Exploring people's intentions to use the health passbook in self-management: An extension of the technology acceptance and health behavior theoretical perspectives in health literacy

A health passbook is a personal health information system that provides people with access to their medical records, gives them their right to know this information, and makes the management of their own health status more convenient. However, the literature related to people's behavior in terms of using personal health information systems is scant. This study proposes an integrated research model to explain people's intentions to use a health passbook from the perspectives of health behavior, technology acceptance, and health literacy. The sample includes people over the age of 20 who have national health insurance (NHI). The results show that people's intentions to use the health passbook are positively related to perceived susceptibility, perceived barriers, self-efficacy, cues to action, perceived usefulness (PU), perceived ease of use (PEOU), and health literacy; their intentions to use are negatively related to perceived barriers and rewards for maladaptive behavior. Furthermore, PEOU is positively related to PU, while health literacy has been found to have a positive effect on self-efficacy, PEOU, and PU. The results provide the basis for a model of health technology acceptance that can serve as the starting point for future research in this relatively unexplored, yet potentially fertile, area of research.