Marketing Strategies and Digital Mental Healthcare Consumption in Guangxi, China: The Mediating Role of Customer Perception and Digital Technology
Main Article Content
Abstract
Background and Aim: Chinese mental healthcare providers increasingly adopt digital technologies to address mental distress. This study examines how marketing strategies influence digital mental healthcare consumption among young adults (18-25) in Guangxi, China, focusing on the mediating roles of customer perception and digital technology.
Methodology: Data were collected from 735 young adults aged 18-25. To capture an effective sample, the survey was distributed to psychological counseling centers in universities to sample those who have used digital mental healthcare services. Structural equation modeling and the Bootstrap Test were used as statistical analyses.
Results: More than 30% of young adults consumed digital mental healthcare through Apps, web-based. Female respondents dominantly used digital mental healthcare (72.9% - 86.6%). Marketing strategy indirectly affected consuming behavior, significantly mediated by digital technology (β = 0.553, 95% CI [0.435, 0.655] in the urban population dominated model; β = 0.110, 95% CI [0.035, 0.174] in the rural population dominated model) and customer perception (β = 0.084, 95% CI [0016, 0.152] and 0.090, 95% CI [0.042, 0.148], respectively). Digital technology’s mediating effect significantly outweighed customer perception in the urban population-dominated model, while exhibiting no significantly greater effect size in the rural population-dominated model.
Conclusion: Our empirical findings provide novel insights into the patterns of out-of-pocket consumption on digital mental healthcare. Specifically, the study highlights the mediating roles of digital technology and customer perception in shaping consumer behavior. These factors not only influence the willingness to pay but also affect the perceived accessibility, trust, and effectiveness of such services, thereby offering a more nuanced understanding of out-of-pocket consumption in the digital healthcare landscape.
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References
Akbarialiabad, H., Taghrir, M. H., Abdollahi, A., & Shojaei, S. (2021). Screening for depression in patients with chronic diseases: A meta-analysis. Medical Journal of the Islamic Republic of Iran, 35, 121–129.
Ali, M., & Anwar, M. (2021). Consumer behavior towards mental health apps: An emerging market study. Journal of Consumer Studies, 45(2), 201–218.
American Psychiatric Association. (2023). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Publishing.
Belk, R. W. (2013). Extended self in a digital world. Journal of Consumer Research, 40(3), 477–500.
Belk, R. W., & Russell, W. (1975). Situational variables and consumer behavior. Journal of Consumer Research, 2(3), 157–164.
Ben-Zeev, D. (2020). The digital revolution and mental health. Psychiatric Services, 71(1), 10–13.
Bloom, P. N., Propst, R. A., & Kang, H. (2012). Cause-related marketing: Product–cause fit and consumer attitudes. Nonprofit and Voluntary Sector Quarterly, 41(5), 826–847.
Bond, G. R., Drake, R. E., Luciano, A., & Torrey, W. C. (2023). Digital interventions for serious mental illnesses: State of the science. Psychiatric Services, 74(1), 18–26.
Camacho, E., & Torous, J. (2023). Digital mental health: Challenges and opportunities in psychiatric practice. Current Psychiatry Reports, 25(2), 45–52.
Caspi, A., Sugden, K., Moffitt, T. E., Taylor, A., Craig, I. W., Harrington, H., ... & Poulton, R. (2020). Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene. Science, 301(5631), 386–389.
China National Center for Mental Health Assessment and Development (CCMHAD). (2021). Annual report on mental health in China (2020). People's Medical Publishing House.
Choudhary, A., Mehta, A., & Rana, S. (2024). Understanding user engagement in mental health mobile applications: A consumer perspective. Digital Health, 10, 20552076241234567. https://doi.org/10.1177/20552076241234567
Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 13(3), 319–340.
Faturohman, T., Handayani, P. W., & Azzahro, F. (2021). Evaluating mental health app quality: A systematic review. Health Information Science and Systems, 9(1), 1–12.
Giles, D. C., Bosworth, G., & Watt, R. (2013). User attitudes towards digital health services. Journal of Medical Internet Research, 15(6), e112.
Goodday, S. M., Atkinson, L., Goodwin, L., & Vaillancourt, T. (2023). The rise of digital therapeutics for youth mental health. Child and Adolescent Psychiatry and Mental Health, 17(1), 15-20.
Gratzer, D., & Torous, J. (2021). Tackling the digital divide: Engaging low-income patients in digital mental health. Psychiatric Services, 72(6), 721–723.
Grönroos, C. (1984). A service quality model and its marketing implications. European Journal of Marketing, 18(4), 36–44.
Habibi, H. R., & Rasoolimanesh, S. M. (2021). Users' behavioral intentions toward mental health apps: An integration of UTAUT2 and the health belief model. Telematics and Informatics, 58, 101523. https://doi.org/10.1016/j.tele.2020.101523
Hamilton, H. A., Goldsmith, C., & Pasha, T. (2024). Social media and adolescent mental health: A longitudinal perspective. Journal of Adolescent Health, 74(1), 15–22.
Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data. British Journal of Clinical Psychology, 44(2), 227–239.
Holt, D. B. (1995). How consumers consume: A typology of consumption practices. Journal of Consumer Research, 22(1), 1–16.
Intarot, P., & Beokhaimook, J. (2018). Attitudes of university students towards mental health mobile applications in Thailand. Asian Journal of Psychiatry, 36, 15–20.
Kamalul Ariffin, S., Mohan, T., & Goh, Y. N. (2018). Influence of interactivity and vividness of mobile mental health apps on user engagement. Internet Research, 28(2), 475–495.
Kannan, P. K. (2017). Digital marketing: A framework, review and research agenda. International Journal of Research in Marketing, 34(1), 22–45.
Li, L., Zhang, Y., Wang, X., & Wang, C. (2020). The role of trust in promoting mental health app usage: Evidence from China. Information & Management, 57(7), 103317.
Luo, C., & Hancock, J. T. (2020). Self-disclosure on social media: The role of perceived audience and contextual factors. Journal of Computer-Mediated Communication, 25(1), 60–75.
MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614.
MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research, 39(1), 99–128.
Magrath, J. (1986). Psychological aspects of consumer behavior. Journal of Marketing Management, 2(2), 195–205.
Mannan, M., Mamun, M. A., Dhand, N. K., & Nabi, M. Y. (2019). Mobile health apps for mental health in low- and middle-income countries: Challenges and potential. JMIR Mental Health, 6(2), e12389.
Marquez, P. V., & Saxena, S. (2016). Making mental health a global development priority. World Bank Blogs. https://blogs.worldbank.org/health/making-mental-health-global-development-priority
McCord, R. F., He, W., & Liu, Y. (2020). Using machine learning to predict mental health service utilization. Journal of Medical Internet Research, 22(12), e22198.
McGorry, P., Mei, C., & Killackey, E. (2022). Transforming youth mental health care in the digital era. The Lancet Psychiatry, 9(3), 197–199.
Mitchell, A. A. (1999). Consumer behavior and mental health. Consumer Psychology, 4(1), 25–37.
People’s Daily Health Times (PDHT). (2022). Mental health in China: Public perception and service needs. People’s Daily Health Times.
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891.
Rafiq, M., Fulford, H., & Lu, X. (1995). Building market orientation: The role of top management. European Journal of Marketing, 29(10), 57–74.
Ramos, A., Costa, P. A., & Silva, D. R. (2024). Mental health apps and behavioral change: A systematic review. Frontiers in Psychology, 15, 1223345.
Song, H., Zmyslinski-Seelig, A., Kim, J., Drent, A., Victor, A., Omori, K., & Allen, M. (2021). Does Facebook make you lonely? A meta-analysis. Computers in Human Behavior, 36, 446–452.
Souki, G. Q., Soares, B. P., & Vieira, V. A. (2020). Digital engagement with health apps and user satisfaction. Journal of Retailing and Consumer Services, 54, 102030.
Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 53–55.
Torous, J., Firth, J., & Huckvale, K. (2021). The growing field of digital psychiatry: Current evidence and the future of apps, social media, chatbots, and virtual reality. World Psychiatry, 20(3), 318–335.
Wahyudi, M. T., & Parahiyanti, T. (2021). Examining the role of digital mental health platforms in promoting well-being. Indonesian Journal of Psychology, 38(2), 94–103.
Wang, X., Zhang, Y. & Yu, Y. (2020). Factors influencing the adoption of mobile mental health services in China. Health Informatics Journal, 26(1), 595–610.
World Health Organization. (2020). Mental Health Atlas 2020. World Health Organization. https://www.who.int/publications/i/item/9789240036703
Zhang, Q., Li, L., Wang, F., & Lin, Y. (2023). Understanding digital empathy in mental health services: A systematic review. Digital Health, 9, 20552076231234567. https://doi.org/10.1177/20552076231234567
Zhang, W., & Luo, J. (2024). Trust and usability in mental health apps: A user-centric analysis. Computers in Human Behavior, 146, 107759. https://doi.org/10.1016/j.chb.2023.107759