The role of culture in the adoption of mobile applications for the self-management of diabetes in low resourced urban communities

Diabetes mellitus has been documented as a global health problem with a high mortality rate. In the current digital age, the use of technology to overcome such health problems in pursuance of Sustainable Development Goal 3 is widely recognised. The increased penetration of mobile devices provides one avenue to support the self-management of conditions such as diabetes. As a first step towards this, individuals have to first accept and use the technology. However, the literature indicates low levels of technology use amongst diabetic patients with low socio-economic indicators. We posit that the culture of patients is a contributory factor for the low acceptance and use of technology. This study assessed how culture influences mobile health (m-health) acceptance among diabetic patients from low-resourced urban communities through semi-structured interviews. The theoretical model that was used as a lens for the investigation comprised a juxtaposition of Hofstede's cultural dimensions and the Unified-Theory of Acceptance and Use of Technology 2 (UTAUT2). The analysis of the resultant qualitative data indicates that culture does influence the adoption of m-health applications among the research population. The study determined that cultural dimensions in respect of masculinity-femininity have a negative influence while indulgence has a positive influence on mobile application adoption. The findings also indicated that uncertainty avoidance has both a positive and negative influence on m-health application adoption.