Predictors of nursing students' intentions to participate in an internationalization-at-home program: The roles of expectancies for success and subjective task value.

BACKGROUND: Internationalization-at-home programs are a unique opportunity for those who had been planning to study abroad to learn global clinical practices and cultures at home. However, the factors influencing the motivation of students to join such programs remain unexplored. OBJECTIVE: To investigate the relationship among expectancies for success, subjective task value, and the intention to participate in an internationalization-at-home program, and to identify key factors predicting such an intention among undergraduate nursing students. DESIGN: A descriptive correlational design with a predictive approach was adopted. METHODS: A total of 522 undergraduate and postgraduate nursing students in a Hong Kong university participated in the study. Intention to participate in the program was assessed using the Comprehensive Relative Autonomy Index. Expectancies for success and subjective task value were assessed as potential predictors. A multiple linear regression analysis was adopted to examine the predictive effects. RESULTS: The participants were aged 17-31 years (mean = 20.95, SD = 2.39). Those who reported having previously participated in the program (ß = 0.10, p-value = .014), greater intercultural communication competence (ß = 0.14, p-value = .003), greater perceived social competence (ß = 0.11, p-value = .031), and a higher subjective value of the program (ß = 0.28, p-value<.001) expressed a greater intention to join the program. Collectively, the three variables accounted for 14.7 % of the variances in intention to participate in the program. CONCLUSIONS: Cultural self-efficacy, intercultural communication competence, perceived social competence, individual interest, foreign language learning motivation, and subjective value of the program were found to be key factors predicting the intention of nursing students to participate in internationalization-at-home. Future studies can provide interventions to address these factors and enhance the benefits of internationalization-at-home programs.

Effect of a Mobile Health Application With Nurse Support on Quality of Life Among Community-Dwelling Older Adults in Hong Kong: A Randomized Clinical Trial.

Importance: Mobile health (mHealth) smartphone apps are becoming increasingly popular among older adults, although the reactive care approach of these apps has limited their usability. Objective: To evaluate the effects of an interactive mHealth program supported by a health-social partnership team on quality of life (QOL) among community-dwelling older adults in Hong Kong. Design, Setting, and Participants: This was a 3-group, randomized clinical trial conducted in 5 community centers in Hong Kong from December 1, 2020, to April 30, 2022, with a last follow-up date of January 31, 2022. Participants included older adults aged at least 60 years who were living within the service area, used a smartphone, and had at least 1 of the following problems: chronic pain, hypertension, or diabetes. Data were analyzed from May 1 to 10, 2022. Interventions: Participants were randomly assigned to the mHealth with interactivity (mHealth+I) group, mHealth group, or control group. Participants in the mHealth+I group received the mHealth app and nurse case management supported by a health-social partnership team. The mHealth group received the mHealth app only. The control group received no mHealth app or health-social care services. Main Outcomes and Measures: The primary outcome was the change in QOL from baseline to 3 months after completion of the intervention. Results: Among 221 participants (mean [SD] age 76.6 [8.0] years; 185 [83.7%] women), 76 were randomized to the control group, 71 were randomized to the mHealth group, and 74 were randomized to the mHealth+I group. The most common chronic diseases or problems were hypertension (147 participants [66.5%]), pain (144 participants [65.2%]), cataracts (72 participants [32.6%]), and diabetes (61 participants [27.6%]). At 3 months after the intervention and compared with the intervention group, there were no statistically significant differences in either the physical component summary (mHealth+I: ß = -1.01 [95% CI, -4.13 to 2.11]; P = .53; mHealth: ß = 0.22 [95% CI, -3.07 to 3.50]; P = .90) or the mental component summary (mHealth+I: ß = -0.87 [95% CI, -4.42 to 2.69]; P = .63; mHealth: ß = 1.73 [95% CI, -1.89 to 5.34]; P = .35) QOL scores. Only secondary outcomes, including self-efficacy (ß = -2.31 [95% CI, -4.26 to -0.36]; P = .02), systolic blood pressure (ß = -2.30 [95% CI, -5.00 to -0.13]; P = .04), pain levels (ß = 1.18 [95% CI, 0.52 to 2.00]; P = .02), and health services utilization (ß = 0.98 [95% CI, 0.32 to 2.09]; P = .048) improved in the mHealth+I group compared with the control group. Conclusions and Relevance: This randomized clinical trial found no difference in the primary outcome between the mHealth+I group and the control group confirming that there were no incremental benefits to adding interactivity in mHealth programs for older adults with chronic diseases. Trial Registration: Clinicaltrials.gov Identifier: NCT03878212.