Understanding the Influence of Data Breaches on Patients’ Willingness to Share Protected Health Information: A Mixed Methods Study of a Construals Privacy Calculus Perspective

This study investigates why patients withhold new voluntary protected health information (PHI) from healthcare providers, focusing on the influence of data breaches. It integrates Construal Level Theory (CLT) with privacy calculus to understand how patients frame and construe their understanding of data breaches. The research highlights that psychological limitations influence a rational analysis of the risks and rewards of disclosing PHI, and that PHI-disclosure decisions are construed based on contextual cues embedded within data breach information. The study finds that if data breach details are construed abstractly, privacy and risk concerns are less important than PHI-disclosure benefits in influencing new PHI disclosure decisions. It also shows that new disclosure relies on the benefits of receiving appropriate medical care in the presence of high privacy concerns. The findings suggest that perceived benefits suppress patients' privacy concerns at any moment, and that patients' perceptions of benefits, operationalized in location-based and personalized health services, positively influence new disclosure intentions. The study employs a sequential mixed-methods design with quantitative and qualitative components, using the factorial survey method (FSM) and linear mixed modeling (LMM) for the quantitative portion, and semi-structured interviews for the qualitative portion. The results indicate that social and hypothetical distance are the only dimensions influencing perceived privacy concerns and risk, and that using perceived PHI sensitivity as the full model moderator fundamentally alters the influence of psychological distance in shaping an individual's privacy calculus and disclosure intention. The study concludes that high perceived PHI sensitivity diminishes the impact of temporal, social, and hypothetical distance, as the emotional immediacy and personal relevance of health information anchor an individual's perception of privacy concern and perceived privacy risk consistently at a high level.