Abstract
Platform-based medical escort services help patients navigate offline care amid population aging and strained healthcare resources. Using survey data from 904 Beijing residents, this study tested an integrated enabler-inhibitor model combining UTAUT2 and innovation resistance theory with a second-order structural equation approach, specifying technology trust and psychological resistance as mediators of usage intention. Results showed that usage and image barriers were the primary antecedents of psychological resistance, whereas tradition barriers had a weaker effect. Technology trust was positively associated with intention to use and exhibited a competitive mediation pattern by partially offsetting the negative indirect influence of psychological resistance. This dual-path view clarifies how users balance adoption drivers and resistance factors in online-to-offline health services. The findings point to leverage points for platform design and governance, suggesting that coordinated trust-building and resistance-reducing psychological interventions can support broader and more equitable uptake of digital health services.