Determinants of Behavioral Intention to Use Digital Healthcare Services: A Cross‐Sectional PLS‐SEM Study on the Shukhee App in Bangladesh

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Background and Aims: The rapid proliferation of digital technologies in the healthcare system has made digital health services indispensable for enhancing access, efficiency, and patient engagement. Digital healthcare, such as the Shukhee app, has become prominent; however, the factors influencing users' behavioral intention to adopt it have not been studied extensively. This paper aims to examine the important variables that determine the behavioral intention to use digital health services with specific focus on the mediating effect of e-health literacy. Methods: This paper adopts the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) to determine the factors that affect the behavioral intention to use digital health services, with a specific focus on the mediating effect of e-health literacy. A total of 417 digital health service user or were familiar with the services within the past year were chosen in this study. Data were analyzed using partial least squares-based structural equation modeling (PLS-SEM) with SmartPLS 4.1. Results: The findings show that perceived trust, social influence, performance expectancy, facilitating conditions, effort expectancy, and e-health literacy significantly predicted behavioral intention. E-health literacy also mediates the impact of critical predictors like trust, social influence, and performance expectancy, while not showing significant mediation for perceived ease of use, perceived usefulness, effort expectancy, or facilitating conditions. Conclusion: The intention to use digital healthcare services is influenced by technology-related perceptions, as well as trust, social context, and digital health competencies of users. The results highlight that enhancing trust, empowering social support, and promoting e-health literacy can be particularly significant for Bangladesh and other settings in improving the uptake of digital healthcare platforms.

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