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Communications of the Association for Information Systems

Author ORCID Identifier

DeJarvis Oliver: https://orcid.org/0000-0003-2725-3959

Humayun Zafar: https://orcid.org/0000-0001-9936-9753

Saurabh Gupta: https://orcid.org/0000-0002-5622-341X

Abstract

The adoption of health information technology (HIT) continues to grow, yet many patients remain reluctant to share personal health information. Prior information systems research often explains this reluctance using the privacy calculus, which frames disclosure as a tradeoff between expected benefits and privacy concerns. However, this approach leaves the antecedents of those benefit–risk evaluations under-specified. Drawing on Multidimensional Development Theory (MDT), we develop and test a model that integrates internal factors (autonomy of HIT use, privacy self-efficacy), environmental cues (perceived tracking and the perceived effectiveness of technological and regulatory protections), and interpersonal privacy calculus to predict willingness to disclose personal health information. Survey data from 500 U.S. adults were analyzed using partial least squares structural equation modeling. Results show that autonomy of HIT use increases expected positive outcomes and reduces privacy concerns, perceived tracking increases privacy concerns, and perceived technological and regulatory protections increase expected positive outcomes. Consistent with the privacy calculus, expected positive outcomes increase willingness to disclose, while privacy concerns decrease it. Consistent with MDT, these evaluations are shaped by internal and environmental conditions rather than arising in isolation.

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