International Journal of Medical Informatics

BACKGROUND Wearable technology has shown the potential of improving healthcare efficiency and reducing healthcare cost. Different from pioneering studies on healthcare wearable devices from technical perspective, this paper explores the predictors of individuals' adoption of healthcare wearable devices. Considering the importance of individuals' privacy perceptions in healthcare wearable devices adoption, this study proposes a model based on the privacy calculus theory to investigate how individuals adopt healthcare wearable devices. METHOD The proposed conceptual model was empirically tested by using data collected from a survey. The sample covers 333 actual users of healthcare wearable devices. Structural equation modeling (SEM) method was employed to estimate the significance of the path coefficients. RESULTS This study reveals several main findings: (1) individuals' decisions to adopt healthcare wearable devices are determined by their risk-benefit analyses (refer to privacy calculus). In short, if an individual's perceived benefit is higher than perceived privacy risk, s/he is more likely to adopt the device. Otherwise, the device would not be adopted; (2) individuals' perceived privacy risk is formed by health information sensitivity, personal innovativeness, legislative protection, and perceived prestige; and (3) individuals' perceived benefit is determined by perceived informativeness and functional congruence. The theoretical and practical implications, limitations, and future research directions are then discussed.

[1]  Henry Been-Lirn Duh,et al.  A study on Singaporean women's acceptance of using mobile phones to seek health information , 2011, Int. J. Medical Informatics.

[2]  David Gefen,et al.  The impact of personal dispositions on information sensitivity, privacy concern and trust in disclosing health information online , 2010, Decis. Support Syst..

[3]  Ritu Agarwal,et al.  Electronic Health Records Assimilation and Physician Identity Evolution: An Identity Theory Perspective , 2012, Inf. Syst. Res..

[4]  Mayuram S. Krishnan,et al.  The Personalization Privacy Paradox: An Empirical Evaluation of Information Transparency and the Willingness to be Profiled Online for Personalization , 2006, MIS Q..

[5]  Tiago Oliveira,et al.  Determinants of end-user acceptance of biometrics: Integrating the "Big 3" of technology acceptance with privacy context , 2013, Decis. Support Syst..

[6]  Sumeet Gupta,et al.  Disclosure Intention of Location-Related Information in Location-Based Social Network Services , 2012, Int. J. Electron. Commer..

[7]  Seyedmostafa Safavi,et al.  Conceptual Privacy Framework for Health Information on Wearable Device , 2014, PloS one.

[8]  O. Kwon,et al.  User acceptance of context-aware services: self-efficacy, user innovativeness and perceived sensitivity on contextual pressure , 2007, Behav. Inf. Technol..

[9]  Ángel Francisco Agudo-Peregrina,et al.  Behavioral intention, use behavior and the acceptance of electronic learning systems: Differences between higher education and lifelong learning , 2014, Comput. Hum. Behav..

[10]  Dimitrios Asteriou,et al.  The effect of board composition on the informativeness and quality of annual earnings: Empirical evidence from Greece , 2010 .

[11]  Barton A. Weitz,et al.  Self-Disclosure on the Web: the Impact of Privacy Policy, Reward, and Company Reputation , 2002 .

[12]  J. Phelps,et al.  Privacy Concerns and Consumer Willingness to Provide Personal Information , 2000 .

[13]  Heng Xu,et al.  Information privacy and correlates: an empirical attempt to bridge and distinguish privacy-related concepts , 2013, Eur. J. Inf. Syst..

[14]  Trevor T. Moores,et al.  Towards an integrated model of IT acceptance in healthcare , 2012, Decis. Support Syst..

[15]  Matthew D Langer,et al.  Design and evaluation of a wearable self-applied therapeutic ultrasound device for chronic myofascial pain. , 2013, Ultrasound in medicine & biology.

[16]  Ritu Agarwal,et al.  The Digitization of Healthcare: Boundary Risks, Emotion, and Consumer Willingness to Disclose Personal Health Information , 2011, Inf. Syst. Res..

[17]  Vincenzo Russo,et al.  Privacy calculus model in e-commerce – a study of Italy and the United States , 2006, Eur. J. Inf. Syst..

[18]  Xitong Guo,et al.  UNDERSTANDING THE ACCEPTANCE OF MOBILE HEALTH SERVICES: A COMPARISON AND INTEGRATION OF ALTERNATIVE MODELS , 2013 .

[19]  C. Fornell,et al.  Evaluating structural equation models with unobservable variables and measurement error. , 1981 .

[20]  Hock Chuan Chan,et al.  The perception and intention to adopt female-focused healthcare applications (FHA): A comparison between healthcare workers and non-healthcare workers , 2009, Int. J. Medical Informatics.

[21]  Zhaohua Deng,et al.  Comparison of the middle-aged and older users' adoption of mobile health services in China , 2014, Int. J. Medical Informatics.

[22]  Kai Zheng,et al.  Modeling the longitudinality of user acceptance of technology with an evidence-adaptive clinical decision support system , 2014, Decis. Support Syst..

[23]  Wolfgang Maass,et al.  Design and evaluation of Ubiquitous Information Systems and use in healthcare , 2012, Decis. Support Syst..

[24]  Carmen C. Y. Poon,et al.  Unobtrusive Sensing and Wearable Devices for Health Informatics , 2014, IEEE Transactions on Biomedical Engineering.

[25]  H. Raghav Rao,et al.  A trust-based consumer decision-making model in electronic commerce: The role of trust, perceived risk, and their antecedents , 2008, Decis. Support Syst..

[26]  Yong Jin Kim,et al.  Do visitors' interest level and perceived quantity of web page content matter in shaping the attitude toward a web site? , 2006, Decis. Support Syst..

[27]  Robert E. Crossler,et al.  Disclosing too much? Situational factors affecting information disclosure in social commerce environment , 2014, Electron. Commer. Res. Appl..

[28]  Deborah Compeau,et al.  Computer Self-Efficacy: Development of a Measure and Initial Test , 1995, MIS Q..

[29]  A. Hausman,et al.  The effect of web interface features on consumer online purchase intentions , 2009 .

[30]  Ling Liu,et al.  Adoption of Big Data Analytics in Healthcare: The Efficiency and Privacy , 2015, PACIS.

[31]  J. Hair.  Multivariate data analysis , 1972 .

[32]  Nicolae Nistor,et al.  When technology acceptance models won't work: Non-significant intention-behavior effects , 2014, Comput. Hum. Behav..

[33]  Marko Hölbl,et al.  Privacy antecedents for SNS self-disclosure: The case of Facebook , 2015, Comput. Hum. Behav..

[34]  Catherine E. Tucker,et al.  The economics of advertising and privacy , 2012 .

[35]  Ing-Long Wu,et al.  The adoption of mobile healthcare by hospital's professionals: An integrative perspective , 2011, Decis. Support Syst..

[36]  James C. Anderson,et al.  STRUCTURAL EQUATION MODELING IN PRACTICE: A REVIEW AND RECOMMENDED TWO-STEP APPROACH , 1988 .

[37]  Naresh K. Malhotra,et al.  Internet Users' Information Privacy Concerns (IUIPC): The Construct, the Scale, and a Causal Model , 2004, Inf. Syst. Res..

[38]  Andreas Herrmann,et al.  Conformity and the Crowd , 2013 .

[39]  Jiyoung Kim,et al.  Joint influence of online store attributes and offline operations on performance of multichannel retailers , 2010, Behav. Inf. Technol..

[40]  Yuan Li,et al.  The impact of disposition to privacy, website reputation and website familiarity on information privacy concerns , 2014, Decis. Support Syst..

[41]  Yuan Li,et al.  Theories in online information privacy research: A critical review and an integrated framework , 2012, Decis. Support Syst..

[42]  Colin Harrison,et al.  An e-maturity analysis explains intention-behavior disjunctions in technology adoption in UK schools , 2014, Comput. Hum. Behav..

[43]  Detmar W. Straub,et al.  Validation Guidelines for IS Positivist Research , 2004, Commun. Assoc. Inf. Syst..

[44]  Hock-Hai Teo,et al.  The Role of Push-Pull Technology in Privacy Calculus: The Case of Location-Based Services , 2009, J. Manag. Inf. Syst..

[45]  Keiichi Nakata,et al.  Comparing British and Japanese Perceptions of a Wearable Ubiquitous Monitoring Device , 2013, IEEE Technology and Society Magazine.

[46]  R. Laufer,et al.  Privacy as a Concept and a Social Issue: A Multidimensional Developmental Theory , 1977 .

[47]  Shin-Yuan Hung,et al.  Investigating primary health care nurses' intention to use information technology: An empirical study in Taiwan , 2014, Decis. Support Syst..

[48]  Subhajyoti Bandyopadhyay,et al.  An Analysis of the Adoption of Digital Health Records under Switching Costs , 2010, Inf. Syst. Res..

[49]  Sian Harris.  Catwalk goes techno - [engineering fashion] , 2008 .

[50]  Neil Vidmar,et al.  Concern for Personal Privacy in an Electronic Age. , 1985 .

[51]  D. Pitta,et al.  Consumer Concerns for Healthcare Information Privacy: A Comparison of US and Canadian Perspectives , 2009 .

[52]  Ritu Agarwal,et al.  A Conceptual and Operational Definition of Personal Innovativeness in the Domain of Information Technology , 1998, Inf. Syst. Res..

[53]  Rathindra Sarathy,et al.  The role of affect and cognition on online consumers' decision to disclose personal information to unfamiliar online vendors , 2011, Decis. Support Syst..

[54]  Stéphane M. Meystre,et al.  Text de-identification for privacy protection: A study of its impact on clinical text information content , 2014, J. Biomed. Informatics.

[55]  Jean-Yves Fourniols,et al.  Smart wearable systems: Current status and future challenges , 2012, Artif. Intell. Medicine.

[56]  Paul J. Hart,et al.  Privacy Concerns and Levels of Information Exchange: An Empirical Investigation of Intended e-Services Use , 2006 .

[57]  H. Teo,et al.  Effects of Individual Self-Protection, Industry Self-Regulation, and Government Regulation on Privacy Concerns: A Study of Location-Based Services , 2012 .

[58]  M. Culnan,et al.  Information Privacy Concerns, Procedural Fairness, and Impersonal Trust: An Empirical Investigation , 1999 .

[59]  Yongqiang Sun,et al.  The dark side of elderly acceptance of preventive mobile health services in China , 2013, Electron. Mark..

[60]  Heng Xu,et al.  Information Privacy Concerns: Linking Individual Perceptions with Institutional Privacy Assurances , 2011, J. Assoc. Inf. Syst..

[61]  Leonard V. Coote,et al.  Corporate sponsorship of a cause: the role of identification in purchase intent , 2005 .

[62]  Yiwen Gao,et al.  An empirical study of wearable technology acceptance in healthcare , 2015, Ind. Manag. Data Syst..

[63]  Ann M. Hirsch,et al.  Plant-Associated Symbiotic Burkholderia Species Lack Hallmark Strategies Required in Mammalian Pathogenesis , 2014, PloS one.

[64]  Hock-Hai Teo,et al.  Research Note - Effects of Individual Self-Protection, Industry Self-Regulation, and Government Regulation on Privacy Concerns: A Study of Location-Based Services , 2012, Inf. Syst. Res..

[65]  Albert H. Segars,et al.  An Empirical Examination of the Concern for Information Privacy Instrument , 2002, Inf. Syst. Res..

[66]  Mary Beth Rosson,et al.  The personalization privacy paradox: An exploratory study of decision making process for location-aware marketing , 2011, Decis. Support Syst..

[67]  Yves Perriard,et al.  Design and Optimization of A Blood Pump for A Wearable Artificial Kidney Device , 2013, IEEE Transactions on Industry Applications.

[68]  Greg Taylor,et al.  The Informativeness of On-Line Advertising , 2011 .

[69]  Tao Wang,et al.  Exploring determinants of adoption intentions towards Enterprise 2.0 applications: an empirical study , 2014, Behav. Inf. Technol..

[70]  Tao Zhou,et al.  Integrating TTF and UTAUT to explain mobile banking user adoption , 2010, Comput. Hum. Behav..

[71]  F. Huber,et al.  Brand misconduct: Consequences on consumer–brand relationships , 2010 .

[72]  David Madigan,et al.  Optimizing the leveraging of real-world data to improve the development and use of medicines. , 2015, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[73]  Maryam Masoudi,et al.  The effect of web interface features on consumer online purchase intentions , 2015 .

[74]  A. Riahi‐Belkaoui,et al.  Accounting for corporate reputation , 1992 .

[75]  Ritu Agarwal,et al.  Adoption of Electronic Health Records in the Presence of Privacy Concerns: The Elaboration Likelihood Model and Individual Persuasion , 2009, MIS Q..

[76]  D. Campbell,et al.  Convergent and discriminant validation by the multitrait-multimethod matrix. , 1959, Psychological bulletin.

[77]  M. E. Gordon,et al.  Direct Mail Privacy-Efficiency Trade-offs within an Implied Social Contract Framework , 1993 .

[78]  Yoo Jung Kim,et al.  Why smartphone advertising attracts customers: A model of Web advertising, flow, and personalization , 2014, Comput. Hum. Behav..

[79]  Tamara Dinev,et al.  An Extended Privacy Calculus Model for E-Commerce Transactions , 2006, Inf. Syst. Res..

[80]  Joseph Wei,et al.  How Wearables Intersect with the Cloud and the Internet of Things : Considerations for the developers of wearables. , 2014, IEEE Consumer Electronics Magazine.

[81]  Yuan Li,et al.  Empirical Studies on Online Information Privacy Concerns: Literature Review and an Integrative Framework , 2011, Commun. Assoc. Inf. Syst..

[82]  Mary Ann Eastlick,et al.  Understanding online B-to-C relationships: An integrated model of privacy concerns, trust, and commitment , 2006 .