The Role of Computer Anxiety and Computer Experience in Digital Health Systems Adoption among Healthcare Workers in Malawi

Abstract

Introduction: While computer experience is often considered a key determinant of digital health adoption, psychological factors such as
computer anxiety may play an equally important role. This study examined the relative contributions of computer experience and
computer anxiety to digital health adoption intention among healthcare workers in Malawi.
Methods: A cross-sectional survey was conducted among 615 healthcare workers in Malawi. The primary outcome variable was digital
health adoption intention, while key explanatory variables included computer anxiety and Computer experience. Internal
consistency was assessed using Cronbach’s alpha. Bivariate associations were examined using Welch’s t-tests and chi-square tests,
while Pearson correlation analysis was used to assess relationships among key variables. Hierarchical linear regression models were
estimated to evaluate the independent effects of computer experience and computer anxiety on digital health adoption intention.
Results: Participants reported high digital health adoption intention (mean = 6.52, SD = 1.02) and relatively low computer anxiety (mean =
2.08, SD = 1.33). Compared with healthcare workers with low digital health system adoption intention, those with high adoption intention were more likely to have received DHS training (42.3% vs. 32.8%, p = 0.021), reported longer computer use experience (9.2 vs. 7.9 years, p = 0.010), and exhibited lower computer anxiety scores (1.77 vs. 2.49, p < 0.001). In hierarchical regression analyses, computer experience variables explained only 1.1% of the variation in adoption intention (R² = 0.011), whereas computer anxiety alone explained 6.9% (R² = 0.069). After adjusting for computer experience, age, gender, qualification, occupation, and experience, computer anxiety remained the only significant predictor of adoption intention (β = -0.212, 95% CI: - 0.277 to -0.147, p < 0.001).
Conclusions: The findings of the study suggest that interventions aimed at reducing computer anxiety play a critical role in improving the acceptance and sustainability of digital health systems in resource-constrained healthcare settings.