Exploring behavioral and contextual factors influencing adoption of digital primary care services in Scotland

Purpose:
The purpose of this study is to explore how adults aged 18-45 engage with and continue the use of NHS digital primary care services in Scotland, focusing on the influence and interaction of behavioural and contextual factors shaping this process of adoption using the COM-B model as a theoretical lens.

Design/methodology/approach:
The study adopts a theory-informed qualitative research design. Semi-structured interviews will be conducted with adults aged 18–45, who have used or attempted to use NHS digital primary care services such as online appointment booking, electronic repeat prescriptions and video consultation. Participants will be recruited through purposive sampling. Interview data will be analysed using the Framework analysis, where initial coding will be based on predefined categories using COM-B followed by inductive analysis if new themes emerge from participants lived experiences.

Findings:
It is anticipated that the study will show that engagement with digital primary care services is shaped not simply by the availability of technology, but by the interaction between behavioural and contextual conditions. Factors such as digital literacy, trust, service usability and access to resources are likely to influence whether individuals adopt and continue using these services. The study is also expected to highlight how assumptions about age related digital literacy plays a role in shaping the process of adopting these digital services offered at primary care level.

Originality/value:
This research contributes to the digital health literature by focusing on digital primary care services in Scotland and examining adults aged 18–45. Although frequently included in broader samples, this population is rarely analysed separately. In addition, existing studies combines patients, clinicians, and caregivers often limiting the understanding of user specific behavioural patterns. Much of the literature focuses on older adults or children, where adoption is considered as more challenging, while assumptions of digital capability remain largely unexamined. Younger adults are often assumed to be digitally capable. This assumption overlooks the specific skills required to navigate digital health services. By addressing these gaps, this study provides insight into factors shaping engagement and aims to inform more inclusive digital health policy and user centred service design.