Driving healthcare wearable technology

adoption for Generation Z consumers in

Hong Kong
Man Lai Cheung, Ka Shing Wilson Leung and Hak Sin Chan

Abstract Man Lai Cheung is based

Purpose – Young consumers have increasingly adopted wearable health-care technology to improve at the Department of
their well-being. Drawing on generation cohort theory (GCT) and the technology acceptance model Marketing, The Hang Seng
(TAM), this study aims to illuminate the major factors that drive the adoption of health-care wearable University of Hong Kong,
technology products by Generation Z (Gen-Z) consumers in Hong Kong. Shatin, Hong Kong and
Design/methodology/approach – A self-administrated online survey was used to collect data from a Newcastle Business
sample of Gen-Z consumers in Hong Kong with experience in using health-care wearable technology. School, University of
Data analysis was performed using partial least-squares-structural equation modeling to verify four Newcastle, Newcastle,
hypotheses.
Australia.
Findings – The results reveal that consumer innovativeness (CI) and electronic word-of-mouth referral Ka Shing Wilson Leung is
(EWOM) are significant predictors of perceived credibility, perceived ease of use and perceived based at the College of
usefulness, which subsequently drive online engagement intention and adoption intention (AI).
Professional and
Practical implications – This research provides practical guidance for marketers of health-care
Continuing Education, The
wearable technology products. In particular, CI and EWOM hold the key to young consumers’ product
Polytechnic University of
perceptions (and thereby their online engagement and AIs).
Hong Kong, Hong Kong.
Originality/value – This research leverages the insights of GCT to enrich the TAM, specifically by
including CI and EWOM as antecedents and online engagement as a consequence in the context of Hak Sin Chan is based at
health-care wearable technology. The results of an empirical study enhance theoretical understanding of the Department of
Gen-Z consumers’ perceptions and behavioral intentions toward health-care wearable technology. They Marketing, The Hang Seng
also point to actionable recommendations for marketing this new technology to young consumers. University of Hong Kong,
Keywords Generation cohort theory, Generation Z, Technology acceptance model, Shatin, Hong Kong.
Health-care wearable technology, Adoption intention
Paper type Research paper

1. Introduction
With the exponential development of information technology, health-care wearable
devices have enjoyed phenomenal success in recent years (Kim and Chiu, 2019). Widely
regarded as one of the most promising areas of the Internet of Things (Marakhimov and
Joo, 2017), health-care wearable technology comprises smart technology products that
are incorporated into different types of accessories attachable to users’ bodies. Prime
examples are the Apple Watch, Fitbit, Samsung Gear and the Mi Band wristbands
(Wright and Keith, 2014).
Health-care wearable technology significantly contributes to consumer wellness, helping Received 9 April 2020
users to conveniently track their health conditions (Zhang et al., 2017). Myriad wearable Revised 6 June 2020
Accepted 8 July 2020
technology products are designed to monitor such things as the number of steps and
The authors are grateful for
distance traveled, calories burned and workout intensities (Gao et al., 2015). They are constructive comments offered
especially important to sports and health-care industries, providing accurate, real-time by the anonymous reviewers.

DOI 10.1108/YC-04-2020-1123 © Emerald Publishing Limited, ISSN 1747-3616 j YOUNG CONSUMERS j

 physiological measurements such as heart rate, running pace and core temperature, along
with other kinematic parameters and temporal parameters (Düking et al., 2018).
Given the health value and quality-of-life implications (Kim and Chiu, 2019), the health-care
wearable technology market is projected to reach US$50bn by 2022 (Reuters, 2019), with
an annual growth rate of more than 15% between 2016 and 2022. In particular, Generation
Z (Gen-Z) consumers – those who were born since 1997 – are tech-savvy, health-conscious
and willing to spend their time in sports and fitness (Ding et al., 2017; Kira ľova
 and
Hamarneh, 2017). As such, it is not surprising that Gen-Z consumers are increasingly
adopting health-care wearable devices to collect real-time health data (Goodyear et al.,
2019; Ng et al., 2019). Notably, Gen-Z consumers frequently share lifestyle information and
interact with like-minded peers on social media platforms (Bencsik et al., 2018; Nielsen,
2015, 2018b). The popularity of electronic word of mouth about new technologies on social
media platforms, such as Facebook, Instagram and YouTube, in the form of product
reviews, new product briefs or user experience sharing has caused Gen-Z consumers to
become highly engaged with health-care wearable technology (Pinto and Yagnik, 2017). As
such, Gen-Z consumers are acknowledged as the most important segment for health-care
wearable technology, warranting more understanding about their behavioral intentions
regarding these blossoming technology products (Goodyear et al., 2019; Talukder et al.,
2019).
According to a recent report, the Hong Kong government is committed to promoting a
healthy environment with favorable science and technology policies (Tang, 2019). The
report also indicates that more than 70% of young people aged 16–24 are interested in
wearable technology. These Gen-Z consumers embrace smart technologies and are
therefore a catalyst for the growth of health-care wearable technology products. Note also
that Gen-Z consumers in Hong Kong are inclined to participate in sports and regular
exercise, seeking to maintain a good health status (Nielsen, 2018a). With their interests in
digital technology, health and sports, Gen-Z consumers in Hong Kong should be motivated
to learn and share about health-care wearable technology products and, as a result,
develop positive perceptions towards these products (Abbott, 2019; Leung and Zheng,
2012). Concurrent with the increasing adoption rates of health-care wearable technology
(Wang et al., 2018), smart technology brands have allocated more resources to create and
promote health-care wearable devices in Hong Kong (SCMP, 2018), resulting in heightened
competitive intensity as manifested by plenty of product choices and a large amount of
pertinent information available on social media platforms (Pinto and Yagnik, 2017). Against
this background, there is a practical need for a more in-depth understanding of consumer
behavior towards health-care wearable technology (Kim and Chiu, 2019).
The literature on health-care wearable technology is still in its infancy. There is an
inadequate understanding of the diffusion process, especially about the antecedents of
Gen-Z consumers’ adoption intention (AI) and online engagement behavior (Goodyear
et al., 2019; Kim and Shin, 2015; Pinto and Yagnik, 2017). Although the technology
acceptance model (TAM) has been used to examine technology adoption behavior in
various contexts (Kim and Chiu, 2019; Mehrad and Mohammadi, 2017; Talukder et al.,
2019), empirical research on factors influencing Gen-Z consumers’ AI for health-care
wearable devices is very limited. As discussed earlier, Gen-Z consumers are tech-savvy
and highly involved in social media and information technology and are hence regarded as
one of the most important customer segments for technology products (Nielsen, 2015,
2018b).
To advance the literature, we integrate generation cohort theory (GCT) and TAM to explain
Gen-Z consumers’ adoption motive towards health-care wearable technology. Note that
GCT identifies distinct generation cohorts born in different time periods, with each cohort
sharing similar experiences from major events during their coming of age. The theory is
useful for understanding consumers’ preferences and behaviors and for generating insights

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into market segmentation (Ting et al., 2018). According to GCT, Gen-Z consumers are
distinguished in terms of the information search pattern, attitude towards technology and
information sharing behavior (Ng et al., 2019). They are also key users of health-care
wearable devices (Naumovska, 2017) and are thus the focal cohort in the current research.
In short, the objective of this research is to explore the antecedents that lead to the
adoption of health-care wearable technology by Gen-Z consumers in Hong Kong. From a
theoretical perspective, this research broadens the theoretical understanding of
consumer behavior regarding the adoption of health-care wearable technology. From a
managerial perspective, it offers guidance for marketers to develop effective strategies
to promote health-care wearable technology products.

2. Theoretical background and hypotheses

In this section, we first provide a literature review of GCT and TAM, both of which provide
the theoretical background for this research. Then, we discuss the theoretical relevance of
the key constructs to our hypotheses on the AI of health-care wearable technology.

2.1 Generation cohort theory

According to GCT, values and behaviors of consumers in a generation cohort are largely
shaped by the collective experiences during their formative years (Deranek et al., 2020).
Previous research has adopted GCT to understand how the experiences formulated as a
result of external events – such as social and economic developments – during the late
adolescent years affect a common cohort’s beliefs and behaviors (Gardiner et al., 2014;
Ting et al., 2018). In marketing, GCT has been used for segmentation purposes – identifying
various generation cohorts with similar values, expectations, beliefs and behaviors (Ng
et al., 2019). Major consumer cohorts include baby boomers (born between 1946 and
1964), generation X (Gen-X; born between 1965 and 1980), generation Y (Gen-Y; born
between 1981 and 1996) and Gen-Z (born from 1997 onwards) (Dimock, 2019).
Gen-Z consumers are highly involved in digital technology compared to previous cohorts
(i.e. baby boomers, Gen-X and Gen-Y) because they have grown up in an era
characterized by dramatic advances in information communication technology (Ng et al.,
2019). Gen-Z consumers spend considerable amounts of time searching for the newest
digital devices, seeking referrals on social-media platforms in their decision-making
process (Tan and Lau, 2016). The implication is that not only are Gen-Z consumers
motivated to adopt smart technology products but they also tend to engage in value co-
creation activities, such as providing user feedback and getting involved in new product
development processes (Zhang et al., 2017; Zhang, 2019).
Growing up in the information technology era, Gen-Z consumers in Hong Kong are
increasingly involved in information search on social media platforms. Through social
media, they may, for instance, participate in cultural exhibitions (Chung, 2018), engage
collectively in virtual reality games (Lovric, 2020) and share their shopping experiences
(Vojvodic, 2018), as well as their workout data from health-care wearable devices (Nielsen,
2018a, 2018b). Overall, Gen-Z consumers in Hong Kong are tech-savvy, heavy users of
social media and instant messaging and arguably one of the most important markets for
smart technology products (Leung and Zheng, 2012). This qualifies Hong Kong’s Gen-Z
consumers as a prime cohort for investigating the adoption of smart technology along with
the associated value co-creation behaviors.
Gen-Z consumers have been featured in recent research on technology adoption behavior
(Priporas et al., 2017; Tan and Lau, 2016). This is because they are highly involved in digital
technology and tend to put in considerable effort to learn about features, attributes and
benefits of digital information products (Ng et al., 2019; Zhang, 2019). Gen-Z consumers

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 are also heavy users of electronic word of mouth on social media platforms (Duffett, 2017;
Fan et al., 2019; Styvén and Foster, 2018). They are – by virtue of GCT and recent research –
a fitting cohort to explore technology acceptance in general, and the adoption of health-care
wearable technology in particular.

2.2 Technology acceptance model

Regarded as one of the most important theories on information technology adoption, TAM
was introduced by Davis (1989) to explain why individuals would accept a new technology
(Kim and Chiu, 2019; Mehrad and Mohammadi, 2017; Talukder et al., 2019). It highlights
perceived ease of use (PEOU) and perceived usefulness (PU) as factors contributing to
consumers’ AI for technology products, such as mobile commerce, social networking sites
and health-care wearable devices. The former, PEOU, refers to the degree to which an
individual believes that using technology would be free of effort (Davis, 1989). The latter,
PU, refers to the degree to which an individual believes that using a specific technology
would be performance enhancing.
Prior research has adopted TAM to study smart technology adoption by young consumers.
For example, Tan and Lau’s (2016) study examined Gen-Y’s adoption of mobile banking in
Malaysia, emphasizing the role of performance expectancy in driving behavioral intention
and usage behavior. More recently, Ng et al. (2019) applied TAM to study the antecedents
leading to young consumers’ adoption of smart retailing technologies in Malaysia and
confirmed the importance of PU in driving attitude and referral intention.
Following TAM, we posit that PEOU and PU are critical drivers of AI for health-care wearable
technology. But we also seek to build a more holistic framework with other pertinent
constructs, including perceived credibility (PC), consumer innovativeness (CI), electronic
word-of-mouth referral (EWOM) and online engagement intention (OEI). As noted before,
Gen-Z consumers are interested in using smart technology products (Liberato et al., 2019;
Ng et al., 2019), browsing for credible EWOM (Duffett, 2017) and engaging in value co-
creation activities (Priporas et al., 2019). It, therefore, stands to reason that Gen-Z
consumers are easily influenced by EWOM on social media platforms, especially for smart
technology products. Naturally, Gen-Z consumers are also apt to share and post EWOM
after product consumption (PrakashYadav and Rai, 2017).
In summary, it is logical to posit that Gen-Z consumers’ technology AI is intricately linked
with CI, EWOM, PC and OEI. These constructs are added to TAM to build a richer
nomological network, which is elaborated below.

2.3 Consumer innovativeness

CI refers to consumers’ willingness to try out new products. This construct is closely related
to consumers’ beliefs about new technology (Agarwal and Prasad, 1997). Arguably,
consumers higher in CI recognize the value of technology products and have a higher
intention to use these technology products to achieve their goals (Yi et al., 2006).
Prior research has affirmed the importance of CI in driving consumers’ positive perceptions
of technology products. For example, Lafferty and Goldsmith (2004) reported that CI is
critical in driving PC and thereby a positive brand attitude and purchase intention. Kuo and
Yen (2009) found that CI has a positive impact on PEOU and PU, resulting in a higher AI.
Alda s-Manzano et al. (2009) found that CI is positively associated with PC, which in turn
strengthens usage intention. Natarajan et al. (2017) confirmed that CI plays an important
role in driving PEOU and PU, which in turn strengthen AI. Recently, Kim and Chiu (2019)
verified that CI exerts a positive influence on PEOU and PU in the context of health-care
wearable technology. On the basis of prior literature, we hypothesize the following:

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 H1. Consumer innovativeness has a positive impact on the (a) PEOU, (b) PU and (c) PC
of health-care wearable technology products.

2.4 Electronic word-of-mouth referral

EWOM refers to the positive product reviews left by current, former or potential customers
on social media platforms, such as Facebook, Instagram, online forums and blogs (Cheung
et al., 2019; Hennig-Thurau et al., 2004). The influence of EWOM on consumers’ decision-
making process is widely acknowledged in the literature (Cheng and Huang, 2013; Cheung
et al., 2018; Cheung et al., 2020a; Nuseir, 2019). For instance, Reza Jalilvand and Samiei
(2012) found that EWOM plays an important role in driving consumers’ product perceptions,
which in turn affects their purchase intention. As far as TAM is concerned, Kim and Song
(2010) documented the role of EWOM in strengthening PEOU and PU, which in turn
increase shopping intention. In the context of technology consumption, Parry et al. (2012)
again found that EWOM enhances PC and, in turn, usage intention. As a whole, our
synthesis of the literature leads to the following hypothesis regarding EWOM and consumer
perceptions of health-care wearable technology:
H2. EWOM has a positive impact on the (a) PEOU, (b) PU and (c) PC of health-care
wearable technology products.

2.5 Adoption intention

Empirical studies based on TAM have shown that PU, PEOU and PC positively influence
consumers’ intention to use a technology (Leong et al., 2019; Natarajan et al., 2017). In
particular, PU refers to “the prospective user’s subjective probability that using a specific
[technology] will increase his or her job performance”, whereas PEOU refers to “the degree
to which the prospective user expects the [use of the technology] to be free of effort” (Davis
et al., 1989, p. 985). The positive influence of PU and PEOU on behavioral intention has
been confirmed in various technology contexts, including e-commerce (Gefen et al., 2003),
big data analytics (Verma et al., 2018), social commerce (Gibreel et al., 2018), mobile
banking (Luarn and Lin, 2005) and smart wearable technology (Chang et al., 2016).
Following Chang et al. (2016), we argue that consumers tend to adopt health-care wearable
devices that are perceived as useful and easy to use. Specifically, when consumers believe
a wearable device can enable them to easily monitor their health status and effectively
cultivate a healthy lifestyle, they are likely to adopt it. In addition, we argue that the PC is
another important factor contributing to technology adoption (Wang et al., 2003). Previous
research suggests that PC involves two dimensions, namely, perceived technology
accuracy and perceived privacy protection (Zhang et al., 2017). According to Zhang et al.,
acceptable health-care wearable systems should deliver accurate and real-time health
feedback and pathological diagnosis. Zhang et al.’s study further points to the importance of
privacy protection, with acceptable health-care wearable technology products offering good
protection for personal health data. In light of previous research, we hypothesize that – in
addition to PU and PEOU – PC also facilitates the adoption of healthcare wearable
technology. This hypothesis is stated formally as follows:
H3. AI for health-care wearable technology products is positively influenced by (a)
PEOU, (b) PU and (c) PC.

2.6 Online engagement intention

OEI refers to consumers’ desire to interact with social media sites or websites, such as
visiting, downloading, or recommending the site pages (Calder et al., 2009). In the digital
age, consumers often access online platforms to receive, combine and share product
information in the decision-making process (Muntinga et al., 2011). They are particularly

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 interested in reading and posting content about a focal product with like-minded others
(Schivinski et al., 2016). Prior research suggests that OEI is largely driven by consumers’
perceptions of the focal product. In particular, Filieri et al. (2015) found that consumers are
more willing to share product information with their peers via social media when the
products are perceived to be credible and useful. Yang and Wang (2015) found that
consumers are more willing to share information with their peers online when social media
usage is perceived to be user-friendly. Similarly, Tussyadiah and Pesonen (2018) also
found a positive relationship between PEOU and online sharing behavior. More recently,
Cheung et al. (2020d) found that when information available on social media is deemed to
be trendy and useful, consumers are more willing to provide feedback.
Additionally, prior research has established a link between consumers’ OEI and AI (Mishra,
2019; Simon and Tossan, 2018; Teng et al., 2017). In general, when consumers have a
positive attitude towards technology products, they are more willing to interact with their
peers via social media to discuss and share information related to their favorite brands and
products (Lin and Kim, 2016). Combining the aforementioned insights, we extend TAM by
hypothesizing that OEI is driven by PEOU, PU, PC and AI of health-care wearable
technology products:
H4. OEI is positively influenced by (a) PEOU, (b) PU, (c) PC and (d) AI.

3. Methodology
The empirical study is cross-sectional in nature. We conducted a self-administrated online
survey (in English) using a convenience sample in Hong Kong. The measurement items
were adapted from previous studies, and a seven-point Likert scale (1 = strongly disagree,
2 = disagree, 3 = somewhat disagree, 4 = neither agree nor disagree, 5 = somewhat
agree, 6 = agree, 7 = strongly agree) was used to capture the perceptions about health-
care wearable technology products by Gen-Z consumers in Hong Kong. In particular,
we adopted four items from Reza Jalilvand and Samiei (2012) to measure EWOM and three
items from Talukder et al. (2019) to measure CI. We also adopted four items and three items
from Zhang et al. (2017) to measure PC and PU, respectively, whereas adopting four items
from Kim and Chiu (2019) to measure PEOU. Lastly, three items were adopted from Chuah
et al. (2016) and Zhang et al. (2017) to measure AI and three items were adopted from
Piehler et al. (2019) to measure OEI.
The target respondents were Gen-Z consumers in Hong Kong with experience of using
health-care wearable technology. We sent invitations to university students via email and
instant messaging (WhatsApp, Facebook and Instagram) for approximately 12 weeks, from
September to December 2019. Respondents without experience in health-care wearable
technology were excluded from the current study. We collected 211 usable responses from
Gen-Z consumers, all of whom were users of wearable health-care technology products.
The sample was comprised of 56.4% male and 43.6 female, with ages ranging from 18 to
22 years. A large proportion of the sample was between 18 and 20 of age (88.1%).

4. Results
Partial least-squares-structural equation modeling (PLS-SEM) was used for data analysis
because of its unique advantages. First, PLS-SEM is a good technique for theory testing
and theory confirmation (Hair et al., 2017; Sarstedt et al., 2019; Tan et al., 2019; Ting et al.,
2019), so it fits the objective of this study. Second, PLS-SEM is useful when the study aims
to further advance the arguments and propositions of theoretical models, as is the case of
similar studies in the area of marketing and technology adoption (Cheung et al., 2020a; Kim
and Chiu, 2019). Third, PLS-SEM is appropriate for studies with smaller sample sizes (i.e.
less than 500; Cheung et al., 2020c; Lau et al., 2019; Leung et al., 2019; Wong et al., 2019).

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4.1 Measurement model
Following Hair et al. (2017), we tested the reliability of the measurement items by checking
their factor loadings, Cronbach’s alphas and composite reliability (CR) coefficients. The
loadings of all items were greater than 0.808 and significant (p  0.000), with Cronbach’s
alphas and CRs all greater than 0.844, which is well above the recommended 0.70
threshold. Hence, the reliability of the measurement items was confirmed (Table 1).
In addition, as reported in Table 2, we tested the convergent validity of the model by using
the average variance extracted (AVE). With all of the AVE values larger than the
recommended value of 0.50, the convergent validity of the model was confirmed.
Furthermore, discriminant validity was tested using the Fornell and Larcker (1981) criterion.
Because the AVE square roots were all larger than the corresponding correlations,
discriminant validity was demonstrated. We also checked discriminant validity using the
heterotrait–monotrait (HTMT) ratio (Franke and Sarstedt, 2019; Henseler et al., 2015). As
presented in Table 3, the HTMT ratios were all smaller than the threshold value of 0.90,

Table 1 Measurement model results

Construct Loading t-value Alpha CR

EWOM 0.915 0.940

I often read other consumers’ online reviews to find out whether healthcare wearable device makes a
good impression on others 0.903 56.47
I often consult other consumers’ online reviews to help choose a good healthcare wearable device 0.902 65.10
I frequently gather information from consumers’ online reviews before I choose to buy a healthcare
wearable device 0.928 95.47
If I don’t read consumers’ online reviews when purchasing healthcare wearable devices, I worry
about my decision 0.838 34.08
CI 0.836 0.902
I like to experiment with new things and products 0.900 65.86
I think a new way of life and a new pattern of consumption is a kind of progress compared with the
past 0.893 53.69
In general, I am among the first in my circle of friends to use a new technological product or service
when they appear 0.810 32.32
PC 0.918 0.942
The data provided by the healthcare wearable device are in line with my personal health data 0.911 88.79
I would find the software system of the healthcare wearable device credible 0.895 38.56
An adequate protection of my personal health information would make it more possible for me to use
the healthcare wearable device 0.906 54.90
It is more possible for me to use the healthcare wearable device if my personal health information will
be protected and will not be shared with other entities without my authorization 0.871 43.53
PEOU 0.909 0.936
Learning to use the healthcare wearable device would be easy for me 0.843 39.10
It would be easy for me to become skilful at using the healthcare wearable device 0.861 31.98
I think the healthcare wearable device is easy to carry 0.935 128.96
I have access to the healthcare wearable device everywhere 0.906 65.09
PU 0.918 0.948
Using the healthcare wearable device would be useful in my personal health management 0.920 78.98
Using the healthcare wearable device would help me develop healthy habits 0.934 87.99
Using the healthcare wearable device would help me maintain healthy status 0.926 73.14
OEI 0.915 0.946
I often read articles about healthcare posted on Facebook/ Instagram/WeChat/websites 0.923 72.40
I often “like” posts about healthcare available on Facebook/ Instagram/WeChat/websites 0.929 64.21
I often post comments on posts about healthcare available on Facebook/Instagram/WeChat/
websites 0.921 74.95
AI 0.931 0.956
I am interested in using the healthcare wearable device 0.937 100.81
I plan to adopt the healthcare wearable device in the future 0.934 55.05
I will develop healthy habits with the healthcare wearable device in the future 0.94 99.09

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 Table 2 Discriminant validity of measurement model – based on the Fornell–Larcker
criterion
Constructs AI EWOM CI OEI PEOU PC PU AVE

AI 0.939 0.882
EWOM 0.757 0.904 0.818
CI 0.776 0.725 0.858 0.737
OEI 0.788 0.756 0.692 0.919 0.845
PEOU 0.755 0.662 0.757 0.638 0.877 0.769
PC 0.793 0.655 0.747 0.652 0.851 0.904 0.817
PU 0.788 0.748 0.821 0.69 0.783 0.799 0.927 0.859
Notes: Diagonal values (italicized) represent the square roots of the AVE values, whereas the off-
diagonals represent the correlations between variables; EWOM = electronic word-of-mouth referral,
CI = consumer innovativeness, PEOU = perceived ease of use, PC = perceived credibility, PU =
perceived usefulness, OEI = online engagement intention, AI = adoption intention

Table 3 Discriminant validity of measurement model – based on the HTMT ratio

Constructs AI EWOM CI OEI PEOU PC PU

AI
EWOM 0.82
CI 0.882 0.829
OEI 0.851 0.824 0.794
PEOU 0.815 0.721 0.865 0.688
PC 0.856 0.713 0.852 0.705 0.93
PU 0.853 0.815 0.937 0.751 0.855 0.87
Notes: EWOM = electronic word-of-mouth referral, CI = consumer innovativeness, PEOU =
perceived ease of use, PC = perceived credibility, PU = perceived usefulness, OEI = online
engagement intention, AI = adoption intention

except for the pairs of CI–PU and PEOU–PC. Given multiple variables in the model, we
applied the variance inflation factor (VIF) method to check for multicollinearity. The results
indicated that all VIF values were lower than the threshold value of 5, so multicollinearity did
not appear to be a concern in this study (Hair et al., 2017; Leung et al., 2019).
Lastly, because we collected self-reported data from a single source, common method
variance (CMV) could have exaggerated the hypothesized relationships. We followed the
suggestion of Kock and Lynn (2012) to check for CMV with full collinearity assessment. As
shown in the Appendix, all the VIF values were less than 5, suggesting that CMV was not a
concern in this study (Hair et al., 2017).

4.2 Structural model

We used SmartPLS v3.28 (Ringle et al., 2015) with the 5,000-bootstrap procedure to test the
hypotheses in our research model. As reported in Figure 1 and Table 4, the results fully
supported nine and marginally supported two of the 13 hypotheses. Specifically, the impact
of CI on PEOU (& = 0.585, p < 0.01), PU (& = 0.589, p < 0.01) and PC (& = 0.574, p <
0.01) was positive and significant, thus supporting H1(a), (b) and (c). Likewise, EWOM has
a positive and significant impact on PEOU (& = 0.238, p < 0.05), PU (& = 0.321, p < 0.01)
and PC (& = 0.239, p < 0.05), thus supporting H2(a), (b) and (c). Moreover, the impacts of
PU (& = 0.386, p < 0.01) and PC (& = 0.361, p < 0.01) on AI were positive and significant,
whereas the impact of PEOU (& = 0.145, p < 0.10) on AI was positive and marginally
significant. Thus, H3(a) and (b) were supported and H3(c) was marginally supported.
Regarding the antecedents of OEI, the impact of AI was positive and significant (& = 0.647,

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Figure 1 Research model results

Table 4 PLS-SEM analysis

Relationship Standardized coefficient t-value p-value f2 R2 Q2

PEOU
EWOM ! PEOU 0.238 2.49 0.013 0.068 0.601 0.467
CI ! PEOU 0.585 6.30 0.000 0.407
PC
EWOM ! PC 0.239 2.53 0.012 0.066 0.585 0.466
CI ! PC 0.574 6.056 0.000 0.377
PU
EWOM ! PU 0.321 3.51 0.000 0.177 0.724 0.617
CI ! PU 0.589 6.32 0.000 0.596
AI
PEOU ! AI 0.145 1.78 0.075 0.017 0.700 0.609
PC ! AI 0.361 3.97 0.000 0.000
PU ! AI 0.386 6.51 0.000 0.161
OEI
PEOU ! OEI 0.049 0.474 0.636 0.002 0.635 0.534
PC ! OEI 0.046 0.429 0.668 0.001
AI ! OEI 0.647 4.47 0.000 0.343
PU ! OEI 0.179 1.88 0.060 0.024
Notes: EWOM = electronic word-of-mouth referral, CI = consumer innovativeness, PEOU =
perceived ease of use, PC = perceived credibility, PU = perceived usefulness, OEI = online
engagement intention, AI = adoption intention

p < 0.01), whereas the impact of PU on OEI was positive and marginally significant
(& = 0.179, p < 0.10). Thus, H4(d) was supported and H4(b) was marginally supported.
However, the impacts of PEOU (& = 0.049, p > 0.10) and PC (& = 0.046, p > 0.10) on
OEI were non-significant, thus H4(a) and (c) was not supported.

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 Additionally, we performed the Cohen’s f2 analysis (Table 4) to test the importance of the
exogenous variables in the research model (Cohen, 1988). According to Cohen, f2 values at
or above 0.05, 0.15 and 0.35 are indicative of small, medium and large effects, respectively,
of the exogenous latent variables. In this analysis, the effect sizes of CI on PU (f2 = 0.596),
PEOU (f2 = 0.407) and PC (f2 = 0.377) were large, the effect sizes of EWOM on PU (f2 =
0.177) and PU on AI (f2 = 0.161) were medium, and the effect sizes of EWOM on PEOU (f2 =
0.068) and PC (f2 = 0.066) were small.
The research model had good explanatory power, as indicated by the R2 values of the
endogenous variables (Table 4). Specifically, the R2 values were 0.724 for PU, 0.700 for AI,
0.635 for OEI, 0.601 for PEOU and 0.585 for PC. They all greatly exceeded the
recommended criterion benchmark of 0.10 (Chin, 1998). In other words, the research model
was explaining a good amount of variation in the endogenous variables (Chin, 1998).
Besides, we also checked the predictive relevance (Q2) of the research model using
the blindfolding procedure (Cheah et al., 2019; Table 4). The Q2 value of each
endogenous variable was greater than zero, suggesting acceptable predictive
relevance (Hair et al., 2019). Lastly, we checked the predictive power of the research
model using PLS-predict (Koay et al., 2019; Shmueli et al., 2019). As presented in
Table 4, the root mean square error (RMSE) values of practically all indicators of PEOU,
PU, PC and AI in the linear regression model were smaller than the RMSE values in the
PLS model. As such, we conclude that the predictive power of PEOU, PU, PC and AI is
strong. Note, however, that the predictive power of OEI appears trivial. But since AI
(and its antecedents), rather than OEI, are the focal constructs of this research, we
conclude that the research model’s overall predictive power is good (Table 5).

5. Discussion
This research has yielded three key findings. First, PC and PU play a major role in
enhancing Gen-Z consumers’ AI for health-care wearable technology, which in turn
strengthens their OEI. Second, PC and PU are significantly influenced by EWOM and CI.
Third, PEOU only has a marginal impact on AI, whereas its impact on OEI is non-existent. In

Table 5 PLS-predict assessment

PLS LM PLS-LM
Decision of
predictive
RMSE Q2_predict RMSE Q2_predict RMSE Q2_predict relevance

AI1 1.039 0.592 1.042 0.59 0.003 0.002 Strong

AI2 1.004 0.581 0.991 0.592 0.013 0.011
AI3 1.065 0.541 1.11 0.5 0.045 0.041
OEI1 1.159 0.504 1.098 0.554 0.061 0.05 Trivial
OEI2 1.432 0.405 1.339 0.48 0.093 0.075
OEI3 1.226 0.509 1.046 0.642 0.18 0.133
PEOU1 1.081 0.509 1.112 0.481 0.031 0.028 Strong
PEOU2 1.023 0.544 1.041 0.528 0.018 0.016
PEOU3 1.078 0.359 1.114 0.315 0.036 0.044
PEOU4 1.143 0.407 1.161 0.388 0.018 0.019
PC1 0.98 0.494 1.006 0.467 0.026 0.027 Strong
PC2 1.12 0.41 1.154 0.373 0.034 0.037
PC3 1.12 0.44 1.131 0.429 0.011 0.011
PC4 1.06 0.472 1.098 0.434 0.038 0.038
PU1 0.945 0.566 0.977 0.536 0.032 0.03 Strong
PU2 0.839 0.629 0.861 0.61 0.022 0.019
PU3 0.854 0.634 0.866 0.623 0.012 0.011
Notes: AI = adoption intention, OEI = online engagement intention, PEOU = perceived ease of use,
PC = perceived credibility, PU = perceived usefulness

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short, this study empirically confirms that EWOM and CI are key predictors of PC and PU,
which in turn drive AI and OEI for health-care wearable technology products. The
theoretical and managerial implications of these findings are discussed below.

6. Theoretical implications
This research has implications for information systems theory by illuminating what drives
Hong Kong’s Gen-Z to adopt health-care wearable technology. Although health-care
wearable technology provides distinct advantages for improving the well-being of
individuals, empirical research related to the AI for this technology is limited (Kim and Shin,
2015). The present research extends the extant GCT literature by responding to recent calls
for research on how the values and lifestyles of Gen-Z consumers in Hong Kong affect their
technology usage (Ng et al., 2019; Ting et al., 2018). Specifically, we propose and confirm
the role of EWOM and CI as antecedents of Gen-Z consumers’ AI in the health-care
wearable technology context. Our findings reveal that EWOM and CI are key drivers of
PEOU, PU and PC en route to strengthening AI. Relatively speaking, CI is more powerful
than EWOM in terms of effect size, and this suggests that CI is the most important
determinant of Gen-Z’s AI for health-care wearable technology products. In other words,
Gen-Z consumers’ intrinsic savviness for technology is the primary driver of their decision to
adopt health-care wearable technology. Moreover, Gen-Z consumers’ reliance on EWOM
plays a secondary role in driving their intention to adopt these technology products.
Although our research affirms TAM in general, it shows that – as far as health-care
wearable technology is concerned – the impact of PEOU on AI and OEI is limited at best.
One possible reason for this surprising finding is that health-care wearable technology is
high in user friendliness and requires little learning and behavioral change, especially for
the tech-savvy Gen-Z consumers. Future research may further explore this possible
boundary condition for TAM in other technology contexts and among other generation
cohorts.
Consistent with previous studies (Luarn and Lin, 2005; Venkatesh, 2000; Verma et al.,
2018), PU emerges as a significant predictor of Gen-Z consumers’ AI for health-care
wearable technology. More importantly, we identify PC as exerting a major influence
on AI. Not only does this finding expand and enrich TAM but also dovetails with prior
research in the context of internet banking (Wang et al., 2003). It appears that
credibility concerns (e.g. system reliability, privacy protection) are salient for health-
care technology products as much as they are for financial technology products. The
convergence of findings thus points to a fruitful avenue for future research.

7. Managerial implications
Our research offers practical guidance for marketers of health-care wearable
technology. First, given the roles of CI and EWOM as key drivers of PC, PEOU and PU,
and in turn, AI, marketers should emphasize the truly innovative features of health-
care wearable technology, such as how it may help consumers monitor their workout
intensity and sleep quality. To target Gen-Z consumers, it is particularly important for
marketers to engage the social media communities in health care and sports. Overall,
a trendy, cutting-edge image could be the key to gaining the favor of Gen-Z
consumers.
Second, our results suggest that marketers of health-care wearable technology should
strike a good balance between novelty and credibility in their promotion campaigns. Note
that PC plays a major role in Gen-Z consumers’ decision to adopt health-care wearable
technology. To remove any credibility concerns, marketers should convey truly reassuring
messages regarding the accuracy and privacy of the health data generated by these novel
health-care products.

j YOUNG CONSUMERS j
 Third, our results also confirm the conventional wisdom that functionality is a vital
aspect of health-care wearable technology. In light of PU’s significant impact on AI,
marketers of health-care wearable devices should be committed to continuous value
improvement in their product strategy. Special emphasis should, for example, be
placed on matching product designs to the active lifestyles of Gen-Z consumers.

8. Conclusion and directions for future research

To the best of our knowledge, our research is among the first empirical investigations
into Hong Kong Gen-Z consumers’ adoption of health-care wearable technology.
Through the theoretical lens of TAM and GCT, we propose and demonstrate that Gen-Z
consumers’ perceptions of this novel technology (and, in turn, adoption propensity) are
largely driven by their intrinsic innovativeness and product referrals on social media
platforms. These findings have significant theoretical and managerial implications as
explicated above.
In spite of the useful findings, this study has several limitations. First, it was conducted in
Hong Kong, a cosmopolitan city with a diverse culture. Further research is warranted to
replicate our findings in more homogeneous cultures, because the culture is known to
influence consumers’ adoption of innovations (Sun et al., 2019). Second, although the
exogenous variables in this study have adequate explanatory power, future research
may include more actionable variables, such as brand awareness and brand image
(Cheung et al., 2019; Cheung et al., 2020b), to strengthen the strategic implications of
the model. Along the same lines, a model of technology adoption may not be complete
without such pertinent (and managerially relevant) variables such as gender and
education. Third, this study used a student sample, which could limit the generalizability
of some findings. Future research may consider using non-student samples to ascertain
the results reported here.

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 Appendix

Table A1 Full collinearity assessment

Construct Random dummy variable

AI 4.397
EWOM 3.491
CI 4.114
OEI 3.565
PEOU 3.333
PC 2.661
PU 4.302
Notes: AI = adoption intention, EWOM = electronic word-of-mouth referral, CI = consumer
innovativeness, OEI = online engagement intention, PEOU = perceived ease of use, PC = perceived
credibility, PU = perceived usefulness

Corresponding author
Man Lai Cheung can be contacted at: [email protected]

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