Factors influencing the use of weight management APP among obese patients in Chinese cities in the post-epidemic era.

Objectives: In the post-epidemic era, the prevalence of obesity among urban residents in China has risen sharply, with 34.8% of the population being overweight and 14.1% classified as obese. Obesity has become a critical public health challenge. Given the potential of weight management application (APP) in facilitating health management and weight control, this study aims to explore the factors influencing the adoption of weight management APP by obese patients, providing a scientific basis for the effective health management strategies.

Methods: From March to October 2023, a randomized sampling method was used to conduct an online survey among 1 728 residents aged 18-65 from six major Chinese cities: Beijing, Shanghai, Guangzhou, Wuhan, Changsha, and Chengdu. A theoretical model extending the technology acceptance model (TAM) was proposed, incorporating psychological variables such as perceived usefulness, perceived ease of use, social influence, perceived risk, health knowledge, and attitude, alongside demographic variables such as gender, age, education level, and residence. Hypothesis testing was conducted using structural equation modeling to analyze the factors influencing the adoption of weight management APP by obese patients.

Results: For obese patients, perceived ease of use significantly predicted perceived usefulness (=0.301, <0.001), social influence (=0.132, <0.001), and attitude (=0.266, <0.001). Perceived usefulness significantly predicted social influence (=0.171, <0.001) and attitude (=0.499, <0.001). Social influence (=0.285, <0.001) and knowledge (=0.078, <0.001) were significant positive predictors of attitude. The negative impact of perceived risk on attitude was not significant (=0.166), but its negative influence on actual use was significant though weak (=-0.051, =0.036). Attitude significantly influenced actual use (=0.549, <0.001), highlighting that positive user attitudes are a key driver of actual usage behavior. Additionally, demographic variables such as gender, age, education level, and residence significantly moderated the relationships between attitude and actual use. Female users were more likely to translate perceived usefulness into attitudes, whereas male users were more likely to translate attitudes into actual use, characterizing women as "pragmatists" and men as "action-takers". Younger users (below 35 years) focused on effectiveness, while higher-educated users (college level and above) were more likely to forgo APP usage due to risk concerns, although positive attitudes drove their actual use.

Conclusions: Promoting the use of weight management APP in the post-pandemic era is a critical measure to enhance self-management capabilities among obese patients. Understanding the factors influencing users adoption can help popularize healthy lifestyles, improve chronic disease prevention and control, and elevate overall quality of life and health levels.