Physicians' Perceptions as Predictors of the Future Use of the National Death Information System in Peru: Cross-sectional Study.

BACKGROUND: A computer application called the National Death Information System (SINADEF) was implemented in Peru so that physicians can prepare death certificates in electronic format and the information is available online. In 2018, only half of the estimated deaths in Peru were certified using SINADEF. When a death is certified in paper format, the probability being entered in the mortality database decreases. It is important to know, from the user's perspective, the factors that can influence the successful implementation of SINADEF. SINADEF can only be successfully implemented if it is known whether physicians believe that it is useful and easy to operate. OBJECTIVE: The aim of this study was to identify the perceptions of physicians and other factors as predictors of their behavioral intention to use SINADEF to certify a death. METHODS: This study had an observational, cross-sectional design. A survey was provided to physicians working in Peru, who used SINADEF to certify a death for a period of 12 months, starting in November 2019. A questionnaire was adapted based on the Technology Acceptance Model. The questions measured the dimensions of subjective norm, image, job relevance, output quality, demonstrability of results, perceived usefulness, perceived ease of use, and behavioral intention to use. Chi-square and logistic regression tests were used in the analysis, and a confidence level of 95% was chosen to support a significant association. RESULTS: In this study, 272 physicians responded to the survey; 184 (67.6%) were men and the average age was 45.3 (SD 10.1) years. The age range was 24 to 73 years. In the bivariate analysis, the intention to use SINADEF was found to be associated with (1) perceived usefulness, expressed as "using SINADEF avoids falsifying a death certificate" (P<.001), "using SINADEF reduces the risk of errors" (P<.001), and "using SINADEF allows for filling out a certificate in less time" (P<.001); and (2) perceived ease of use, expressed as "I think SINADEF is easy to use" (P<.001). In the logistic regression, perceived usefulness (odds ratio [OR] 8.5, 95% CI 2.2-32.3; P=.002), perceived ease of use (OR 10.1, 95% CI 2.4-41.8; P=.001), and training in filling out death certificates (OR 8.3, 95% CI 1.6-42.8; P=.01) were found to be predictors of the behavioral intention to use SINADEF. CONCLUSIONS: The behavioral intention to use SINADEF was related to the perception that it is an easy-to-use system, the belief that it improves the performance of physicians in carrying out the task at hand, and with training in filling out death certificates.

Comparison of students' use and acceptance of emergency online learning due to COVID-19 in the USA, Mexico, Peru, and Turkey.

Due to the COVID-19 pandemic, and pursuant to the governments' order of citizens remaining at home, several countries were required to transition from face-to-face instruction to an online model to provide higher education to their students. While factors affecting the use of online learning are diverse and have been studied by models of use and acceptance of technology, this cross-sectional study explores the factors unique to the current emergency situation that influence students' use and acceptance of emergency online learning. Moreover, it proposes a model to predict a student's cognitive engagement in Mexico, Peru, Turkey, and the USA. This is a quantitative study with an exploratory and descriptive scope and cross-sectional design. Data was collected from 1009 students from the four countries, who completed surveys anonymously. The factors analyzed were attitude, affect, and motivation, perceived behavioral control (ease of use, self-efficacy, and accessibility), and cognitive engagement. The data was analyzed using descriptive, correlation, and regression analysis. The predictive model shows that students' attitude toward online learning impacts their cognitive engagement in Mexico, Peru, and the USA. Furthermore, self-efficacy is a significant moderator for cognitive engagement in all four countries. The model also shows that each country has different determinants for cognitive engagement. Understanding the factors that affect the use of emergency online learning is essential for the success and/or achievement of its maximum benefits in situations like a global pandemic. Limitations of this study have been identified as use of convenience sampling, and an inability to explore factors related to instruction and system attributes. Professors who did not teach online learning lacked knowledge about online educational strategies and used the technological resources that were immediately available to them. Therefore, research that explores the use of instructional strategies and the use of technological systems during emergency online learning is necessary. This study includes suggestions to incorporate open educational resources that use microlearning and emphasizes the importance of student self-efficacy; because it was predictor of cognitive engagement in all four countries. Faculty and higher education institutions can and should develop strategies to increase students' sense of self-efficacy.

Proposing a TAM-SDT-Based Model to Examine the User Acceptance of Massively Multiplayer Online Games.

This study is focused on the massively multiplayer online games' acceptance. In general, while specialized literature reveals that the online gaming industry has grown strongly in recent years, little evidence is identified on its user acceptance. In this manner, the present study is an attempt to fill this gap. Concretely, two aims are defined: (1) proposing an acceptance model to predict the continuance usage of massively multiplayer online games, and (2) knowing how this continuance usage encourages social well-being. The model proposed employing the structural equation modeling with partial least squares (PLS-SEM) methodology. This PLS-SEM model has been defined using a combination of the technology acceptance model (TAM) and the self-determination theory (SDT), comprising eight constructs: (1) autonomy and competence, (2) relatedness, (3) achievement and challenge, (4) flow experience, (5) perceived enjoyment, (6) social well-being, (7) perceived ease of use, and (8) continuance intention. The findings reveal that continuance intention impacts on social well-being. Moreover, the pivotal role of flow experience for continuance intention has been demonstrated. Additionally, continuance intention has been impacted by the perceived enjoyment, showing that it is a key construct for the acceptance of massively multiplayer online games. Thus, two contributions are highlighted. First, these results provide the gaming industry and software developer companies with considerations on gamers' motivations in the online game design, in order to stimulate and incentivize its use. Second, the present study can be useful for academicians and practitioners to understand the online gamers' emotions and well-being, showing some light over their psychology and mental health. Finally, limitations and future directions are exposed.

Assessing the telemedicine acceptance for adults in Brazil.

PURPOSE: This study aimed to find factors influencing the acceptance of telemedicine for adults in Brazil. Moreover, it investigates the moderating role of disease complexity and the generational digital divide phenomenon on the intention to use the telemedicine service. DESIGN/METHODOLOGY/APPROACH: A quasi-experiment was employed. Primary data were collected using a survey research method considering two different scenarios based on disease complexity and symptom severity. A total of 248 responses were collected using a structured questionnaire. The authors also tested these two scenarios in three generations (X, Y and Z) of adults. Partial least squares structural equation modeling (PLS-SEM) was used to analyze the collected data and test the research hypotheses. FINDINGS: The results indicated that performance expectancy and perceived security and reliability are two predictors of the behavioral intention to use telemedicine, whereas effort expectancy and social influence showed no statistical significance. Furthermore, the results demonstrated that adults tend to adopt telemedicine regardless of the level of disease complexity. Finally, this study does not support the existence of a digital divide in the three generations. ORIGINALITY/VALUE: The study applies the UTAUT model to assess the telemedicine acceptance for younger generations. It examines patient risk perception (security and reliability) as one antecedent of telemedicine acceptance.