How Do Parents Choose Children’s Telemedicine? A Hybrid Model from the Integrated DOI-ECM Framework

With the rapid development of medical technology, children’s telemedicine (CTM) is becoming increasingly popular; however, there is still limited research on how parental cognitive formation influences their willingness to continue using it. Based on a sample of parents of children aged 0–7 years in China (N = 420), this study uses the three stages of knowledge, persuasion, and diffusion of innovation theory (DOI) as the analysis framework and integrates flow theory (FT), perceived risk theory (PTR), and the expectation confirmation model (ECM) to construct and test the multi-stage adoption model of CTM. The results show that in the knowledge stage, perceived enjoyment (PE) significantly improves expectation confirmation (EC), and concentration (CON) significantly enhances perceived usefulness (PU). Perceived privacy risk (PPR) significantly reduced perceived convenience (PC) and perceived medical quality (PMQ), while perceived psychological risk (PsyR) significantly reduced PC and EC. In the persuasion phase, both PC and PMQ significantly improved EC and PU, and EC further enhanced PU and satisfaction (SA), while PU also significantly improved SA. PMQ, PU, and SA all significantly promote intention to continue (INC) at the decision-making stage. This study reveals the phased mechanism of parents’ cognitive formation and attitude transformation to behavioral decision-making in the process of CTM adoption and expands the application of related theories in CTM contexts. The study further shows that through gamification interaction, privacy information visualization, emotion-friendly design, process optimization, and medical quality improvement, the user experience can be effectively improved, the INC can be enhanced, and the theoretical basis and practical reference for the promotion and application of CTM can be provided.