Date of Award

January 2024

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Zhao Ni

Abstract

Background: Cardiovascular diseases (CVD) are the leading cause of mortality globally, particularly in China's aging population. Mobile health (mHealth) technologies offer a promising avenue to address healthcare disparities and enhance CVD management among the elderly. This study aims to explore the acceptance of mHealth in improving self-management of CVD among older adults in China, focusing on its potential to mitigate accessibility and treatment challenges.

Methods: This cross-sectional study was conducted at the Xinhua Hospital of Shanghai Jiao Tong University. Data were collected using an online Qualtrics questionnaire from 225 participants who met inclusion criteria including being Chinese speakers, diagnosed with cardiovascular diseases (CVD), and prescribed cardio-protective medications. Independent variables included age, education, prior telehealth experience, self-efficacy, and self-management, while the primary dependent variable was mHealth acceptance, measured via perceived usefulness. Statistical analyses, including bivariate and multivariate linear regression tests and multinomial logistical regression, were conducted using R software.

Results: Participants’ demographics showed an average age of 60.43 years with 57% under 65 years old, a sex distribution of 60.89% males, with 47.11% in high/associate school. Among the participants, over 40% reported a family history of CVD with only 24.44% having used telehealth services before. Multivariate regression analyses revealed that higher self-efficacy was significantly associated with increased mHealth acceptance, whereas factors like age, educational level, previous telehealth usage, and self-management did not show significant impacts. Sex did not significantly modify the effects of other variables on mHealth acceptance, but further detailed assessments revealed that while self-efficacy significantly boosts mHealth acceptance for both sex groups, its impact is more pronounced in males, enhancing both moderate and high levels of acceptance.

Conclusion: The study indicates that self-efficacy is a significant determinant of mHealth application acceptance among Chinese patients with CVD, underscoring the pivotal role of self-management confidence in the adoption of healthcare technology. This study also highlights the necessity for sex-specific strategies in health policy, advocating for interventions that tailor mHealth education and accessibility to effectively address the unique needs and acceptance patterns of older adults in managing CVD.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 05/07/2026

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