Wearable health information systems intermittent discontinuance: A revised expectation-disconfirmation model

Purpose: Wearable health information systems (IS) open up a new era for personal health self-management, and bring about disruptive changes to individual lives. However, prior studies on IS post-adoptive behavior primarily focused on either continuance or discontinuance, neglecting the mutual transformation process between IS usage and rejection behavior. This behavior is expressed as intermittent discontinuance in the current study. By revising and extending the expectation-disconfirmation model, the purpose of this paper is to understand the factors affecting information system intermittent discontinuance in the context of wearable eHealth. Design/methodology/approach: This study proposes a revised expectation-disconfirmation model by incorporating four new theoretical constructs, i.e. neutral disconfirmation, attitudinal ambivalence, neutral satisfaction, and intermittent discontinuance. An online survey was used to validate the research model, and 428 wearable health device users were recruited in this study. Findings: Empirical results demonstrate that neutral disconfirmation exerts positive effects on neutral satisfaction and attitudinal ambivalence, both of which further have positive effects on intermittent discontinuance. In addition, attitudinal ambivalence also has a positive and significant effect on neutral satisfaction. Originality/value: This study extends the current understanding on IS post-adoption usage behavior by introducing a new concept, i.e., intermittent discontinuance. In particular, post-adoption usage behavior is viewed as a dynamic process within a changing environment in this study. Some unique features specific to intermittent discontinuance are also identified. In this regard, neutral and conflicting constructs further add new values to IS adoption and diffusion literature. In addition, the integration of eHealth and wearable devices provides a fruitful research context for future research, and this study represents one of the first attempts to empirically explore the intermittent usage problems encountered within this emerging phenomenon.