Three Essays in Using Communication to Motivate Adoption and Compliance among Users of Healthcare and Emergency Systems
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This thesis explores how information and communication technologies can be used to impact behavior. Specifically, this thesis studies the role of message framing in two domains: health care and extreme events. In both domains, when the communication is persuasive it impacts lives in a positive way. The key component of all communication is information quality. This research show the impact of information on the decisions that people make. The key objective of this dissertation is to keep people safer. Specifically this research examines human behavior in term of (a) adoption of technologies in the healthcare context (b) compliance with message sent through media in extreme events context. This dissertation tries to answer these questions: • Does communication influence human behavior? • What is the role of message framing in impacting adoption and compliance? • Does empowerment persuade users to adopt and comply? To answer these questions, this thesis provides evidence from the healthcare domain and the extreme events domain. In both these domains, the persuasion to adopt/comply comes from being personally impacted by these domains rather than an organizational effort to enforce adoption and compliance. The coercive forces come from the event rather than an organization entity. Traditional economics assume that people are rational decision makers but the last two decades of behavioral economics research show that people are not purely driven by rationality when making decisions. When organization cannot change policies in a certain way and cannot give economic incentives for certain actions then they have to use other means to motivate people to engage in the desired behavior. The broad implicit assumption in all of the 3 essays that form part of this thesis is that users have a choice to comply or not comply / adopt or not adopt. Furthermore, the belief is that people empowered with knowledge make rational choices. Thus, in each of the three essays we empower users with knowledge and control and examines the influence on compliance and adoption. In extreme events, being able to reach students almost immediately to inform them about emergency situations on campus and how to react to them is very important from a compliance point of view. Twersky and Kahneman (1974) suggest that people rely heavily on the first piece of information they receive when making prompt decisions. Despite the rapid adoption of campus emergency notification systems; in the last decade approximately 227 people were killed in shootings that took place in campuses and schools. Likewise; the center for disease control reports that between 1% and 2% of violent death occurs at or near schools. The difference between life and death can be due to lack of communication between university officials and students. The decision of individual to choose a certain behavior is influenced by the way the information is presented. Campus Emergency notification systems (ENS) can be used efficiently improve communication between University officials and students. Using a scenario based survey we investigate the appropriate message framing to improve compliance with messages sent via ENS for extreme events. Thus, essay 2 tries to answer the following main question: • How does message framing impact students’ compliance to ENS messages in fast moving extreme events such as active shooter? In the health care context, Health information exchanges (HIEs) are multi-sided platforms in which many entities interact—patients as well as various types of providers, such as hospitals, primary care physicians, and laboratory testing facilities, among others. HIEs enable smoother interoperability and better integration of data related to a specific patient. Availability of patient records to providers is based on patient consent. Patient consent relates to patients permitting the sharing of their personal health information with providers who are part of the Health Information Exchange. Patient consent is therefore an important driver that allows for much of the activity on the Health Information Exchange to take place. It is therefore vital for the long-term sustainability of the Health Information Exchanges as it also drives provider adoption of HIEs. Very few studies have addressed the issue of patient consent. We use persuasive means to increase consent and thus improve the sustainability of HIEs. Essays 1 and 3 try to answer the following questions: • How does message framing impacts patient consent? • How does providing greater information-flow control to patients’ impacts patient consent? • How does empowering patients with additional services (such as PHR) to control and communicate their health information impacts patients consent? Persuasive communication, message framing, and argument framing have been extensively investigated in the health arena and communication and marketing research. However, to our knowledge, limited research has been conducted in the field on healthcare and emergency systems.