A moderated mediation model of AI acceptance in healthcare: Perceived AI usage competence, AI trust, and AI anxiety

This study examined whether perceived AI usage competence is associated with AI acceptance in healthcare and whether this association is mediated by AI trust and moderated by AI anxiety. A cross-sectional, correlational survey design was used. Data were collected online from 422 adults in Türkiye who had used healthcare services within the previous six months. Perceived AI usage competence was modeled as the independent variable, AI trust as the mediating variable, AI acceptance in healthcare as the outcome variable, and AI anxiety as the moderating variable. Descriptive statistics, reliability analysis, confirmatory factor analysis, Pearson correlation analysis, and Hayes PROCESS Macro Model 8 were used to analyze the data. The findings indicated that perceived AI usage competence was positively associated with AI trust and AI acceptance in healthcare, and AI trust was positively associated with AI acceptance. The trust-mediated indirect association between perceived AI usage competence and AI acceptance was statistically significant. AI anxiety moderated both the competence–trust association and the direct competence–acceptance association, with weaker associations observed at higher levels of AI anxiety. Overall, the findings suggest that AI acceptance in healthcare is related not only to perceived technical competence but also to psychosocial factors such as trust and anxiety.