Beyond a “Take It” or “Leave It” Approach to eConsent Design on Health Social Networks: The Role of Emotion and Cognition

Beyond a “Take It” or “Leave It” Approach to eConsent Design on Health Social Networks: The Role of Emotion and Cognition

Wendy Rowan, Yvonne O'Connor, Laura Lynch, Ciara Heavin
Copyright: © 2020 |Pages: 21
DOI: 10.4018/IJPCH.2020070103
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With the proliferation of eHealth resources promoting health data storage, analysis, and dissemination, it is important for individuals to understand the implications of sharing their highly sensitive personal health information (PHI) online. However, uncertainty remains about the level of individual awareness and understanding when sharing PHI on health social networks (HSN). This article explores individuals' emotion and cognition in the provision of eConsent for PHI on a HSN focusing on individual engagement of emotion pre- and post-registration. Prior to participants reading the HSN's privacy policy (PP) and terms and conditions (T&Cs), a ‘just click' behavior was widely observed. This article shows that educating users about the implications of T&Cs and PPs changes their attitudes toward giving eConsent. By exploring individual emotion and cognition, this study proposes guidelines for software developers designing eConsent for HSNs.
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1. Introduction

Emotion and cognition underpin human decision-making (De Martino, Kumaran, Seymour, & Dolan, 2006). Many believe that emotions are the dominant driver of most meaningful decisions in life (Ekman, 2007; Gilbert, 2006; Loewenstein & Lerner, 2003; Oatley, Keltner, & Jenkins, 2006). Pfister & Böhm (2008) argue that emotion and rationality cannot be omitted from research. Lamia (2010) suggests that some decisions are informed by emotional responses because emotions are designed to appraise and summarize an experience, to inform action. The basis for emotions is to a certain extent evolutionary, determined, and related to survival strategies (Cruciani, 2017). However, these are tempered by environmental restraints and the way factors are appraised (Reber, Allen, & Reber, 2017). By using both emotion and cognitive judgement the outcomes of decision making enable the individual to experience new emotions (Lerner, Li, Valdesolo, & Kassam, 2015). It is fair to surmise that emotions and rational thought go hand in hand in the decision-making process (Lerner et al., 2015).

Health Social Networks (HSN) have a profound impact on the well-being of end-users (Pavleska & Jerman Blažič, 2017). Zhao et al. (2013) argue that such opportunities can only be fully realized if members willingly contribute useful information and knowledge. The extent to which a member contributes in online fora is influenced 1) by their emotions (Pentina & Zhang, 2017) and 2) by how the platform intends to utilize their contribution (i.e. the wording of Terms and Conditions and Privacy Policy documents associated with online health networks) and what the member is electronically consenting (eConsent) to (Lindegren, Karegar, Kane, & Pettersson, 2019). Users have understood and comprehend the risks/benefits worded in these policy statements (O’Connor, Rowan, Lynch, & Heavin, 2017). Yet, it is argued that the emotional dimension surrounding eConsent is neglected (Assale, Barbero, & Cabitza, 2019).

This article aims to explore eConsent on HSNs and the role that both emotions and cognition play in an individual’s decision choice and action. We explore a particular type of decision that involves both emotion and cognitive judgement: the decision to register and join HSNs. Such results contribute to the ongoing efforts of many researchers focused on improving the design and experience of the eConsent process (Coiera & Clarke, 2004; Feldman, Kumar, Pugliese, Mateo, & Kachnowski, 2019; Lindegren et al., 2019; O'Connor, Twohig, & O'Brien, 2021; O’Connor et al., 2017; Wilbanks, 2018).

This article is organized as follows; we provide a description of HSNs, and the privacy and data protection issues associated with this type of social network. We consider the key issues relating to emotional and cognitive attributes of decision-making behaviours focusing on risk assessment. The methodological approach and the results are presented. We consider the theoretical and practical implications arising from this exploratory research. Finally, the limitations of the study and opportunities for further research are presented.

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