Mobile health applications (MHAs) have been widely used by community health workers (CHWs) in primary care to facilitate their workflow, but the continuance of these applications by CHWs remains inadequate. This article employs expectation confirmation theory as the overarching theory, complemented by the information system success model and the consumer expectations model, to propose a research model aimed at examining the factors influencing CHWs’ MHA continuance. To validate this research model, a survey was conducted involving 459 CHWs who used MHAs. The analysis results confirm many hypothetical relationships within the research model. First, we propose an extended expectation confirmation model remedying deficiency of the expectation confirmation theory. Second, this study uncovers an inverted U-shaped relationship between CHWs’ expectations and expectation confirmation. Third, we study continuance from a novel perspective – that of CHWs. Fourth, we reveal one boundary condition of our research model by considering the moderating role of health institution type. In addition, practical implications for both policymakers in healthcare systems and MHA providers are delivered.

中文翻译：

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社区卫生工作者持续使用移动医疗应用：扩展的期望确认模型


移动医疗应用程序 (MHA) 已被社区卫生工作者 (CHW) 在初级保健中广泛使用，以促进他们的工作流程，但社区卫生工作者对这些应用程序的持续使用仍然不够。本文以期望确认理论为总体理论，辅以信息系统成功模型和消费者期望模型，提出了一个旨在检验社区卫生工作者MHA持续性影响因素的研究模型。为了验证这一研究模型，我们对 459 名使用 MHA 的社区卫生工作者进行了一项调查。分析结果证实了研究模型中的许多假设关系。首先，我们提出了一种扩展的期望确认模型，弥补了期望确认理论的缺陷。其次，本研究揭示了社区卫生工作者的期望与期望确认之间的倒 U 形关系。第三，我们从一个新颖的角度——社区卫生工作者的角度——研究延续性。第四，我们通过考虑卫生机构类型的调节作用揭示了我们研究模型的一个边界条件。此外，还对医疗保健系统的政策制定者和 MHA 提供者产生了实际影响。