‘To protect my health, or to protect my health data?’ Eexamining the influence of health information privacy concerns on citizens’ health technology adoption.

This study conducts a holistic investigation of citizens’ health information privacy concerns (HIPC). Specifically, it develops a framework for examining the drivers, dimensions, and outcomes of HIPC. It is proposed that HIPC are formed from individuals’ characteristics, perceptions, and experiences. HIPC are expected to reduce individuals’ intentions (1) to accept Electronic Health Records (EHRs) and (2) to adopt mobile health (mHealth) solutions. To explore these assumptions, the study utilises a three-stage sequential mixed methods approach. In the first stage, exploratory interviews were conducted to refine the proposed framework. In the second stage, the hypothesised relationships in the framework were empirically tested, using a survey of 445 citizens in Ireland and the United States. In the third stage, in-depth interviews were conducted with 50 citizens in both countries to further explore these relationships. The quantitative and qualitative findings were then integrated to elucidate the underpinnings of HIPC. The integrated findings show that citizens’ HIPC are shaped by characteristics such as age and healthcare need, perceptions of trust, risk, and sensitivity, and experience of privacy media coverage. HIPC reduces adoption intentions, and influences the type of mHealth solution citizens are willing to adopt, as well as the type and volume of data disclosed. Perceived hedonic and utilitarian benefits positively influence adoption intentions, but in order to sustain this influence, these benefits must remain relevant to the individual. The study provides detailed insights into how citizens’ HIPC are developed, and how along with perceived benefits, they can influence adoption intentions and subsequent use behaviours. It also extends the Information Boundary theory (Petronio, 1991), Protection Motivation theory (Rogers, 1975), and Privacy Calculus theory (Culnan 1993) to the health information privacy context. The study’s findings provide actionable insights which can assist health organisations and technology companies in addressing citizens’ HIPC more successfully