Author ORCID Identifier

Defense Date


Document Type


Degree Name

Doctor of Philosophy


Health Related Sciences

First Advisor

Dr. Jonathan P. DeShazo

Second Advisor

Dr. Laura E. McClelland

Third Advisor

Dr. Teresa M. Salgado

Fourth Advisor

Dr. Keisha Burnett


With the shift to patient- and person-centered care, personal health records (PHRs) have been touted as a strategy to empower patients, improve patient-provider communication, and support self-management. Health care organizations around the world have implemented PHRs in a global push to meet three aims of health care—improve access to care, reduce costs, and increase the quality of care. The capabilities that PHRs support vary by organizations, yet basic functions include allowing patients to view their laboratory results, refill prescription medications, and request appointments. More advanced PHRs enable patient-centered communication through secure messaging.

As the burden of chronic disease grows, PHRs are expected to provide individuals with the health information needed to track their health status and stimulate shared decision-making. Although many health care organizations have PHRs, adoption by patients has been low. Various reasons have been identified, including a lack of health care provider support. Most research has focused on the patient perspective since patients are seen as the primary users.

The goal of this research was to better understand patient and health care provider adoption of a PHR in a large government health system in the Kingdom of Saudi Arabia. This study was guided by an adapted model of the unified theory of acceptance and use of technology (UTAUT), a widely used technology adoption model.

This study found that performance expectancy, effort expectancy, and attitude were significant predictors of patients’ behavioral intention to use a PHR. Experience with health applications moderated the relationship between social influence and behavioral intention in patients. In health care providers, performance expectancy and attitude were significant predictors of behavioral intention to accept the PHR. Age, years of experience, and professional role did not moderate any relationships. For behavioral intention to accept secure messaging, performance expectancy and attitude were significant predictors. There were no moderating effects of age, years of experience, or professional role. This study provides useful insights for health care organizations, health care providers, and patients.


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