Methods Inf Med 2021; 60(01/02): 062-070
DOI: 10.1055/s-0041-1731389
Original Article

Development of an Instrument for Assessing the Maturity of Citizens for Consumer Health Informatics in Developing Countries: The Case of Chile, Ghana, and Kosovo

Abubakari Yakubu
1   Institute for Medical Informatics, Section of Medical Informatics, Heidelberg University, Heidelberg, Germany
2   Department of Operations, Postal and Courier Services Regulatory Commission, Accra, Ghana
Fortuna Paloji
1   Institute for Medical Informatics, Section of Medical Informatics, Heidelberg University, Heidelberg, Germany
Juan Pablo Guerrero Bonnet
1   Institute for Medical Informatics, Section of Medical Informatics, Heidelberg University, Heidelberg, Germany
3   Centro de Informática Médica Telemedicina, Facultad de medicina, Universidad de Chile, Chile
Thomas Wetter
1   Institute for Medical Informatics, Section of Medical Informatics, Heidelberg University, Heidelberg, Germany
4   Department of Biomedical, Informatics and Medical Education, University of Washington, Seattle, United States
› Author Affiliations


Objective We aimed to develop a survey instrument to assess the maturity level of consumer health informatics (ConsHI) in low-middle income countries (LMIC).

Methods We deduced items from unified theory of acceptance and use of technology (UTAUT), UTAUT2, patient activation measure (PAM), and ConsHI levels to constitute a pilot instrument. We proposed a total of 78 questions consisting of 14 demographic and 64 related maturity variables using an iterative process. We used a multistage convenient sampling approach to select 351 respondents from all three countries.

Results Our results supported the earlier assertion that mobile devices and technology are standard today than ever, thus confirming that mobile devices have become an essential part of human activities. We used the Wilcoxon Signed-Rank Test (WSRT) and item response theory (IRT) to reduce the ConsHI-related items from 64 to 43. The questionnaire consisted of 10 demographic questions and 43 ConsHI relevant questions on the maturity of citizens for ConsHI in LMIC. Also, the results supported some moderators such as age and gender. Additionally, more demographic items such as marital status, educational level, and location of respondents were validated using IRT and WSRT.

Conclusion We contend that this is the first composite instrument for assessing the maturity of citizens for ConsHI in LMIC. Specifically, it aggregates multiple theoretical models from information systems (UTAUT and UTAUT2) and health (PAM) and the ConsHI level.

Ethical Approval

The authors sought and obtained administrative ethics committee approvals from the appropriate authorities in all three countries (Chile, Ghana, and Kosovo). The impact of our methods is regarded as negligible according to human subject research ethics. Subsequently, the fact that an interviewee was a patient for a particular condition becoming known outside the treatment contract was controlled through subjects' anonymity by the researchers.

Publication History

Received: 20 January 2021

Accepted: 22 May 2021

Article published online:
08 July 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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