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Article history: Society has already accepted the use of physical implants that increase an individual's seductive power as
Received 28 June 2016 well as technological implants that correct physical disabilities. Various companies are currently
Received in revised form developing technological implants to increase the innate capacity of the human body (insideables) (e.g.,
9 December 2016
memory implants). Public acceptance of this new technology has not yet been investigated in academic
Accepted 28 December 2016
Available online 3 January 2017
research, where studies have instead focused on the ethical and evolutionary implications of insideables.
The main aim of this study is the development of a model, namely the Cognitive-Affective-Normative
(CAN) model, for assessing the acceptance of new types of technological products. The CAN model
JEL classification:
M3
combines the cognitive variables perceived usefulness and perceived ease of use, as well as the normative
variable subjective (or social) norm, from the TAM models with the affective variables positive emotions,
Keywords: negative emotions and anxiety. The CAN model was tested on a sample of 600 randomly selected in-
Insideable dividuals through structural equation modeling. Data were obtained from a self-administered, online
Technology acceptance survey. The proposed model explains 73.92% of the intention to use the technological product in the very
Perceived usefulness
early stages of its adoption, that is, its early acceptance. Affective and normative factors have the greatest
Ease of use
Emotions
influence on the acceptance of a new technology; within the affective dimension, positive emotions have
Subjective norm the greatest impact. Any technology acceptance model should thus consider the emotions that the new
technology produces, as well as the influence of the social norm.
© 2016 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.chb.2016.12.063
0747-5632/© 2016 Elsevier Ltd. All rights reserved.
J. Pelegrín-Borondo et al. / Computers in Human Behavior 70 (2017) 104e112 105
would open up a huge potential market for businesses. Neverthe- (Davis ibid., p. 320). The influence of perceived usefulness and
less, public acceptance of this new technology has not yet been perceived ease of use on attitudes toward the use of a new tech-
investigated in academic research, where studies have instead nology was established by the Technology Acceptance Model (TAM)
focused on the ethical and evolutionary implications of insideables. (Davis, 1989; Davis et al., 1989). Subsequently, Venkatesh and Davis
The latter involve the development of cyborg theories (i.e., theories (2000) demonstrated the influence of the variables perceived use-
related to the notion of creatures that are both part human and part fulness and perceived ease of use on the intention to use a new
machine), which view insideables as an evolutionary success that technology in their TAM2 model. In the field of technology accep-
will allow reasonable people to enhance their capabilities as much tance, the influence of perceived usefulness and perceived ease of
as the technology allows (Rosahl, 2004; Schermer, 2009; Selinger & use on the acceptance of a new technology has also been proven
Engstro € m, 2008). (e.g., Abdullah, Ward, & Ahmed, 2016; Mohammadi, 2015; Tan, Ooi,
There is evidence pointing to the potential acceptance of Chong, & Hew, 2014). Several studies have empirically confirmed
insideables by a significant portion of humanity. Technological im- that TAM models consistently explain a substantial part of the
plants that correct for physical disabilities have been accepted, as variance (approximately 40%) in the intention to use innovative
have non-technological implants that increase the body's innate technologies (Venkatesh & Davis, 2000).
capacity. For instance, Schermer (2009) found that the use of With regard to the acceptance of body implants, Adams (2010)
technological body implants to compensate for physical disabilities, already established the importance of the variable perceived use-
i.e., for health-related reasons, has not only been accepted but has fulness as a vital factor in the decision to undergo cosmetic surgery.
also become a widespread practice. Cochlear implants to assist In addition, Giudici, Carlson, Krupa, Meierbachtol, and VanWhy
children with hearing impairments (Pray & Jordan, 2010), pace- (2010) showed that the decision to have a submammary defibril-
makers, cardioverter defibrillators, catheters and heart valves, lator, cardiac resynchronization therapy device, cardioverter defi-
among others, have all seen rapid penetration worldwide (Hill & brillator or pacemaker implanted is associated with the system's
Sawaya, 2004; Rosahl, 2004). Likewise, many people have already ability to provide greater comfort and better aesthetic results than
chosen to modify their body to help them increase their seductive external body systems. In relation to technological implants,
capacities (Lawton, 2004) and achieve their social or personal goals Christie and Bloustien (2010) noticed the perceived usefulness that
(Adams, 2010). In the U.S. alone, 11.8M cosmetic surgeries were the deaf community attributes to cochlear implants in providing
performed in 2007 (Chauhan, Warner, & Adamson, 2010), of which them with certain key capacities required to thrive in an oral world.
augmentation mammoplastydthe incorporation of (non-techno- Reinares-Lara, Olarte-Pascual, Pelegrín-Borondo, and Pino (2016)
logical) physical implants for breast augmentationdseems to be showed that the perceived usefulness of capability-enhancing
the most popular procedure (Sevin et al., 2006; Siclovan & Jomah, nanoimplants significantly influences people's attitudes toward
2008). Moreover, some authors argue that the penetration of such devices. Consumers' decisions to adopt wearable technology
(technological) implants in modern society has led to the percep- are affected by perceived usefulness (Choi & Kim, 2016).
tion that the body is modifiable (Christie & Bloustien, 2010; Lai, Based on the conceptual framework of the TAM models, and the
2012). In this vein, Buchanan-Oliver and Cruz (2011) have noted results of studies in the therapeutic arena, we propose the
that the human body is increasingly seen as a machine assembled following hypotheses in relation to insideables:
from multiple parts and systems that can be replaced when broken,
H1. The perceived usefulness of insideables positively affects the
and that body performance can be improved using simple pros-
intention to use them.
thetic devices to correct sensory functions (e.g., eyeglasses) or by
incorporating technology into the body through sensory prostheses H2. The perceived ease of use of insideables positively affects the
(e.g., neuroprostheses, exoskeletons, deep brain stimulation, and intention to use them.
neurofeedback (Schermer, 2009)).
The remainder of this article is organized as follows. Section 2
introduces the model variables and hypotheses. Section 3 de- 2.2. Influence of emotions on the intention to use a new technology
scribes the methodology. Section 4 presents the statistical analysis
resulting from the application of the CAN model, namely, the Along with cognitive factors, we propose the addition of affec-
relative importance of cognitive, affective and normative factors in tive explanatory variables since they enable a better understanding
the acceptance of insideables. Section 5 discusses the results and of the assessments subjects make (Campbell, 2007; Laverie et al.,
their implications. Section 6 contains the conclusion. 2002; Parren ~ o, Sanz-Blas, Ruiz-Mafe, & Aldas-Manzano, 2013;
Shiv & Fedorikhin, 1999; Van Osselaer et al., 2005; Zielke, 2011). In
2. Model variables and hypotheses order to define the concept of emotion, we used the Componential
Emotion Theory. This theory identifies the minimum common
The CAN model combines the cognitive variables perceived traits required to define the concept of emotion (Ortony and Turner,
usefulness and perceived ease of use and the normative variable 1990; Russell, 2003; Richins, 1997; Scherer, 2001, 2005), namely,
subjective (or social) norm from the TAM models with the affective the need for a stimulus, attribution of the cause of the stimulus,
variables positive emotions, negative emotions and anxiety. The cognitive assessment, physiological reaction, feelings of pleasure-
following subsections describe the model variables and underlying displeasure, a qualitative feeling of uniqueness, a tendency to-
hypotheses. ward a characteristic action, and a short-duration processes.
In terms of how emotions influence behavior, some emotions
2.1. Influence of perceived usefulness and perceived ease of use on stimulate action, while others inhibit or change it (Cohen, Pham, &
the intention to use a new technology Andrade, 2006; O'Neill and Lambert, 2001; Oliver, Rust, & Varki,
1997; Turner, Love, & Howell, 2008; White & Yu, 2005). In gen-
Davis (1989, p. 320) defines the variable perceived usefulness as eral, objects causing positive emotions are evaluated favorably,
“the degree to which a person believes that using a particular whereas objects causing negative ones are evaluated unfavorably
system would enhance his or her performance.” Perceived ease of (Bagozzi, Gopinath, & Nyer, 1999; Mano, 2004). Moreover, there is a
use, on the other hand, is defined as “the degree to which a person natural tendency to make decisions that minimize the likelihood of
believes that using a particular system would be free of effort” negative emotions occurring (Elliott, 1998; Han, Lerner, & Keltner,
106 J. Pelegrín-Borondo et al. / Computers in Human Behavior 70 (2017) 104e112
A ecƟve
Negative
emotions
Positive
H4 = - Anxiety
emotions
H3 = + H5 = -
Perceived
ease of use H2 = +
Subjective
CogniƟve norm NormaƟve
Perceived H6 = +
usefulness
H1 = +
Intention to
use
Table 1
Technical details of the study and sample description.
Sample characteristics
Table 2
Operational definition.
there was great dispersion in the mean value for the variable verify the factors formed from the observable variables (i.e., the
intention to use insideables (approximately 3.3). When respondents' measurement scales). The results for the perceived usefulness (PU),
opinions were broken down by age, profound differences could be perceived ease of use (PE), subjective norm (SN) and intention to use
seen. The youngest respondents both intended to use implants (IU) scales are formed, in all cases, by a single factor with high
(mean 5.92 and median 7.00) and expected to use them (5.76 and explained variance: PU ¼ 91.90% (KMO ¼ 0.845), PE ¼ 91.97%
7.00). Both the intention to use and the predicted use of insideables (KMO ¼ 0.875), SN ¼ 95.14% (KMO ¼ 0.500), and IU ¼ 97.48%
decreased with age; subjects between the ages of 31 and 40 would (KMO ¼ 0.500). Bartlett's sphericity tests reflect a significance level
not use implants (mean 3.92 and median 4.00) and did not expect of less than 0.001 for all the aforementioned scales.
to use them in the future (mean 4.05 and median 4.00). For all age With regard to the scale of the emotions triggered by the idea of
strata, dispersion of the mean was greater than 3. In light of these insideables, results from the exploratory factor analysis showed that
dispersion levels, a theoretical model was proposed to explain the together three factors account for 71.53% of the variance in the
intention to use insideables. intention to use insideables. The KMO index provided good results
(0.931), and Bartlett's sphericity test reflected a level of significance
of less than 0.001. The three extracted factors are explained below:
4.1. Exploratory factor analysis
Table 3
Constructs, items and sources.
Construct/items Source
Notes: The items removed during the purification process (i.e., the model respecification) are shown in italics. A more detailed explanation is provided in the section
“Assessment of the structural model.”
Table 5
Outer model loadings and cross loadings.
Perceived usefulness Perceived ease of use Positive emotions Anxiety Negative emotions Subjective norm Intention to use
(PU) (PEU) (PE) (A) (NE) (SN) (IU)
of explanatory power. Venkatesh et al. (ibid.) conducted a panel significant. This finding is consistent with those reported by
survey, interviewing the same respondents about their acceptance Venkatesh et al. (2003) with regard to the UTAUT model. They
of a new technology product at three different points. However, the rejected the hypothesis that the anxiety produced by new tech-
individual R2 for each of these points was around 50% of variance nology significantly impacts the intention to use it. In this vein, the
explained. Subsequently, they applied the UTAUT model to data fear of dehumanization caused by the idea of the cyborg (Lai, 2012)
pooled across the three time periods, obtaining a PLS R2 of 76%. In cannot be confirmed to have a decisive impact on the decision to
contrast, the CAN model was tested using cross-sectional data, accept insideables.
specifically, one-time-point data, and refers to the emerging tech- The variable with the second greatest explanatory power was
nological product of insideables. The model explained 73.9% of the the subjective or social norm (25.19%). Several studies have
variance in the intention to use insideables. corroborated that family atmosphere, friends and society as a
The CAN model jointly assessed (1) cognitive variables whole have a decisive influence on decisions to modify one's body
(perceived usefulness, perceived ease of use), (2) affective variables (Adams, 2010; Javo & Sørlie, 2010; Dorneles de Andrade, 2010;
(positive emotions, negative emotions, anxiety), and (3) a normative Most et al., 2007; Von Soest et al., 2006).
variable (subjective or social norm). All of the examined variables, The cognitive variables perceived usefulness and perceived ease of
with the exception of anxiety, affected the intention to use inside- use explained lower percentages of the intention to use insideables
ables. Five of the six hypotheses were thus accepted (H1, H2, H3, H4, (5.20% and 6.20% respectively).
H6), while one (H5) was rejected. Numerous studies have confirmed that cognitive and affective
Although all the variables integrated in H1, H2, H3, H4 and H6 factors do influence subjects' assessments of products (e.g.,
influenced the intention to use insideables, they did so to Campbell, 2007; Dean, Raats, & Shepherd, 2008; Holbrook &
different degrees. Positive emotions accounted for the highest Hirschman, 1982; Parren ~ o et al., 2013). Moreover, several studies
percentage of variance explained (32.04%), while negative emo- have reported benefits derived from including both cognitive and
tions accounted for the lowest (4.59%). The natural tendency that affective factors in order to better understand these assessments
some authors have reported to make decisions that minimize the (Bagozzi, 1982; Laverie et al., 2002; Levav & McGraw, 2009; Van
likelihood of negative emotions occurring (Elliott, 1998; Han et al., Osselaer et al., 2005; Van Waterschoot, Kumar Sinha, Van
2007; Schwarz, 2000) thus seems to have little impact on the Kenhove, & De Wulf, 2008; Zielke, 2011). Nevertheless, the re-
intention to use insideables. Our results reinforce those of studies sults of this research show that the benefits of including them are
arguing that positive emotions toward a product generally favor a not equal. Positive emotions should be included since they explain
positive assessment thereof (Bagozzi, 1997; Mano, 2004; Shiv & a great deal of the intention to use; the contribution of negative
Fedorikhin, 1999). Nevertheless, a new emotional dimension must emotions and cognitive factors is comparatively much smaller.
also be taken into account, namely, anxiety regarding the idea of
insideables. This dimension is a disaggregation of the negative 6. Conclusions
emotions dimension of the PANAS scale by Watson et al. (1988).
However, its impact on the intention to use insideables was not The main contribution of this study is the development of the
110 J. Pelegrín-Borondo et al. / Computers in Human Behavior 70 (2017) 104e112
Table 6
Construct reliability, convergent validity and discriminant validity.
Construct Composite reliability > 0.7 Cronbach's Alpha AVE > 0.5 PU PEU PE A NE SN IU
Note: Diagonal elements (in bold) are the square root of the AVE. Off-diagonal elements are the correlations among the constructs.
Table 7
Structural model results.
Lower Upper
**
H1: Perceived usefulness ¼> (þ) Intention to use 0.083 2.57 0.02 0.14 Accepted
H2: Perceived ease of use ¼> (þ) Intention to use 0.114*** 4.13 0.06 0.17 Accepted
H3: Positive emotions ¼> (þ) Intention to use 0.426*** 11.35 0.35 0.50 Accepted
H4: Negative emotions ¼> () Intention to use 0.170*** 5.35 0.23 0.11 Accepted
H5: Anxiety ¼> () Intention to use 0.041n.s. 1.24 0.10 0.02 Rejected
H6: Subjective norm ¼> (þ) Intention to use 0.364*** 10.15 0.30 0.43 Accepted
Note: Based on a one-tailed t (4,999) distribution (Henseler, Ringle, & Sinkovics, 2009): * ¼ p<0.05 ¼> t > 1.65; ** ¼ p<0.01 ¼> t > 2.33; *** ¼ p<0.001¼> t > 3.09; n.s. ¼ not
significant.
J. Pelegrín-Borondo et al. / Computers in Human Behavior 70 (2017) 104e112 111
Table 8
Effect on endogenous variables.
CAN model for assessing the acceptance of new types of techno- people, this could result in “first-class” and “second-class” citizens,
logical products in the early stages of their development. This study thereby considerably increasing the equality gap.
addresses a type of technological product so new that many people Finally, the present paper has analyzed the relationships be-
may not yet even be aware of it; some products are currently in tween cognitive, affective, and normative variables for assessing
development, while others have already been patented but have the acceptance of new types of technological products. Future
not yet been launched. The proposed model strongly explains the research should continue to analyze the reasons for the relation-
intention to use the technological product in the very early stages of ships between these variables.
its adoption, that is, its early acceptance. Affective and normative
factors have the greatest influence on the acceptance of a new Acknowledgements
technology; within the affective dimension, positive emotions have
the greatest impact. Any technology acceptance model should thus This work has been funded by The Ministry of Economy and
consider the emotions that the new technology produces, as well as Competitivity (Spain), Research Project with reference: ECO2014-
the influence of the social norm. 59688-R, Programa Estatal de Investigacio n, Desarrollo e
Risselada, Verhoef & Bijmolt (2014, p. 54) looked at the adoption Innovacion Orientada a los Retos de la Sociedad, Plan Estatal de
of high-tech products and found that the effect of social norms on n Científica y Te
Investigacio cnica y de Innovacio
n 2013e2016.
product acceptance decreases soon after society begins to adopt the
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