quality of life, and decrease mortality. However, despite the immense potential of mHealth to significantly improve HF self-management, very little is known regarding individual characteristics, attitudes, and perceptions that influence adoption of mHealth, especially in the older population, who are known to be slower to adopt new technology compared to their younger counterparts. In order to facilitate the implementation of mHealth in HF self-management, it is essential to examine potential facilitators and barriers to its adoption. The purpose of the proposed study is to examine facilitators and barriers that influence intention to adopt mHealth among older people with HF.
The specific aims of the study are to: (1) examine the relationship between eHealth literacy, attitude towards technology, and perceptions of mHealth; (2) examine the relationship between perceptions about mHealth and intention to use mHealth; (3) explore the patients' perceptions of facilitators and barriers to mHealth adoption; and (4) describe the facilitators and barriers to mHealth adoption. Guided by the Technology Acceptance Model, which posits that intention is the strongest predictor of actual technology use; the study will use an explanatory sequential mixed-methods design to gain an in-depth understanding of the facilitators and barriers to mHealth adoption. Quota sampling will be used to recruit HF patients (=65y), cared for at the Johns Hopkins Hospital, for the quantitative strand of the study, where they will be asked to complete a survey. Purposive sampling of study participants, who expressed the least and the most intention to adopt mHealth in their response to the quantitative survey, will be used to select participants to be interviewed for the qualitative strand of the study. The proposed study is directly aligned with the National Institute of Nursing Research's (NINR) strategic plan to expand knowledge and application of health care technologies to facilitate decision support, self-management, and access to health care.

Public Health Relevance

3.9 million Americans, over the age of 65, have heart failure (HF) and they account for over 70% of all HF- related hospitalizations every year. mHealth has the potential to revolutionize HF self-management since it has been shown to decrease hospitalizations, improve QOL for people with HF, and decrease mortality; however, despite its potential, very little is known regarding individual characteristics, attitudes, and perceptions tht influence the adoption of mHealth, particularly among older people with HF. The proposed study will examine facilitators and barriers that influence intention to adopt mHealth, which can facilitate the implementation of mHealth in HF self-management.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
1F31NR015943-01
Application #
8978979
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Banks, David
Project Start
2015-09-01
Project End
2018-02-28
Budget Start
2015-09-01
Budget End
2016-08-31
Support Year
1
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Cajita, Maan Isabella; Hodgson, Nancy A; Lam, Katherine Wai et al. (2018) Facilitators of and Barriers to mHealth Adoption in Older Adults With Heart Failure. Comput Inform Nurs 36:376-382
Cajita, Maan Isabella; Hodgson, Nancy A; Budhathoki, Chakra et al. (2017) Intention to Use mHealth in Older Adults With Heart Failure. J Cardiovasc Nurs 32:E1-E7
Cajita, Maan Isabella; Rodney, Tamar; Xu, Jingzhi et al. (2017) Quality and Health Literacy Demand of Online Heart Failure Information. J Cardiovasc Nurs 32:156-164
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