Intention to use wearable health devices and its predictors among diabetes mellitus patients in Amhara region referral hospitals, Ethiopia: Using modified UTAUT-2 model

Introduction: The burden of diabetes mellitus is increasing in Africa. Wearables have a proven track record of combating chronic diseases. However, little is known about patients’ intentions to use such technologies in resource-limited settings. Therefore, this study aimed to assess DM patients' intentions to use wearable health devices and its predictors in Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 924 diabetes mellitus patients from May 19 to June 23, 2022, at referral hospitals in the Amhara regional state of Ethiopia. An interviewer-administered questionnaire was used to collect the data using the Kobo Collect app. A systematic random sampling technique was used to select the study participants. Descriptive statistics were done using SPSS version 25 software and presented using tables and pie charts. Structural equation modeling analysis with SPSS AMOS version 26 software was employed to identify predictors associated with the intention to use wearable health devices in Ethiopia. Results: A total of 883 diabetes mellitus patients, with a 95.56% response rate, participated in the study. The proportion of intention to use wearable health devices was 47.1%, 95% CI (43.7–50.5). Effort expectancy (β = 0.543, P < 0.01), performance expectancy (β = 0.306, P < 0.01), facilitating condition (β = 0.131, P < 0.05), and habit (β = 0.093, P < 0.05) had a positive direct relationship with intention to use wearable health devices. Age (β = 0.439, p < 0.001) was moderate performance expectancy, while gender (β = 0.780, p < 0.001) had moderate effort expectancy to the intention to use wearable health devices. Conclusions: Overall, diabetes mellitus patients’ intentions to use wearable health devices were promising. The intention to use wearables was positively related to effort expectancy, performance expectancy, facilitating conditions, and habit. Thus, increasing patient intention to utilize it could be achieved through capacity building, access to technology, and technical support. In addition, implementers should prioritize improving the availability of devices, patients' abilities, encouraging customers, to utilize the product on a regular basis by actively fostering their relationship with them, and create awareness about usefulness of wearable health devices