Bridging the Implementation Gap in Diabetic Foot Care: Determinants of Healthcare Professionals' Adoption of Smart Screening Technology (Preprint)

BACKGROUND Implementation barriers impede clinical adoption of preventive digital health solutions for diabetic foot screening. Understanding determinants influencing healthcare professionals' technology adoption decisions is crucial for successful implementation. OBJECTIVE This study aimed to identify determinants influencing healthcare professionals' adoption of a smart diabetic foot screening system ("FootHow") using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. METHODS We conducted a cross-sectional survey with 80 healthcare professionals across two medical centers from June to September 2023. Participants completed questionnaires measuring seven UTAUT constructs and behavioral intention to adopt FootHow. Multiple regression analysis identified key predictors, complemented by qualitative data on implementation barriers. RESULTS UTAUT domains showed favorable ratings: effort expectancy (mean 4.47, SD 0.54), performance expectancy (mean 4.32, SD 1.23), and attitude (mean 4.18, SD 0.58). Bivariate correlations showed significant associations between adoption intention and attitude (r=0.600, P<.01), effort expectancy (r=0.352, P<.01), self-efficacy (r=0.305, P<.01), and social influence (r=0.272, P<.05). Multiple regression revealed attitude as the sole significant independent predictor (β=0.605, P<.01), explaining 36% of variance. Qualitative data identified barriers including usability concerns for older patients, accuracy issues, and cost considerations. CONCLUSIONS Attitude toward diabetic foot screening technology is the primary implementation determinant. Implementation strategies should focus on shaping positive provider perceptions while addressing contextual barriers of usability, accuracy, and cost. CLINICALTRIAL na