Background: During the COVID-19 pandemic, the provision of and access to health care have been uniquely challenging, particularly during lockdowns or when dealing with COVID-19 cases. Health care professionals have had to provide patients with the necessary health care. However, delivering health care services while reducing face-to-face interaction puts an immense strain on health systems that are already overburdened. Against this backdrop, it is now more critical than ever to ensure the accessibility of health care services. Such access has been made increasingly available through mobile health (mHealth) apps. These apps have the potential to significantly improve health care outcomes and expectations and address some of the challenges confronting health care systems worldwide. Despite the advantages of mHealth, its acceptance and adoption remain low. Hence, health care organizations must consider the perceptions and opinions of physicians if the technology is to be successfully implemented. Objective: The objective of this systematic review was to explore and synthesize the scientific literature on the factors influencing the acceptance and adoption of mHealth among physicians during the COVID-19 pandemic. Methods: A systematic review of the studies published between March 2020 and December 2022 was conducted using the MEDLINE, Scopus, Embase, and ProQuest databases. The database search yielded an initial sample of 455 potential publications for analysis, of which 9 (2%) met the inclusion criteria. The methodology of this review was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Results: The factors influencing mHealth acceptance and adoption by physicians were divided into perceived barriers and perceived facilitators, which were further grouped into the following 3 major thematic categories: technological, individual, and organizational barriers and facilitators, respectively. The technological barriers were accessibility, technical issues, usefulness, and data management; individual barriers were perceived patient barriers, time and workload pressure, technical literacy, knowledge of mHealth, and peer support; and organizational barriers were financial factors, management support and engagement, data security, telemonitoring policy, and collaboration. The technological facilitators of uptake were technical factors, clinical usefulness, and data management; individual facilitators were patient-related care, intrinsic motivation, collaboration, and data sharing (individual); and organizational facilitators were workflow-related determinants, organizational financial support, recommendation of mHealth services, and evidence-based guidelines. Conclusions: This review summarized the evidence on the factors influencing mHealth acceptance and adoption by physicians during the COVID-19 pandemic. The main findings highlighted the importance of addressing organizational readiness to support physicians with adequate resources, shifting the focus from technological to patient-centered factors, and the seamless integration of mHealth into routine practice during and beyond the pandemic. Trial Registration: PROSPERO CRD42022356125; https://tinyurl.com/2mmhn5yu

Background: The COVID-19 pandemic has highlighted the critical role of mobile health applications in the management of health crises. Despite the promising outcomes of these technologies, however, their acceptance and use among physicians in the developing world such as Saudi Arabia are notably low. Objective: The study aimed to explore the factors influencing the acceptance and adoption of mobile health applications by physicians in Saudi Arabia during the COVID-19 pandemic. Method: The study employed a qualitative research method, guided by the Unified Theory of Acceptance and Use of Technology (UTAUT). The study collected data through semi-structured interviews with 16 physicians to delve into the determinants of their readiness to adopt m-health technologies. Data were analysed using template analysis to identify key themes and patterns. Results: In line with the UTAUT, the study identified performance expectancy, effort expectancy, social influence and facilitating conditions as significant influencing factors of the acceptance and adoption of mobile health applications by physicians in Saudi Arabia during the pandemic. This study also inquired into context-specific determinants, such as data privacy concerns, patient engagement, organisational support and compatibility with religious and cultural norms, which are especially relevant in Saudi Arabia and similar developing countries, where these factors, alongside the exigencies arising from the COVID-19 pandemic, have shaped the landscape of mobile health applications utilisation. Conclusions: This study enriches the literature by expanding the UTAUT model to include context-specific drivers of acceptance and adoption. It highlights the need for tailored adoption frameworks to fit local contexts for successful m-health integration. Implications: This research broadens the UTAUT model by including cultural compatibility and data privacy concerns, offering deeper insights into mHealth adoption during crises. It highlights the need for policies and practices that support culturally sensitive app design, strengthen data privacy measures and provide improved training and patient engagement to enhance mHealth adoption.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: During the COVID-19 pandemic, the provision of and access to health care have been uniquely challenging, particularly during lockdowns or when dealing with COVID-19 cases. Health care professionals have had to provide patients with the necessary health care. However, delivering health care services while reducing face-to-face interaction puts an immense strain on health systems that are already overburdened. Against this backdrop, it is now more critical than ever to ensure the accessibility of health care services. Such access has been made increasingly available through mobile health (mHealth) apps. These apps have the potential to significantly improve health care outcomes and expectations and address some of the challenges confronting health care systems worldwide. Despite the advantages of mHealth, its acceptance and adoption remain low. Hence, health care organizations must consider the perceptions and opinions of physicians if the technology is to be successfully implemented. Objective: The objective of this systematic review was to explore and synthesize the scientific literature on the factors influencing the acceptance and adoption of mHealth among physicians during the COVID-19 pandemic. Methods: A systematic review of the studies published between March 2020 and December 2022 was conducted using the MEDLINE, Scopus, Embase, and ProQuest databases. The database search yielded an initial sample of 455 potential publications for analysis, of which 9 (2%) met the inclusion criteria. The methodology of this review was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Results: The factors influencing mHealth acceptance and adoption by physicians were divided into perceived barriers and perceived facilitators, which were further grouped into the following 3 major thematic categories: technological, individual, and organizational barriers and facilitators, respectively. The technological barriers were accessibility, technical issues, usefulness, and data management; individual barriers were perceived patient barriers, time and workload pressure, technical literacy, knowledge of mHealth, and peer support; and organizational barriers were financial factors, management support and engagement, data security, telemonitoring policy, and collaboration. The technological facilitators of uptake were technical factors, clinical usefulness, and data management; individual facilitators were patient-related care, intrinsic motivation, collaboration, and data sharing (individual); and organizational facilitators were workflow-related determinants, organizational financial support, recommendation of mHealth services, and evidence-based guidelines. Conclusions: This review summarized the evidence on the factors influencing mHealth acceptance and adoption by physicians during the COVID-19 pandemic. The main findings highlighted the importance of addressing organizational readiness to support physicians with adequate resources, shifting the focus from technological to patient-centered factors, and the seamless integration of mHealth into routine practice during and beyond the pandemic. Trial Registration: PROSPERO CRD42022356125; https://tinyurl.com/2mmhn5yu

Background/Objectives: Although artificial intelligence (AI) has the potential to strengthen disease surveillance, predictive analytics, preventive interventions, and population-level decision-making, its successful integration requires health systems to be adequately prepared across technical, workforce, governance, and organizational dimensions. Saudi Arabia’s rapid digital health transformation provides a unique national context for exploring these readiness conditions. This study explored stakeholder perceptions of conditions relevant to health system readiness for integrating AI into public health in Saudi Arabia, including perceived challenges, implementation requirements, and strategic opportunities. Methods: A qualitative descriptive study was conducted using semi-structured interviews with 32 participants, including healthcare professionals, health informatics experts, and policymakers or healthcare planning stakeholders in Saudi Arabia. Participants were purposively selected based on their relevant professional experience. Data were analyzed using Braun and Clarke’s six-phase reflexive thematic analysis. Results: Four major themes were identified: (1) infrastructure readiness, reflecting progress in digital health platforms alongside persistent interoperability and data-integration challenges; (2) workforce capacity, highlighting limited AI literacy and the need for practical, role-specific training; (3) data governance and ethics, emphasizing privacy, accountability, algorithmic bias, and the need for greater regulatory clarity; and (4) perceived strategic opportunities, including preventive care, population health monitoring, disease surveillance, and decision support. The first three themes reflected conditions perceived as relevant to health system readiness, whereas the fourth captured anticipated applications and potential benefits rather than a dimension of current readiness. Overall, participants perceived substantial national strategic commitment and digital health development while identifying important implementation challenges related to interoperability, workforce capability, governance, and regulation. Conclusions: Participants’ accounts suggest that responsible AI integration into public health requires coordinated attention to interoperable infrastructure, workforce competencies, governance mechanisms, regulatory oversight, and human-centered implementation. A phased implementation approach, supported by role-specific AI training and clear governance and regulatory frameworks, may help translate national AI ambitions into safe and effective public health practice. These findings may inform policy development, workforce planning, and implementation strategies for responsible AI integration in Saudi Arabia and other regions whose health systems are undergoing rapid digital transformation.

Background/Objectives: The Sehhaty app (v.3.38.0), the Saudi Ministry of Health patient portal, is the principal digital interface between citizens and the national health system. What distinguishes patients who derive functional value from superficial users remains poorly characterized. This study aimed to identify distinct patient viewpoints on Sehhaty use in western Saudi Arabia using Q-methodology grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT). Methods: A 42-statement Q-set was derived from a systematic literature review covering eight extended UTAUT constructs plus usage behaviour. Twenty-four participants, purposively recruited via a matrix stratified by age, gender, chronic disease status, and location, completed online Q-sorts on a forced quasi-normal distribution (−5 to +5), followed by post-sorting interviews. Analysis used KADE v1.2.1 with centroid factor extraction and varimax rotation; principal component analysis only checked the number of factors. Results: Two viewpoints accounted for 51% of the variance among the Q-sorts. Factor 1 (“Cautious Users”) showed high digital readiness and security confidence but limited perceived functional value. Factor 2 (“Functionally Engaged Users”) perceived the application as efficient, care-integrated, and empowering. Fourteen consensus statements confirmed shared endorsement of usability, information clarity, and security trust. Neither viewpoint attributed app use to age, gender, chronic illness, or location, although the small purposive sample precludes demographic inference. Conclusions: Within the sampled viewpoints, the dominant perceived barrier to deeper engagement was limited perceived functional and clinical value rather than usability, access, or security. This exploratory finding informs Vision 2030 digital health policy and warrants larger quantitative confirmation.