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Navigating the Privacy-Health Nexus: A Smart Health Monitoring Systems Perspective

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Thesis embargoed until 10th April 2027(3.91 MB)

Date

2025

Authors

Zhang, Jingjing

Supervisor

Hassandoust, Farkhondeh
Johnston, Allen C.

Item type

Thesis

Degree name

Doctor of Philosophy

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Publisher

Auckland University of Technology

Abstract

The digital age has sharpened the clash between health and privacy. Smart health monitoring systems (SHMSs) grant unparalleled health insights to empower individuals and communities, but their intrusive nature of data collection raises concerns for privacy. To delve more deeply into the intricacies of privacy phenomena in the health empowerment context through SHMSs, the present study includes two manuscripts organized as Chapter 2 and Chapter 3. Manuscript 1 aims to provide a comprehensive review of privacy contextualization in SHMSs. It addresses the question of, “What are the key insights provided by the existing IS privacy literature that can inform our perspective on privacy in the SHMSs context?”. Manuscript 2 employs a mixed-methods approach to explore actual and potential SHMS users through the lens of health empowerment theory. It aims to conduct a value-reflexive examination of health and privacy within the SHMS health empowerment context, addressing another research question of this study: “How do users' value perceptions of health empowerment and privacy evolve in the context of SHMSs, and what factors influence these changes?” Manuscript 1 develops a contextual framework derived from a systematic review of 49 peer-reviewed articles. This framework provides valuable insights for scholars aiming to understand the multifaceted privacy concerns in SHMSs settings. The findings help both healthcare providers and policymakers in pinpointing and addressing potential privacy issues surrounding personal health information when developing and implementing healthcare surveillance systems. Furthermore, the findings highlight existing knowledge gaps and suggest some key future research avenues to achieve a more profound understanding of privacy within the realm of SHMSs. Manuscript 2 uncovers intricate dynamics between privacy and health priorities in SHMS use, particularly across age groups. The findings suggest that individuals tend to prioritize health over broader ethical and privacy considerations in the context of immediate health concerns, which may challenge the notion of traditional trade-off. However, this tendency varies with age. Non-elderly users (under 65) express greater discomfort with SHMS-related privacy loss compared to their elderly counterparts, hinting at generational shifts in privacy expectations. Furthermore, an interesting disconnect emerges in community health perspectives, where non-elderly users perceive their own health empowerment as inherently linked to the well-being of their communities, while, for elderly users, these concepts seem less intertwined. The study presents a comprehensive review of privacy contextualization and a nuanced re-evaluation of privacy within SHMSs, recognizing the complex interplay between health and privacy in the digital world. It is among a number of pioneering papers reporting on the prioritization of health empowerment over privacy concerns in SHMSs. This study also exhibits a notable opportunity to embrace contrarian thinking and explore alternative viewpoints. Theoretically, it contributes to the extension of health empowerment theory, adding to the development of the SHMS health empowerment research model. Practically, it suggests that SHMS practitioners should reassess the dynamics of the relationship between privacy concerns and health empowerment. Emphasizing perceived health benefits at personal and communal levels can be an effective strategy to address the tension between privacy and health empowerment.

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http://hdl.handle.net/10292/19030

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