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Theories Informing eHealth Implementation: Systematic Review and Typology Classification
Milena Heinsch1,2, Jessica Wyllie3, Jamie Carlson3
1Centre for Brain and Mental Health Priority Research Centre, The University of Newcastle, Callaghan, Australia.
Journal of Medical Internet Research
|May 31, 2021
Summary
This systematic review found that most eHealth implementation theories focus on user acceptance, like the Technology Acceptance Model (TAM) and UTAUT. More complex sociotechnical theories are needed for sustainable digital health integration.
Area of Science:
- Implementation Science
- Digital Health (eHealth)
- Sociotechnical Change Theories
Background:
- Theory-guided approaches are crucial for eHealth intervention translation and adoption in clinical settings.
- Existing evidence is limited regarding the most effective theories for complex eHealth implementation challenges.
Purpose of the Study:
- To systematically identify theories used in eHealth implementation.
- To classify these theories using Sovacool and Hess's typology of sociotechnical change.
Main Methods:
- Conducted an electronic literature search across 10 databases (June 2019).
- Included peer-reviewed studies published between 2009-2019 reporting empirical research on eHealth implementation theories.
- Classified identified theories using a sociotechnical change typology.
Main Results:
- Identified 36 theories from 119 included studies.
- Technology Acceptance Model (TAM) and Unified Theory of Acceptance and Use of Technology (UTAUT) were most common (n=33, n=32).
- These focused on individual/interpersonal acceptance, with less emphasis on broader social/structural factors (e.g., Normalization Process Theory, Structuration Theory).
Conclusions:
- Current eHealth implementation theories primarily address end-user acceptance.
- Theories capturing complex sociotechnical dynamics are underrepresented.
- Future research should develop models reflecting the multidimensional, dynamic, and relational aspects of eHealth implementation.
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