Trust, Risk Barriers and Health Beliefs in Consumer Acceptance of Online Health Services

The Web is an important health information dissemination channel. Potential benefits cannot materialize unless online health information services are accepted and used by consumers. This study develops a research model by integrating the health belief model (HBM) and extended valence framework to explain user acceptance (behavioral intentions). We collected data from a sample of 703 university students in [country X]. Trust had the strongest effect on acceptance. Perceived risk barriers also had significant impacts on acceptance. Furthermore, we confirmed health belief variables, namely perceived susceptibility and severity, are important to consumer acceptance. Self-efficacy was found to moderate the effect of perceived severity on acceptance. The model explains 47.5% of the variance in intentions to use online health information services. Results have helped us identify the relative salience of HBM and extended valence framework in consumer acceptance of online health information services and have important implications for practice

Trust and risk in consumer acceptance of e-services

Thesis (Ph.D. (Information Systems))--University of the Witwatersrand, Faculty of Commerce, Law & Management, School of Economic and Business Sciences, 2015Electronic services (or e-services) are defined as any service whose delivery is based on Internet, IT and communications technology, and which incorporates a large self-service component. They offer consumers the promise of increased convenience, lower-cost of transacting, greater choice and accessibility by eliminating space and time constraints to their interactions with service providers. Benefits of e-services cannot however materialize without consumer acceptance. Unfortunately, uncertainty and fears of opportunism still characterize the online context and varying degrees of consumer acceptance and engagement in use of e-services has thus been observed. The extant literature considers consumer perceptions of risk and their trust beliefs amongst the most important psychological states influencing their online behavior. However, despite the number of empirical studies that have explored the effects of trust and risk perceptions on consumer acceptance of e-services, the field remains fragmented and the posited research models are contradictory. For example, the trust-risk relationship has been modeled differently in past studies and the causal relationship between trust and risk perceptions has not been clarified. In addition, research into the antecedents of trust has not been integrated to provide an answer as to which are the most significant antecedents. Furthermore, past research has paid more attention to initial trust or risk perceptions and has not adequately examined whether these perceptions change over time or how they come to influence later stage acceptance of e-services. To address these gaps in our understanding of trust and risk in consumer acceptance of e-services, this thesis adopted three research designs, namely meta-analytic approaches, cross-sectional surveys and longitudinal designs. First, a meta-analytic study1 was used to aggregate empirical findings from across prior studies in e-service. This allowed the nature of the relationship between trust, perceived risk, and acceptance of e-services to be synthesized and for competing nomological models of the trust-risk-acceptance relationship to be compared. 52 studies were examined and it was found that trust is most important to form consumer positive attitude for acceptance. By comparing competing models, it found that trust and risk are significantly related and trust may influence risk in consumer acceptance of e-services. 1 Presented at 34th International Conference on Information Systems (ICIS 2013), Milano, Italy. iv Moderator analysis within the meta-analysis was also carried out to determine if different types of consumer cultures (e.g., Western versus Eastern), different types of e-services (e.g., commercial versus non-commercial), or different objects of trust (e.g., trust in vendor versus trust in website technology) influence the relationships between trust, risk and acceptance of e-services. Furthermore, the antecedents of trust as suggested by past research were examined via a second meta-analysis of 59 prior studies2. The antecedents of trust were classified as vendor and institution-based antecedents, technological-based antecedents, knowledge-based antecedents, and consumer characteristics-based antecedents. Technological-based antecedents were found the most significant antecedents of trust. For all antecedents, studies classified as having been carried out in Eastern cultures reported on average stronger effect sizes than those carried out in Western cultures. In addition to the meta-analytical studies, this thesis also carried out cross-sectional and longitudinal investigations to study trust and risk in an understudied context of e-services, namely consumer acceptance of online health information services. The motivation to adopt this context is because previous studies of e-services were mostly focused on commercial (e.g., e-commerce, e-shopping and e-banking, etc) and mostly on non-commercial context such as e-government. However, e-health services are relatively under-explored. Moreover, the Web has become an important health information dissemination channel. People are increasingly searching for health information online and engaging in the self-management of their health. Trust and risk are considered important to the online health context, and it therefore served as an appropriate e-service context for empirical analysis. Two cross-sectional studies3,4 were carried out to explain user acceptance of online health information services. This cross-sectional work was underpinned by multiple theoretical perspectives namely Theory of Reasoned Action (TRA), Health Belief Model (HBM) and Extended Valence Framework (EVF). Findings showed that multiple dimensions of trust (trust in provider, trust in website and trust in institutional structures) have both direct and indirect effects, via perceived usefulness, on consumer acceptance. 2 Presented at 18th Pacific Asia Conference on Information Systems (PACIS 2014), Chengdu, China. 3 Forthcoming at 35th International Conference on Information Systems (ICIS 2014), Auckland, New Zealand. 4 Forthcoming at 25th Australasian Conference on Information Systems (ACIS 2014), Auckland, New Zealand. v One-dimensional risk was not found to have a significant influence on consumer acceptance. However, multi-dimensional risk (performance risk, psychological risk and time risk) did combine with health belief variables such as perceived susceptibility and severity to influence consumer acceptance. Because cross-sectional data is limited in its ability to address causal connections amongst phenomena, two longitudinal investigations were also carried out. These investigations were used to explain whether trust beliefs and risk perceptions change over time in consumer acceptance of e-services, how early stage trust and risk perceptions influence later stage acceptance and usage behaviors, and whether there is reciprocal causality between trust and risk perceptions. This work was underpinned by TRA and Expectation-Confirmation Theory (ECT), and employed both path modeling and cross-lagged structural equation modeling techniques. The results showed that trust, risk perceptions and perceived usefulness are important to the prediction of consumer acceptance of online health services at both the early and later usage phases5. Furthermore, trust in provider and trust in website have reciprocal relations and empirical data supported the influence of risk perceptions on trust. Through the meta-analytic design, cross-sectional approaches and longitudinal designs, this thesis contributes to research on e-services in a number of ways. First, meta-analytic approaches integrated the available evidence from prior studies, which resulted in the generation of a dataset which was larger in scope and scale than could feasibly be achieved in any single research study. This dataset could then be used to compare competing nomological models found in the literature. In so doing, results have improved our understanding of how trust and risk are related, how they combine to influence consumer acceptance, as well as identifying the most important antecedents of trust. Results provide a benchmark against which future studies can compare their effect sizes. Moreover, by examining the heterogeneity of effect sizes, the meta-analysis has also identified moderators that can account for observed inconsistencies in the effect sizes reported by prior studies. Together, the findings have extended our understanding of how trust and risk relate to e-service acceptance in different e-service contexts, across 5 Presented at 18th Pacific Asia Conference on Information Systems (PACIS 2014), Chengdu, China. vi different consumer cultures, and whether trust in the vendor or technology platform has relatively greater importance to consumers. Second, this thesis also integrated trust into HBM to examine online health information seeking as both a health behavior and online consumer behavior. Results help us better understand this specific case of e-service acceptance. Third, this study is also the first to develop and validate a dynamic trust and risk model in consumer acceptance of online health information services. The longitudinal design integrates trust into the theoretical framework of TRA and ECT to develop the dynamic research model. Tests of the model have made a key contribution to the development of a theory that explains the dynamic nature of e-service acceptance. Furthermore, the cross-lagged longitudinal design contributed to our understanding of the casual relationship between consumers’ trust and risk perceptions in the context of online health information services. Taken together this thesis illustrates how meta-analysis and structural equation modeling can be integrated together to approach the fragmented and contradictory nature of the field. Moreover, this thesis addresses the lack of longitudinal studies on acceptance, and presents a novel method, cross-lagged structural equation modeling, to examine controversial causal relationships within the field of Information Systems. This thesis also has important practical implications. It provides insights into the relative importance of trust and risk perceptions necessary to inform practitioners on risk reduction and trust-building mechanisms. The investigation into the antecedents of trust reveals especially important factors which are within the control of e-service providers. With this understanding, practitioners can be better positioned to establish their online service offerings. Website designers can also benefit from understanding the extent to which particular antecedents of trust (e.g., ease of use and system quality) are important for e-service acceptance. By studying the online health information services context, this thesis has also shed light on the general perceptions and attitudes of consumers towards this high-potential area of e-service

Consumer health protection and Information and Communication Technology

The environmental emergencies, the alimentary crisis, the increase of chronic illnesses, pushes the consumers to seek informative channels often also "virtual" as a reassurance for their own health, for the salubriousness of food and above all as a direct channel with the enterprises. For these last, then, it becomes fundamental to look at the information, to the virtual nets, and to the Information and Communication Technologies (ICTs) especially as powerful means of communication. Therefore, the work analyzes the role that the ICTs develop in the productive sector of ‘Mozzarella di Bufala Campana’, a particularly important product for the economy of the Region but in crisis because installed in a context of environmental emergencies that have seriously compromise the trust of the consumer, worried about the implications for the health. Particularly, the work proposes a survey both on the dairies that on the consumers with the purpose to appraise the propensity of the first ones to use Internet in their own strategies of web marketing and the importance of such tool, for the seconds, in presence of a situation of alarm for the health.Health, consumer protection, food quality, Information and Communication Technologies., Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety,

Alter ego, state of the art on user profiling: an overview of the most relevant organisational and behavioural aspects regarding User Profiling.

This report gives an overview of the most relevant organisational and\ud behavioural aspects regarding user profiling. It discusses not only the\ud most important aims of user profiling from both an organisation’s as\ud well as a user’s perspective, it will also discuss organisational motives\ud and barriers for user profiling and the most important conditions for\ud the success of user profiling. Finally recommendations are made and\ud suggestions for further research are given

Vital Decisions

Presents findings from surveys conducted in 2001 and 2002. Looks at how Internet users make decisions about what online health information to trust. Includes a guide from the Medical Library Association about smart health-search strategies

Critical factors affecting consumer acceptance of online health communication: an application of service quality models

The paper examines critical factors affecting consumer behavioral intentions in accepting online health communication through social networking sites. Unlike recent research under this topic, the paper assimilates some components of service quality dimensions and consumer behavior theories. The paper employs factor analysis and structural equation modelling analysis with latent variables to identify critical factors from the survey data collected from Korean consumers. The results of the study identifies three major constructs: consumer needs for health information, the perceived value of tangible attributes of health information providers, and the perceived value of intangible attributes of health information providers. The results show that consumer needs for health information and the tangible and intangible attributes of health information providers should be considered as important antecedents of accepting online health communication through social networking sites. The findings suggest that the success of online health communication via social networking sites largely depends on the tangible and intangible attributes of health information providers

Credibility of Health Information and Digital Media: New Perspectives and Implications for Youth

Part of the Volume on Digital Media, Youth, and Credibility. This chapter considers the role of Web technologies on the availability and consumption of health information. It argues that young people are largely unfamiliar with trusted health sources online, making credibility particularly germane when considering this type of information. The author suggests that networked digital media allow for humans and technologies act as "apomediaries" that can be used to steer consumers to high quality health information, thereby empowering health information seekers of all ages

Talking together : consumer communities in healthcare

Consumer involvement in computer mediated communities (CMCs) is increasing particularly in high involvement services such as healthcare. This paper examines the role of CMCs as providers of patient information and support and the subsequent effect on the relationship between 'informed' consumers and health care providers. The evolving dialogue between consumers in virtual communities provides one key axis along which professional service consumption will evolve. The challenge for service consumers is to develop frameworks that facilitate robust dialogue and exchange of information and emotional support to complement their rising authority. The parallel challenge is for the established medical profession to recognise the consequences of this evolving dialogue and develop approaches to service delivery that effectively engage with consumers on the basis of this increasing authority

An Examination of Privacy Policies of US Government Senate Websites.

US Government websites are rapidly increasing the services they offer, but users express concerns about their personal privacy protection. To earn user's trust, these sites must show that personal data is protected, and the sites contain explicit privacy policies. This research studied privacy policy protection of 50 US Senate sites and found that few had comprehensive elements of privacy policies and a general lack of protection of personal data that could be obtain from the website. The study reviewed which specific privacy elements are most often mishandled, as well as suggestions for improving an overall online privacy practice