Customers’ intentions to adopt digital health services: An extended TAM

This study explores the factors influencing customers’ intentions to adopt digital health services in Algeria, focusing on an extended Technology Acceptance Model (TAM). Given the growing importance of digital health solutions in enhancing healthcare accessibility and efficiency, understanding the determinants of adoption is crucial. Using a convenience sample of 132 respondents and an 18-item questionnaire, the research employs multiple regression analysis to examine the effects of perceived usefulness, perceived ease of use, attitude, and electronic word-of-mouth (eWOM) on adoption intentions. The findings reveal that all four factors significantly impact customers’ intentions to adopt digital health services. Specifically, perceived usefulness and high perceived ease of use, along with positive attitudes, and favorable eWOM, are crucial in shaping adoption decisions. This study contributes to the literature by providing empirical evidence on the factors driving digital health adoption in an Algerian context, offering valuable insights for policymakers and service providers to enhance digital health strategies and address adoption barriers effectively.

1 Introduction

Technology offers a strategic advantage in enhancing operations and achieving organizational goals across various sectors, including healthcare (Edo et al. 2023). In recent years, the digital health industry has witnessed rapid growth, driven by advances in technology and increasing consumer demand for accessible and effective healthcare solutions (Abdelwahed et al. 2024). According to Zhou et al. (2019), the relationship between digital health systems and traditional health services is mutually supportive, not substitutional. Digital health services, including telemedicine, health apps, mobile health (mHealth), and electronic health records, promise to revolutionize the way individuals manage their health and interact with healthcare providers (Mouloudj et al. 2023; Safi et al. 2019). Although digital health services have great potential, there is still a lack of comprehensive understanding regarding how customers perceive and adopt these services (Goel et al. 2024), leading to inconsistent adoption rates. Therefore, understanding the factors that influence customers’ intentions to adopt digital health services is critical for stakeholders (e.g., „telehealth system developers, governments, investors, and hospitals“) in order to enhance user engagement and maximize the benefits of these innovations (Zhou et al. 2019).
Digital health services in Algeria are increasingly recognized as vital to improving healthcare accessibility and efficiency, especially in a country with diverse geographical and socio-economic challenges (Mouloudj et al. 2023). The Algerian government has initiated several projects to integrate digital health solutions, such as telemedicine and electronic health records, into the national healthcare system. These efforts aim to address disparities in healthcare access between urban and rural areas and streamline healthcare management. However, the adoption of these services is uneven, influenced by factors such as infrastructure limitations, digital literacy, and regulatory hurdles. As digital health solutions continue to evolve, addressing these challenges is essential for maximizing their potential benefits and ensuring equitable access to quality healthcare across Algeria.
The technology acceptance model (TAM) provides a foundational framework for examining technology adoption. Originally developed by Davis (1989), TAM posits that perceived usefulness and perceived ease of use are primary determinants of technology acceptance (Venkatesh and Bala 2008). Perceived usefulness refers to „the degree to which a person believes that using a technology will enhance their job performance or personal life“, while perceived ease of use pertains to „the extent to which a person believes that using the technology will be free of effort“ (Davis 1989). While TAM has been instrumental in understanding technology adoption in various contexts (Bouarar et al. 2023), the digital health system presents unique challenges and opportunities that necessitate an extension of the model (Al-Sulimani and Bouaguel 2024; Mouloudj et al. 2023).
In the context of digital health, it is essential to consider additional constructs beyond the original TAM framework (Ahmad et al. 2020; Almazroi et al. 2022; Tsai et al. 2019). Attitude toward adopting digital health services is a significant factor influencing adoption (Al-Sulimani and Bouaguel 2024). Attitude encompasses users’ overall evaluations and feelings towards digital health technologies (Mouloudj et al. 2023), which can affect their willingness to engage with these technologies (Kim et al. 2023). Additionally, electronic word-of-mouth (eWOM) plays a crucial role in shaping users’ perceptions and adoption intentions (Koo 2016; Ngo et al. 2024). eWOM refers to „the information and opinions shared by other users online, which can influence potential adopters’ attitudes and decisions“ (Cheung and Thadani 2012). In the digital age, where information is easily disseminated and accessed, eWOM can significantly impact users’ trust and willingness to adopt new technologies (Akdim 2021; Kim et al. 2018; Zulkiffli et al. 2022).
This study aims to investigate how perceived usefulness, perceived ease of use, attitude, perceived value, and eWOM impact customers’ intentions to adopt digital health services. By extending the TAM framework to include additional constructs, the research will provide a more comprehensive understanding of the factors that drive adoption in the digital health sector (Al-Sulimani and Bouaguel 2024; Zin et al. 2023). The findings will offer valuable insights for digital health service providers, policymakers, and technology developers seeking to enhance user engagement and improve the effectiveness of their services.
Understanding these factors is crucial for designing and implementing strategies that can effectively address barriers to adoption and leverage enablers (Almazroi et al. 2022; Tsai et al. 2019). For instance, if perceived usefulness is found to be a significant predictor of adoption, providers may focus on demonstrating the tangible benefits of their services to potential users. Similarly, if eWOM is identified as a key influence, strategies to encourage positive user reviews and manage online reputation may be prioritized. Accordingly, the primary objective of this study is to assess the effects of perceived usefulness, perceived ease of use, attitude, perceived value, and eWOM on customers’ intentions to adopt digital health services in the Algerian context. This research will contribute valuable insights into the factors that drive digital health adoption and provide actionable recommendations for enhancing the uptake of these services. By addressing these objectives, the study aims to advance both theoretical understanding and practical applications in the realm of digital health.

2 Literature review and research hypotheses

2.1 Digital health services

Digital health technology involves utilizing information and communication tools, along with technological devices, to oversee and manage patient care through digital means; it includes, „record management systems, health monitoring systems, medical dispensing devices, prescribing systems, and other software that support and improve patient care process management“ (Edo et al. 2023, p. 1). The COVID-19 pandemic has significantly increased the demand for remote healthcare services (Goel et al. 2024; Katsaliaki 2024). According to Tsai et al. (2019), digital health can facilitate the creation of innovative healthcare services aimed at improving medical quality and efficiency. By centering the healthcare delivery process on customers, these services have the potential to provide tailored and more effective health solutions, contributing to a stronger and more resilient health system (Goel et al. 2024). Digital health technology offers a solution to numerous accessibility issues encountered by ethnic and racial minorities, rural areas, and economically disadvantaged groups (Ghaddar et al. 2020). In addition, it offers substantial advantages, such as enhanced quality of care, increased efficiency, and cost savings, particularly benefiting individuals with chronic conditions and the elderly (Al-Sulimani and Bouaguel 2024; Jokisch et al. 2022; Zin et al. 2023). Safi et al. (2019) suggest that widespread adoption of digital health apps could enhance personalized healthcare solutions and „warrants governance“. On the other hand, despite recent advancements in digital health services, major challenges persist, especially concerning customer acceptance and the adoption of digital health service systems (Zhou et al. 2019). In this context, Klaver et al. (2021) discovered that „performance risk“, „legal concern“, and „privacy risk“ were negatively associated with the willingness to adopt mHealth apps.

2.2 Developing hypotheses

2.2.1 Perceived usefulness of digital health services

Perceived usefulness, a core component of the TAM, significantly influences users’ intentions to adopt new technologies, including digital health technologies (Edo et al. 2023). This construct refers to „the degree to which a user believes that using a particular technology will enhance their job performance or improve their overall well-being“ (Mouloudj et al. 2023). In the context of digital health services, perceived usefulness encompasses the perceived benefits these services offer, such as improved access to healthcare, more accurate health monitoring, and enhanced convenience (Al-Sulimani and Bouaguel 2024). Research indicates that when individuals perceive digital health as beneficial to their health management and daily life, they are more likely to exhibit a positive intention toward adopting these technologies (Almazroi et al. 2022; Jokisch et al. 2022; Katsaliaki 2024; Tsai et al. 2019). For instance, if customers believe that digital health platforms can provide personalized health insights or streamline communication with healthcare providers, they are more inclined to integrate these tools into their routines (Zin et al. 2023). Kim et al. (2023) found that perceived usefulness of a „robotic health advisor“ positively affects customers’ attitudes and their intentions to use this technology. Yuen et al. (2020) found that perceived value impacts customers’ willingness to adopt telehealth. Ahmad et al. (2020) discovered that perceived usefulness affects „patients’ continuance intention to use digital health wearables“. However, Bahanan and Alsharif (2023) found that perceived usefulness was not a significant predictor of customers’ willingness to accept teledentistry. Building on these considerations, we put forward the following hypothesis:
H1: Perceived usefulness of digital health services has a positive effect on customers’ intentions to adopt digital health services.

2.2.2 Perceived ease of digital health services use

Perceived ease of use, a fundamental element of the TAM, plays a critical role in shaping customers’ intentions to adopt digital health services (Mouloudj et al. 2023). This construct refers to „the extent to which a user believes that utilizing a technology will be free of effort or complexity“ (Davis, 1989). In the realm of digital health services, perceived ease of use encompasses the simplicity and user-friendliness of the interface, the clarity of instructions, and the overall accessibility of the service (Almazroi et al. 2022). When users find digital health platforms intuitive and easy to navigate, they are more likely to have a favorable attitude toward using these services (Zin et al. 2023). Research supports that ease of use directly influences attitude toward using „digital health services“ (Al-Sulimani and Bouaguel 2024; Zin et al. 2023), adoption intentions (Katsaliaki 2024; Zhou et al. 2019), and continuance intention (Ahmad et al. 2020). So, customers are more inclined to embrace digital health solutions if they perceive them as straightforward and hassle-free. For example, an app with a seamless on boarding process and minimal technical issues will likely attract more users. Abdelwahed et al. (2024) discovered that challenges in using digital health tools undermine both the attitudes towards and the intentions to embrace digital health services. However, Edo et al. (2023) found that perceived ease of use was not a significant predictor of health workers’ willingness to adopt digital health technologies. A similar result was observed by Almazroi et al. (2022) and Bahanan and Alsharif (2023) in the context of adopting electronic health (e-health) services and teledentistry, respectively. Hence, we propose the following hypothesis:
H2: Perceived ease of use of digital health services has a positive effect on customers’ intentions to adopt digital health services.

2.2.3 Attitude toward adopt digital health services

Attitude toward adopting digital health services is a pivotal factor influencing customers’ intentions to use these technologies. This construct reflects „an individual’s overall evaluative judgment about digital health services, encompassing their positive or negative feelings and beliefs about these tools“ (Mouloudj et al. 2023). Customer attitudes toward digital health technology may improve with higher perceived usefulness and compatibility, while they may be adversely affected by transition costs (Tsai et al. 2019). A positive attitude is characterized by the perception that digital health services offer significant benefits, such as convenience, improved health management, and better communication with healthcare providers. When customers hold favorable attitudes and perceive these services as valuable and beneficial, their intention to adopt and use them increases (Al-Sulimani and Bouaguel 2024). Empirical studies suggest that individuals with positive attitudes and enthusiasm for the potential advantages of digital health services – “such as improved accessibility to healthcare information or personalized health monitoring“ are more likely to adopt these technologies (Ghaddar et al. 2020; Kim et al. 2023; Tsai et al. 2019; Zin et al. 2023). Conversely, negative attitudes, influenced by concerns over usability, privacy, or effectiveness, can hinder adoption. Consequently, the following hypothesis is proposed:
H3: Attitude toward adopting digital health services has a positive effect on customers’ intentions to adopt digital health services.

2.2.4 Electronic word-of-mouth (eWOM)

eWOM describes the continuous and evolving process of information sharing over the Internet among current, prospective, or past consumers about a „product, service, brand, or company“ (Ismagilova et al. 2020). In digital health, eWOM refers to online reviews, ratings, and recommendations shared by users about their experiences with digital health services across various platforms, such as social media, forums, and review sites. Positive eWOM can enhance the credibility and attractiveness of services, such as digital health services, by providing prospective users with real-life testimonials and success stories (Akdim 2021). When individuals encounter favorable feedback and recommendations from trusted sources or peers, they are more likely to perceive the services as reliable and effective, thereby increasing their willingness to adopt them (Cheung and Thadani 2012; Kim et al. 2018; Koo 2016). Conversely, negative eWOM can deter potential users by highlighting possible shortcomings or issues. Jin and Ryu (2024) discovered that customers’ attitudes and the quality of information are key factors in boosting customer satisfaction, promoting continued use, and enhancing eWOM for digital health service systems. Research supports that eWOM acts as a powerful social influence, impacting users’ attitudes and intentions (Ismagilova et al. 2020; Ngo et al. 2024; Xiao et al. 2022; Zulkiffli et al. 2022) by leveraging the experiences of others. In the medical tourism sector, Abubakar and Ilkan (2016) discovered that eWOM has a positive impact on both customer trust and intention. Shan et al. (2024) suggest that in online health communities, patients’ decision-making is positively influenced by both the volume and the quality of eWOM. As a result, it is hypothesized that:
H4: eWOM has a positive effect on customers’ intentions to adopt digital health services.

3 Research metholodogy

3.1 Instrument development

In this investigation, a self-administered questionnaire was employed to gather data from participants. The questionnaire was structured into two main sections. The first section collected demographic information, including respondents’ age, age group, educational level, monthly income level, and marital status. The second section focused on evaluating the constructs of the study model (see Table 1). For measuring perceived usefulness of digital health services, an adapted scale from Tsai et al. (2019) was utilized. Perceived ease of use was assessed using the scale developed by Tsai et al. (2019) and Zhou et al. (2019). Attitudes towards behavior were measured with the scale proposed by Bouarar et al. (2023) and Mouloudj et al. (2023), while eWOM was gauged using Abubakar and Ilkan’s (2016) scale. Customers’ intentions to adopt digital health services were evaluated through a scale derived from Mouloudj et al. (2023) and Yuen et al. (2023). Each construct was measured with three items on a five-point Likert scale to capture the intensity of respondents’ perceptions and intentions accurately.
To ensure the validity and reliability of the questionnaire, it was first developed in English and then translated into Arabic using a reverse translation method to maintain accuracy. Additionally, three marketing studies experts reviewed the questionnaire to confirm the relevance and clarity of the items. A pilot study involving 17 respondents was conducted to test the clarity of the questions and make necessary adjustments before the full-scale distribution of the questionnaire. This rigorous instrument development process aimed to ensure that the data collected would be both reliable and valid for analyzing the adoption of digital health services in Algeria.

Table 1: Measurement item
Source: Authors

3.2 Sample and data collection

For this study, we employed a convenience (non-random) sampling method to gather data on the adoption of digital health services. A total of 200 questionnaires were distributed to respondents at several points such as pharmacies, private clinics, and locations in front of public hospitals from May to July 2024. Out of these, 138 responses were collected. Six questionnaires were deemed invalid due to incomplete responses. Therefore, only 132 questionnaires were analyzed with a response rate of 66%. The data collection targeted individuals aged 18 and older, ensuring a diverse representation of potential digital health service users. The questionnaires were distributed in three cities: Medea, Algiers, and Blida, to capture a broad regional perspective. Participants were thoroughly informed about the study’s objectives and their rights, including the option to decline participation or withdraw at any stage. The completion time for each questionnaire was approximately ten minutes, allowing respondents to provide thoughtful and considered answers. This approach aimed to ensure a reliable and representative sample while accommodating participants’ convenience and privacy.

4 Research results and discussion

4.1 Descriptive statistics

Table 2 outlines the demographic details of the survey participants. The sample comprised 52.27% males and 47.73% females. The largest age group was 31 to 40 years old, making up 31.06% of the respondents, followed by those aged 41 to 50 years at 28.79%. Respondents aged 51 and older and those between 18 and 30 years constituted 22.73% and 17.42% of the sample, respectively. Regarding educational attainment, 50.76% had completed high school or less, 39.39% held a postgraduate degree, and 9.85% had completed a postgraduate degree. For monthly household income, 43.94% earned between 40,000 and 60,000 DZD, 32.57% earned less than 40,000 DZD, 12.88% earned between 60,000 and 80,000 DZD, and 10.61% had an income exceeding 80,000 DZD. Finally, regarding the marital status, 49.24% were married, 43.94% were single, and 6.82% were either divorced or widowed.

Table 2: Participants’ characteristics (N = 132)
Source: Authors

Mean scores and „standard deviations“ (SDs) were computed for each construct (refer to Table 3). The analysis revealed that respondents had strong intentions to adopt digital health services (M = 3.87), high perceived usefulness (M = 3.59), substantial perceived ease of use (M = 3.75), favorable attitudes towards adopting digital health services (M = 3.31), and significant eWOM (M = 3.62). Cronbach’s Alpha values varied from 0.870 (for intention) to 0.937 (for perceived usefulness), all surpassing the 0.7 threshold recommended by Hair et al. (2013).

Note: Perceived usefulness (PU), Perceived ease of use (PE), Attitude (AT), Electronic word of mouth (eWOM).
Table 3: Mean, cronbach’s alpha, kurtosis, and skewness
Source: Authors

To assess normality, skewness and kurtosis were calculated for each construct (see Table 3). Skewness values for all constructs were within ±2, and kurtosis values were within ±7, indicating that the normality condition was satisfied, allowing for multiple regression analysis (Mouloudj et al. 2013).

4.2 Hypotheses testing

To evaluate multicollinearity, the „variance inflation factor“ (VIF) and tolerance levels were computed (see Table 4). All VIFs were below the recommended maximum of 5, and tolerance exceeded the recommended minimum of 0.2 (Hair et al. 2013), suggesting no multicollinearity issues.

Table 4: Regression analysis for intentions to adopt digital health services
Source: Authors

Table 4 summarizes the results of the extended TAM model, revealing that perceived usefulness (β = 0.161, p < 0.01), perceived ease of use (β = 0.321, p < 0.001), attitude (β = 0.255, p < 0.001), and eWOM (β = 0.181, p < 0.01) all have a positive and significant impact on customers’ intentions to adopt digital health services. This supports hypotheses H1, H2, H3, and H4.
The R2 value for the extended TAM model was 0.671, which means that the four factors-perceived usefulness, perceived ease of use, attitudes, and eWOM – accounted for 67.10% of the variation in predicting customers’ intentions to adopt digital health services. Moreover, perceived ease of use emerged as the strongest predictor of behavioral intentions, followed by positive attitudes towards the use of digital health services.
Extending the TAM proves highly feasible, as demonstrated by the results of the multiple regression analysis. The significant positive effects of all constructs on customers’ intentions to adopt digital health services highlight the model’s robustness when supplemented with additional constructs. Furthermore, the data show that attitudes and eWOM are the second and third most influential predictors, respectively, underscoring the extended model’s effectiveness in capturing key antecedents of technology acceptance in digital health. The strong support for the hypotheses suggests that incorporating these constructs enhances the model’s explanatory power in predicting customer adoption behaviors. This underscores the importance of expanding TAM with additional factors, making it a more comprehensive tool for investigating and predicting technology acceptance in digital health environments.

4.3 Discussion

The results indicate that perceived usefulness significantly influences customers’ intentions to adopt digital health services in Algeria. This finding aligns with existing research on the TAM, which consistently highlights perceived usefulness as a crucial determinant of technology adoption. For instance, Davis’s foundational studies (1989) and subsequent research by Venkatesh and Davis (2000) underscore that perceived usefulness drives users’ acceptance and utilization of technology. In the context of digital health, the positive effect of perceived usefulness suggests that customers are more likely to adopt these services when they believe that the technology will enhance their health management or provide tangible benefits (Ahmad et al. 2020; Kim et al. 2023; Zin et al. 2023). Comparatively, this result corroborates similar findings in different geographic and cultural settings, such as the studies by Almazroi et al. (2022), Edo et al. (2023), Jokisch et al. (2022), Katsaliaki (2024), and Tsai et al. (2019), which demonstrate that perceived usefulness significantly impacts the adoption of health technologies. However, the specific context of Algeria introduces unique cultural and systemic factors that may further influence this relationship. For example, while perceived usefulness is a strong predictor universally, the level of perceived usefulness might be shaped by personal factors such as „privacy concerns and self-efficacy“ (Jokisch et al. 2022), and/or regional factors such as healthcare infrastructure, digital literacy, and local health needs. This suggests that while the core relationship between perceived usefulness and adoption intention remains robust, local contextual factors may modulate its impact. In addition, this relationship suggests that enhancing the perceived usefulness of digital health services can effectively drive higher adoption rates, making it a crucial focus for developers and healthcare providers aiming to encourage widespread use of digital health innovations.
Moreover, the findings demonstrate that perceived ease of use positively impacts customers’ intentions to adopt digital health services in Algeria. This supports the TAM, where perceived ease of use is recognized as a significant predictor of technology acceptance. According to Davis (1989) and Venkatesh and Bala (2008), ease of use contributes to a user’s willingness to embrace new technologies, as it lowers the perceived effort and complexity associated with their use. This result is consistent with prior studies that highlight the importance of perceived ease of use in technology adoption and intention to continue using it (Ahmad et al. 2020). For instance, research by Katsaliaki (2024) and Zhou et al. (2019) demonstrates that when customers find technology easy to use, their likelihood of adoption increases. In the context of digital health services in Algeria, this finding suggests that customers are more inclined to adopt these services if they perceive them as user-friendly and straightforward to navigate (Mouloudj et al. 2023). However, the impact of perceived ease of use might be influenced by Algeria’s specific socio-cultural and technological environment. Compared to more technologically advanced regions, users in Algeria might place a higher value on ease of use due to varying levels of digital literacy and access to technology. This highlights the necessity of designing digital health services that are intuitive and accessible, particularly in regions with diverse levels of technological familiarity. In this context, by focusing on enhancing the ease of use, developers can reduce user resistance and facilitate higher adoption rates, ultimately contributing to the broader acceptance of digital health technologies.
In addition, the findings indicate that attitude toward adoption has a positive effect on customers’ intentions to adopt digital health services in Algeria. This result reinforces the extended TAM, which incorporates attitude as a critical mediator between perceived attributes of technology and actual adoption behavior (Davis 1989). The positive relationship between attitude and adoption intentions is consistent with the work of Bouarar et al. (2023), who assert that attitudes shape behavioral intentions by „reflecting an individual’s favorable or unfavorable evaluation of a behavior“. This finding also aligns with studies such as those by Al-Sulimani and Bouaguel (2024), Ghaddar et al. (2020), Kim et al. (2023), Tsai et al. (2019), and Zin et al. (2023), which highlight that a positive attitude towards technology is a significant predictor of adoption. Ghaddar et al. (2020) emphasize that increasing awareness of digital health technology and enhancing eHealth literacy are crucial for cultivating favorable attitudes towards telehealth and boosting its adoption. In the Algerian context, where digital health services are relatively new, a favorable attitude likely plays a crucial role in overcoming initial resistance and fostering acceptance (Mouloudj et al. 2023). This suggests that efforts to improve the public perception of digital health services-through awareness campaigns, positive user experiences, and demonstrating benefits-could enhance overall adoption rates. However, this effect might vary depending on cultural and social factors unique to Algeria. For example, societal attitudes toward technology and healthcare might influence how attitudes towards digital health services are formed. Understanding these contextual factors can provide deeper insights into how attitudes towards adoption are shaped in specific regions. Safi et al. (2019) suggest that understanding potential users’ attitudes toward these technologies is crucial for their eventual success in the market. In this context, by fostering a positive attitude through clear communication of benefits and addressing potential concerns, stakeholders can enhance users’ willingness to integrate digital health services into their lives, thereby promoting wider acceptance and utilization of these innovative tools.
Lastly, the findings reveal that eWOM has a positive effect on customers’ intentions to adopt digital health services in Algeria. This outcome highlights the significant role of social influence and online recommendations in shaping adoption behaviors (Akdim 2021; Ngo et al. 2024; Zulkiffli et al. 2022), aligning with established research on the impact of eWOM in technology adoption. Studies such as those by Cheung and Thadani (2012), Ismagilova et al. (2020), Kim et al. (2018), and Xiao et al. (2022) demonstrate that eWOM can effectively enhance customers’ perceptions of technology by providing credible, user-generated information that influences attitudes and behaviors. In the context of digital health services in Algeria, the positive influence of eWOM suggests that recommendations, reviews, and shared experiences on digital platforms significantly affect potential users’ intentions to adopt these services. This is particularly relevant in a market where direct experiences with the technology might be limited, and individuals often rely on peer opinions and online reviews to gauge its effectiveness and reliability. Comparatively, while the role of eWOM is well-documented globally (Abubakar and Ilkan 2016), its impact in Algeria might be influenced by the local digital landscape and social media usage patterns. Given the increasing penetration of internet access and social media in Algeria, eWOM could be a powerful tool for spreading information and fostering trust in digital health services. However, the effect of eWOM might also be moderated by factors such as the message credibility (Koo 2016); as well as review popularity and reviewer reputation on social networking sites (Shan et al. 2024).

5 Conclusion

This study highlights the essential factors influencing customers’ intentions to adopt digital health services in Algeria, revealing that perceived usefulness, perceived ease of use, attitude, and eWOM all significantly impact adoption intentions. The results underscore the importance of enhancing the perceived benefits and user-friendliness of digital health services, as well as cultivating positive attitudes and demonstrating clear value to drive adoption. Additionally, eWOM emerges as a crucial element, indicating that user experiences and recommendations are significant in shaping the perceptions of potential adopters. From a theoretical perspective, this study extends the TAM by integrating eWOM into the adoption framework for digital health services. By doing so, it provides a more comprehensive understanding of the factors that influence adoption intentions in this specific context. Practically, the findings offer valuable implications for digital health service providers, policymakers, and technology developers. Service providers can leverage these insights to enhance their offerings by focusing on improving the perceived usefulness and ease of use of their digital platforms. Additionally, fostering positive user attitudes and clearly demonstrating the value of digital health services can further drive adoption. Given the significant role of eWOM, providers should also consider strategies to encourage and manage positive user reviews and testimonials, as these can significantly influence potential users’ perceptions. Policymakers and technology developers can use these findings to tailor their strategies and interventions, ensuring that digital health services meet the needs and expectations of the target population, thereby facilitating greater adoption and utilization.

5.1 Practical implications

For digital health service providers and policymakers in Algeria, the study offers several actionable insights. To enhance adoption rates, it is crucial to focus on improving the perceived usefulness and ease of use of digital health solutions. Providers should prioritize user-friendly designs and clearly communicate the tangible benefits of their services to potential users. Cultivating positive attitudes towards digital health through educational initiatives and user engagement can further support adoption. Additionally, leveraging eWOM by encouraging satisfied users to share their experiences and managing online reputations effectively can amplify positive perceptions and influence others. Policymakers can facilitate this process by developing supportive regulations and infrastructure to address barriers and promote the integration of digital health solutions.

5.2 Limitations and future research

While this study offers valuable insights into the factors influencing customers’ intentions to adopt digital health services in Algeria, several limitations must be acknowledged. First, the sample size of 132 respondents may not fully capture the diversity of perspectives across different demographics and regions. As the sample is convenience-based, it may not be representative of the broader population, potentially limiting the generalizability of the findings. Second, the study focuses solely on perceptions related to usefulness, ease of use, attitude, and eWOM, without accounting for other potentially significant variables. Therefore, future research should consider incorporating additional variables such as customer confidence and prior experience with digital health services. These factors could provide a more comprehensive understanding of adoption intentions and potentially reveal new insights into user decision-making processes. Third, future research could delve into how contextual elements, such as healthcare infrastructure and socioeconomic conditions, interact with perceived usefulness and ease of use to influence the adoption of digital health services. Understanding these interactions could provide deeper insights into how contextual factors shape user perceptions and decisions. Fourth, future studies should examine how cultural perceptions and societal norms impact attitudes toward digital health services. By understanding these influences, researchers can better grasp how cultural factors shape adoption intentions and identify strategies to address potential cultural barriers. Lastly, further exploration of different dimensions of eWOM, such as source credibility and content quality, could reveal how these aspects affect adoption intentions in the digital healthcare context. This research could help identify which eWOM characteristics are most influential in shaping user attitudes and behaviors.

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Kľúčové slová/Key words

technology adoption, digital health, digital marketing, electronic word-of-mouth, Algeria
prijatie technológií, digitálne zdravie, digitálny marketing, elektronické ústne podanie, Alžírsko

JEL klasifikácia/JEL Classification

I15, M31

Résumé

Zámery zákazníkov prijať digitálne zdravotnícke služby: Rozšírený TAM
Táto štúdia skúma faktory ovplyvňujúce zámery zákazníkov prijať digitálne zdravotnícke služby v Alžírsku so zameraním na rozšírený model akceptácie technológií (TAM). Vzhľadom na rastúci význam digitálnych zdravotníckych riešení pri zvyšovaní dostupnosti a efektívnosti zdravotnej starostlivosti je kľúčové pochopenie determinantov prijatia. Na základe pohodlnej vzorky 132 respondentov a 18-položkového dotazníka sa vo výskume využíva viacnásobná regresná analýza na preskúmanie vplyvu vnímanej užitočnosti, vnímanej jednoduchosti používania, postoja a elektronického ústneho podania (eWOM) na zámery prijatia. Zo zistení vyplýva, že všetky štyri faktory významne ovplyvňujú zámery zákazníkov prijať digitálne zdravotnícke služby. Konkrétne, vnímaná užitočnosť a vysoká vnímaná jednoduchosť používania spolu s pozitívnymi postojmi a priaznivými eWOM sú rozhodujúce pri formovaní rozhodnutí o prijatí. Táto štúdia prispieva k literatúre tým, že poskytuje empirické dôkazy o faktoroch, ktoré podmieňujú prijatie digitálneho zdravotníctva v alžírskom kontexte a ponúka cenné poznatky pre tvorcov politík a poskytovateľov služieb na zlepšenie stratégií digitálneho zdravotníctva a účinné riešenie prekonávania prekážok.

Recenzované/Reviewed

10. November 2024 / 15. November 2024