Precursors of trust in virtual health communities: A hierarchical investigation

Enhancing students' online collaborative PBL learning performance in the context of coauthoring-based technologies: A case of wiki technologies

Understandability and completeness are essential in modern collaborative digital platforms and their learning systems. These platforms have shaken up the traditional education setting, particularly in leveraging the coauthoring approach in problem-solving and streamlining the learning behavior of cowriting or corevising. Such a learning context has attracted considerable interest from various stakeholders; however, it needs to be explored further as an independent topic. Based on social capital and social identity theories, we explore how online collaborative problem-based learning (PBL) effectiveness, relational quality, and social identity influence students' perceived PBL performance during learning activities. Based on the core elements of online coauthoring processes (i.e., platform, cocreation, and problem-solving), this study employs a holistic view of the coauthor to discuss the effects of understandability and completeness. This study also highlights the mediating impact of trust on students' social identity. Based on the responses of 240 students, the results support the proposed hypotheses using partial least squares analysis. The study's implications suggest guidelines to educators on how to enhance students' perceived PBL performance by using wiki technologies.

Digital transformation of healthcare during the COVID-19 pandemic: Patients’ teleconsultation acceptance and trusting beliefs

The COVID-19 pandemic boosted the digital transformation of many services, including healthcare, and access to medical care using teleconsultation has increased rapidly. Thus, a growing number of online platforms have been developed to accommodate patients’ needs. This paper examines the factors that predict the intention to use medical teleconsultation by extending the unified theory of acceptance and use of technology (UTAUT2) with the three dimensions of trusting beliefs and self-efficacy. A survey was administered to patients who had used a teleconsultation platform during the pandemic period. As one of the largest studies to date, a sample of 1233 respondents was collected and analyzed using a partial least squares approach, often mobilized in the information systems (IS) domain. Furthermore, a deep analysis using all recommended metrics was performed. The results highlight the significance of trusting beliefs, and self-efficacy in the adoption of digital healthcare services. These findings contribute to both theory and practice in COVID-19 research.

Exploring the effects of health information seeking on e-satisfaction in online health communities: an empirical investigation

BACKGROUND

Online health communities (OHCs) are becoming effective platforms for people to seek health information. Existing studies divide health information into general and specific information in OHCs. However, few studies discuss the effects of different types of information seeking in OHCs on users' electronic satisfaction (e-satisfaction).

OBJECTIVE

This study explores the effects of general and specific information seeking on users' e-satisfaction with OHCs through the mediating roles of perceived benefits and costs drawing on the social information processing theory and the social exchange theory.

METHODS

This study conducted an online survey to collected data from individuals who used OHCs to seek information. The structural equation model was used to analyze the collect data and the research model. Specifically, this study examined the common method bias and conducted a robustness check.

RESULTS

Results show that general and specific information seeking affect e-satisfaction through the mediating roles of perceived benefits and costs. An interesting result is that general information seeking has a stronger effect on e-satisfaction than specific information seeking.

CONCLUSIONS

This study suggests that e-satisfaction should be further enhanced by information seeking as online healthcare practices evolve and change. Managers of OHCs should focus on increasing users' perceived benefits, thereby increasing their e-satisfaction. Besides, this study discusses implications, limitations, and future research directions.

Online Patient Recommender Systems for Preventive Care: Propositions to Advance Research (Preprint)

BACKGROUND

Preventive care helps patients identify and address medical issues early when they are easy to treat. The internet offers vast information about preventive measures, but the sheer volume of data can be overwhelming for individuals to process. To help individuals navigate this information, recommender systems filter and recommend relevant information to specific users. Despite their popularity in other fields, such as e-commerce, recommender systems have yet to be extensively studied as tools to support the implementation of prevention strategies in health care. This underexplored area presents an opportunity for recommender systems to serve as a complementary tool for medical professionals to enhance patient-centered decision-making and for patients to access health information. Thus, these systems can potentially improve the delivery of preventive care.

OBJECTIVE

This study proposes practical, evidence-based propositions. It aims to identify the key factors influencing patients' use of recommender systems and outlines a study design, methods for creating a survey, and techniques for conducting an analysis.

METHODS

This study proposes a 6-stage approach to examine user perceptions of the factors that may influence the use of recommender systems for preventive care. First, we formulate 6 research propositions that can be developed later into hypotheses for empirical testing. Second, we will create a survey instrument by collecting items from extant literature and then verify their relevance using expert analysis. This stage will continue with content and face validity testing to ensure the robustness of the selected items. Using Qualtrics (Qualtrics), the survey can be customized and prepared for deployment on Amazon Mechanical Turk. Third, we will obtain institutional review board approval because this is a human subject study. In the fourth stage, we propose using the survey to collect data from approximately 600 participants on Amazon Mechanical Turk and then using R to analyze the research model. This platform will serve as a recruitment tool and the method of obtaining informed consent. In our fifth stage, we will perform principal component analysis, Harman Single Factor test, exploratory factor analysis, and correlational analysis; examine the reliability and convergent validity of individual items; test if multicollinearity exists; and complete a confirmatory factor analysis.

RESULTS

Data collection and analysis will begin after institutional review board approval is obtained.

CONCLUSIONS

In pursuit of better health outcomes, low costs, and improved patient and provider experiences, the integration of recommender systems with health care services can extend the reach and scale of preventive care. Examining recommender systems for preventive care can be vital in achieving the quadruple aims by advancing the steps toward precision medicine and applying best practices.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/43316.

Patient distrust toward doctors in online health communities: integrating distrust construct model and social-technical systems theory

Purpose

This article aims to explore the factors influencing patients' distrust toward doctors in online health community.

Design/methodology/approach

This study leveraged the distrust construct model and socio-technical systems theory to establish a research model. The authors used the survey method to validate the research model by developing and distributing questionnaires to online health community users. 518 valid responses were collected.

Findings

The data analysis results showed that patients' distrusting beliefs were significantly related to their distrust toward doctors in online health communities. Meanwhile, social factors included perceived egoism and lack of expertise; whereas technical factors included no structural assurance, and lack of third-party recognition.

Originality/value

This study not only provides a solid and comprehensive theoretical understanding of patient distrust toward doctors in online health communities but also could serve as the basis to relieve the distrust between patients and doctors in online health communities, or even in the offline environment.

Inclusive Digital Innovation in South Africa: Perspectives from Disadvantaged and Marginalized Communities

Inclusive digital innovation (IDI) entails rolling out policies and digital innovations to ensure equal access to services and new goods by previously excluded and marginalized societies. Digital commerce (d-commerce) has the potential to foster an inclusive community through IDI empowerment in emerging economies; however, the literature on inclusive digital innovation and citizen empowerment is limited on the effect of e-strategy policies and empowerment on d-commerce adoption, use, and recommendation propensity. Underpinned by three theories: the Extended Unified Theory of Acceptance and Use of Technology, the citizen empowerment theory, and the affective decision-making theory of optimism bias and risk, this study proposes a model to establish the determinants of use intention, use behavior, and propensity to recommend d-commerce in disadvantaged and marginalized communities in South Africa. Using survey data from 983 disadvantaged d-commerce users to test the proposed model and hypotheses using IBM Amos for Windows and structural equation modeling (SEM), this paper provides a unique narrative to the empowerment discourse of marginalized people. Results show that privacy, security, trust, and citizen empowerment positively influence use intention and optimism bias, use behavior, and citizen empowerment mediate the propensity to recommend. Factors that promote or hinder citizens’ choices to use and recommend d-commerce are pertinent to scholars, government agencies, and regulators seeking better policy implementations to eradicate socio-economic inequalities, sustainable societies, and the empowerment of disadvantaged and marginalized people.

Understanding Online Health Community Users’ Payment Intention

Users often lack the motivation to pay for health information and services in online health communities (OHC). This may undermine the sustainable development of OHC. Integrating both perspectives of perceived value and trust, this research identified the factors affecting OHC users’ payment intention. The results indicated that payment intention is influenced by both functional value and trust. Functional value includes price utility and information quality, whereas trust includes trust in doctors and trust in community. We did not find the effect of emotional value and social value on payment intention. The results imply that OHC need to create a trustworthy climate and offer utilitarian value to users in order to facilitate their payment intention.

Examining Online Health Community Users' Information Adoption Intention

Due to the doubt on information credibility, users often hesitate to adopt the health information posted on online health communities (OHC). This may undermine the sustainable development of OHC. The purpose of this research is to identify the determinants of OHC users’ information adoption intention. The results indicated that both information factors and social interaction affect the adoption intention. Information factors include argument quality and source credibility, whereas social interaction includes perceived similarity and familiarity. The results imply that OHC need to ensure information quality and support users’ interaction in order to facilitate their information adoption.

The Effect of Sense of Community on Users' Continuance of Online Music Communities

Due to the intense competition, retaining users and facilitating their continuance are crucial to the success of online music communities. The purpose of this research is to examine the effect of sense of community on users' continuance intention of online music communities. Structural equation modeling was adopted to conduct data analysis. The results indicated that social support and flow experience have significant effects on sense of community, which further affects continuance intention. The main limitation is that the results need to be generalized to other countries that had developed online music communities. This research disclosed the mechanism underlying users' continuance in online music communities, which represent an emerging application.

Evaluating Factors Influencing Knowledge-Sharing Behavior of Students in Online Problem-Based Learning

Adopting online problem-based learning (OPBL) to internship educational programs is an effective teaching method to stimulate self-directed and collaborative learning and knowledge-sharing behavior (KSB) of students. However, the OPBL collaboration experience is different from the traditional lecture-based learning experience for students. Integrating social identity theory and commitment-trust theory develops a formative research model that explains the KSB of students when using social media tools for the OPBL process. This process encourages social interaction and communication of students, in turn, facilitating the integration of collective intelligence or the creation, sharing, and exchange of knowledge. Data collected from 425 nursing students who studied at seven nursing colleges or medical universities in Taiwan were analyzed using the partial least squares (PLSs) technique. The results indicate that social identification is a crucial antecedent of KSB. Relationship quality plays a vital role in shaping the effects of interpersonal trust and relationship commitment (RC) on KSB during internship periods. The findings can contribute to theoretical discussions and enhance the effectiveness of KSB in the literature of internship and non-internship in the higher education field.

Understanding online health community users' information adoption intention: an elaboration likelihood model perspective

Purpose

The purpose of this research is to draw on the elaboration likelihood model (ELM) to examine users' information adoption intention in online health communities (OHC).

Design/methodology/approach

The authors collected 350 valid responses using a survey and conducted the moderated regression analysis to examine the research model.

Findings

The results indicated that users' information adoption intention is influenced by both central cues (argument quality) and peripheral cues (source credibility and emotional support). In addition, self-efficacy moderates the effect of both central cues and peripheral cues on information adoption intention.

Originality/value

Previous research has focused on the effect of individual motivations such as reciprocity and benefits on user behavior, and has seldom disclosed the influencing process of external factors on OHC users' behavioral decision. This research tries to fill the gap by adopting ELM to uncover the mechanism underlying OHC users' information adoption.

Influences of Medical Crowdfunding Website Design Features on Trust and Intention to Donate: Controlled Laboratory Experiment

Background

As a type of donation-based crowdfunding, medical crowdfunding has gradually become an important way for patients who have difficulty paying medical bills to seek help from the public. However, many people still have limited confidence in donating money to medical crowdfunding projects.

Objective

Given that the features of a medical crowdfunding website may be important to gain users’ trust, this study draws upon two-factor and trust theories to explore how different design features of medical crowdfunding websites affect potential donors’ cognition-based trust and affect-based trust, and how these types of trust affect the intention to donate.

Methods

A 2 (informativeness: high vs low) × 2 (visual cues: cool color vs warm color) × 2 (social cues: with vs without) between-subject laboratory experiment was performed to validate our research model. A total of 320 undergraduate students recruited from a university in China participated in the controlled laboratory experiment.

Results

Cognition-based trust (β=.528, P<.001) and affect-based trust (β=.344, P<.001) exerted significant effects on the intention to donate of potential donors of medical crowdfunding. Informativeness as a hygiene factor positively influenced potential donors’ cognition-based trust (F_1,311=49.764, P<.001) and affect-based trust (F_1,311=16.093, P<.001), whereas social cues as a motivating factor significantly influenced potential donors’ cognition-based trust (F_1,311=38.160, P<.001) and affect-based trust (F_1,311=23.265, P<.001). However, the color of the webpages affected the two dimensions of trust differently. Specifically, medical crowdfunding webpages with warm colors were more likely to induce affect-based trust than those with cool colors (F_1,311=17.120, P<.001), whereas no significant difference was found between the effects of cool and warm colors on cognition-based trust (F_1,311=1.707, P=.19).

Conclusions

This study deepens our understanding of the relationships among the design features of medical crowdfunding websites, trust, and intention to donate, and provides guidelines for managers of medical crowdfunding platforms to enhance potential donors’ trust-building by improving the website design features.

Examining online health community users’ sharing behaviour: A social influence perspective

Online health communities (OHC) provide a platform for users to exchange health-related information and seek emotional support. However, users often lack the intention to share their knowledge, which may lead to the failure of OHC. Drawing on the social influence theory, this research examined OHC users’ sharing behaviour. The results indicated that users’ sharing intention is influenced by three social influence factors, which include subjective norm, social identity and group norm. In addition, social support and privacy concern have effects on these three social influence factors. The results imply that OHC need to leverage social influence in order to facilitate users’ sharing behaviour.

Re-Examining the Impact of Multidimensional Trust on Patients' Online Medical Consultation Service Continuance Decision

Recent years have witnessed the rapid growth of an emerging digital healthcare service - online medical consultation (OMC). Despite its popularity, many OMC platforms have encountered issues in initial adoption and continuance use among patients. We posit that many of the hesitation and resistance may arise from a lack of trust toward OMC, which is a complex phenomenon that involves both interpersonal and technological-oriented considerations. This study seeks to clarify the conceptualization of online trust in the context of OMC. It compares two plausible explanations (i.e., trust as a direct cause vs. trust as a moderator) regarding how interpersonal and technological trust contributes to the service continuance decision in OMC. By contextualizing the valence framework, we identify the critical factors in making the risk-benefit assessment of patients' OMC decision. We conduct an online survey of 365 experienced OMC users and analyze our structural model using a partial least square approach. Our results show that the multidimensional conceptualization approach, which incorporates both interpersonal and technological aspects of trust, is superior to the unitary approach. Besides, our findings suggest that the role trust plays in determining service continuance decisions in OMC is more of a direct cause than a qualifier that buffers the impacts of risk-benefit evaluation. We believe the findings can help both researchers and practitioners recognize the multidimensional perspective of trust and better understand the role trust plays in OMC and other online healthcare delivery problems.

Patients' Perceptions of Different Information Exchange Mechanisms: An Exploratory Study in the United States

BACKGROUND

Patients may seek health care services from various providers during treatment. These providers could serve in a network (affiliated) or practice separately (unaffiliated). Thus, using secure and reliable health information exchange (HIE) mechanisms would be critical to transfer sensitive personal health information (PHI) across distances. Studying patients' perceptions and opinions about exchange mechanisms could help health care providers build more complete HIEs' databases and develop robust privacy policies, consent processes, and patient education programs.

OBJECTIVES

Due to the exploratory nature of this study, we aim to shed more light on public perspectives (benefits, concerns, and risks) associated with the four data exchange practices in the health care sector.

METHODS

In this study, we compared public perceptions and expectations regarding four common types of exchange mechanisms used in the United States (i.e., traditional, direct, query-based, patient-mediated exchange mechanisms). Traditional is an exchange through fax, paper mailing, or phone calls, direct is a provider-to-provider exchange, query-based is sharing patient data with a central repository, and patient-mediated is an exchange mechanism in which patients can access data and monitor sharing. Data were collected from 1,624 subjects using an online survey to examine the benefits, risks, and concerns associated with the four exchange mechanisms from patients' perspectives.

RESULTS

Findings indicate that several concerns and risks such as privacy concerns, security risks, trust issues, and psychological risks are raised. Besides, multiple benefits such as access to complete information, communication improvement, timely and convenient information sharing, cost-saving, and medical error reduction are highlighted by respondents. Through consideration of all risks and benefits associated with the four exchange mechanisms, the direct HIE mechanism was selected by respondents as the most preferred mechanism of information exchange among providers. More than half of the respondents (56.18%) stated that overall they favored direct exchange over the other mechanisms. 42.70% of respondents expected to be more likely to share their PHI with health care providers who implemented and utilized a direct exchange mechanism. 43.26% of respondents believed that they would support health care providers to leverage a direct HIE mechanism for sharing their PHI with other providers. The results exhibit that individuals expect greater benefits and fewer adverse effects from direct HIE among health care providers. Overall, the general public sentiment is more in favor of direct data transfer. Our results highlight that greater public trust in exchange mechanisms is required, and information privacy and security risks must be addressed before the widespread implementation of such mechanisms.

CONCLUSION

This exploratory study's findings could be interesting for health care providers and HIE policymakers to analyze how consumers perceive the current exchange mechanisms, what concerns should be addressed, and how the exchange mechanisms could be modified to meet consumers' needs.

The Role of Information Technology Mindfulness in the Postadoption Stage of Using Personal Health Devices: Cross-Sectional Questionnaire Study in Mobile Health

Background

Although personal health devices (for example, smartwatches, fitness trackers and intelligent bracelets) offer great potential to monitor personal fitness and health parameters, many users discontinue using them after a few months. Thus, it is critical to study the postadoption behaviors of current users to enhance their engagement with personal health devices and use behaviors. However, there is little empirical research on the factors affecting users’ engagement in beneficial use behaviors. Mindfulness and identity are not new topics, but the applications of these concepts in the field of information systems are emerging themes. Information technology (IT) mindfulness has been conceptualized in previous studies; however, little is known about the antecedents and consequences of IT mindfulness in the mobile health (mHealth) context.

Objective

The main aim of this study is to explore both IT identity and IT mindfulness to develop a new ground for research in the domain of mHealth postadoption. Thus, we aim to explain why users should be fully mindful of their engagement with PHDs and what could be the consequences and implications.

Methods

This study proposes that IT mindfulness can play an important role in improving the use behaviors of users. Through a web-based survey with 450 current users of a personal health device, this paper tests the relationship between IT identity and IT mindfulness in the postadoption stage of using personal health devices.

Results

We found that IT identity significantly shapes IT mindfulness associated with PHDs. Moreover, the IT identity–IT mindfulness relationship is negatively moderated by individuals’ perceived health status (P=.003). Finally, the results of this study show that IT mindfulness can significantly predict automatic use behaviors (eg, continued intention to use), active use behaviors (eg, feature use and enhanced use behaviors), and commitment behaviors in using personal health devices (eg, positive word-of-mouth intention).

Conclusions

The findings of this study provide implications for both research and practice. This study can contribute to our current understanding of IT mindfulness by developing and empirically testing a research model that explains the determinants and outcomes of the IT mindfulness construct in the context of personal health devices. The results imply that IT mindfulness significantly helps individuals express their alertness, awareness, openness, and orientation in the present in their postadoption interactions with smart devices used for health care purposes. Finally, our findings may assist practitioners and IT developers in designing mindfulness-supporting PHDs. Owing to the impact of IT mindfulness on postadoption behaviors, its 4 dimensions could be used for developing PHD technologies. Moreover, PHD developers may need to direct their efforts toward increasing IT mindfulness by reinforcing IT identity to serve and retain a wide range of target users.

Examining User's Initial Trust Building in Mobile Online Health Community Adopting

Due to the high perceived risk, it is critical to foster users’ initial trust in the promotion of mobile online health community (MOHC) adoption. The present study focused on the role of two different trust elements and examined the initial trust building process based on elaboration likelihood model and trust transfer theory. The results indicated that initial trust in MOHC context was composed of two interrelated components: health service provider (doctor) and underlying technology (MOHC platform). Especially, the initial trust in MOHC platform exerted greater effects on adopting intention. Both performance-based cue (doctors’ information quality and interaction quality) and transfer-based cue (trust in the offline doctors’ health service) positively shaped the initial trust in doctor. Meanwhile, only the performance-based cue (MOHC platform’s information quality and service quality) has significant positive association with initial trust in MOHC platform. However, interpersonal recommend is insignificantly related to the initial trust in doctor. Trust in the mobile internet service is insignificantly related to the initial trust in MOHC platform.

The Impacts of the Perceived Transparency of Privacy Policies and Trust in Providers for Building Trust in Health Information Exchange: Empirical Study

BACKGROUND

In the context of exchange technologies, such as health information exchange (HIE), existing technology acceptance theories should be expanded to consider not only the cognitive beliefs resulting in adoption behavior but also the affect provoked by the sharing nature of the technology.

OBJECTIVE

We aimed to study HIE adoption using a trust-centered model. Based on the Theory of Reasoned Action, the technology adoption literature, and the trust transfer mechanism, we theoretically explained and empirically tested the impacts of the perceived transparency of privacy policy and trust in health care providers on cognitive and emotional trust in an HIE. Moreover, we analyzed the effects of cognitive and emotional trust on the intention to opt in to the HIE and willingness to disclose health information.

METHODS

A Web-based survey was conducted using data from a sample of 493 individuals who were aware of the HIE through experiences with a (or multiple) provider(s) participating in an HIE network.

RESULTS

Structural Equation Modeling analysis results provided empirical support for the proposed model. Our findings indicated that when patients trust in health care providers, and they are aware of HIE security measures, HIE sharing procedures, and privacy terms, they feel more in control, more assured, and less at risk. Moreover, trust in providers has a significant moderating effect on building trust in HIE efforts (P<.05). Results also showed that patient trust in HIE may take the forms of opt-in intentions to HIE and patients' willingness to disclose health information that are exchanged through the HIE (P<.001).

CONCLUSIONS

The results of this research should be of interest to both academics and practitioners. The findings provide an in-depth dimension of the HIE privacy policy that should be addressed by the health care organizations to exchange personal health information in a secure and private manner. This study can contribute to trust transfer theory and enrich the literature on HIE efforts. Primary and secondary care providers can also identify how to leverage the benefit of patients' trust and trust transfer process to promote HIE initiatives nationwide.

Examining users’ knowledge sharing behaviour in online health communities

Purpose

The purpose of this paper is to draw on the stimulus-organism-response (SOR) framework to examine users’ knowledge sharing in online health communities (OHC).

Design/methodology/approach

Based on the 326 valid responses collected from a survey, structural equation modelling was employed to examine the research model.

Findings

The results indicated that both information quality and service quality affect trust in community, whereas both informational support and emotional support affect trust in other members. Both types of trust and privacy risk determine users’ sharing intention, which in turn affects sharing behaviour.

Research limitations/implications

The results imply that service providers need to improve their community platforms and create a supportive climate in order to facilitate users’ trust and their knowledge sharing behaviour.

Originality/value

Previous studies have examined a few determinants of OHC user behaviour such as privacy concern, trust and motivations. However, they have seldom disclosed the internal decision process underlying users’ knowledge sharing. This research tries to fill the gap.

Understanding users’ participation in online health communities: A social capital perspective

Due to the intense competition, it is crucial for online health communities to facilitate users’ participation and retain them. Drawing on the social capital theory, this research examined users’ participation in online health communities. The results indicated that social support, which includes informational support and emotional support, has a significant effect on social capital, which in turn affects users’ participation including health knowledge acquisition and contribution. The results imply that online health communities need to create a supportive climate in order to develop social capital and facilitate users’ participation.