Objectives: This study used the Technology-Organization-Environment (TOE) framework to identify the factors involved in the decisions made by integrated medical and healthcare organizations to adopt artificial intelligence (AI) elderly care service resources.Method: This study identified the Decision-making Trial and Evaluation Laboratory-Interpretive Structural Modeling (DEMATEL-ISM) method was used to construct a multilayer recursive structural model and to analyze the interrelationships between the levels. A MICMAC quadrant diagram was used for a cluster analysis.Results: The ISM recursive structural model was divided into a total of seven layers. The bottom layer contained the four factors of High risk of data leakage (T1), Lack of awareness of the value and benefits of AI healthcare technology (T5), Lack of management leadership support (O1), and Government policies (E1). Having a low dependency but high driving force, these factors are the root causes of adoption by healthcare organizations. The topmost layer contained the most direct factors, which had a high dependency but the low driving force, influencing adoption: Competitive pressures (E2), Lack of patient trust (E5), and Lack of excellent partnerships (E7). Healthcare organizations are more concerned with technology and their environments when deciding to adopt intelligent healthcare resources.Conclusion: The combination of the three methods of DEMATEL-ISM-MICMAC construction models provides new ideas for smart healthcare services for hospitals. The DEMATEL method favors the construction dimension of the micro-model, while the ISM method favors the construction dimension of the macro-model. Combining these two methods may reduce the loss of information within the system, simplify the matrix calculation workload, and improve the efficiency of operations while decomposing the complex problems into several sub-problems in a more comprehensive and detailed way. Conducting cluster analysis of the adoption determinants utilizing MICMAC quadrant diagrams may provide strong methodological guidance and decision-making recommendations for government departments, senior decision-makers in healthcare organizations, and policy-makers in associations in the senior care industry.

In the past few years, internet celebrities have become a new and important way to get people to buy energy-saving products. Their psychological mechanisms for promoting fans’ intention to purchase have become the focus of academic attention, but a unified conclusion has yet to be reached. This study uses online communities as a scenario, with the characteristics of influencers’ expertise, social attraction, and task attraction as antecedent variables and social cognitive theory and parasocial interaction theory as the theoretical basis to explore their influence on fans’ intention to purchase household energy-saving products. The study investigates the mediating role of parasocial relationships and the moderating role of fans’ green self-efficacy in influencing internet celebrities’ expertise and attraction of fans’ parasocial relationships. The results showed that the parasocial relationships formed between fans and influencers mediated the relationship between the expertise and attraction of influencers and fans’ intention to purchase energy-saving products and that “green self-efficacy” positively moderated the parasocial relationships formed between fans and internet celebrities in terms of their expertise and task attraction. The moderating effect of “green self-efficacy” on the parasocial relationships between fans and internet celebrities was insignificant.

In the context of urban tourism, the sensory experience arising from tourists' interaction with the city plays an important role in shaping their pro-environmental behaviors. Nevertheless, existing research on this topic remains limited. The present study examines how urban tourists' pro-environmental behaviors are associated with their sensory impressions of the urban destination. The results suggest that: (1) sensory impressions are related to tourists' pro-environmental behaviors, both directly and indirectly, through the sequential pathways of social connectedness and subjective well-being. (2) Compared with tourists reporting lower levels of self-esteem, those with higher self-esteem tend to report stronger social networks. (3) Tourists with higher self-esteem also report higher levels of subjective well-being than their counterparts with lower self-esteem. By clarifying the conditions under which sensory impressions are linked to the pro-environmental behaviors of urban tourists, this study adds to the understanding of urban environmental behaviors.