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NTU Management Review Vol. 33 No. 3 Dec. 2023

exterior-interior factor model to figure out why users want to switch from their current
health app to other new ones. We believe that on the one hand, users may be positively
motivated to switch their current app; on the other hand, they may be deterred from
selecting other new apps due to certain factors. The result of the trade-off between the

two powers is eventually determined by which power is larger than the other. Thus, we
apply positive drivers (exterior power) and negative drivers (interior power) in this model
to investigate switching intentions for health apps. By referring to variables proposed in

past research (Bhattacherjee et al., 2012; Fan and Suh, 2014; Hou and Shiau, 2020; Wong
et al., 2019; Chong et al., 2022; Nugroho and Wang, 2023), we select five variables that
are consistent with the idea of external and internal driving forces. The former includes
attractive alternatives, social influence, and dissatisfaction with the current health app; the
latter includes procedural switching costs and habits.

The remainder of this paper is organized as follows. Section 2 reviews the related
literature. Section 3 proposes the research model and hypotheses. Section 4 introduces
the research methodology. Section 5 presents the findings of the analysis of the empirical

data. Section 6 presents the contributions, implications, and limitations, and makes
recommendations for future researchers.

2. Literature Review

The framework of our research model can be divided into two parts, positive drivers
(exterior power) and negative drivers (interior power). The variables in the exterior are the
positive effects on switching intention, while the variables in the interior are the negative

effects on switching intention. The idea of the research model stems from the push–
pull–mooring (PPM) population migration model (see Figure 1), which has been used to
illustrate the effects of migratory migrants’ intentional behavior (Lee, 1966; Bogue, 1969;
Cohen, 1996; Bansal, Taylor, and St. James, 2005; Nugroho and Wang, 2023). We argue
that push effects create a positive power to arouse users’ intention to switch health apps,

whereas pull effect forms a negative power to hold users who keep on staying with their
current health apps. In accordance with the argument, this study selects five determinants
attractive alternatives, social influence, (dis)satisfaction, switching costs, and habits
from the related research in the past (Bhattacherjee et al., 2012; Fan and Suh, 2014; Lee,

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