Digital Health Innovation: Exploring Adoption of COVID-19 Digital Contact Tracing Apps

With the outbreak of COVID-19, contact tracing is becoming a used intervention to control the spread of this highly infectious disease. This article explores an individual's intention to adopt COVID-19 digital contact tracing (DCT) apps. A conceptual framework developed for this article combines the procedural fairness theory, dual calculus theory, protection motivation theory, theory of planned behavior, and Hofstede's cultural dimension theory. The study adopts a quantitative approach collecting data from 714 respondents using a random sampling technique. The proposed model is tested using structural equation modeling. Empirical results found that the perceived effectiveness of privacy policy negatively influenced privacy concerns, whereas perceived vulnerability had a positive influence. Expected personal and community-related outcomes of sharing information positively influenced attitudes toward DCT apps, while privacy concerns had a negative effect. The intention to adopt DCT apps were positively influenced by attitude, subjective norms, and privacy self-efficacy. This article is the first to empirically test the adoption of DCT apps of the COVID-19 pandemic and contributes both theoretically and practically toward understanding factors influencing its widespread adoption

Emergency Notification on Mobile Devices – A Trade-off between Protection Motivation and Privacy Concern

Traditional design methods, based on analytical rationale, often cannot address upcoming challenges e.g., related to the digital business transformation in volatile environments. Analytical rationale assumes a particular result and provides the methods and tools for achieving it. Nowadays, however, the result of a business transformation is often not precisely known nor the ways and means to achieve it. As a result, methods and tools are required that foster creativity while allowing customization to specific requirements or stakeholder needs. This paper proposes customized design thinking processes, realized with a conceptual modelling approach. The approach supports creativity in transformative business design. It shows how numerous design thinking tools can be integrated into a single conceptual modelling approach - supported by a modelling platform. The platform facilitates efficient and flexible design of novel business solutions. The created models moreover serve as a formalized knowledge base that enables knowledge processing and reuse

Privacy Vs. Health: The Role of Privacy Trade-offs in the Adoption of Public Health Applications

Innovations in healthcare technology aim to address challenges in health outcomes. COVID-19 contact tracing apps were introduced in various countries as an innovative health solution to stop the spread of the virus. Although aiming for the greater good of the population through maintaining public health, the introduction of these apps was accompanied by controversial debates about their privacy implications leading to low adoption worldwide. In fact, digital contact tracing raised privacy concerns associated to information sharing within the app, which impacts intention to use. However, in the question of health versus privacy several factors come into consideration. We apply a privacy calculus approach to study users’ intention to use COVID-19 apps under privacy trade-offs. Based on representative samples from Germany and Switzerland, we find that individual safety outweighs societal safety benefit, trust is crucial for mitigating risk perceptions, and social norm has a great impact on individual’s intentions to use

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

Three Research Essays on Propensity to Disclose Medical Information Through Formal and Social Information Technologies

Abstract This dissertation, which is comprised of three essays, examined disclosure propensity of healthcare providers from the US and Thailand and disclosure of personal health problems of healthcare consumers in social media context. Essay 1: A Deterrence Approach in Medical Data Misuse among Healthcare Providers Information and communication technology (ICT) have long been available for use in health care. With the potential to improve the quality, safety, and efficiency of health care, the diffusion of these technologies has steadily increased in the health care industry. With the adoption of electronic health records, personal electronics devices, internet connections and social network connections, comes the increased risk of medical data breaches. Due to the sensitivity of the information involved, and the existence of laws governing the use of this data, the responsibilities of a healthcare provider after a data breach remain a concern. Based on previous breach reports, institutional insiders were among the leading causes of medical data breaches. The causes were related to unawareness of institutional information security policies and system misuse. Thus it has become important to understand how to reduce such behaviors. Previous studies suggested deterrence theory that relies on security countermeasures can deter individuals\u27 misuse behaviors by increasing the perceived threat of punishment. Thus our model posits that security countermeasures decrease medical data misuse through the two mediators; perceived certainty of sanctions and perceived severity of sanctions. This model was tested by 176 healthcare providers from different institutions across the US. The results suggested that perceived severity of sanctions has more effect in reducing medical data misuse than perceived certainty of sanctions. Hospital information security policies and HIPAA has stronger effect on perceived severity of sanctions than perceived certainty of sanctions whereas EHR monitoring and auditing has stronger effect on perceived certainty of sanctions than perceived severity of sanctions. Results of the study and implications for the research are discussed. Essay 2: Propensity to Misuse Medical Data in an International Context - Deterrence and Cultural Values As information abuse by healthcare providers is a problem that is faced around the globe, our study examined the effect of deterrence within two cultures; Asian and American (Thailand and the US). The reason to compare these two countries is because the foundation of the structures of the laws and the hospital policies for medical data protection of these two countries are similar. Thus others confounding factors are minimized. In terms of cultural influences, Hofstede\u27s cultural dimensions that describe the effects of society\u27s culture on the values to its members are considered as factors that can have an interaction effect with deterrence. Four Hofstede\u27s cultural values were used; individualism-collectivism (IDV); uncertainty avoidance (UAI); power distance (PD); and long-term orientation (LTO). Also, social norms and morality were included. This study employed espoused values of Hofstede\u27s cultural values, since all individuals from a country will not have identical values. In this study, we examined 1) the effect of espoused cultural values on deterrence, and 2) the effect of Hofstede\u27s national cultural values on deterrence in two different healthcare cultures. Our model was tested by 613 healthcare providers; 437 from Thailand and 176 from the US. The results suggested that technical countermeasures had stronger effect on certainty and severity perception for both Thai and US cases, whereas procedural countermeasures had uncertain effect on sanctions perception for both cultures. The young generation of Thais was found more individualized and tended to have the same perception on sanctions as the Westerners. Social norms played an important role in reducing medical data misuse for Thai providers, whereas moral beliefs were more important for the US providers. Individuals who espoused different cultural values had different responses on medical data misuse. Results of the study and implications for the research are discussed. Essay 3: Intention to self-disclose personal health information in social media context In recent years social media is quickly becoming a large part of people\u27s everyday lives. With the availability of smartphones and tablets, coupled with a slew of apps for these devices, people now have ubiquitous access to social media. Virtual social media application encourages people to meet, and share information. Health problems represent one aspect that is shared in a social media context. Benefits and risks of self-disclosure are two main factors that determine social media users\u27 intention to share their sensitive information on social network. This paper integrates social exchange theory, a theory that focuses on gains and losses of building a relationship, and the social penetration theory, a theory that explains human\u27s self-disclosure, to construct the model for investigating self-disclosure intention on personal health problems of social medial users. In addition, we included factors that affect self-disclosure intention including ease of use of social media, social influence, and nature of health problems. Through an online survey, we examined factors that determine self-posting in social media account with 374 social media users across the US. The results suggested that individual and social benefits of self- disclosure outweighed the risks and have significant effect on self-disclosure intention on personal health problems. The individual risks and social risks had little negative effect on self-posting about health problems. In addition, social influence, and social networking experiences were factors that encouraged social media users to reveal their personal health problems

Information Privacy Behaviors during the COVID-19 Pandemic: Focusing on the Restaurant Context

The acquisition of personal information has been generally accepted in the pandemic situation as an effective measure to prevent infection, while at the same time raising concerns regarding the infringement of personal privacy. The current study aimed to propose and empirically test a research model for restaurant customers on the disclosure of personal information in a pandemic situation. Privacy calculus theory and institutional theory were applied to theoretically explain the drivers/inhibitors and behavioral responses that affect disclosure of personal information. We verified that the most influential factor on intention to disclose was “perceived benefit”, followed by “government pressure” as another strong predictor. We present theoretical and practical implications for restaurant managers and policy agencies.Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2019S1A3A2098438)

Genetic profiling: A legal framework to embrace the challenges

The current issues surrounding the use of genetic profiling technologies in New Zealand are analysed and compared with other jurisdictions, resulting in a number of key recommendations for the legal framework. An amendment to the Human Rights Act, review of the Health Information Privacy Code and an increased role for the Insurance and Savings Ombudsman are discussed in light of the developments in other jurisdictions. The implementation of a genetic database registration system and the development of policies to guide employers, insurers and health professionals on acceptable uses of genetic profile information are presented as recommendations to improve the current approaches. The establishment of an Advisory Body would ensure that safeguards against discrimination continue to be fair and effective, keeping pace with the rapid advancements in this field. The increased availability and the more acceptable costing are making the use of genetic profiling technology attractive. This is contributing further to the legal challenges, particularly when combined with the increasing range of applications for the data provided, in such diverse fields as the insurance industry, employment, personalised pharmaceuticals and the use of genetic databases. It is seen as essential that the legal framework promotes and supports the public in their access and use of genetic profiling technologies. These developments promise to be important and at the forefront of future heath care in New Zealand

When Terrorism Threatens Health: How Far are Limitations on Personal and Ecomonic Liberties Justified

The government is engaged in a homeland-security project to safeguard the population\u27s health from potential terrorist attacks. This project is politically charged because it affords the state enhanced powers to restrict personal and economic liberties. Just as governmental powers relating to intelligence, law enforcement, and criminal justice curtail individual interests, so too do public health powers