When acceptance doesn't convert: The mobile acceptance–purchase gap in health device mCommerce: Evidence from home blood pressure monitors in Lagos, Nigeria

Abstract

Technology acceptance models assume that favourable evaluations of a digital channel led to its use and, ultimately, to purchase. This study tests that assumption in a high-involvement, health-related category: home blood pressure monitoring (HBPM) devices in Lagos, Nigeria. Drawing on the Unified Theory of Acceptance and Use of Technology (UTAUT) and the intention–behaviour literature, it examines whether mobile shopping acceptance predicts four stages of consumer purchase (product awareness, brand perception, purchase intention and actual purchase behaviour) and whether age and hypertension diagnosis status condition these  relationships. Survey data from 231 HBPM consumers recruited across pharmacy, hospital, online and medical-representative channels were analysed with partial least squares structural equation modelling (PLS-SEM), 5,000-subsample bootstrapping, PLSpredict and permutation based multigroup analysis. Mobile shopping acceptance was high (67–71% agreement on every item), but it had no significant effect on any purchase stage (all |β| ≤ 0.109, all p ≥ 0.256, R² ≤ 0.012), and all Q²predict values were negative. Purchase intention did not predict actual purchase behaviour. Consumers who accepted mobile shopping were no more likely to report completed purchases than those who did not (43.2% vs 40.8%; χ² = 0.06, p = 0.812). Multigroup comparisons by age (<45 vs ≥45) and diagnosis status revealed no significant differences. Bootstrap confidence intervals rule out moderate or large effects. The findings identify a boundary condition for UTAUT in health-device mCommerce: in a market where
73.6% of purchases occur in pharmacies, mobile acceptance functions as a channel attitude rather than a purchase driver. It is recommended that HBPM retailers and digital pharmacies build pharmacist consultation, product-authenticity verification and links to trusted pharmacies into their mobile platforms rather than rely on mobile acceptance to drive sales, and that future research test trust, perceived risk and task–technology fit as mediators of the gap.