title: Understanding the discriminant factors that influence the adoption and use of clinical communities of practice: the ECOPIH case.
abstract: BACKGROUND
  The aim of the study presented in this article is to analyse the discriminant factors that have an influence on the use of communities of practice by primary and specialist healthcare professionals (physicians and nurses) for information sharing. Obtaining evidence from an ex-ante analysis to determine what factors explain healthcare professionals' clinical community of practice use allows aspects of its use to be identified.
  
  
  METHODS
  A theoretical model based on a modified technology acceptance model was used as the analysis tool, and a discriminant analysis was performed. An ad-hoc questionnaire was designed and sent to a study population of 357 professionals from the Badalona-Sant Adrià de Besòs Primary Care Service in Catalonia, Spain, which includes nine primary care centres and three specialist care centres. The study sample was formed by the 166 healthcare professionals who responded.
  
  
  RESULTS
  The results revealed three main drivers for engagement in a CoP: First, for the whole sample, perceived usefulness for reducing costs associated with clinical practice was the factor with the greatest discriminant power that distinguished between users and non-users, followed by perceived usefulness for improving clinical practice quality, and lastly habitual social media website and application use. Turning to the two sub-samples of healthcare professions (physicians and nurses, respectively), we saw that the usefulness stemming from community of practice use changed. There were differences in the levels of motivation of healthcare professionals with regards to their engagement with CoP. While perceived usefulness for reducing costs associated with clinical practice was the main factor for the physicians, perceived usefulness of the Web 2.0 platform use for communication for improving clinical practice quality and perceived ease of use were the main factors for the nurses.
  
  
  CONCLUSIONS
  In the context of communities of practice, the perception of usefulness of Web 2.0 platform use for communication is determined by organisational, technological and social factors. Specifically, the position that professionals have within the healthcare structure and particularly the closer healthcare professionals' activity is to patients and their professional experience of using social networks and ICTs are crucial to explaining the use of such platforms. Public policies promoting Web 2.0 platform use for communication should therefore go beyond the purely technological dimension and consider other professional and social determinants.
authors.affiliation: Centre d'Atenció Primària la Salut, Institut Català de la Salut, Badalona, Spain. lacasta.david@gmail.com.|Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Santa Coloma de Gramenet, Spain. lacasta.david@gmail.com.|Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. lacasta.david@gmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Lacasta Tintorer
authors.affiliation: Centre d'Atenció Primària la Salut, Institut Català de la Salut, Badalona, Spain. souhelflayeh@gmail.com.
authors.forename: Souhel
authors.initials: S
authors.lastname: Flayeh Beneyto
authors.affiliation: Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Santa Coloma de Gramenet, Spain. jmanresa@idiapjgol.info.|Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. jmanresa@idiapjgol.info.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Manresa
authors.affiliation: Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Santa Coloma de Gramenet, Spain. ptoran.bnm.ics@gencat.cat.|Departament de Ciències Mèdiques, Universitat de Girona, Girona, Spain. ptoran.bnm.ics@gencat.cat.
authors.forename: Pere
authors.initials: P
authors.lastname: Torán-Monserrat
authors.affiliation: Economics and Business Studies and Internet Interdisciplinary Institute, Universitat Oberta de Catalunya, Barcelona, Spain. ajimenezz@uoc.edu.
authors.forename: Ana
authors.initials: A
authors.lastname: Jiménez-Zarco
authors.affiliation: Economics and Business Studies and Internet Interdisciplinary Institute, Universitat Oberta de Catalunya, Barcelona, Spain. jtorrent@uoc.edu.
authors.forename: Joan
authors.initials: J
authors.lastname: Torrent-Sellens
authors.affiliation: Department of Health Sciences and Internet Interdisciplinary Institute, Universitat Oberta de Catalunya, Barcelona, Spain. fsaigi@uoc.edu.
authors.forename: Francesc
authors.initials: F
authors.lastname: Saigí-Rubió
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D019058:Community Networks; D004059:Diffusion of Innovation; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009726:Nurses; D010820:Physicians; D011320:Primary Health Care; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult