Antecedents of Perceived Usefulness (PU) and Perceived Ease-of-Use (PEOU) in the Heuristic-Systematic Model: The Context of Online Diabetes Risk Test

E-Health services are seen as promising to healthcare promotion, but low usage by patients limits their effectiveness. The Technology Acceptance Model (TAM) has shown to be explanatory in the adoption of e-Health services. As the use of e-Health for self-management grows, it is important to identify factors influencing perceived ease-of-use (PEOU) and usefulness (PU) to encourage acceptance. However, the selection of external variables in this context lacks a clear pattern. We applied the Heuristic-Systematic Model (HSM) with the aim of further explaining the external variables in TAM especially in the area of e-health, and selected three external variables: information quality, health information literacy, and social influence. Hence, our study combines the Heuristic-Systematic Model (HSM) and TAM to investigate the mechanism and external factors that promote individuals to act for their health benefits. A total of 198 responses were collected among people having completed an online diabetes risk test on the website of the Finnish Diabetes Association. This data was then analyzed using partial least squares structural equation modeling (PLS-SEM). Our study finds that heuristic cues like health information literacy and social influences impact PEOU, while systematic cues, especially information quality, positively influence PU. Also, higher PU is associated with increased intention to use e-Health services and engage in health-promoting actions, highlighting the importance of the systematic path in the e-Health context. Our theoretical contributions are twofold. First, we add to TAM research in the area of e-health by providing an explanation why heuristic cues link to PEOU while systematic cues link to PU. Second, our research is among very few applying HSM to e-health and finds that overall, the systematic path is more influential than the heuristic path. We also provide practical advice for healthcare providers to improve the impact of their e-health initiatives.