title: Integrating health belief model and technology acceptance model: an investigation of health-related internet use.
abstract: BACKGROUND
  Today, people use the Internet to satisfy health-related information and communication needs. In Malaysia, Internet use for health management has become increasingly significant due to the increase in the incidence of chronic diseases, in particular among urban women and their desire to stay healthy. Past studies adopted the Technology Acceptance Model (TAM) and Health Belief Model (HBM) independently to explain Internet use for health-related purposes. Although both the TAM and HBM have their own merits, independently they lack the ability to explain the cognition and the related mechanism in which individuals use the Internet for health purposes.
  
  
  OBJECTIVE
  This study aimed to examine the influence of perceived health risk and health consciousness on health-related Internet use based on the HBM. Drawing on the TAM, it also tested the mediating effects of perceived usefulness of the Internet for health information and attitude toward Internet use for health purposes for the relationship between health-related factors, namely perceived health risk and health consciousness on health-related Internet use.
  
  
  METHODS
  Data obtained for the current study were collected using purposive sampling; the sample consisted of women in Malaysia who had Internet access. The partial least squares structural equation modeling method was used to test the research hypotheses developed.
  
  
  RESULTS
  Perceived health risk (β=.135, t1999=2.676) and health consciousness (β=.447, t1999=9.168) had a positive influence on health-related Internet use. Moreover, perceived usefulness of the Internet and attitude toward Internet use for health-related purposes partially mediated the influence of health consciousness on health-related Internet use (β=.025, t1999=3.234), whereas the effect of perceived health risk on health-related Internet use was fully mediated by perceived usefulness of the Internet and attitude (β=.029, t1999=3.609). These results suggest the central role of perceived usefulness of the Internet and attitude toward Internet use for health purposes for women who were health conscious and who perceived their health to be at risk.
  
  
  CONCLUSIONS
  The integrated model proposed and tested in this study shows that the HBM, when combined with the TAM, is able to predict Internet use for health purposes. For women who subjectively evaluate their health as vulnerable to diseases and are concerned about their health, cognition beliefs in and positive affective feelings about the Internet come into play in determining the use of health-related Internet use. Furthermore, this study shows that engaging in health-related Internet use is a proactive behavior rather than a reactive behavior, suggesting that TAM dimensions have a significant mediating role in Internet health management.
authors.affiliation: Universiti Putra Malaysia, Faculty of Modern Languages and Communication, Kuala Lumpur, Malaysia. ahadzadeh1980@gmail.com.
authors.forename: Ashraf Sadat
authors.identifier: http://orcid.org/0000-0002-3178-8684
authors.initials: AS
authors.lastname: Ahadzadeh
authors.forename: Saeed
authors.identifier: http://orcid.org/0000-0001-8082-4541
authors.initials: S
authors.lastname: Pahlevan Sharif
authors.forename: Fon Sim
authors.identifier: http://orcid.org/0000-0002-4420-4262
authors.initials: FS
authors.lastname: Ong
authors.forename: Kok Wei
authors.identifier: http://orcid.org/0000-0003-2603-1545
authors.initials: KW
authors.lastname: Khong
mesh_terms: D000328:Adult; D001294:Attitude to Health; D020811:Biomedical Technology / Q000379:methods*; D003256:Community Participation; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012307:Risk Factors; D055815:Young Adult
keywords: Technology Acceptance Model; health beliefs; health-related Internet use behavior; mediation effect