A Gender Perspective on the Adoption of Internet Communication With t...

Background:Internet communication with the general practitioner (GP) is likely to become more important in the future. From the patients' point of view, it is a convenient way to get in contact with the physician and it has many advantages.In this light, it is interesting to look at theories providing antecedents of the patients' adoption of Internet communication with the GP and to investigate the role of gender in this adoption process.

Objective: This study compares adoption of Internet communication with the GP between men and women. Variables were derived from the technology acceptance model (TAM) and the theory of planned behaviour (TPB). The study proposes a causal model consisting of different antecedents of behavioural intention (BI) to use Internet communication with the GP and the impact on actual use (use).Furthermore, the model includes future intention to use the Internet for treatment purposes (e.g. acute disorders, (future intention treatment)) as wellas for administrative purposes (e.g. prescription of receipts (future intentionadministrative purpose)). Two additional antecedents beyond TAM and TPB were added: feelings toward the Internet and personal disposition of a patient in terms of information seeking behaviour. Moderating effects of gender are posited for the constructs relationships.

Methods: The model is tested by an empirical online survey of 1006 randomly selected German patients. The sample was drawn from an e-panel maintained by GfK HealthCare. It was based on a randomly generated set of users, who had visited a general practitioner at least once in the three months prior to the beginning of the survey. Data were checked and missing values were imputed with SPSS. 958 usable questionnaires were analysed by using structural equation modelling calculated with AMOS (version 20.0).

Results: The model fits the data reasonably well. Global fit measures were acceptable. Local fit measures (indicator reliability, factor reliability,average variance extracted) as well as discriminant validity were also acceptable. The proposed model was largely confirmed. For both of the groups (males, females) there was a significant path from the antecedents attitude toward the Web 2.0 as source for health related information and perceived ease of use to BI. A significant path led further to use and future intention administrative purpose. Information seeking personality facets had a significant impact for men and women on all of four endogenous variables (BI,use, future intention treatment, future intention administrative purpose).Gender moderates the path from subjective norm (derived from TAM) to BI in such a way that SN has a significant impact on BI only for women. There is a significant path from BI to future intention treatment only for women and a lack of impact from use to future intention administrative purpose only for women. However, some results differed from expecations, e.g. feelings toward the Internet had no significant impact on the endogenous constructs at all.

Conclusions: Attitude toward Web 2.0 for health related information, perceived ease of use and information seeking personality facets are the primary drivers that enhance the adoption of Internet communication with the GP. Subjective norms only have an influence on female patients. Actual use only has a significant impact on future intention administrative purpose for men. Results from this survey demonstrate that the adoption of Internet communication with the GP may be enhanced by different drivers that could be influenced by the GP(e.g. usability of the homepage and attitude), but a gender perspective should not be neglected.