Mobile health (mHealth) applications have become increasingly valuable in preventive healthcare and in reducing the burden on healthcare organizations. The aim of this paper is to investigate the factors that influence user acceptance of mHealth apps and identify the underlying structure that shapes users' behavioral intention. An online study that employed factorial survey design with vignettes was conducted, and a total of 1,669 participants from eight countries across four continents were included in the study. Structural equation modeling was employed to quantitatively assess how various factors collectively contribute to users' willingness to use mHealth apps. The results indicate that users' digital literacy has the strongest impact on their willingness to use them, followed by their online habit of sharing personal information. Users' concerns about personal privacy only had a weak impact. Furthermore, users' demographic background, such as their country of residence, age, ethnicity, and education, has a significant moderating effect. Our findings have implications for app designers, healthcare practitioners, and policymakers. Efforts are needed to regulate data collection and sharing and promote digital literacy among the general population to facilitate the widespread adoption of mHealth apps.

翻译：移动健康应用程序在预防性医疗及减轻医疗机构负担方面日益重要。本文旨在探究影响用户接受移动健康应用程序的因素，并识别塑造用户行为意图的潜在结构。我们开展了一项采用情境模拟的因子设计在线研究，共纳入来自四大洲八个国家的1669名参与者。通过结构方程模型定量评估了多种因素如何共同影响用户使用移动健康应用程序的意愿。结果表明，用户的数字素养对其使用意愿影响最为显著，其次是在线分享个人信息的习惯，而用户对个人隐私的关注仅产生微弱影响。此外，用户的人口统计背景（如居住国家、年龄、种族及教育程度）具有显著调节效应。本研究结论对应用程序设计者、医疗从业者及政策制定者具有启示意义。需规范数据收集与共享机制，并提升全民数字素养，以促进移动健康应用程序的广泛普及。