The role of perceived e-health literacy in users' continuance intention to use mobile healthcare applications: an exploratory empirical study in China

In recent years, mobile healthcare applications (MHAs) have boomed, providing several new kinds of health services and methods of information transmission. However, MHA vendors face a significant challenge in attracting users to adopt software continuously. Some recent studies recognized users' perceived e-health literacy (PEHL) as a critical factor in continuance intention, but its influence was still unclear. In this paper, based on the elaboration likelihood model (ELM), we investigated how the users' PEHL affects their continuance intention when adopting MHAs. We distributed convenience sample questionnaires by Wechat (similar to WhatsApp) in China, where hundreds of MHAs can be downloaded, and 273 valid samples were collected. The result shows that ELM works well in this model, with six of the eight hypotheses supported. The moderating effect of PEHL is largely significant for the peripheral route but not significant for the central route. The most interesting finding is that, with regard to continuance adoption, PEHL has a positive relationship with users' satisfaction. Possible reasons are discussed, such as there could be a moderator on this relationship. Limitations, future studies and implications for theory, practice and policy are also given.