The population of older adults is growing worldwide, particularly in North America. Health information technology (HIT) is a group of technologies and systems that enhance care by electronically storing, managing, and exchanging data. HIT presents opportunities to support older adults' healthcare needs in communities and long-term care (LTC) environments. Despite their potential benefits, these technologies remain limited in LTC and older adults' healthcare contexts. Evidence is scattered on the factors that affect older adults' adoption of HIT. Little research has investigated the adoption of these technologies by formal healthcare providers and the technologies' impacts on LTC. A multi-method approach was employed in this thesis research, using a combination of a systematic qualitative review, an inductive semi-qualitative Delphi survey, and a quantitative deductive study to manage each research question in order to address these gaps. The systematic literature review used the PRISMA guidelines to identify and critically appraise studies that examined the effect of various HIT adoption factors among older adults in the community. The search involved five databases and a combination of keywords, resulting in the selection of critically appraised articles based on their evidence level and research rigor. A coding scheme was developed to extract information from the selected articles. The results showed that the main factors affecting HIT adoption by older adults relate to performance expectancy, effort expectancy, and high price/cost value. It also highlighted the importance of considering privacy/security and product design when evaluating HIT adoption by older adults. In light of the limited available studies on HIT adoption and impacts in the context of LTC, a Delphi study was developed to collect data from key formal healthcare providers (i.e., nurses) working in LTC at one of the largest and most progressive older adult healthcare facilities in Ontario, Canada. The Delphi study aimed to identify and prioritize the key factors that affect nurses' adoption of new technologies in support of older adults' care. A panel of nurses was solicited to participate in the Delphi study, which involved three rounds of data collection: brainstorming, narrowing down, and ranking. A total of 20 nurses completed the Delphi study, and the top factors that the LTC nurses identified were mainly related to the organizational and technological dimensions, including the complexity of HIT, the training and support provided, the interoperability of HIT systems, the cost of implementation, and the availability of HIT infrastructure. For the last part of this research, quantitative secondary data analysis was conducted on a Canadian national survey of nurses to examine their perceived impacts of HIT adoption by nurses in LTC. The survey included questions related to the current state of electronic medical records (EMR) and EMR adoption, the state of virtual care technologies, attitudes and perceptions related to access and the impact of the adoption of digital health technologies in practice, benefits and effects of EMR adoption, and barriers preventing nurses from getting total value from electronic health. A subset of 166 nursing homes/long-term care facilities/older adult residences and homecare nurses were selected for this analysis. Data management and analysis were conducted using IBM SPSS v28. The results showed that HIT adoption by nurses in LTC was positively associated with perceived benefits and organizational support. However, HIT adoption was negatively associated with perceived complexity and privacy/security concerns. This thesis research suggests that HIT adoption by older adults and nurses in LTC is complex and multifaceted, requiring attention to individual, organizational, and technological factors. There is a need for improved communication and collaboration among LTC team members and better working conditions to improve staff well-being and reduce turnover. The findings from the systematic review and Delphi study contribute to the theoretical understanding of the factors influencing the adoption of HIT in LTC facilities. The survey results provide valuable insights into the current state of HIT use in LTC facilities and can be used to inform the development of targeted interventions to improve HIT adoption and use. Overall, this study contributes to the growing body of knowledge on HIT adoption in LTC facilities and provides important recommendations for policymakers, administrators, and LTC staff to improve the use of HIT and ultimately enhance the quality of the care supplied to LTC residents.

[pt] A teleconsulta, como ferramenta tecnológica, pode gerar maior acessibilidade a serviços de saúde de qualidade, além de servir para lidar com os desafios de recursos na indústria da saúde. Pode também ser particularmente relevante durante a pandemia de COVID-19, com o distanciamento social que demanda novas soluções tecnológicas para a oferta de serviços de qualidade com contato pessoal reduzido. Este trabalho propõe um modelo integrativo de aceitação de tecnologia para avaliar os fatores determinantes da adoção de teleconsulta pelos pacientes, alinhando construtos de caráter cognitivo e comportamental, oriundos do modelo de aceitação de tecnologia, com outros construtos de natureza distintas: (i) prontidão tecnológica, representando o fator de natureza tecnológica do modelo; e (ii) confiança e autoeficácia, representando construtos relacionados com aspectos específicos e relevantes na adoção de tecnologias em serviços de saúde. Para testar e validar o modelo conceitual proposto, foi utilizada a modelagem de equações estruturais com dados dos questionários de 415 consumidores. Os resultados obtidos indicam relações significativas entre os construtos avaliados, com particular relevância nos efeitos da utilidade percebida, antecedida pela confiança e prontidão tecnológica, sobre atitude e intenção de uso da teleconsulta. O uso deste modelo integrativo, com seis potenciais antecedentes, possibilitou explicar 67,7 por cento da variância da intenção comportamental de uso dos respondentes. Os achados também sugerem que o contexto pandêmico associado com o Covid-19 possa influenciar o comportamento dos pacientes quanto à intenção de uso da teleconsulta. Desta forma, os resultados obtidos fornecem avanços no debate da aceitação de tecnologia nos serviços de saúde, ao propor um modelo integrativo e potencialmente inédito de avaliação das intenções de uso, sobre a ótica dos pacientes. Também servem como potenciais fontes orientadoras para organizações de saúde e reguladores públicos, na formatação de estratégias para o futuro da teleconsulta no Brasil no período posterior à pandemia de COVID-19. / [en] Teleconsultation can be a strategic technological tool for patients to access quality healthcare while dealing with resource challenges within health industry. It can be particularly relevant during and after the COVID-19 pandemic, when the social distancing world had to scramble for new technological solutions to offer quality healthcare services with reduced personal contact. Our research proposes an integrative technology acceptance model to evaluate the drivers of teleconsultation adoption by patients, aligning cognitive and behavioral constructs from the technology acceptance model with other drivers associated with distinct natures, such as: (i) technology readiness, a factor with technological characteristics; and (ii) trust, and self-efficacy, constructs strongly associated and relevant to the acceptance of technologies in health-related services. To test and validate the proposed conceptual model, this study applied structural equations modeling based on survey’s data from a sample of 415 consumers. Results indicate significant relationships between the assessed constructs, with particular relevance on the effects of perceived usefulness, anteceded by trust and technology readiness, on attitude and intention to use teleconsultation. The model was able to explain 67.7 percent of respondents behavioral intention in adopting teleconsultation. Our findings also suggested the potential impact of the pandemic context (Covid-19) on the respondents answers and behaviors. Our findings support the debate on technology acceptance by providing an integrative and potentially new model for assessing patients intention of adopting new health-related technologies. In addition, results provide helpful insights for health organizations and regulators in their future strategies and debates on the teleconsultation introduction in Brazil in the period post-Covid-19 pandemic.

The thesis examines technology adoption within the real estate development industry, an industry that has historically lagged the adoption rate of innovations compared to industrial counterparts. The study finds that the favorable market conditions for real estate as an asset class following the debt crisis in 2008 may have been a significant denominator in slowing down the technology adoption within the industry when several industries at the same time have faced fundamental industrial disruption. The absence of vertical integration within the industry decreases the transparency and complicates the emergence of innovative solutions as technology developers continuously fail to identify what features and functionalities that are desired by industry practitioners. The study finds that the higher the observability of the innovation, the higher is the probability of technology adoption within an organization. In addition, organizations are heavily dependent on having the facilitating conditions in-place internally to enable an effective technology adoption and implementation. / Avhandlingen granskar teknikupptagning inom fastighetsutvecklingsbranschen, en bransch som historiskt sett har haft en lägre adoptionsgrad av innovationer jämfört med industriella motsvarigheter. Studien konstaterar att de gynnsamma marknadsförhållandena för fastigheter som tillgångsslag efter finanskrisen 2008 kan ha varit en betydande nämnare för att hålla tillbaka teknikutvecklingen i industrin när flera industrier samtidigt har genomgått fundamental förändring. Frånvaron av vertikal integration inom branschen minskar insynen och komplicerar framväxten av innovativa lösningar, eftersom teknikutvecklare kontinuerligt har misslyckats att identifiera de funktioner och funktionaliteter som önskas av professionella inom branschen. Studien konstaterar att ju högre möjligheten att observera innovationens kapacitet är, desto högre är sannolikheten för teknisk adoption inom en organisation. Dessutom konstateras att organisationer är starkt beroende av att stödjande infrastruktur finns på plats internt för att möjliggöra en effektiv teknikupptagning och implementation.

Smart technology, such as the internet of things, artificial intelligence, and big data, provides consumers with a new level of convenience through various smart-connected products (SCPs). Although many experts have increasingly warned about the privacy vulnerability issues of various SCPs, consumers often underestimate privacy risks when adopting smart technology. Accordingly, this dissertation presents a literature review and three empirical studies that examine the privacy problems and suggest new concepts and models for a deeper understanding of the privacy suspension phenomenon. The first chapter reviews the literature related to the privacy suspension phenomenon by integrating the antecedents of consumers' privacy concerns. New concepts of privacy concerns, such as active and inactive privacy concerns, are suggested along with multiple propositions for the proposed privacy suspension theory, which extends the dimension of ambivalence toward trust and distrust regarding smart technology. The second chapter presents the proposed privacy–common good trade-off model and three assumptions related to privacy trade- offs, privacy reduction, and anchoring effects in the sustainable smart-connected car context. This study also discusses the relationships between governments, companies, and consumers regarding the effects of the common good of sustainability and government subsidies. The third chapter evaluates the mediation effects between sustainability, trust, privacy concerns, disclosure intentions, and purchase intentions when purchasing sustainable smart-connected cars based on the proposed sustainability–trust–behavior model. Finally, the fourth chapter provides a practical solution to resolve privacy suspension issues using the design science research approach. This study proposes privacy information type characteristics to evaluate SCPs' tailored data collection capabilities, visualizing them through a spider diagram design method with nudges. / Doctor of Philosophy / This dissertation discusses the consumer privacy suspension phenomenon when adopting smart technology. The first chapter summarizes existing studies regarding privacy concerns, trust, distrust, and ambivalence in adopting technology. It also proposes new concepts of privacy concerns and outlines the unique relationship between consumer privacy concerns and ambivalence toward trust and distrust in smart-connected products, thus helping readers understand why consumers reduce privacy concerns when adopting smart technology. The second chapter presents an empirical study that examines how consumers trade their privacy for the common good of sustainability based on the proposed privacy–common good trade-off model and outlines three key assumptions in the sustainable smart-connected car context. The third chapter discusses the roles of sustainability and trust when consumers decide to disclose their personal information and purchase sustainable smart-connected cars based on the proposed sustainability–trust–behavior model. Last, the fourth chapter provides a practical solution to improve the current inefficient privacy notification systems that cannot apply to different smart-connected products due to various smart sensors collecting different types of personal information. Thus, this dissertation contributes to a deeper understanding of the consumer privacy suspension phenomenon and how sustainability benefits can mitigate the conflicting interests between governments, companies, and consumers when adopting smart technology. In addition, the suggested practical solution using the design science research approach can help consumers make better privacy decisions when purchasing smart-connected products.

This study was designed to examine computer based instruction in the 9-12 public high school. All high schools included in the study were part of the original Digital High School grants, and had a student population of over 1000 students. The purposes of the study were to examine factors affecting technology implementation, to explore how teacher attitudes, expertise, and cultural and pedagogical beliefs affected adoption, to determine how critical staff development and resources were in successful implementation, and to investigate organizational variables that were in place for successful adoption of computer based instruction. The study was conducted using Everett Rogers' five stages of the innovation-decision process. Nine technology coordinators were interviewed for this study. Following the interviews, 13 categories emerged and a grounded theory was formed. The study concluded with five recommendations for practitioners who would like to successfully implement technology on their school sites.

The educational system is going through a rapid shift towards digital learning, a phenomenon happening all over the world. This thesis examines the possibilities and conditions for digital learning amongst primary school children living in the township Kayamandi in Stellenbosch, South Africa. The project was carried out as a case study and has used a focused ethnographic approach. The objective was to conduct an explorative study of digital learning in a smaller township and to provide an understanding of the educational system, technology adoption in schools and among children, children's and teachers' digital literacy, and what opportunities for digital learning exist today. Three Kayamandi schools in Stellenbosch have been visited for observation: Kayamandi Primary School, Ikaya Primary School, and A.F. Louw Primary School. In addition, interviews have been conducted with different stakeholders within education, as well as focus groups and a survey with the children. Among the findings this master’s thesis shows that a digitalisation is ongoing but that there is an uneven accessibility to digital technologies and data which could be tackled with a tailored digital strategy. This study also notes on positive effects from using edtech programs and indicates that personalised learning and gamification might be key to success for digital learning in a township. A preliminary conclusion is that there are possibilities for digital learning, but the conditions are complex and various contextual factors need to be addressed in a collective and mindful manner. / Utbildningssystemet går igenom en snabb förändring mot digitalt lärande, ett fenomen som händer över hela världen. Denna avhandling undersöker möjligheterna och förutsättningarna för digitalt lärande bland grundskolebarn som bor i kåkstaden Kayamandi i Stellenbosch, Sydafrika. Projektet utfördes som en fallstudie och har använt ett fokuserat etnografiskt tillvägagångssätt. Målet var att genomföra en explorativ studie av digitalt lärande i en mindre kåkstad och att ge en förståelse för utbildningssystemet, teknikanvändningen i skolorna och bland barnen, barnens och lärarnas digitala kunskaper och, vilka möjligheter till digitalt lärande som finns idag. Tre Kayamandi-grundskolor i Stellenbosch har besökts för observation: Kayamandi Primary School, Ikaya Primary School och A.F. Louw Primary School. Dessutom har intervjuer genomförts med olika intressenter inom utbildning, samt fokusgrupper och en enkät med barnen. Bland resultaten visar denna masteruppsats att en digitalisering pågår men att det finns en ojämn tillgänglighet till digital teknik och internet som skulle kunna hanteras genom en skräddarsydd digital strategi. Denna studie noterar också positiva effekter av att använda edtech-program och indikerar att personligt lärande och spelifiering (gamification) kan vara nyckeln till framgång för digitalt lärande i en kåkstad. En preliminär slutsats är att det finns möjligheter för digitalt lärande, men förutsättningarna är komplexa och olika kontextuella faktorer behöver hanteras på ett kollektivt och medvetet sätt.

The financial industry is currently undergoing radical change as a result of the increased implementation of digitalisation strategies. Due to pressure from a number of sources, finance firms, including asset managers, are looking to adopt technology solutions in their business processes. Through the introduction of new technologies and digitalisation strategies, the asset managers are hoping to secure their market segments in the future. Choosing which technology to implement is considered one of the most difficult decisions a manager has to make. Hence, this thesis proposes a framework to be used by asset managers in order to efficiently and swiftly evaluate a number of technologies when looking to digitalize manual processes. The largest bank in the Nordic region is Nordea, who have just recently announced that they will be looking to implement more digital solutions. This thesis was conducted in collaboration with Nordea Asset Management. The thesis explores three core areas: the future of the asset management industry, digitalisation strategies, and new technology adoption in order to produce the analytical framework. The framework is constructed using previously explored methods described in literature along with the key information gathered from experts at Nordea Asset Management. The result is a framework which combines expert knowledge of the asset management industry, successful methods regarding conceptual frameworks, technology life cycle and new technology adoption theory and digitalisation strategy concepts. In order for traditional asset managers to maintain their market position they will need to adapt new technologies. This is not only needed for efficiency and cost reasons but also because customers are starting to demand it. The sales channels, operations, personnel requirements and the business model as a whole are areas identified by this research project that will adapt through the introduction of digitalisation strategies being introduced. The framework constructed in this thesis provides the asset management firms with a method of successfully applying digitalisation strategies through new technology adoption. / Finansindustrin genomgår just nu radikala förändringar på grund av att digitaliseringsstrategier implementeras. Efter påtryckning från en rad olika håll, känner sig finansbolag, som inkluderar kapitalförvaltningsbolag, tvungna att implementera nya tekniska lösningar i sin verksamhet. Genom att adoptera nya tekniker och digitaliseringsstrategier hoppas kapitalförvaltare på att kunna försäkra sina marknadsandelar i framtiden. Men att välja vilken teknik som ska implementeras är ett av de svåraste beslut en ansvarig måste ta. Alltså, så föreslår detta arbete ett ramverk som kan användas av ett kapitalförvaltningsbolag för att, på ett effektivt och snabbt sätt, kunna evaluera en mängd tekniker när man vill digitalisera manuella processer. Den största banken i den nordiska regionen är Nordea, som just har informerat allmänheten att de kommer att börja implementera digitala strategier. Detta arbete skrevs i samarbete med Nordea Asset Management (NAM). Detta arbete koncentreras på tre centrala områden. Framtiden av kapitalförvaltningsindustrin, digitaliseringsstrategier, samt implementering av nya tekniker för att producera ett analytiskt ramverk. Ramverket är hopsatt genom att använda metoder från tidigare forskning tillsammans med nyckelinformation samlad av experter på NAM. Resultatet blir då ett ramverk som kombinerar expertkunskap från kapitalförvaltningsindustrin, lyckade metoder i relation till konceptuella ramverk, tekniklivscykel och ny teknikimplementationsteorier samt digitaliseringsstrategikoncepter. För att traditionella kapitalförvaltare ska kunna bibehålla sina nuvarande marknadspositioner, kommer de att behöva implementera nya tekniker. Detta behövs inte endast för effektivitet och kostnadsanledningar utan också för att kunden kommer att begära det. De områden som detta arbete har identifierat som kommer att behöva ändras på i och med implementeringen av digitaliseringsstrategier är: säljkanaler, operations, personalbehov och verksamhetsmodell. Ramverket konstruerat i detta arbete, förser kapitalförvaltningsbolag med en metod för att implementera digitaliseringsstrategier på ett effektivt och framgångsrikt sätt.

The financial services division has been significantly impacted by the emergence of mobile payments, which can be attributed to the fast progressions in mobile technology and the widespread adoption of smartphones. The present research investigates critical factors prompting the adoption of mobile payment services in developed and developing countries, namely Sweden, Estonia, Germany, Pakistan, and Sri Lanka. This research aims to explain the resemblances and gaps in the adoption of mobile payments in developed and developing nations. The detailed analysis of the related past studies has identified organization, trust and security, financial inclusion, consumer preferences, and government support as the primary determinants that impact mobile payment adoption. The present investigation is based on the Technology Acceptance Model, including the extended model of Unified Theory of Acceptance and Use of Technology 2. Developed economies such as Sweden, Estonia, and Germany have the infrastructure to implement mobile payment alternatives effectively. The widespread adoption of mobile payments in these countries can be recognized by several factors, such as governmental initiatives that promote digitalization, a well-established financial framework, and consumer knowledge of various payment modalities. While implementing mobile payment services in developing nations like Pakistan and Sri Lanka presents distinctive obstacles. A significant portion of the general public lacks access to banking services, insufficient digital infrastructure, and reduced trust in technology exists. The anticipated surge in mobile payment adoption within emerging markets can be attributed to the widespread availability of smartphones and governmental efforts to broaden access to Mobile payment services. This research enhances our comprehension of the factors and barriers that constrain the implementation of mobile payment services. This research is useful for policymakers, banks, and technology firms as they develop strategies to expand mobile payment options.

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