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

Feel Safe to Take More Risks? Insecure Attachment Increases Consumer Risk-Taking Behavior

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On-line privacy behavior: using user interfaces for salient factors

The problem of privacy in social networks is well documented within literature; users have privacy concerns however, they consistently disclose their sensitive information and leave it open to unintended third parties. While numerous causes of poor behaviour have been suggested by research the role of the User Interface (UI) and the system itself is underexplored. The field of Persuasive Technology would suggest that Social Network Systems persuade users to deviate from their normal or habitual behaviour. This paper makes the case that the UI can be used as the basis for user empowerment by informing them of their privacy at the point of interaction and reminding them of their privacy needs. The Theory of Planned Behaviour is introduced as a potential theoretical foundation for exploring the psychology behind privacy behaviour as it describes the salient factors that influence intention and action. Based on these factors of personal attitude, subjective norms and perceived control, a series of UIs are presented and implemented in controlled experiments examining their effect on personal information disclosure. This is combined with observations and interviews with the participants. Results from this initial, pilot experiment suggest groups with privacy salient information embedded exhibit less disclosure than the control group. This work reviews this approach as a method for exploring privacy behaviour and proposes further work required

Attachment Style: How Pre-Adoptive Trauma Influences International Adoptees

An individual’s attachment style influences many aspects of his life, including emotional, behavioral, cognitive, and social development. Attachment style is largely dependent upon both the quality and quantity of care a child receives from a caregiver in the earliest stages of life. Children who have been adopted internationally may have been exposed to challenges posed by inadequate caregiving or resources, which includes malnutrition, poor medical attention, and instances of abuse, neglect, or deprivation. Because of these adverse experiences, international adoptees may be at risk of developing attachment disorders, experiencing behavioral issues, and struggling socially and psychologically. However, many of these challenges can be overcome with parental sensitivity and positive familial relationships

Home and community based parenting support programmes and interventions: report of Workpackage 2 of the DataPrev project

The last decade has witnessed an increasing interest in the promotion of mental health and wellbeing because of its importance for health and social functioning at the individual level and for the social and economic wellbeing of societies. Recent research from a range of disciplines has highlighted the importance of the quality of the parent-child relationships and parenting on children‟s emotional and social development, and on adult mental health and wellbeing. Intervention studies involving children of all age groups have shown that if parenting can be influenced for the better outcomes can be changed. The DataPrev project was funded by the 6th Framework of the European Community Research Programme under Policy-Orientated Research with the aim of establishing a database of evidence-based programmes in Europe that promote mental health and wellbeing and prevent mental illness throughout the life course. This is the report of the Workpackage 2 describing the international evidence base on programmes to support parenting, including home and community based programmes