Vol. 13 No. 1 February 2022 DOI: 10.18196/jgp.v13i1.13541 http://journal.umy.ac.id/index.php/jsp 86 Citizens’ Adoption of an E-Health SysteM During the PandeMic AFFILIATION: 1University of the Visayas (UV) 2Mindanao State University – Iligan Institute of Technology (MSU-IIT) 3 Mindanao State University – Iligan Institute of Technology (MSU-IIT) 4 Mindanao State University – Iligan Institute of Technology (MSU-IIT) CORRESPONDENCE: (fayelorrainemina@gmail.com, enrique.batara@g.msuiit.edu.ph eucil.hussien@g.msuiit.edu.ph rabby.lavilles@g.msuiit.edu.ph) HOW TO CITATE: Mina, F. L., Batara, E. B., Hussien, E. P., & Lavilles, R. Q. (2022). Citizens’ Adoption of an E-Health System During The Pandemic. Jurnal Studi Pemerintahan, 13(1). 86-111 ARTICLE HISTORY: Received: December 15, 2021 Revised: December 25, 2021 Accepted: January 25, 2022 FAYE LORRAINE P. MINA*1 , ENRIQUE B. BATARA2 , EUCIL P. HUSSIEN 3 , AND; RABBY Q. LAVILLES 4 , ABSTRACT This study aimed to determine the factors influencing the behavioral intention of PhilHealth members to adopt My PhilHealth Portal using an extended unified theory of acceptance and use of technology (UTAUT). Variables from this theory were operationalized through indicators which were then translated into a self-reported online survey questionnaire distributed through email and Facebook. Purposive-homogeneous sampling was used to determine the sample size from the target population who are Cagayan de Oro City based PhilHealth formal economy members employed in either private or public sector. The data from the online survey was tested for reliability using IBM SPSS Statistics (version 20), and the Cronbach’s alpha (1951) coefficient was used to assess the validity of variables. To determine the causal relationship of variables on specific constructs, data were processed using licensed ver- sions of IBM SPSS AMOS (version 26) to perform Structural Equation Model- ling, which will further show the account for a specific impact of the constructs and moderating variables to behavioral intention. It is cross-sectional in na- ture and conducted within a short period of time. Citizens’ perceptions to- wards the adoption of My PhilHealth Portal can change over time as new knowledge and experiences will be accumulated. Therefore, future studies could employ a longitudinal design to obtain more accurate findings that are relevant to the general public’s adoption of government portals. Findings show that citizens’ behavioral intention to adopt My PhilHealth Portal is influenced by their trust on internet, trust on government, effort expectancy, and their perceived competence. However, the selected moderating variables appear to have no significant effect on TOI, TOG, EE, and PC to BI. Keywords: e-Health; Behavioral Intention; UTAUT; Citizen Adoption; Formal Economy Member; e-Government ABSTRAK Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi niat perilaku anggota PhilHealth untuk mengadopsi My PhilHealth Portal menggunakan memperluas teori penerimaan dan penggunaan teknologi terpadu (UTAUT). Variabel dari teori ini dioperasionalkan melalui indikator yang kemudian diterjemahkan ke dalam kuesioner survei online yang dilaporkan sendiri yang didistribusikan melalui email dan Facebook. Purposive-homo- geneous sampling digunakan untuk menentukan ukuran sampel dari populasi sasaran yang merupakan anggota ekonomi formal PhilHealth yang berbasis di Cagayan de Oro City yang bekerja di sektor swasta atau publik. Data dari http://journal.umy.ac.id/index.php/jsp mailto:(fayelorrainemina@gmail.com mailto:enrique.batara@g.msuiit.edu.ph mailto:eucil.hussien@g.msuiit.edu.ph https://orcid.org/0000-0002-7128-5723 https://orcid.org/0000-0003-0655-5288 https://orcid.org/0000-0002-2631-6594 https://orcid.org/0000-0001-9798-543X JURNAL STUDI PEMERINTAHAN survei online diuji reliabilitasnya menggunakan IBM SPSS Statistics (versi 20), dan koefisien Cronbach’s alpha (1951) digunakan untuk menilai validitas variabel. Untuk menentukan hubungan sebab akibat variabel pada konstruksi tertentu, data diproses menggunakan versi berlisensi dari IBM SPSS AMOS (versi 26) untuk melakukan Struc- tural Equation Modelling, yang selanjutnya akan menunjukkan akun untuk dampak spesifik dari konstruksi dan variabel moderasi terhadap niat perilaku Ini bersifat cross- sectional dan dilakukan dalam waktu singkat. Persepsi warga terhadap adopsi My PhilHealth Portal dapat berubah seiring waktu karena pengetahuan dan pengalaman baru akan terakumulasi. Oleh karena itu, studi masa depan dapat menggunakan desain longitudinal untuk mendapatkan temuan yang lebih akurat yang relevan dengan adopsi portal pemerintah oleh masyarakat umum. Temuan menunjukkan bahwa niat perilaku warga untuk mengadopsi My PhilHealth Portal dipengaruhi oleh kepercayaan mereka pada internet, kepercayaan pada pemerintah, harapan usaha, dan kompetensi yang mereka rasakan. Namun variabel moderasi yang dipilih ternyata tidak berpengaruh signifikan terhadap TOI, TOG, EE, dan PC to BI. Kata kunci: e-Health; Niat Perilaku; UTUT; Adopsi Warga Negara; Anggota Ekonomi Formal; e-Government INTRODUCTION On March 11, 2020, the World Health Organization (WHO, 2020) declared the COVID-19 outbreak to be the sixth public health emergency of international concern characterized as a pandemic. To tackle the disease’s long-term effects, a powerful combination of e-Governance, creative use of emerging and ad- vanced technology, strong community cohesion, long-term e- health systems, and citizen engagement has been needed. Citizens’ willingness to adopt e-Gov services is critical to its effectiveness (Shareef et al., 2011), therefore the lack of adoption impedes the successful implementation (Zhao et al., 2014; Carter & Belanger, 2005; Gupta & Dasgupta, 2008; Rana & Dwivedi 2015a). Furthermore, Venkatesh et al. (2008) state that any technology must be used in order to be effective. According to Shareef et al. (2011), research on this topic is still in its initial phases, with user perspectives not being fully explored (Van Deursen et al., 2006). To fill this gap of e-Government adoption, it is necessary to look into the adoption of PhilHealth members by investigating certain factors that influence the members’ behavioral intention to use My PhilHealth Portal in order to measure and assess the success of 87 Vol. 13 No. 1 February 2022 88 e-Government services in the Philippines. This study is signifi- cant because it provides information on the current state of adop- tion of an e-Health system in the Philippines. As a result, PhilHealth, policymakers, program implementors, and other stakeholders, including the general public, will recognize the sig- nificance of implementing e-health systems in this context, as it refers to My PhilHealth Portal, during this time of health crisis. Specifically, this research sought to answer the following questions: Q1. To what extent do trust on internet (TOI), trust on government (TOG), effort expectancy (EE), perceived com- petence (PC), social influence (SI) and facilitating conditions (FCs) affect citizens’ intention to use My PhilHealth Portal in Cagayan de Oro are City? Q2. How does gender, age, internet experience (INEX) and voluntariness of use (VOU) moderate these associations on the selected constructs? LITERATURE REVIEW UNIFIED THEORY OF ACCEPTANCE AND USE OF TECH- NOLOGY The UTAUT model is the result of a thorough investigation of the various models with the goal of achieving a common un- derstanding of user acceptance (Venkatesh et al., 2003). UTAUT model is said to be capable of explaining up to 70% of the vari- ance in behavioral intention. It has been widely used in a variety of fields, including e-health and mobile health (Nug & Aubert, 2013; Lin & Anol (2008). It encapsulates the contribution of eight (8) key theories namely: Theory of Reasoned Action (TRA) by Fishbein and Ajzen (1975), Theory of Acceptance Model (TAM) by Davis (1989), Motivational Model (MM) by Davis et al. (1992), Theory of Planned Behavior (TPB) by Ajzen (1991), Combined TAM and TPB (C-TAM-TPB) by Taylor and Todd (1995a), Model of Personal Computer Utilization (MPCU) by Thompson et al. (1991), Innovation Diffusion Theory (IDT) by Rogers (1995) and, finally, Social Cognitive Theory (SCT) by Compeau and Higgins (1995). JURNAL STUDI PEMERINTAHAN E-GOVERNMENT ADOPTION 89 Today, the government moves beyond traditional means, with the increasing use of information technology and the internet, the government is capable of delivering information and services directly to the public (Dadios et al., 2018). In this sense, e-Gov- ernment is committed to providing people with more open, effi- cient, and effective public services (Sipior, Ward and Connolly, 2011; Reddick and Roy, 2013). Citizens’ perception of the ex- pected benefit from using e-Government systems, according to Scott et al. (2016), determines the systems’ long-term viability. Many scholars, on the other hand, have studied the technical challenges concerning citizens’ adoption of e-Government ser- vices (Abu-Shanab et al., 2014; Al-Rashidi, 2010), such as trust (Gilbert et al., 2004; Pieterson et al., 2007), protection and cybersecurity (Ebrahim and Irani, 2005; Schwester, 2009), re- sources (Angelopoulos et al., 2010; Hwang et al., 2004), the lack of ICT abilities (Norris, 2009; Norris and Moon, 2005), the ab- sence of awareness (Aerschota and Rodousakis, 2008; Shalini, 2009), and the digital divide (Faisal and Rahman, 2008; Wang (2014); Liu & Zhou, 2010). Furthermore, Persson et al. (2015) contends that investigating the factors associated with adoption is a way to understand their overarching priorities, and that align- ing citizens’ perceptions in adopting e-Government services may be a key to success. According to researchers, acceptance of e- Government services is a substantial contribution to the litera- ture. (Wang et al., 2010; Wang, C., 2014). E-GOVERNMENT ADOPTION PREDICTORS There are numerous studies exploring the adoption of e-Gov- ernment services, which exist in the literature today. In particu- lar, these studies utilized the Unified Theory of Acceptance and Use of Technology UTAUT, one of the most recent developments in the field of the general technology acceptance model (Venkatesh et al., 2003). UTAUT explicates the individual ac- ceptance of information technology into a unified theoretical Vol. 13 No. 1 February 2022 90 model (Venkatesh et al., 2003) and the subsequent usage behav- ior (Maranguniæ and Graniæ, 2015). The UTAUT suggests that four core constructs (effort expectancy, perceived competence, social influence, and facilitating conditions) are direct determi- nants of behavioral intention (BI) (Venkatesh et al., 2003). The UTAUT model also takes into account moderators that have an impact on the predictors, such as gender, age, internet experi- ence, and voluntariness of use (Venkatesh et al. 2003). More than the factors presented in the UTAUT model, this study focused on several more specific variables that affect the citizens’ adoption of e-Government services in the context of this study. A. Trust on Internet - The ability to trust the internet tends to be a potentially important factor in increasing adoption (Alsaghier et al., 2009; Liu and Zhou, 2010; Berdykhanova et al., 2010). Considering the indefinite and frequently changing nature of the Internet, it was hypothesized that trust would be a determi- nant of behavioral expectations. Due to the extreme risks (Alsaghier et al., 2009; Liu and Zhou, 2010; Berdykhanova et al., 2010), online conditions entail the establishment of trust (Langton and McKnight, 2006). Carter et al. (2016) examined a cross-country study involving the United States and the United Kingdom their results revealed that the government should use confidence-building initiatives to promote public trust in e-Gov- ernment services, as TOI has a favorable impact on e-Govern- ment adoption (Carter et al., 2016). Based on these, this study hypothesized that: H1: Trust on Internet (TOI) affects the behavioral intention (BI) to adopt My PhilHealth Portal B. Trust on Government - Citizens’ trust in the government is another critical aspect of e-Government adoption. Data pro- tection and confidentiality appear to be the most common ante- cedents for trust in governments that influence the use of e-Gov- ernment services. This was illustrated in Asgarkhani’s (2005) JURNAL STUDI PEMERINTAHAN report on a pilot study of a digital government project in New 91 Zealand. Confidence in online privacy statements has been found to be very important in predicting trust in e-Government for both experienced and inexperienced users (Beldad et al. 2012). Shareef et al. (2011) discovered that security beliefs contribute to the development of trust in e-government (Shareef et al., 2011). According to Teo et al. (2008), the impact of trust in e-Govern- ment websites on satisfaction is partly mediated by system and service quality, with service quality having a significantly stron- ger influence than system quality. Carter and Bélanger (2005) emphasize that citizens must have trust in both the government (TOG) and the enabling technologies in order to participate in e-Government services. Based on these, this study hypothesized that: H2: Trust on Government (TOG) affects the behavioral inten- tion (BI) to adopt My PhilHealth Portal. C. Effort Expectancy - Many studies have found that effort expectancy is an important predictor of e-service use. A study of tax services in Indonesia, for example, discovered that the effort expectancy of the e-filing system has a positive impact on the country’s adaptation of e-filing services (Tahar, et al., 2020). Arunachalam (2019) found similar results indicates that the more user- friendly an e-learning platform is, the more likely it is that the learning will continue. It is also supported by Beldad et al. (2012), he found out that effort expectancy of prior online gov- ernment transactions has been a major impact in shaping trust in government among respondents with e-Government experi- ence. Based on these, this study hypothesized that: H3: Effort expectancy affects the behavioral intention (BI) to adopt My PhilHealth Portal. D. Perceived Competence – Bhuasiri et al. (2016) examined the factors that influence citizens’ intention to use an electronic tax filing and payment system in Thailand. The findings reveal Vol. 13 No. 1 February 2022 92 that perceived competence can augment extrinsic motivation and has a substantial indirect effect on people’s willingness to use the system. Another study conducted by Tiika and Tang (2019) on the adoption of e-Government services in Ghana discovered that a lack of competency in ICT skills is a significant barrier to adopting e-services. This is consistent with the other findings in this section, as it demonstrates that, in most cases, perceived competence is proportionate to the uptake of e-Government ser- vices. Based on these, this study hypothesized that: H4: Perceived competence (PC) affects the behavioral intention (BI) to adopt My PhilHealth Portal. E. In the context of technological adoption, social influence is described as a person’s perception that important others be- lieve he or she should use the new system. This variable is com- posed of other similar ones, namely subjective norm (TRA, TAM2, TPB and DTPB), social factors (model of PC utilization) and image (IDT) (Venkatesh et al. 2003). Studies of technology adoption (e.g., Chiu et al. 2010; Park et al. 2006; Pynoo et al. 2007; Sumak et al. 2010) have also supported the positive and significant impact of social influence on attitude Susanto and Aljoza (2015) concluded in their study of the factors associated with the adoption of e-Government services in Indonesia that social influence, along with trust, is one of the most significant factors influencing the adoption of e-services. These two factors were ranked higher than perceived usefulness and perceived ease of use. Based on these, this study hypothesized that: H5: Social influence (SI) affects the behavioral intention (BI) to adopt My PhilHealth Portal. F. Venkatesh et al. (2003) claim that facilitating conditions become irrelevant in predicting behavioral purpose when condi- tions such as performance expectancy and effort expectancy are present. In the context of the research, facilitating conditions is similar to research conducted by Batara, et al. (2017) in their JURNAL STUDI PEMERINTAHAN study of the adoption of e-Government services among employ- 93 ees in two cities in two countries: Surabaya, Indonesia, and Davao City, Philippines. According to their findings, facilitating condi- tions, such as process redesign, structuring, and behavioral and cultural aspects in city government, have a significant impact on respondents’ intentions to embrace the features required for e- Government services. Alraja (2016) reached similar conclusions in his study on government employees’ adoption of e-Govern- ment services in Oman. Similar research was conducted in Saudi Arabia (Alsobhi, Kamal, and Weerakkody, 2009), which yielded similar results, perhaps because the safety of personal data, low education level, and complexity of online services provided are all factors that impede citizen adoption. Based on these, this study hypothesized that: H6: Facilitating Conditions (FCs) affect the behavioral inten- tion (BI) to adopt My PhilHealth Portal. G. Moderator – Gender In terms of gender, earlier research has revealed that men are more likely than women to find mobile e-services useful (Nysveen et al. 2005). There are also differences in security perceptions between men and women; women place a much higher value on privacy and security than men (Vega, 2015). Puschel et al. (2010), on the other hand, gathered 666 respondents in Brazil and dis- covered that mobile banking users were mostly men. Similarly, Joshua and Koshy (2011) found that men may use electronic bank- ing services more than women after interviewing 553 people in India. Based on these, this study hypothesized that: H7a: The influence of EE on behavioral intention will be mod- erated by gender. H7b: The influence of PC on behavioral intention will be mod- erated by gender. H7c: The influence of SI on behavioral intention will be moder- ated by gender.R Vol. 13 No. 1 February 2022 94 H. Moderator – Age People’s perceptions of e-service quality are influenced by their age (Yarimoglu, 2017). Several studies have been undertaken to look into the implications of demographics on the adoption of new technology. Early adopters of technological innovations, according to Rogers (1995), are often younger, have greater in- comes, are better educated, and have higher social standing and employment. Another research on mobile banking adoption found that typical electronic banking users were young (Joshua & Koshy, 2011) or that the elderly had more resistance to change and a negative attitude toward using mobile banking services (Laukkanen et al. 2007). Several studies found that respondents aged 50 and up were the most concerned about using mobile banking services. However, the typical mobile banking users were aged 30 to 49 (Laukkanen & Pasanen 2008), and that middle-aged or older customers were the primary users of electronic banking (Laforet & Li, 2005). Based on these, this study hypothesized that: H8a: The influence of EE on behavioral intention will be moderated by age. H8b: The influence of PC on behavioral intention will be mod- erated by age. H8c: The influence of SI on behavioral intention will be moder- ated by age. H8d: The influence of FCs on behavioral intention will be mod- erated by age. I. Moderator – Internet Experience Internet experience (IE) was identified as an underlying mod- erator of usage behavior by Venkatesh et al. (2003). Studies (Agarwal and Prasad, 1999; Jiang et al., 2008) discovered that Internet experience influences both perceived utility and ease of use, which in turn influences people’s actual use or intention to use specific services. Prior experience with online transactions, according to Lee et al. (2005), is a statistically significant predic- JURNAL STUDI PEMERINTAHAN tor that should not be overlooked. Internet experience has a sig- 95 nificant impact on technology adoption decisions (Lippert and Forman 2005; Alshamaila et al. 2013) because it affects people’s attitudes toward new phenomena, new technology, or new online environments (Bandura 1977). Su et al. (2017) investigated how users’ Internet experience influences their adoption of mobile payment and their findings show that users’ experience with com- puters and the Internet in financial activities increases users’ perceived usefulness, ease of use, and compatibility which fur- ther enhance user’s intention to use mobile payment. Based on these, this study hypothesized that: H9a: The influence of EE on behavioral intention will be mod- erated by IE. H9b: The influence of SI on behavioral intention will be moder- ated by IE. H9c: The influence of FCs on behavioral intention will be mod- erated by IE. J. Moderator - Voluntariness of Use In the UTAUT model, Venkatesh et al. (2003) incorporated the voluntariness of use or compliance impact. Even though they were an explicit criterion at the time of TAM creation, Davis (1989) did not add voluntariness as an explicit element. How- ever, it was eventually incorporated as a moderator component in social influence (e.g. Venkatesh et al. 2003; Venkatesh and Davis, 2000; Agarwal and Prasad, 1997; Venkatesh and Morris, 2000; Barki and Hartwick, 1994). Based on these, this study hy- pothesized that: H10a: The influence of SI on behavioral intention will be. This research used a linear regression model (Figure 1), wherein the independent variables TOG, TOI, EE, PC, SI and FCs were hypothesized to be associated with the dependent vari- able Bl. The model was modified to fit the study’s context, and the constructs measured are as shown in Figure 1: Vol. 13 No. 1 February 2022 96 Figure 1. Research Model Notes: Legend: *p<0.05, ***p<0.001 (statistically significant) Source: Mina et al., 2022 RESEARCH METHOD DATA GATHERING TECHNIQUES In order to answer the questions and provide enough data to achieve the objectives of this study (Easterby-Smith et al., 2002), the researcher utilized an online self-reported survey question- naire using Google forms. During the collection of data, the re- searcher utilized Google forms as the online self-reported survey questionnaire. Due to the government restrictions and proto- cols, the online self-reported survey questionnaire was distrib- uted, filled up, and collected online. Prior to fielding, the survey questionnaire was pilot tested to ensure proper statement for- mat and wording, as well as the reliability and validity of con- structs. JURNAL STUDI PEMERINTAHAN RESEARCH PARTICIPANTS 97 This research employed a purposive homogeneous sampling in choosing the participant. The participants in this study were 400 Cagayan de Oro City-based PhilHealth Formal Economy members, 200 of which are government employees and 200 of which work in the private sector. TREATMENT AND ANALYSIS OF DATA The data from the online survey underwent a reliability test using IBM SPSS Statistics (version 20), coefficient of Cronbach’s alpha (1951) was used to assess the validity of variables. Ander- son and Gerbing (1988) explain that when computing covari- ance estimates between pairs of latent variables, the discriminant validity of variables must be tested. The respondents’ demo- graphic profiles were treated using descriptive statistics and fre- quencies using IBM SPSS Statistics (version 20). To test the hy- potheses and determine the causal relationship of variables, data from each item on specific constructs in section 2 of the online survey were treated by obtaining the mean and then using li- censed versions of IBM SPSS AMOS (version 26) to perform Structural Equation Modelling. RESULT AND DISCUSSION DEMOGRAPHIC PROFILE OF RESPONDENTS In terms of age, the data collected shows that the majority of the participants were between the ages of 20 and 30. With re- gards to gender, the majority of the respondents during the con- duct of the study are mostly male. The respondents’ job sector was adequately represented, with 50% working in the private sector and 50% working in the government. Furthermore, data suggests that huge percentage of respondents have access to mobile data, while only a few have internet access. According to the data, a significant portion of them have more than two years of internet experience, indicating that the respondents are al- ready familiar in using the internet. Vol. 13 No. 1 February 2022 98 RELIABILITY ANALYSIS The table below reveals the reliability analysis using Cronbach’s alpha, which indicates the internal consistency of indicator items such as TOI, TOG, EE, PC, SI, and FCs that measure the same construct. A minimum Cronbach’s alpha value of 0.70 indicates construct reliability and validity. All constructs passed the test and demonstrated a high level of reliability. Table 1. Validity of Constructs (N=400) Constructs Squared Multiple Correlation Cronbach' s Alpha Cronbach's Alpha Based on Standardized Items No of Items Trust on Internet .344 .778 .755 6 Trust on Government .480 .743 .755 6 Effort Expectancy .435 .738 .755 6 Perceived Competence .422 .737 .755 6 Social Influence .429 .733 .755 6 Facilitating Conditions .380 .731 .755 6 Source: Mina et al., 2022 CONSTRUCTS AND THEIR RELATIONSHIP TO BEHAV- IORAL INTENTION (BI) Data shows that there is a significant association between be- havioral intention (BI) and TOI (p<0.01), TOG and PC (p<0.001), EE (p<0.05), and FCs (p<0.05), indicating that the hypothesis is accepted at the 0.05 alpha level of significance. However, with p- value of .098 and .052 respectively, there is no significant rela- tionship between the BI and SI, and FCs and BI, resulting in the rejection of the hypothesis. TOI and EE as shown above has a negative coefficient, the findings suggest that as the independent variables TOI and EE increases, the dependent variable BI tends to decrease. The significant relationship of the five constructs accounts for 24% in BI (with an R2 of 0.24). Results show that trust in the government and perceived com- petence are highly significant to behavioral intention. The re- spondents of this study believe that the government has the re- JURNAL STUDI PEMERINTAHAN sources to deliver dependable and reliable online services, and 99 that it can give all relevant information necessary to fulfill their needs through online transactions, as shown in Table 4.2.4. This indicates that the intention to use My PhilHealth Portal is asso- ciated to their perceived trust in the government. This is similar to the findings of Abu-Shanab (2014), who discovered that trust in government is one of the variables that predict Jordanian use of e-Government services which is also a predictor in the UTAUT model derived from Venkatesh et al. (2003). When it comes to the perceived competence, it shows a high significance on the respondent’s intention to adopt the portal. The majority of respondents have access to mobile data, and only a few have access to the internet from an internet service provider, implying that having a high-speed internet connection would increase their willingness to use the portal. They also indi- cated that a suitable device is a factor in their reluctance to use the portal, which, according to the findings, they are using mo- bile data, implying that their gadgets are mobile phones. Studies (Eschenbrenner and Nah, 2014; Berry, 1997; Fuerst & Cheney, 1982) show that when users’ competency is high, typical resis- tance to change is reduced, and performance improves. Accord- ing to Venkatesh et al. (2003), the most important factor in de- ciding whether or not to utilize a new technology is based on the perceived competence whether the use is voluntary or manda- tory (Venkatesh et al., 2003). Third, trust in the internet is an important indicator of their behavioral intention to use the portal. As shown in Table 2, re- spondents do not trust the internet as a safe place to conduct secure transactions and are unsure whether to provide financial and other personal information in the portal. In terms of effort expectancy, data shows that effort expectancy is highly associ- ated with behavioral intention to adopt My PhilHealth Portal. This means that the ease of use of the portal (Venkatesh et al., 2003) influences the respondents’ intention to adopt. It is also revealed that the respondents’ intention to use the Vol. 13 No. 1 February 2022 100 portal has no relationship to facilitating conditions. Based on the UTAUT model (Venkatesh et al., 2003), this variable has a direct and significant impact on the actual use of a technology but in this study, it doesn’t have a significant impact on BI. Hence, as the organization’s efficiency improves and more resources and support are available for users’ demands, the impact of this vari- able increases (Venkatesh et al., 2003). Finally, the results show that there is no correlation between SI and BI. In the UTAUT model, SI is a predictor of BI (Venkatesh and Davis, 2000), but not in the context of this study. Although respondents believe that using the portal will keep them safe from Covid-19 and that people who use the portal are safe and healthy, SI appears to have no significant impact on BI. In this case, the users do not recognize the significance that others believe he or she should use the new facility or My PhilHealth Portal (Venkatesh et al., 2003). This means that as the number of users who are positive about using the portal increases exponentially, so will the num- ber of users who are socially influenced in their immediate envi- ronment. This implies that the people influencing the respon- dents’ behavior have little intention of using the portal. Table 2. Relationship of Independent Variables to Dependent Variable Relationship Regression Weights S.E. C.R. P-value Hypothesis TOI → BI -.105 .041 -2.554 .011 Accepted TOG → BI .453 .055 8.287 *** Accepted EE → BI -.129 .063 -2.040 .041 Accepted PC → BI .227 .051 4.436 *** Accepted SI → BI .089 .054 1.655 .098 Rejected FCs → BI .093 .048 1.942 .052 Rejected Note: Legend: ***p<0.001 (statistically significant) Source: Mina et al., 2022 MODERATORS’ INFLUENCE TO SPECIFIC CONSTRUCTS According to the findings, the interaction between age and social influence appears to be the most significant on Behavioral JURNAL STUDI PEMERINTAHAN Intention (BI) with p<0.00 and the interaction of voluntariness of use and social influence has a significant impact on behav- ioral intention, with p<0.05. As seen in the data, there is no significant relationship between the interaction of gender to EE, PC and SI implying the rejection of the hypothesis. Furthermore, the interaction of age to PC and FCs has no effect on BI, hence the interaction of age to SI affects BI. Also, the data show that the influence of internet experience moderated by EE, SI, and FCs has no significant effect to BI. Moreover, social influence moderated by VOU has a significant effect to BI. Table 3. Relationship Between Moderators and Selected Constructs Dependent <--- Interaction Variable Regression Weights S.E. C.R. P-value Hypothesis BI <--- GEN_EE -.089 .117 -.763 .445 Rejected BI <--- GEN_PC .171 .090 1.906 .057 Rejected BI <--- GEN_SI -.040 .103 -.393 .694 Rejected BI <--- AGE_EE .092 .046 1.988 .047 Rejected BI <--- AGE_PC -.047 .036 -1.317 .188 Rejected BI <--- AGE_SI .152 .042 3.603 *** Accepted BI <--- AGE_FC -.065 .026 -2.473 .013 Rejected BI <--- INEX_EE -.012 .055 -.213 .832 Rejected BI <--- INEX_SI -.090 .048 -1.860 .063 Rejected BI <--- INEX_FC -.025 .045 -.572 .567 Rejected BI <--- VOU_SI .169 .073 2.328 * Accepted Notes: Legend: *p<0.05, ***p<0.001 (statistically significant) Source: Mina et al., 2022 IMPLICATIONS TO THEORY In the context of the study and the context of PhilHealth Formal Economy Members, TOI, TOG, EE, and PC are pivotal indicators to the adoption of My PhilHealth Portal during the pandemic. In the unified theory of acceptance and use of tech- nology, it suggests that four core constructs (performance expect- ancy, effort expectancy, social influence, and facilitating condi- tions) are direct determinants of behavioral intention and that these constructs are in turn moderated by gender, age, internet 101 Vol. 13 No. 1 February 2022 102 experience, and voluntariness of use (Venkatesh et al., 2003). This study proves the determinants of behavioral intention and the following moderators that impact the constructs in the adop- tion of My PhilHealth Portal. Despite the fact that trust in the government and trust in the internet is not included in the UTAUT model, some studies show that these are a significant predictor of resistance to using e-Gov- ernment services (Abu-Shanab,2014; Mpinganjira, 2015; Teo et al.,2008), and it was discovered in this study that TOG and TOI are pivotal predictors of portal adoption. Interestingly, TOI has a negative impact on BI, implying that respondents do not trust the internet as a reliable medium for conducting secure transac- tions. Effort expectancy and perceived competence were discov- ered to be significant predictors of portal adoption, which, there- fore, lends credence to some claims in the literature (Tahar, et al., 2020; Arunachalam, 2019; Ramli and Rahmawati, 2020; Hamid et al., 2016) and in the UTAUT model (Venkatesh et. al., 2003). EE has a negative impact on BI, indicating that respon- dents believe navigating My PhilHealth Portal is complicated. However, SI and FCs do not appear to be predictors of BI, im- plying those notions of prominent studies (Taylor and Todd,1995b; Chiu et al. 2010; Lee and Lin 2008; Alraja, 2016; Carter et al., 2012), including the UTAUT model (Venkatesh et. al., 2003), appear to be different in the context of this study. Gender appears to be non - significant as a moderating vari- able for EE, PC, and SI. These results refute the assertions of studies (Nysveen et al. 2005; Cruz et al. 2010; Joshua and Koshy, 2011; Vega, 2015). EE, SI, and FCs appear to be moderated by age, with FCs being negatively moderated by age, as demonstrated among those in the age bracket of 50 and above. These findings validate the UTAUT model and the study of Yarimoglu (2017) and Berraies et al.(2017), which shows how users’ perceptions of the availability of technical assistance to facilitate the usage of a system are influenced by their age. Internet experience, as a moderating variable is not relevant to EE, SI and FCs, which JURNAL STUDI PEMERINTAHAN contradicts the UTAUT model and some studies (Lippert and Forman 2005; Alshamaila et al., 2013). Finally, VOU appears to moderate SI; this finding lends support to the UTAUT model (Venkatesh et al., 2003) and other studies (Agarwal & Prasad, 1997; Chiu et al., 2017). Therefore, this study indicates that the moderators derived from the UTAUT model in the context of this study don’t influence the selected constructs. This study has shown the roles of predictors (TOI, TOG, EE, and PC) and moderators (Age and VOU) of BI in the context of this study, as seen in the validated research model (Figure 2), are the factors influencing citizen adoption of My PhilHealth Por- tal. The study’s clear contribution to the advancement of e-gov- ernment adoption literature is the examination and validation of the selected constructs’ roles in the adoption of new technol- ogy or systems. 103 Figure 2. Validated Research Model Notes: Legend: *p<0.05, ***p<0.001 (statistically significant) Source: Mina et al., 2022 IMPLICATIONS TO PRACTICE Among the six constructs on portal adoption, TOG and PC stand out as key factors. This means that, in order to increase adoption, members should be made aware of the portal’s secu- rity features, as well as the agencies and staff’s ability to perform online transactions faithfully. The negative impact of TOI on BI Vol. 13 No. 1 February 2022 104 clearly explains that in practice, proper education and under- standing about the internet’s safety when disclosing confidential information must be realized by the agency in order to increase the portal’s adoption. Since EE has an impact on BI, the portal’s features must be convenient to use, especially since there are us- ers aged 50 and above, and it must be available 24/7. This is a critical feature for users during the pandemic because it allows them to transact their needs at any time and from any location. The agency should encourage the voluntary use of the portal in adopting it; mandating it would have an impact on the portal’s adoption because citizens are accustomed to freely use the portal without being obligated to do so. Based on the findings of this study, PhilHealth can establish a national strategy to increase portal adoption, taking into account other PhilHealth member categories. CONCLUSION In this study, it was discovered that trust on internet, trust on government, effort expectancy, and perceived competence are all directly related to behavioral intention in the context of My PhilHealth Portal adoption. Few constructs in the UTAUT model (EE and PC) emerge as determinants of adoption, as such TOI and TOG are proven to be highly significant to BI, contributing to the broad study and theory of technology adoption. Due to the Covid-19 protocols, respondents have found the portal use- ful because it can be accessed from anywhere at any time without risk of virus exposure, which is appropriate for their needs in conducting transactions with the agency. Because the effect of EE on BI is moderated by age, PhilHealth should ensure that the portal is simple to use so that older adults, not just young adults, can take advantage of its features. In addition, a lack of access to a high-speed internet connection and appropriate gad- gets makes it difficult for them to adopt the portal. SI and FCs did not appear to be a factor in the intention to use the portal. As a result, PhilHealth should strongly encourage the general JURNAL STUDI PEMERINTAHAN public to use the My PhilHealth Portal, particularly during a health crisis. Finally, it is a challenge for the agency to prioritize proper training on how to navigate the portal for all members, regardless of age, in order to increase adoption. 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Thank you to all of the respondents who took the time to fill out the questionnaire which contributed significantly to this paper. To the Political Science Department, colleagues and friends, thank you for the knowl- edge, encouragement, guidance, and constant supervision you bestowed on us. Finally, to our loved ones, your steadfast support, love, and encouragement have been priceless throughout the process of researching and writing this study. 111