Health innovation adoption : the role of attitudes, control, and risk appraisal

O'Connor, Erin Leigh (2007) Health innovation adoption : the role of attitudes, control, and risk appraisal. PhD thesis, Queensland University of Technology.


Three studies were conducted to examine the role of psychosocial factors in the prediction of health innovation uptake. A health innovation is a device, treatment or altered food product intended to improve the health of an individual or group and considered new by the population of interest. Health innovations may be used to address current health problems in individuals but also play a key role in preventative health efforts. Encouraging individuals to adopt appropriate health innovations is often an important strategy in improving the general health and minimising the social cost of illness of a population.

The current program of research examined the influence of predictors from the Theory of Planned Behaviour (TPB; Ajzen, 1991), the Technology Acceptance Model (TAM; Davis, 1989; Davis, Bagozzi, & Warshaw, 1989), and risk technology literature (Fischhoff, Slovic, Lichtenstein, Read, & Combs, 1978; Slovic, 1987; Slovic, Fischhoff, & Lichtenstein, 1980) on health innovation decision-making. Additionally, the study examined the background factors of previous experience with the innovation, age, and gender. Guided by the overall conceptualisations of change presented in the Stages of Change Model (Prochaska & DiClemente, 1984; Prochaska & Velicer, 1997) and the Innovation Decision Model (Rogers, 1958, 2003), the three studies aimed to examine the role of the proposed predictors for a number of different innovations at various stages of diffusion.

Study 1 (N = 358) employed a correlational design to predict people's intentions and willingness to use the four health innovations of functional foods, vitamin supplements, alternative therapies and pedometers. Participants completed questionnaires based on the TPB examining attitude (favourability towards the innovation), subjective norms (pressure from others for innovation uptake) and perceived behavioural control (PBC; sense of control over adopting the innovation). In addition, participants completed items assessing the constructs of usefulness of the innovation and ease of use of the innovation from the TAM and familiarity of risks and dread of risks associated with the innovation, adapted from the risk literature. Background factors, such as previous innovation use and age and gender of the participants, were also examined. The underlying behavioural, normative, and control belief constructs of the TPB were examined to differentiate between those participants who reported that they were intending to or willing to adopt the health innovation and those who were not intending to or willing to adopt the health innovation. Overall, the results of Study 1 supported the TPB constructs, perceived usefulness from the TAM, and risk familiarity.

Study 2 (N = 102) utilized an experimental design where usefulness of the four innovations examined in Study 1 and the familiarity of risks associated with them were manipulated in a 2 x 2 scenario based study. As in Study 1, participants completed measures of the TPB factors, an assessment of the dread of risk and reported background factors such as previous innovation use, and their age and gender. Participants read reports of 'recent research' that contained information about the innovations' usefulness in relation to health benefit and familiarity of risk in comparison to traditional health products. As in Study 1, people's intentions and willingness to use the health innovations were examined, as was a third outcome measure; participant predicted future use of each innovation. The results of Study 2 provided support for the TPB constructs of attitude and subjective norms. The study also provided limited support for the TAM factor of usefulness, as well as for the risk dimensions of familiarity of risks and dread of risks. The TPB construct of PBC and the background factors of age and gender were not supported.

Study 3 (N = 116) employed a 2 x 2 between-subjects design where usefulness and dread of risks were manipulated for a previously unavailable health innovation, calcium enriched mints. Study 3 also involved a within-subjects measurement of two behaviour measures (estimated consumption, and a diary recorded measure of consumption) over three time periods. Intention was retained as a third uptake measure of innovation uptake. Participants were presented with manipulated information about the usefulness and dread of risks associated with calcium enriched mints. Study 3 examined the role of the manipulated constructs, the TPB factors, familiarity of risk, and demographics in the prediction of the enriched mints uptake. The design of this study addressed limitations identified in the literature and mirrored a number of authentic health innovation uptake situations. The results of Study 3 strongly supported the role of attitude and subjective norms as influential predictors of intention to consume the calcium enriched mints, and intention as a predictor of estimated and diary recorded measures of consumption. The study offered limited support for the risk factors of familiarity of risks and dread of risks and did not support the TAM construct of usefulness as a predictor of calcium enriched mint uptake.

Taken together, the results of this research provided strong support for the role of the TPB factors of attitude and subjective norms, but not PBC, as predictors of health innovation intentions and willingness. The results also supported the role of intention as a predictor of health innovation adoption behaviour. Limited support was found for the risk dimensions of familiarity of risks and dread of risks, suggesting that another conceptualisation of risk may be more appropriate for health innovation decision-making. The results found little support for the TAM variables of usefulness and ease of use, or the influence of demographic characteristics of age and gender. These findings indicate that the general decision-making model of the TPB, with the exception of the role of PBC, provides a useful framework to understand people's health innovation decision-making. Given the limited support for PBC in the prediction of intentions and behaviour in this context, the Theory of Reasoned Action (Fishbein & Ajzen, 1975), with some consideration of risk factors, may be an appropriate approach to adopt to facilitate an understanding the factors underlying people's decision to use innovations designed to improve their health.

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ID Code: 16509
Item Type: QUT Thesis (PhD)
Supervisor: White, Katherine, Biggs, Herbert, & Mahar, Douglas
Keywords: theory of planned behaviour, technology acceptance model, risk, health innovation
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Psychology & Counselling
Department: Faculty of Health
Institution: Queensland University of Technology
Copyright Owner: Copyright Erin Leigh O'Connor
Deposited On: 03 Dec 2008 04:04
Last Modified: 22 Feb 2013 04:41

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