A mHealth adoption model for diabetes self-management: patient-centered insights from UNRWA clinics

Abstract

This study develops and validates a mobile health (mHealth) adoption model to enhance diabetes self-management among type 2 diabetes mellitus (T2DM) patients in UNRWA primary healthcare clinics across Palestinian refugee camps. This study fills a gap in research on mHealth adoption in low-resource settings by combining the technology acceptance model (TAM), task-technology fit (TTF), and self-efficacy theory (SET). A descriptive, cross-sectional design was employed using a structured, validated questionnaire administered to 503 T2DM patients. Reliability analysis yielded high internal consistency (Cronbach’s α = 0.808–0.966). Structural equation modeling (SEM) using SPSS and AMOS validated the model fit, evidenced by a comparative fit index (CFI) of 0.941 and a root mean square error of approximation (RMSEA) of 0.048. Out of the eleven factors that were examined, Perceived Usefulness had the most positive impact on self-care management (β = 0.67, p < 0.001), while Task Requirement had the least. Notably, Perceived Self-Efficacy showed no significant effect on behavior (p > 0.05). These findings highlight usability, usefulness, and tool functionality as central to promoting mHealth use. The validated model can be modified for other chronic disease settings in comparable healthcare environments and provides practical advice for creating patient-centered mHealth interventions.