title: Consumers' intention to use health recommendation systems to receive personalized nutrition advice.
abstract: BACKGROUND
  Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment.
  
  
  METHODS
  204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses.
  
  
  RESULTS
  We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity.
  
  
  CONCLUSIONS
  We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to rely on endorsement by the medical sector. This has considerable implications for the distribution as well as the communication channels of health recommendation systems which may be quite difficult to put into practice outside traditional health service channels.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, P.O. Box 15683500BN, Utrecht, The Netherlands.
authors.forename: Sonja
authors.initials: S
authors.lastname: Wendel
authors.forename: Benedict G C
authors.initials: BG
authors.lastname: Dellaert
authors.forename: Amber
authors.initials: A
authors.lastname: Ronteltap
authors.forename: Hans C M
authors.initials: HC
authors.lastname: van Trijp
mesh_terms: D000293:Adolescent; D000328:Adult; D003258:Consumer Behavior; D054626:Consumer Health Information / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D003376:Counseling; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009426:Netherlands; D009751:Nutritional Requirements; D011795:Surveys and Questionnaires; D055815:Young Adult
references.citation: Am J Clin Nutr. 2003 Apr;77(4 Suppl):1028S-1034S
references.pmid: 12663313
references.citation: Br J Gen Pract. 2003 Oct;53(495):798-800
references.pmid: 14601357
references.citation: Am J Public Health. 2005 Oct;95(10):1825-31
references.pmid: 16186461
references.citation: Community Genet. 2004;7(1):33-43
references.pmid: 15475669
references.citation: New Genet Soc. 2010 Sep 1;29(3):261-290
references.pmid: 21076647
references.citation: Can J Diet Pract Res. 2008 Winter;69(4):177-82
references.pmid: 19063807
references.citation: Sci Technol Human Values. 2003 Summer;28(3):365-402
references.pmid: 16208885
references.citation: J Pers Soc Psychol. 1986 Dec;51(6):1173-82
references.pmid: 3806354
references.citation: Public Health Genomics. 2012;15(1):22-30
references.pmid: 21654153
references.citation: Health Educ Res. 1998 Jun;13(2):207-14
references.pmid: 10181019
references.citation: Br J Nutr. 2007 Jul;98(1):26-31
references.pmid: 17381877
references.citation: Am J Public Health. 1993 Aug;83(8):1094-9
references.pmid: 8342715