Rebecca Davenport (Green Bay, Wisconsin, Human Resource Management/Health
Care Administration) and Dr. Gaurav Bansal
Moderating Role of Perceived Health Status on Privacy Concern Factors
and Intentions to Transact with High versus Low Trustworthy Health Websites
Collection
Research Methodology
H1
Web based lab experiment comprising of a scenario grid of 11 websites
ranging in terms of high trust (offering low discount) to low trust (offering
high discount)
Total 245 students participated. 55 responses were eliminated.
Examined discriminant and convergent validity using exploratory factor
analysis
Examined reliability using Cronbach alpha
 Data was analyzed using Ordinary Least Square Regression
All the multivariate variables were estimated by averaging the item scores
Moderation analysis was performed by multiplying the centered variables
(Ray et al. 2005)
.35***
Introduction
The study examines the relative role of health information privacy concern
factors and perceived health status on the trade-off between trust and discount
when buying vitamins online. The study relies on Utility Theory to argue that
the privacy concern factors and perceived health status impact one’s preference
for trust over discount.
Research Model
Collection
H1
Unauthorized
Secondary Use
Improper
Access
H2
Preference
of Trust
over
Discount
H3
H4
H6
H8
Errors
H5
H7
Construct
Privacy
concern
Collection
Code
Col1
Col2
Perceived
Poor
Health Status
Financial Status
Literature Review and Theory





Research suggests that people are concerned for the privacy of their
health information (Bansal et al. 2008; Malhotra et al. 2004; Westin
2006).
People are concerned that once their health information is released, it
cannot be made secret again (Rindfleisch 1997), that the information
may fall in wrong hands (USA Today.com 2008).
Those who perceive their health to be “poor” are more sensitive about
their health information (Bansal et al. 2010).
Privacy concerns have been defined as comprising of four subconstructs: collection, unauthorized secondary use (internal / external),
improper access, and errors (Smith et al. 1996; Stewart and Segars
2002).
Utility theory suggests that people tend to maximize benefit. Those who
are more concerned for privacy protection would trade trust for
discount. Those who are less concerned would like to avail discount at
the expense of perceived privacy protection.
Collection
Concern
Secondary Use
Concern
Errors
My level of concern that online companies may:
Share my health information, without prior authorization with other companies is
(very low / very high)
Sell my health information to other companies is (very low / very high)
Misuse my health information for other reasons without prior authorization is
(very low / very high)
Privacy
concern –
Improper
access
Imp1
Imp2
I am concerned that when it comes to preventing unauthorized access to my
health information, the online companies:
(have sufficient controls / do not have sufficient controls)
(devote sufficient time and effort / do not devote sufficient time and effort at all)
Privacy
concern Errors
Err1
Err2
I am concerned that when it comes to correcting and verifying the accuracy of
my health information, the online companies:
(have excellent procedures/ have poor procedures)
(devote a great deal of time and effort / do not devote any time and effort at all)
Model 1
Model 2
Model3
Model 4
Model 5
Model 6
Intercept
3.00***
3.07***
2.88***
3.03***
2.94***
3.00***
Collection (H1)
0.35***
0.35***
0.36***
0.35***
0.35***
0.34***
Secondary Use (H2)
0.07
0.06
0.05
0.07
0.06
0.06
Improper Access (H3)
-0.19*
-0.19*
-0.18*
-0.19*
-0.20*
-0.17*
Error (H4)
0.17*
0.17*
0.17*
0.17*
0.18*
0.18*
Fin. Status (Control)
0.29***
0.28**
0.31***
0.28**
0.30***
0.29**
0.01
Health status x Sec. Use (H6)
0.05
-0.07*
1.
2.
3.
-0.03
0.04
0.07
7.
Usage of the user information for other purposes, without the users’
approval
Health Status x Errors (H8)
R2
0.24
0.24
0.25
0.24
0.24
0.26
Improper Access
Concern
Unauthorized access to the user information
Adjusted R2
0.22
0.22
0.23
0.21
0.21
0.23
F - Model
10.97
9.11
9.78
9.19
9.21
6.87
Errors Concern
Errors in the user information
p - value
0.00
0.00
0.00
0.00
0.00
0.00
Max VIF
1.99
1.99
2.01
1.99
1.99
2.56
H4
.17*
H6
-.09*
H8
H7
Controls:
Financial Status
(.29**)
Literature Cited
5.
6.
-0.03
R2=24.52%
Collection and error concerns are positively associated with trust over
discount. Improper access is positively associated with discount over trust.
People probably feel that HIPAA explicitly protects them from unauthorized
secondary use and improper access.
People still feel unprotected for collection and error concerns for which
they probably rely on the implicit protection via trust in the health website.
Other reason for the negative role of improper access could be higher
perceived likelihood of improper access of the user’s health information
stored with the trustworthy companies than with the lesser known
companies. E.g., Hacking of Google, CitiBank, Pentagon etc.
Moderation analysis suggests that less healthy people use the explicit
protection to save money in order to buy more medication.
Health websites need to follow different strategies in order to gain their
clients’ business. These strategies need to vary depending upon the
perceived health status of their users.
One impression is that companies need to assure their users about
collection and error concerns, in particular, because findings of this study
suggest that the users are willing to pay a premium in lieu of protection
against these two concerns.
4.
Health Status x Imp. Access (H7)
H3
-.19*
Conclusion and Implications
-0.10*
Collecting too much information on the users
Preference
of Trust
over
Discount
Perceived
Poor
Health Status
Result of the Regression Analysis
Hypothesis / variable
H2
H5
My level of concern when online companies:
Ask for my health information is (very low / very high)
Collect too much health information is (very low / very high)
Health status x Collection (H5)
Definition of the Privacy Concern Factors (Smith et al. 1996)
Improper
Access
Items (Adapted from: Smith et al. 1996, Malhotra et al. 2004)
Privacy
Sec 1
concern –
Sec 2
unauthorized Sec 3
secondary use
Controls:
Unauthorized
secondary use
Estimated Model
Abbreviations:
*** p < .001
** p < .01
* p < .05
8.
9.
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privacy assurance mechanisms for building trust: A multiple-context investigation, in the proceedings of the
International Conference on Information Systems, Paris.
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instrument, Information Systems Research, 13, 1, 36-49.
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2010)