- Title
- Understanding the mechanisms influencing the adoption of transformative health services: a case in mental health
- Creator
- Wyllie, Jessica
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2017
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- For all individuals, the domains of mental, physical and social health are critical to the human experience, and are as such, interwoven into an individual’s personal and societal roles. Over the last decade, government and public policy bodies have become attuned to the importance and influence of mental functioning and its interconnectedness with physical and social outcomes, as well as health and well-being outcomes at an individual, community and national platforms (Herman et al., 2005; WHO, 2011). At a macro level, mental disorders affect 450 million (14%) individuals worldwide (CDC, 2011; WHO, 2009) and is consequently regarded as the leading cause of disability adjusted life years (DALYs) worldwide, accounting for 37% of healthy years lost (WHO, 2011). Given the prevalence of mental health disorders amongst the global population, it is foreseeable that the burden of mental illness impacts the well-being of an individual’s (emotional, social, cognitive and financial) abilities (Lourey et al., 2013) and the abilities of collectives (CDC, 2011; WHO, 2011). However, a critical challenge faced in the mental health service sector, is the perpetual and increasing service adoption gap for psychological treatment amongst young consumers suffering from mental health disorders, necessitating the need for radical marketing approaches and thinking. Consequently, researchers in diverse areas such as service and health management have identified the need for more theoretical and empirical elaboration on the mechanisms that influence consumers’ adoption of transformative mental health services. In closing this research gap, this thesis addresses the following research question: “What are the key mechanisms influencing young adults adoption of a transformative services instrumental to achieving individual and collective well-being?” Hence, to advance the body of knowledge on sociocultural (i.e. attitudes, self-stigma) service-related and cognitive mechanisms that influence young-adults in the pre-adoption phase of consumer decision making for transformative services in mental health (e.g. booking an appointment with a general practitioner). Against this backdrop, this research programs seeks to (1) identify the key mechanisms influencing young adults’ adoption of transformative mental health services (2) build and extend the theory of planned behaviour (TPB) to inform the development of an integrated theoretical framework and (3) empirically test the integrated framework of transformative service adoption in mental health. A two-study mixed method research program was designed to address the following research question. Study One was an exploratory study that analysed semi-structured in-depth interviews with 18 information rich participants who self-reported with feeling worried (i.e. anxious) or low (i.e. mildly depressed) within a 12-month timeframe; yet, had no prior service experience with mental health services (i.e. psychologist or psychiatrist). A pre-tested pictorial and written vignette was used at the commencement of each of the interviews, due to the sensitive nature of this study. Functioning as a projective-association technique the vignette elicited meaningful perspectives, feelings and behaviours from interviewees. The interviews were transcribed verbatim and analysed using NVivo 10 software. The findings from this study provide evidence for the existence of service and individual-based mechanisms in the pre-adoption phase of mental health service adoption amongst young adults. Further, a proposed integrated model of transformative health service adoption and a set of hypotheses were developed based on the findings of Study One, which were further tested in Study Two. Study Two was a large-scale quantitative study that sought to empirically validate the proposed model of transformative health service adoption. An online-survey was administered Australia-wide to young adults in the target audience of 18-to-35 year olds via a reputable market research panel. After removing ineligible responses, a total sample size of 710 was achieved. Reliability and validity analysis were conducted on the data, followed by exploratory factor analysis in IBM SPSS v24. To test the hypothesised path relationships in the proposed model, partial least squares structural equation modelling (PLS-SEM) was performed using Smart PLS v.3.2. The PLS-SEM output revealed that 25 hypotheses were supported, one hypothesis was partially supported and one hypothesis was non-significant. In addition, post-hoc analysis of the open-ended questions within the survey identified five major themes (awareness, mental health services, stigma help-seeking patterns and survey-related), which provide support to existing empirical research and avenues for future research. Beyond establishing foundational insights into the facilitating and inhibiting mechanisms that influence help-seeking intentions, this study substantially contributes new knowledge on the concepts of expected health service quality (EHSDQ) and transformation expectation from a pre-adoption perspective. The findings are also relevant for practitioners and public policy makers affiliated with mental health intervention programs and focuses on the tailoring of these programs. Consequently, helping to facilitate consumer empowerment and positive group identity when help-seeking for mental health services (i.e. professional psychological treatment).
- Subject
- transformative service research; service adoption; individual behaviour; young adults
- Identifier
- http://hdl.handle.net/1959.13/1343197
- Identifier
- uon:29105
- Rights
- Copyright 2017 Jessica Wyllie
- Language
- eng
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| View Details Download | ATTACHMENT01 | Thesis | 3 MB | Adobe Acrobat PDF | View Details Download | ||
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