Exploring the resistance to e-health services in Nigeria: an integrative model based upon the theory of planned behavior and stimulus-organism-response

Despite the evident advantages of electronic health services (eHS), there is a noticeable opposition to their acceptance, which has raised a crucial question about why people, particularly in developing nations, oppose the acceptance of eHS. This study was designed to obtain a comprehensive understanding of the factors that influence the rigid opposition to eHS by integrating two theoretical models: the Stimulus-Organism-Response theory and the Theory of Planned Behavior. In our detailed survey, 543 respondents over 18 years old from various regions of Nigeria participated. We evaluated the proposed model using partial least squares structural equation modeling (PLS-SEM). The findings indicated that lower health literacy was associated with a greater opposition to using eHS. In addition, communication and choice overload and perceived risk contributed to a negative attitude toward eHS. Subjective norms played a significant role in influencing the intention not to use eHS, which highlights social pressure's effect. Further, a greater perception of behavioral control reduced the intention not to use eHS. Ultimately, the intention not to use eHS affected eHS rejection behavior significantly, which makes resistance to it a substantial problem. This research unveils factors that contribute to this behavior and provides insights for policymakers in the health field, with the goal to improve people's acceptance of eHS. Further research is recommended in different geographical samples and contexts to gain a better understanding of the factors related to eHS rejection behavior.