Advancing equitable and safe access to care through pre-service telemedicine acceptability: a UTAUT guided pilot study

The introduction of telemedicine services into healthcare’s daily work routines brings both new resources and challenges. To ensure the development of safe and accessible services, it seems fundamental to co-design services with end-users and, concurrently, evaluate their acceptability to enhance care compliance. The current pilot study aims to develop, validate, and test a context-specific measurement tool grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT) and its extensions. The main objective of the model is to evaluate end-users’ acceptability and its antecedents before they have any experience with telemedicine services, thereby enabling context-specific evaluations of the proposed telemedicine services and fostering interest among patients. The model included different variables from both the original theory (performance expectancy, effort expectancy, and social influence) and its proposed extensions (compatibility, personal innovativeness, and acceptability). In total, we asked 429 participants from different residential contexts (i.e., urban, peripheral, and rural) in northern Italy to complete our cross-sectional survey. Confirmatory factor analysis demonstrated satisfactory convergent and discriminant validity, internal consistency, and full measurement invariance across gender and both educational and residential contexts. Structural equation modelling showed excellent model fit (CFI = 0.96; SRMR = 0.05). Performance expectancy (β = 0.50), compatibility (β = 0.35), and social influence (β = 0.22) significantly predicted telemedicine acceptability. In particular, the compatibility effect on acceptability was partially mediated by performance expectancy. Our research proposes a workflow that provides a practical framework for assessing preparedness and guiding communication strategies to promote safe and equitable telemedicine implementation.