Factors Affecting Continuance Intention in Non-Face-to-Face Telemedicine Services: Trust Typology and Privacy Concern Perspectives

As the COVID-19 pandemic progressed, the resulting demand for telemedicine services increased. This research empirically examines the role of trust, privacy concerns, and perceived usefulness in customer confirmation, satisfaction, and continuing intention in telemedicine. A typology of trust was employed to classify trust into three dimensions and explore the mediating role of the three dimensions of trust in the relationship between satisfaction, perceived usefulness, and continued intention. We also examined the moderating role of personal privacy concerns in the relationship between trust and continued intention. For this study, we developed a structural equation model based on expectation confirmation theory and analyzed 465 questionnaires from Chinese online users. The expectancy confirmation theory (ECT) was reaffirmed by empirical evidence. The results showed that the relationship between perceived usefulness and satisfaction with continued intention is moderated by the three dimensions of trust. Privacy concerns can negatively moderate the relationship between structural assurance-based trust and continued intention. This study also identified potential threats to telehealth market growth alongside new insights.

Online health management continuance and the moderating effect of service type and age difference: A meta-analysis

Numerous empirical studies have been carried out to explore factors of online health management continuance. However, results were not unified. We thus conducted a meta-analysis to identify influential factors and potential moderators. A systematic literature search was performed in nine databases (PubMed, Web of Science, the Cochrane Library, Ovid of JBI, CINAHL, Embase, CNKI, VIP, and CBM) published up to December 2020 in the English or Chinese language. Meta-analysis of combined effect size, heterogeneity, moderator analysis, publication bias assessment, and inter-rater reliability was conducted. Totally 41 studies and 12 pairwise relationships were identified. Confirmation, perceived usefulness, satisfaction, information quality, service quality, perceived ease of use, and trust were all critical predictors. Service type and age difference showed their moderating effects respectively. The perceived usefulness was more noteworthy in medical service than health and fitness service. The trust was more noteworthy in young adults. The results confirmed the validity and robustness of the Expectation Confirmation Model, Information Systems Success Model, and trust theory in online health management continuance. Moderators included but are not limited to age difference and service type. The elderly research in the healthcare context and other analytical methods such as qualitative comparative analysis should be applied in the future.

Acceptance of protection technology in a time of fear: the case of Covid-19 exposure detection apps

Purpose

This study explores the acceptance of protection technology, namely, exposure detection apps, in the context of the Covid-19 pandemic. Unlike other situations, the context of the pandemic is characterized by large levels of threat and fear which largely affect the human decision-making process. To identify such characteristics, this study investigates the acceptance of exposure detection apps from the perspective of protection motivation theory (PMT). It examines how the perceived risk of Covid-19, perceived fear of Covid-19, self-efficacy, response efficacy and protection motivation interact to predict the acceptance of exposure detection apps.

Design/methodology/approach

Data were collected from 306 Jordanian participants, and structural equation modelling was used for data analysis.

Findings

The results reveal that acceptance of these apps is triggered by the perceived risk of Covid-19, which increases the experienced level of fear. The latter then initiates a compelling desire or motivation to protect oneself by using the recommended adaptive response (exposure detection app). The results show that an increased level of self-efficacy and perceived efficacy of exposure detection apps also contribute to the development of protection motivation and later the intent to use exposure detection apps.

Originality/value

This study contributes to the technology acceptance domain by developing a context-driven model of the key characteristics of pandemics that lead to different patterns of technology acceptance. The key components in designing effective marketing campaigns to prompt the use of exposures detection apps are discussed.

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.

Investigating Patients' Intention to Continue Using Teleconsultation to Anticipate Postcrisis Momentum: Survey Study

Background

The COVID-19 crisis has drastically changed care delivery with teleconsultation platforms experiencing substantial spikes in demand, helping patients and care providers avoid infections and maintain health care services. Beyond the current pandemic, teleconsultation is considered a significant opportunity to address persistent health system challenges, including accessibility, continuity, and cost of care, while ensuring quality.

Objective

This study aims at identifying the determinants of patients’ intention to continue using a teleconsultation platform. It extends prior research on information technology use continuance intention and teleconsultation services.

Methods

Data was collected in November 2018 and May 2019 with Canadian patients who had access to a teleconsultation platform. Measures included patients’ intention to continue their use; teleconsultation usefulness; teleconsultation quality; patients’ trust toward the digital platform, its provider. and health care professionals; and confirmation of patients’ expectations toward teleconsultation. We used structural equation modeling employing the partial least squares component-based technique to test our research model and hypotheses.

Results

We analyzed a sample of 178 participants who had used teleconsultation services. Our findings revealed that confirmation of expectations had the greatest influence on continuance intention (total effects=0.722; P<.001), followed by usefulness (total effects=0.587; P<.001) and quality (total effects=0.511; P<.001). Usefulness (β=.60; P<.001) and quality (β=.34; P=.01) had direct effects on the dependent variable. The confirmation of expectations had direct effects both on usefulness (β=.56; P<.001) and quality (β=.75; P<.001) in addition to having an indirect effect on usefulness (indirect effects=0.282; P<.001). Last, quality directly influenced usefulness (β=.34; P=.002) and trust (β=.88; P<.001). Trust does not play a role in the context under study.

Conclusions

Teleconsultation is central to care going forward, and it represents a significant lever for an improved, digital delivery of health care in the future. We believe that our findings will help drive long-term teleconsultation adoption and use, including in the aftermath of the current COVID-19 crisis, so that general care improvement and greater preparedness for exceptional situations can be achieved.

Consumers' Decision-Making Process on Social Commerce Platforms: Online Trust, Perceived Risk, and Purchase Intentions

This study enhances the existing literature on the role of trust and online perceived risk in shaping consumer purchase decision-making in social commerce. The aim of this article is to investigate consumers' purchase decision-making process, the determinant components of social commerce purchase intentions and attitudes, the effect of perceived risk on intention to go shopping in online settings, and consumer trust and buying behavior on online retailing platforms. The insights obtained from our research extend current knowledge as regards determinants of consumer attitudes and intentions toward online purchases, consumers' perceived shopping risk and repurchase behavior when buying products online, and perceived consumer online trust and purchase decisions. Limited research has considered consumers' decision-making processes on social commerce platforms by investigating how their perceptual attitudes, behavioral intentions, and immediate gratifications affect the purchase of products and services online. Our study addresses this gap and extends prior research by focusing on the relationship between online consumer purchase intention, social commerce adoption behavior, and consumers' trust together with risk factors affecting online buying decisions, in light of the characteristics of source credibility. Our findings point toward important avenues of research on psychological determinants of consumer engagement in social media, decision mechanisms lying behind evaluation of prices, the types of perceived risk incurred, and online repurchasing behavior and intention on social commerce platforms. Subsequent directions should clarify whether adoption of mobile payment services may shape online consumers' impulsive buying behavior and decision-making, especially under the influence of online product reviews.

Trust, Risk and Alternative Website Quality in B-Buyer Acceptance of Cross-Border E-Commerce

Cross-border e-commerce (CBEC) has become an imperative mode for global trade. Research on cross-border e-commerce historically focuses mainly on the customer's behavior intention to purchase on a CBEC platform. However, B-buyers are more important compared with C-buyers for CBEC platforms. This is because B-buyers can contribute more gross merchandise volume (GMV) in a CBEC platform, and thus more margin for the firm. The authors apply trust transfer theory, perceived risk, and alternative website quality to study repurchase intention, focusing on B-buyers. The results show that perceived risk, trust in provider, and trust in the website affect repurchase intention significantly, where trust in website is found to be the most important factor. In addition, the authors found that the dimensions of perceived risk in CBEC context can be classified as the following: customer duties risk, confiscation risk, delivery risk, financial risk, and privacy risk. The contributions of the study are addressed lastly.

Patient Continued Use of Online Health Care Communities: Web Mining of Patient-Doctor Communication

BACKGROUND

In practice, online health communities have passed the adoption stage and reached the diffusion phase of development. In this phase, patients equipped with knowledge regarding the issues involved in health care are capable of switching between different communities to maximize their online health community activities. Online health communities employ doctors to answer patient questions, and high quality online health communities are more likely to be acknowledged by patients. Therefore, the factors that motivate patients to maintain ongoing relationships with online health communities must be addressed. However, this has received limited scholarly attention.

OBJECTIVE

The purpose of this study was to identify the factors that drive patients to continue their use of online health communities where doctor-patient communication occurs. This was achieved by integrating the information system success model with online health community features.

METHODS

A Web spider was used to download and extract data from one of the most authoritative Chinese online health communities in which communication occurs between doctors and patients. The time span analyzed in this study was from January 2017 to March 2017. A sample of 469 valid anonymous patients with 9667 posts was obtained (the equivalent of 469 respondents in survey research). A combination of Web mining and structural equation modeling was then conducted to test the research hypotheses.

RESULTS

The results show that the research framework for integrating the information system success model and online health community features contributes to our understanding of the factors that drive patients' relationships with online health communities. The primary findings are as follows: (1) perceived usefulness is found to be significantly determined by three exogenous variables (ie, social support, information quality, and service quality; R²=0.88). These variables explain 87.6% of the variance in perceived usefulness of online health communities; (2) similarly, patient satisfaction was found to be significantly determined by the three variables listed above (R²=0.69). These variables explain 69.3% of the variance seen in patient satisfaction; (3) continuance use (dependent variable) is significantly influenced by perceived usefulness and patient satisfaction (R²=0.93). That is, the combined effects of perceived usefulness and patient satisfaction explain 93.4% of the variance seen in continuance use; and (4) unexpectedly, individual literacy had no influence on perceived usefulness and satisfaction of patients using online health communities.

CONCLUSIONS

First, this study contributes to the existing literature on the continuance use of online health communities using an empirical approach. Second, an appropriate metric was developed to assess constructs related to the proposed research model. Additionally, a Web spider enabled us to acquire objective data relatively easily and frequently, thereby overcoming a major limitation of survey techniques.

Factors Influencing People’s Personal Information Disclosure Behaviors in Online Health Communities: A Pilot Study

To effectively facilitate health information sharing and personal information protection in online health communities (OHCs), it is important to examine the factors influencing people’s personal information disclosure behavior in OHCs. Five factors were supposed as the predictors of people’s personal information disclosure behavior in OHCs. A total of 376 participants in a Chinese online cancer community were analyzed. The empirical results indicate that more participants give more attention to risk factors than motivating factors when they disclose information in OHCs. In a not so severe condition, participants post their personal information to only obtain needed information. In severe disease situations, participants disclose personal information to obtain both needed information and emotional support, and emotional support is prioritized; in addition, they even risk financial loss to seek more useful information or emotional support. OHC managers should make policies to protect people’s personal information, and thus encourage them to share more health information in OHCs.