FACTORS ASSOCIATED WITH ACCEPTANCE AND USE OF MOBILE TECHNOLOGY FOR HEALTH SELF-MONITORING AND DECISION SUPPORT IN LUNG TRANSPLANT RECIPIENTS

Objectives. This cross-sectional study in lung transplant recipients (LTR) described acceptance and use of a smartphone application, Pocket PATH®, for health self-monitoring and decision support for reporting critical values in 12 months post-transplantation; and explored predictors of use and reporting.\ud Methods. This secondary analysis, guided by the Unified Theory of Acceptance and Use of Technology, included 96 LTR randomly assigned to the Pocket PATH group. Intention to use was measured at baseline. Due to skewness, use (percentage of days used) in 0 to 2, > 2 to ≤ 6, > 6 to ≤ 12, and 0 to 12 months was categorized as Low, Moderate, and High, using 25% and 75% as cutoffs. Reporting critical values was dichotomized as 100% and < 100% reporting. Descriptive statistics were used to summarize data and logistic regressions were employed to explore predictors of use and reporting.\ud Results. About 85% of LTR were very likely to use Pocket PATH. However, intention was not associated with use. Use decreased across four time intervals. Self-care agency interacted with gender (OR=0.94, p=0.04) and satisfaction with technology training (OR=0.93, p=0.02) in 0 to 2 months. Use from > 2 to ≤ 6 months was predicted by satisfaction with technology training (OR=3.00, p=0.03), and age interacted with psychological distress (OR=0.96, p=0.04). Use after 6 months was predicted by psychological distress (OR=0.42, p=0.04) and physical function (OR=1.07, p=0.04). Use from 0 to 12 months was predicted by age (OR=1.05, p=0.03), satisfaction with technology training (OR=2.78, p=0.05) and physical function (OR=1.09, p=0.03). Among 53 (55.2%) LTR with critical values detected, 62.3% (n=33) had 100% reporting. With increased technology experience, odds of 100% reporting decreased in men but increased in women (OR=0.21, p=0.03). LTR whose income met basic needs (OR=0.01, p=0.02), or with longer hospital stay (OR=0.94, p=0.01), were less likely to have 100% reporting. Moderate use group was less likely to report than High (OR=0.11, p=0.02) and Low (OR=0.04, p=0.02) use groups.\ud Conclusion. Use of mobile technology for health self-monitoring and for reporting critical values was predicted by different factors. Clinicians should assess LTR at risk for poor use and reporting.\u