Table_1_Factors Influencing the Acceptance of Pediatric Telemedicine Services in China: A Cross-Sectional Study.docx

Background: Pediatrician workforce shortages have aroused great attention from health authorities in China. Telemedicine services have been known to enhance the management of children's health, yet the rate of adoption and usage in Chinese hospitals still at a quite low level, and the factors influencing the acceptance of telemedicine services remains unclear.
Objective: The purpose of this empirical study was to evaluate the reliability and validity of a technology acceptance measurement instrument applied in healthcare, to investigate the perception of telemedicine services on the provider-side and demand-side, and to determine the factors that may drive individuals to adopt telemedicine services.
Methods: A cross-sectional survey study based at Shanghai Children's Hospital, Shanghai Jiao Tong University, was conducted in March 2020. A total of 456 valid responses were obtained by convenience sampling. The internal consistency of items was assessed by Cronbach's alpha (α), composite reliability (CR) and average variance extracted (AVE) to evaluate both the reliability and validity of the questionnaire. Structural equation modeling analysis was used to test and verify the interrelationships among relevant variables.
Results: Price value is the strongest predictor (β = 0.30, p = 0.02), facilitating conditions (β = 0.28, p = 0.01) and hedonic motivation (β = 0.13, p = 0.04) also have significantly positive direct effects on telemedicine acceptance. The results showed the perception of child patients' families were significantly more acceptable to telemedicine services than pediatricians (t = −2.99, p < 0.01). Participants with no prior experience and lower education may be more willing to adopt telemedicine.
Conclusion: Telemedicine will likely continue to have an integral role in pediatric health care delivery, and the findings can assist policy makers and hospital administrators in determining the more valued characteristics of telemedicine services from a behavioral perspective. Future attention will be paid to the pricing, training and service quality of telemedicine in China.

背景：中国儿科医师人力短缺问题已引发国内卫生主管部门的高度关注。远程医疗（Telemedicine）服务已被证实可优化儿童健康管理，但我国医院的远程医疗服务采纳率与使用率仍处于较低水平，且影响其接受度的相关因素尚不明确。
研究目的：本实证研究旨在评估一款应用于医疗领域的技术接受度量表的信度与效度，分别从服务提供方与需求方视角调研其对远程医疗服务的认知，并明确推动个体采纳远程医疗服务的影响因素。
研究方法：本研究于2020年3月在上海交通大学附属儿童医院开展横断面调查，通过便利抽样法共回收有效应答456份。本研究采用克朗巴哈α系数（Cronbach's alpha）、组合信度（Composite Reliability, CR）与平均方差提取量（Average Variance Extracted, AVE）评估量表题项的内部一致性，以此检验问卷的信度与效度；并通过结构方程模型分析相关变量间的相互关系并予以验证。
研究结果：价格价值感知是最强的预测因子（β=0.30，p=0.02），促进条件（β=0.28，p=0.01）与享乐动机（β=0.13，p=0.04）同样对远程医疗服务接受度存在显著的正向直接影响。研究结果显示，儿童患者家属对远程医疗服务的接受度显著高于儿科医师（t=-2.99，p<0.01）；无既往使用经验且受教育程度较低的研究对象，其采纳远程医疗服务的意愿更强。
研究结论：远程医疗在儿童健康照护体系中仍将占据不可或缺的重要地位，本研究结果可帮助政策制定者与医院管理者从行为视角明确远程医疗服务的核心价值属性。未来我国将重点关注远程医疗服务的定价、人员培训与服务质量优化。