Digital Health Adoption Among Patients with Diabetes inQassim Unaizah, Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Diabetes mellitus is a major public health concern in Saudi Arabia, affecting approximately 18.3% of adults. Although over 95% of people in the Qassim region own smartphones, limited information exists regarding how and why patients with diabetes utilize digital health technologies. OBJECTIVE: This study employed an extended Technology Acceptance Model (TAM) incorporating trust, privacy concerns, and self-efficacy to investigate the factors influencing digital health technology adoption among patients with diabetes in Qassim Unaizah, Saudi Arabia. METHODS: A cross-sectional study was conducted from November 2025 to January 2026 following institutional review board approval. The quantitative phase utilized a structured survey (n = 203) measuring TAM constructs via validated 5-point Likert scales. Descriptive statistics, Pearson correlations, and one-way ANOVA were performed. Qualitative themes were derived from open ended responses to contextualize quantitative findings. RESULTS: Most participants were male (62.6%), with a mean age of 47.2 years (SD ± 13.1). Smartphone ownership was nearly universal (99.5%), and 82.8% used blood glucose tracking applications. All TAM constructs exhibited significant positive correlations with behavioural intention (p < 0.001): attitude (r = 0.450), perceived usefulness (r = 0.438), self-efficacy (r = 0.394), trust (r = 0.379), ease of use (r = 0.340), and privacy concern (r = 0.309). Mean scores indicated strong acceptance: perceived usefulness (4.31, SD ± 0.39), behavioural intention (4.21, SD ± 0.44), and attitude (4.17, SD ± 0.42). Daily usage was reported by 63.1% of participants, 81.8% expressed satisfaction, and 63.1% reported that digital tools greatly improved their diabetes management. Privacy concerns were notably low (mean 1.70, SD ± 0.89, reverse-coded; Cronbach's α = 0.921). Supplementary qualitative content analysis of optional open-ended comments (n = 40 respondents) identified six recurring topics: clinical utility, digital literacy, trust, data security awareness, patient empowerment, and social support. CONCLUSIONS: Patients with diabetes in Qassim Unaizah demonstrate substantial digital health adoption, predominantly driven by perceived usefulness, positive attitudes, and self-efficacy. The extended TAM effectively explains adoption within this Saudi Arabian context. Findings support interventions emphasizing clinical benefits, user friendly design, and trust building to optimize digital health utilization in diabetes care.