Exploring community health worker acceptance of mobile health for cardiovascular risk management in rural Indonesian communities

Introduction This study investigates specific behavioural and social factors influencing the adoption of mobile health (mHealth) technologies by Community Health Workers (CHWs) in rural Indonesia. Using the SMARThealth cardiovascular risk management programme in Malang as a case study, the study examines how constructs from the Technology Acceptance Model (TAM) and related frameworks explain CHWs’ intention to use and actual use of mHealth tools. Methods A cross-sectional survey was conducted with 573 CHWs participating in the SMARThealth programme. Data was collected using a structured questionnaire and analyzed using Partial Least Squares Structural Equation Modelling to test ten hypotheses derived from TAM and Unified Theory of Acceptance and Use of Technology. Results Five of the ten hypotheses were supported. Behavioural intention significantly predicted actual use of the SMARThealth app (β = 0.277, p < .001). Behavioural intention was positively associated with perceived usefulness (β = 0.513, p < .001), perceived ease of use (β = 0.372, p < .001), social relationships (β = 0.051, p = .037) and non-financial incentives (β = 0.071, p = .016). Other factors including financial incentives, government support, community support, IT training and motivation were not statistically significant. Conclusion Perceived usefulness, ease of use, social relationships and non-financial incentives significantly influence CHWs’ intention to adopt mHealth tools in Malang, Indonesia. These findings highlight the need for user-friendly design and peer-based, non-monetary support strategies. However, due to contextual differences in CHW roles, infrastructure and community dynamics, these results may not be generalisable. Further research is needed to assess their relevance across other low- and middle-income countries settings.