Experimental study about the use intention of human-supported and self-help eHealth interventions: What is the role of user expectations? (Preprint)

BACKGROUND Self-help eHealth interventions do not require support from a human and could therefore lower the workload of healthcare professionals. However, there are concerns about the uptake of self-help interventions. User expectations about the lack of a relationship (working alliance) with a healthcare professional could hinder uptake. Furthermore, the Unified Theory of Acceptance and Use of Technology (UTAUT) identifies which expectations predict use intention. However, no studies have yet investigated how these expectations influence the uptake of self-help and human-supported eHealth interventions. OBJECTIVE This study investigated the intention to use a self-help eHealth intervention compared to a human-supported eHealth intervention, and the expectations that moderate this relationship. METHODS 146 participants were randomly assigned to one of the two conditions (human-supported or self-help). They evaluated screenshots of an human-supported or self-help app-based stress intervention. We measured intention to use the intervention, the UTAUT constructs performance expectancy, effort expectancy, and social influence, and expected working alliance. RESULTS Use intention did not differ significantly between the two conditions (P = .26). Performance expectancy, effort expectancy, social influence, and expected working alliance were positively related to use intention (P < .001, P = 0.049, P < .001, P < .001 respectively) regardless of condition. The interaction analysis showed that performance expectancy (P = .04), and effort expectancy (P = .045) more strongly influenced use intention in the self-help compared to the human-supported condition. CONCLUSIONS As we found no difference in use intention, our results suggest that we could expect an equal uptake of self-help eHealth interventions and human-supported ones. We should however pay attention to people who have doubts about the intervention’s helpfulness or easiness of use. For those people, additional human support would be beneficial to ensure uptake. Screening user expectations could help healthcare professionals optimize self-help eHealth intervention uptake in practice.