Self-Efficacy, Internet Self-Efficacy, and Proxy Efficacy as Predictors of the Use of Digital Social and Health Care Services Among Mental Health Service Users in Finland: A Cross-Sectional Study

Abstract

Background

The COVID-19 pandemic has accelerated the digitalization of services, but at the same time, some user groups are excluded due to a lack of digital skills. One of the vulnerable groups is people with mental health problems. It has previously been found that self-efficacy beliefs explain the use of digital technology, but the role of social support is largely unexamined. Bandura’s concept of proxy agency provides a useful concept to investigate the role of social support in using digital services.

Objective

The study investigates sources of social support and the effect of proxy agency, Internet efficacy, and self-efficacy beliefs on the intention to use digital health and social care services.

Methods

Participants (N = 121) were users in community-based mental health services who were recruited through four organizations in southern Finland for a cross-sectional study. The scales for proxy agency and intention to use services were developed for purpose of the study. The questionnaire also comprised self-efficacy and Internet efficacy scales. Quantitative data were analyzed using descriptive statistics and linear regression analysis.

Results

Both Internet self-efficacy and proxy efficacy (p < 0.001) predicted the intention to use digital health and social care services. Self-efficacy had an indirect positive effect on intention through Internet self-efficacy. Family members and friends were the main source of social support in using digital services.

Conclusion

Internet self-efficacy and proxy efficacy are important contributors to the intention to use digital health and social care services. Proxy agents may serve as facilitators to reduce the digital divide and promote the use of digital services by complementing individuals’ self-efficacy and Internet self-efficacy beliefs. It is important to develop different forms of social support, such as peer support, to enhance the quality of proxy agency. The limitations of proxy agency are discussed.

Keywords:

• digital services
• Internet self-efficacy
• mental health service users
• proxy efficacy
• self-efficacy
• social support

Abbreviations

ICT, Information and communications technology; NGO, Non-governmental organization.

Disclosure

Dr Soile Juujärvi reports personal fees from Edistia Group outside the submitted work. She is also a member of the advisory board of one of the organizations involved in the study. However, the study has not been on its agenda. The authors report no other conflicts of interest in this work.

Additional information

Funding

This research was conducted as part of the “Toward a Socially Inclusive Digital Society: Transforming Service Culture” project (DigiIN) and was funded by the Strategic Research Council at the Academy of Finland [grant numbers 327169 and 327145].