Abstract

It’s Not Just About Individuals’ disclosure of personal health information

the Product: How (PHI) can hold substantial benefits for both users and
providers, but users are often reluctant to disclose,
even if they gain benefits such as better
Persuasive personalization. While previous research has dealt
with message framing and information quality in a
Communication health-related context, these factors have been
observed separately. To our best knowledge, we are

Affects the among the first to have examined both factors

(attribute framing and argument strength) and their
interactions concerning PHI disclosure. Thus, we
Disclosure of conducted a web-based experiment with 529
participants to examine the impacts of two persuasive

Personal Health message techniques (attribute framing and argument

strength) on individuals’ PHI disclosure. We reveal that
individuals tend to disclose more PHI when they
Information experience persuasive messages with more positively
framed health wearable (HW) attributes or messages
with higher argument strength based on the reasons
Moritz Becker for the data collection. We enable researchers to
LMU Munich uncover the impacts of persuasive messages in highly
sensitive data environments and provide practitioners
with workable suggestions on how to affect individuals’
Christian Matt
PHI disclosure behaviors.
University of Bern
Keywords: Persuasive Messages; Personal Health
Thomas Hess Information (PHI); Data Disclosure; Attribute Framing;
LMU Munich Argument Strength; Health Wearables (HW).

Acknowledgments
This research project was funded by the German
Federal Ministry of Education and Research (BMBF)
within the grant 16KIS0494. A previous version of this
article has been presented at the Hawaii International
Conference on System Sciences 2019 as “Becker, M.,
& Matt, C. (2019). The Impact of Persuasive
Messages on the Disclosure of Personal Health
Information.” Furthermore, we gratefully acknowledge
the support of Isabella Burger.
Introduction
Health wearables (HWs) as a special form of health
information technology (health IT) automatically
gather individuals’ personal health information (PHI) to
provide users with medical feedback for managing
their health and wellbeing on a personal basis. PHI
refers to “personal data related to the physical or
mental health of a natural person, including the
provision of health care services, which reveal
information about his or her health status” (European
Commission of Justice and Consumers, 2016, p. 33).
Individuals perceive PHI as a very sensitive resource,
including serious privacy concerns about how their
PHI is used, disclosed, and protected (Milne, Pettinico,
Hajjat, & Markos, 2017). They are especially
concerned about possible undesirable economic and
social consequences resulting from the misuse of such
information (Bansal & Gefen, 2010). Thus, 55 percent
of Europe’s population is willing to disclose their PHI
to physicians, but only 7 percent to HW providers
(Lutter, Meinecke, Tropf, Böhm, & Esser, 2017).
According to privacy calculus theory, individuals are
willing to voluntarily disclose PHI if they expect that the
perceived value from data disclosure will outweigh the
perceived costs (Plachkinova, Andrés, & Chatterjee,

The DATA BASE for Advances in Information Systems 37 Volume 51, Number 1, February 2020
2015; Wieneke, Lehrer, Zeder, & Jung, 2016).
Previous research suggests that it is not only the
product or privacy policies’ characteristics that may
affect individuals’ willingness to disclose PHI but also
how the information is presented (Adjerid, Acquisti, &
Loewenstein, 2014; Samat & Acquisti, 2017). Thus,
HW providers could use specific communication
strategies, such as persuasive messages, as part of
product presentation to influence individuals’ minds,
attitudes, and practices (Stiff & Mongeau, 2003). In
this sense, HW providers may be able to increase
individuals’ perceived benefits by adapting the
production description and reframing the HW
attributes (attribute framing). Framing refers to the
phenomenon of persuasion in which “simple and
unspectacular changes” in product presentation lead
to changes in choice” (Kühberger, 1998, p. 205).
Research into healthcare has shown that message
content is more likely to positively influence behavior if
the message frame leads to positive thoughts and
associations (Angst & Agarwal, 2009). Thus, attributes
of HWs that are more positively framed (gain-framed
vs. neutral vs. loss-oriented) may increase individuals’
PHI disclosure.
Apart from the product presentation, HW providers
may also think about adapting the presentation of their
privacy policies so as to lower the perceived risks.
Privacy policy statements can be influenced via
different arguments for data collection. It is known that
individuals produce more favorable responses to
messages with strong than with weak arguments
(Petty & Cacioppo, 1986). Following this, HW
providers that directly present reasons for data
collection and thus use higher argument strength
levels (logical arguments vs. no arguments vs. illogical
arguments) may be able to increase individuals’ PHI
disclosure. Both attribute framing and argument
strength have barely been evaluated (Chong, Ge, Li,
& Proctor, 2018; Kühberger, 1998; Samat & Acquisti,
2017; Shen & Kollar, 2015). In the few existing cases,
they were mostly examined in combination with
personality traits such as self-esteem, perceived
prestige, and information sensitivity. Also, they have
mostly been investigated in non-health-related
contexts, while the multidimensional effect of two
persuasive message techniques on PHI disclosure
has not yet been examined (Li, Wu, Gao, & Shi, 2016).
We ask:
RQ: How do attribute framing and argument strength
influence individuals’ PHI disclosure?
To answer this research question, we conducted a
web-based experiment with 529 participants to
analyze the influences of these two persuasive
messages techniques on individuals’ PHI disclosure.
By varying attribute framing (gain-oriented, neutral,
and loss-oriented frames) and argument strength
The DATA BASE for Advances in Information Systems
(logical, no, and illogical arguments) in a 3x3
experimental setting, we reveal that individuals tend to
disclose more PHI when they experience persuasive
messages with more positively framed HW attributes
and messages with higher argument strength
concerning data collection. We enhance the
theoretical understanding of individuals’ information
processing of persuasive messages concerning PHI
disclosure and enable practitioners (HW providers and
health policymakers) to learn how privacy
communication strategies can affect individuals’ PHI
disclosure. Further, we responded to the call for
research by Angst and Agarwal (2009) to identify new
predictors of persuasion in the context of health IT by
investigating individuals’ PHI disclosure.
Conceptual Foundations
Privacy Calculus and Personal Health Information
Health wearables studies have been conducted from
different perspectives to investigate the nature of
individuals’ information disclosure behaviors. They
have adopted different theories, such as theory of
reasoned action, privacy calculus theory, and social
contract theory (Zhang et al., 2018). Among them,
privacy calculus theory is widely adopted to investigate
consumer privacy concerns because it integrates both
the risks and benefits of privacy concerns. The privacy
calculus model assumes that individuals perform a
risk-benefit analysis before they can decide whether to
disclose their personal information (Dinev & Hart,
2006). Following this, persuasive messages’ impacts
on PHI disclosure depends on individuals’ cost-benefit
analyses. Thus, a calculus view of information privacy
suggests that individuals measure the tradeoff
between the usage and the potential negative
outcomes of sharing PHI. Individuals are willing to
voluntarily disclose PHI if they expect that the
perceived value of data disclosure will outweigh the
perceived risks (Wieneke et al., 2016). Privacy
calculus assumes a primarily economic view and
relates to other theories in the field of economics, such
as utility maximization theory, expectancy theory of
motivation, and expectancy value theory (Pavlou,
2011). Privacy calculus postulates that individuals’
behavioral intentions and follow-up actions are
positively affected by the potential gain of disclosure
and are negatively affected by their expected loss from
a potential privacy violation.
However, since not all information is considered
equally sensitive by individuals, the information type
they are asked to disclose affects their perceptions,
processing, and behaviors (Matt et al., 2019; Milne et
al., 2017; Yang & Wang, 2009). Individuals are more
willing to provide certain information types about
themselves compared to other information they
perceive as more sensitive. They evaluate information
38 Volume 51, Number 1, February 2020
about themselves and consider the information to
have different sensitivity levels, which affects
individuals’ risk perceptions (Angst & Agarwal, 2009).
Further, individuals are more willing to provide
demographic and lifestyle information to marketers
compared to health information or personal identifiers
such as name, address, and social security number.
Requests for more sensitive information reduce trust
beliefs and intentions to disclose, increasing risk
perceptions (Malhotra, Kim, & Agarwal, 2004; Roback
& Wakefield, 2013).
Individuals generally want control over their
information and awareness of the information types
collected about them. It is easier for them to trust
organizations if they understand which information
type is gathered, the way in which it is collected, and
that the user can manage the way information is
treated in privacy policies (Becker, 2018). However,
owing to PHI’s very high sensitivity, even elaborate
privacy policies did not fully mitigate individuals’
privacy risk perceptions (Adjerid, Acquisti, &
Loewenstein, 2019; Samat & Acquisti, 2017). It is
argued that when requested information is very
sensitive, the underlying context becomes more
important. Anderson and Agarwal (2011) compared
the sensitivity and the disclosure of PHI and the
different PHI types (general health, mental health, and
genetic information) and found that the requested PHI
type had no significant impacts on the privacy
perceptions, the trust in the technology used for a
transaction, and individuals’ willingness to disclose
PHI. Thus, all PHI types are perceived as sensitive for
individuals, and they do not carefully distinguish
between different PHI subtypes when deciding about
their disclosure (Anderson & Agarwal, 2011; Milne et
al., 2017).
Table 1. Exemplary Studies on Persuasive Communication and PHI Disclosure
Persuasive Communication in the Health Context
According to the definition of Stiff and Mongeau
(2003), any message that seeks to reshape, force, or
change individuals’ responses can be referred to as
persuasive communication. Through conformity
effects such as compliance or identification, online
persuasion has become increasingly important owing
to the digital age and social media. However, there has
been little research into online persuasion, which has
mainly been used for product advertising and health
communication messages (Stiff & Mongeau, 2003;
Zhang et al., 2018). Most studies have focused on
information disclosure regarding e-commerce
transactions, use of online services and social network
sites, and technology acceptance (e.g. Baruh, Secinti,
& Cemalcilar, 2017). Focusing on studies that
specifically analyzed decision-making and persuasive
communication in the health context, we identified
three main research streams (Table 1).
The first research stream analyzes sharing behaviors
concerning personal health record data with clinicians
and public health entities (e.g. Weitzman, Kelemen,
Kaci, & Mandl, 2012). The second stream examines
individual factors that influence the adoption of health
technologies, treatments, and disclosures. The third
research stream measures the influence of perceived
risks and benefits on behavioral intentions and framing
concepts so as to enhance benefits concerning health
decisions (Bartels, Kelly, & Rothman, 2010; Edwards,
Elwyn, Covey, Matthews, & Pill, 2001).
According these research streams, we developed our
conceptual framework of how persuasive
communication affects PHI disclosure (Figure 1). We
used the two established techniques—attribute
framing and argument strength—as persuasive
messages (Samat & Acquisti, 2017; Zhao, Strasser,
Cappella, Lerman, & Fishbein, 2011). This means that
message content can be presented in different frames
(attribute framing) and different levels of usefulness of
the information (argument strength).

Research
Focal object References Research topic
stream
e.g. Angst & Agarwal, 2009; Jena, Sharing personal health record data
Sharing
1 2015; Weitzman et al., 2012; Zhang with clinicians and public health
medical data
et al., 2018 entities
e.g. Alrige et al., 2014; Anderson &
Health-IT Agarwal, 2011; Krishnamurthy et al., Adapting technologies, treatments,
2
adoption 2001; Li et al., 2016; Schöning, Matt, and disclosures
& Hess, 2019
e.g. Bartels et al., 2010; Edwards et Framing effects on individuals’
3 Framing effects al., 2001; Elbert & Ots, 2018; Samat decisions (e.g. health behaviors,
& Acquisti, 2017 disclosure intentions)

The DATA BASE for Advances in Information Systems 39 Volume 51, Number 1, February 2020
 Figure 1. Theoretical Framework
Framing refers to the phenomenon whereby “simple
and unspectacular changes” in product presentation
lead to changes in choices (Kühberger, 1998, p. 205).
This research shows that the argumentation in
privacy-relevant information interacts with the effect of
changes in the objective privacy risk as a result of
disclosure and individuals’ propensity to disclose
personal information. It can be assumed that attribute
framing would increase individuals’ perceived benefits
and that argument strength would lower the perceived
risks (Samat & Acquisti, 2017). We will now describe
both techniques in some detail.
Attribute framing: Concentrating on attitude changes
caused by persuasive communication, a well-known
influence on individual choices, is message framing.
Framing has two logically analogous ways to present
identical information. It refers to either highlighting
benefits and conforming to the message advocacy or
to accentuating costs when failing to comply (Shen &
Kollar, 2015). Two message framing types commonly
used in marketing and in health decision-making are
goal framing and attribute framing. Attribute frames
can be implemented by presenting either desirable vs.
undesirable attributes or the presence vs. absence of
(un)desirable attributes (Block & Keller, 1995). Also
some information system research studies have
investigated framing effects on individuals’ behaviors
(Becker & Matt, 2019; Samat & Acquisti, 2017). We
concentrate on attribute framing, since HWs’ features
can be better described in a positive or negative style
than in a goal accomplishment setting. Attribute
frames can be based on value, award a financial
advantage, or generally deal with gains and losses.
Possible framing elements could be urgency,
persistence, simplicity, or visuals and metaphors that
must be assessed and arranged depending on fit and
effectiveness (Bartels et al., 2010). According to Angst
and Agarwal (2009), message content is more likely to
positively influence behaviors if the message frame
Figure 2. Research Model
The DATA BASE for Advances in Information Systems
leads to positive thoughts and associations. Thus,
message frames that lead to predominantly negative
thoughts may not anticipate substantial changes in
individuals’ attitudes or behaviors.
Argument strength: An argument’s message includes
information, which has two components: information
quality and information quantity. Information quality
can be defined as “[…] the usefulness of the available
attribute information in aiding a decision maker to
evaluate his/her true utility associated with an
alternative,” while information quantity can be
described “[…] as the number of items or attributes
describing an alternative” (Keller & Staelin, 1987, p.
200). When holding quantity fixed, an increase in
quality leads to greater confidence in individuals’
decision-making. Likewise, when holding quality fixed,
an increase in quantity negatively affects individuals’
confidence (Krishnamurthy, Carter, & Blair, 2001). The
combination of the two is called argument strength; it
strongly influences arguments’ persuasiveness,
affecting individuals’ attitudes and behaviors.
Argument strength relates to the information’s
usefulness. Strong arguments are perceived as more
convincing than weak or no arguments (Cialdini, Petty,
& Cacioppo, 1981).
Research Model and Hypothesis
Development
HW providers can increase individuals’ perceived
benefits by adapting the online production description
and reframing the HW attributes (attribute framing). On
the other hand, they can decrease the perceived risks
by using different arguments for data collection
(argument strength). We assume that using these two
persuasive message techniques can influence
individuals’ risk-benefit-tradeoff perceptions and
therefore affect their PHI disclosure (Figure 2).
40 Volume 51, Number 1, February 2020
Attribute Framing
Positive frames have a superior effect on attitude
change when they promote a product or its benefits
(Krishnamurthy et al., 2001). Research shows that a
mere framing of choices (in terms of gains and losses)
significantly affects individuals’ decisions. Labeling
ground beef as 75 percent lean instead of 25 percent
fat significantly affected participants’ perceptions of
beef quality (Levin & Gaeth, 1988). Privacy research
has also shown that presenting information with a
positive or negative framing can also change
individuals’ perceptions and awareness in disclosure
decisions (Acquisti, Adjerid, & Brandimarte, 2013;
Acquisti, Brandimarte, & Loewenstein, 2015; Gluck et
al., 2016). Framing ease individuals’ privacy concerns.
Framing notices with more positive, misleading, or
misdirecting statements can direct individuals’
attention away from the implications of privacy aspects
to product aspects, lowering their privacy awareness
(Gluck et al., 2016). In other words, positively framed
product descriptions may decrease negative thoughts
about possible risk concerning PHI disclosure.
Message content is more likely to positively affect
behaviors if the message frame causes positive
thoughts and associations (Angst & Agarwal, 2009).
Message frames that lead to mainly negative thoughts
may not anticipate considerable changes in individuals’
behaviors. When attribute framing is applied, the
product depicts the object of the frame and arguments
for the product usage are the object’s attributes, which
impact on the decision (Krishnamurthy et al., 2001).
We hypothesize the following:
Hypothesis 1 (H1): Individuals who experience
persuasive messages with more positively framed
HW attributes tend to disclose more PHI than
those who experience neutral or loss-oriented
frames.
Argument Strength
Argument strength is directed at individuals’ rational
judgment rather than the effect of reinforcing or
improving their beliefs (Bhattacherjee & Sanford,
2006). They engage in thorough cognitive activity,
assessing the presented information and thinking
about it. It is known that individuals produce more
favorable responses to messages with strong than
with weak arguments (Petty & Cacioppo, 1986).
Individuals who are influenced by strong arguments
are likely to hold a strong, accessible attitude to the
information. Thus, when a message can be carefully
scrutinized, individuals will likely have more thoughts
or arguments (Lukin, Anand, Walker, & Whittaker,
2017). Following this, logical arguments provide
higher levels of argument strength than explanations
with no argument. In this understanding, explanations
with illogical arguments receive the lowest argument
The DATA BASE for Advances in Information Systems
strength scores. Nonetheless, a disputable view on
argument strength can be discovered in the
photocopier experiment of Langer, Blank, and
Chanowitz (1978). In the experiment, participants are
asked to imagine the following scenario: “You are in a
long queue, waiting to make photocopies. You are next
and then someone comes up to you and says, ‘May I
use the machine, because I have to make copies?’
How likely would you be to let them cut into the line?”
Besides this illogical argument, which Langer et al.
(1978) called placebic information (i), the alternative
scenarios were that the person either gave no
arguments (ii), asking simply “May I use the
photocopier?” or (iii) provided a logical argument: “May
I use the photocopier, because I’m in a rush?” Since
the respective success rates were: (i) 93 percent, (ii)
60 percent, and (iii) 94 percent, Langer et al. (1978)
concluded that individuals exhibit mindless behavior
and pay no attention to the substantive elements that
are relevant for successful resolution. Langer et al.
(1978) referred to this as mindless behavior.
Individuals act mindlessly and reenact prior scripts,
sequences of events in a familiar situation using
heuristic cues, or shortcuts as long as an argument is
offered (Salovaara, Lyytinen, & Penttinen, 2019). This
illustrates the impacts of persuasive messages by
assessing the effect of information quality on
behaviors. Despite the fact that, for logical arguments,
individuals perceive higher argument strength levels
than for illogical or no arguments, the study uncovered
another interesting aspect. It revealed that inquiries
led to a positive outcome significantly more often if
some reasoning was included in the inquiry, while the
argument’s quality was unimportant. Regarding the
use of PHI, HW providers tend to convey the data
handling in their privacy statements and thus do not
directly offer information about data use to individuals.
However, directly presenting reasons for data
collection may influence individuals’ behaviors. Thus,
providing stronger arguments for data collection to
individuals may lower the perceived risks, which would
positively influence individuals’ willingness to disclose
more PHI. We hypothesize the following:
Hypothesis 2 (H2): Individuals who experience
persuasive messages with higher argument
strength levels tend to disclose more PHI.
Methodology
Data Collection
We performed an expert panel and a pilot test to
validate the messages and instruments prior to the
final data collection. Based on this, we conducted
minor changes to the instructions and to certain item
wordings. We conducted the final web-based
experiment in February 2018 using Qualtrics. We
included time stamps to record the time a participant
41 Volume 51, Number 1, February 2020
spent on every page. First, we excluded unrealistic
responses from the analyses. Second, to reduce
variance of individuals’ attitudes concerning former
experiences, we excluded de facto and former users
of this specific HW (Fitbit Charge 2). Thus, we
collected 605 responses from non-users of Fitbit
Charge 2. After screening the responses, based on the
timestamps and deleting the incomplete responses,
we ended up with 529 participants. The ages ranged
from 18 to 78, with a mean of 29.1 years (SD = 10.28);
54.6 percent were male and 45.4 percent were female.
Two-thirds of the participants (68.1 percent) had at
least a two-year college degree or higher; 65.6 percent
were employees or were self-employed, and 31.4
percent were students (Table 2).
Experimental Design
Since HWs are very diverse in terms of functioning and
appearance, we needed to create a similar product
and provider vision by concentrating on a specific
subgroup of the examined technology. We used the
Fitbit Charge 2 from the provider Fitbit, one of the most
frequently sold HWs (Lee, Kim, & Welk, 2014). We
used the original Fitbit Charge 2 website and replaced
its HW attributes and arguments for data collection
with our treatments.
Thus, we ensured that participants received sufficient
knowledge about the provider and HW product, while
keeping them in an intuitive and natural environment.
After the product presentation which resembled an
official product website, the participants received the
questionnaire and had to answer attention check
questions. The participants received three test
questions relating to the product (Fitbit Charge 2), the
features (heartbeat and activity tracking), and the
provider (Fitbit). Participants who failed to answer one
of these attention check questions were rejected from
continuing the experiment. All other participants were
then randomly split into nine treatment groups (Table
3).
The persuasive message treatments consisted of
loss-oriented, neutral, or gain-oriented framed HW
attribute descriptions, and the privacy policy
statements included either logical, illogical, or no
arguments for the data collection. We adapted the
treatments from Raj, Charles, and Alisha (2006) and
modified them to fit the context (see Table A.1 in the
Appendix). After two manipulation checks, we
measured individuals’ PHI disclosure adapting the
scale of MacKenzie and Spreng (1992) to our context.
Thus, the participants had to specify on a seven-point
semantic scale (1 = unlikely/likely, 2 = not
probable/probable, 3 = impossible/possible, and 4 =
unwilling/willing) the extent to which they would reveal
the PHI to the provider Fitbit. We then recorded
demographics such as gender, age, employment, and
education.

Table 2. Sample Description

Demographics Frequency Percentage
Gender
Male 289 54.6%
Female 240 45.4%
Age
18 to 22 149 28.2%
23 to 27 142 26.8%
28 to 31 81 15.3%
32 to 35 75 14.2%
36 to 78 82 15.5%
Education level
None 16 3.0%
High/Secondary school 136 25.7%
Bachelor 170 32.2%
Master’s/Diploma/Magister 182 34.4%
Ph.D. 25 4.7%
Employment status
Employed 271 51.2%
Self-employed 76 14.4%
Student 166 31.4%
Unemployed 16 3.0%

The DATA BASE for Advances in Information Systems 42 Volume 51, Number 1, February 2020
 Table 3. Treatment Overview

Attribute framing

Loss-oriented framing Neutral framing Gain-oriented framing

(LOF) (NF) (GOF)

Logical arguments Group 1 Group 4 Group 7

(LAG) (n = 66) (n = 57) (n= 68)
Argument
strength

Illogical arguments Group 2 Group 5 Group 8

(IAG) (n = 46) (n = 75) (n = 60)
No arguments Group 3 Group 6 Group 9
(NAG) (n = 57) (n = 54) (n = 46)

Manipulation Checks and Group Assignment conducted a Kolmogorov-Smirnov test on the

To verify that our framing manipulation was successful
(i.e. showed a notable difference in the perception of
the framing level), we used the manipulation check
questions of Petty, Cacioppo, and Schumann (1983).
The manipulation checks for attribute framing, using
ANOVA (F = 31,221, p < 0.001; MAverage = 2.74) and
the Bonferroni test, showed that the three descriptions
of the HW attributes were perceived differently,
depending on the framing levels. Gain-oriented
framing (MGOF = 3.59; p < 0.001) revealed significantly
higher positive HW attitudes than neutral framing (MNF
= 2.60; p < 0.001) and loss-oriented framing (MLOF =
2.02; p < 0.001). Thus, the effectiveness of the
implementation of the three framing levels was
supported.
We used the nine manipulation check questions of
Zhao et al. (2011) for argument strength. The ANOVA
(F = 43,951, p < 0.001; MAverage = 3.58) and the
Bonferroni test showed that the argument strengths
were perceived differently for the three factor levels.
Logical arguments (MLAG = 4.38; p < 0.001) revealed a
significantly higher perceived strength than the
descriptions with illogical (MIAG = 3,43; p < 0.001) and
no arguments (MNAG = 2.79; p < 0.01). Thus, the
effectiveness of the implementation of the three
argument levels was supported.
The different groups can be considered independent,
since the subjects are randomly assigned. We
collected samples.
The p-value (0.42) assumed a normal distribution for
the dependent variable PHI disclosure. We also used
the Levenes test and obtained an F-value of 1.951 and
a p-value of 0.51, failing to reject the equal variance
dispersion hypothesis.
Results
First, we used a two-way ANOVA to identify the main
effects and interaction effects. Table 4 shows the
analysis results. From the F-statistic, we found that
attribute framing’s main effect reached a significant
level (F = 11.833, p < 0.001). Concerning the framed
HW attributes (H1), individuals distinguished between
all three framing levels.
Second, to closely examine H1 and H2, we conducted
the mean comparisons among multiple groups using
the Bonferroni test, which is considered suitable for
such analyses (Kirk, 2012). As Table 5 shows, and as
hypothesized in H1, a more positive framing level
increased individuals’ PHI disclosure. The contrasts
for loss-oriented vs. neutral (p < 0.05), neutral vs. gain-
oriented (p < 0.01), and gain-oriented vs. loss-oriented
(p < 0.001) were significant. Loss-oriented framing
(MSLOF = 3.27, SDLOF = 0.14) had a smaller mean
value than neutral framing (MSNF = 3.79, SDNF = 0.13)
and gain-oriented framing (MSGOF = 4.26, SDGOF =
0.14). Thus, H1 was supported.

Table 4. Results of the Two-way ANOVA

Treatment (hypothesis) F Sign.

Attribute framing (H1) 11.833 < 0.001

Argument strength (H2) 39.287 < 0.001

Attribute framing x argument strength 1.039 0.386

The DATA BASE for Advances in Information Systems 43 Volume 51, Number 1, February 2020
 Table 5. Bonferroni Group Comparisons (H1 and H2)

Group A Group B Mean difference (A - B) Sign.

Group comparisons of attribute framing on PHI disclosure (H1)
Loss-oriented mean: 3.27 Neutral mean: 3.79
-0.52 < 0.05
SD: 0.14 SD: 0.13
Neutral mean: 3.79 Gain-oriented mean: 4.26
-0.47 < 0.01
SD: 0.13 SD: 0.14
Gain-oriented mean: 4.26 Loss-oriented mean: 3.27
0.99 < 0.001
SD: 0.14 SD: 0.14
Group comparisons of argument strength on PHI disclosure (H2)
Illogical arguments mean: 3.92 No arguments mean: 2.88
1.04 < 0.001
SD: 0.14 SD: 0.14
No argument mean: 2.88 Logical arguments mean: 4.58
-1.70 < 0.001
SD: 0.14 SD: 0.13
Logical arguments mean: 4.58 Illogical arguments mean: 3.92
0.66 < 0.01
SD: 0.13 SD: 0.14

The main effect on PHI disclosure that arose from
different arguments was significant (F = 39.287, p <
0.001) (see Table 4). Concerning the arguments for
data collection (H2), individuals distinguished between
all three levels. The contrasts for illogical vs. no
arguments (p < 0.001), no arguments vs. logical
arguments (p < 0.001), and logical vs. illogical
arguments (p < 0.01) were significant (see Table 5).
Persuasive messages with higher argument strength
tended to lead to higher PHI disclosure. H2 was
supported. Table 5 shows that persuasive messages
containing arguments for data collection (even illogical
(MSIAG = 3.92; SDIAG 0.14)) elicited higher PHI
disclosure than persuasive messages without
arguments (MSNAG 2,79; SDNAG 0.14). The interaction
effect between attribute framing and argument
strength was insignificant (F = 1.039, p = 0.386).
Figure 3 illustrates the results, which we will now
discuss in some detail.

Figure 3. Impacts of Persuasive Messages on PHI Disclosure

The DATA BASE for Advances in Information Systems 44 Volume 51, Number 1, February 2020
Discussion
Motivated by the question whether persuasive
messages can affect individuals’ willingness to
disclose PHI, we conducted a web-based experiment
with 529 participants to examine the influences of the
persuasive message techniques, attribute framing,
and argument strength on individuals’ PHI disclosure.
We tested three effects on PHI disclosure: (H1) the
effect of framing HW attributes, (H2) the influence of
argument strength concerning data collection, and the
interplay between the two factors. By varying attribute
framing (loss-oriented, neutral, gain-oriented) and
argument strength (logical, illogical, no arguments) in
a 3x3 factorial design, we found support for H1 and
H2.
Attribute Framing
Our results showed that individuals who experience
persuasive messages with more positively framed HW
attributes tend to disclose more PHI. Valence-based
associative processing is probably a valid explanation
of how attribute framing affected the content of
individuals’ PHI disclosure behaviors, and thus why
gain-oriented framing led to more positive evaluations
of the HW attributes than negative HW attribute
framing. Prior research usually investigated evaluation
effects of labeling a key attribute in positive vs.
negative terms without questioning differences in
susceptibility to framing effects (e.g. Elbert & Ots,
2018). By including a neutral frame, we were able to
examine the magnitude of framing effects and found
that participants who received positive framing were
more affected by attribute framing than those who
received negative framing. This indicates that when
individuals experienced gain-framed HW attributes, it
probably outweighed the perceived risks of data
collection; thus, they were more inclined to take risks
and disclose more PHI. This finding is also consistent
with the position that more effortful and less heuristic
processing may reduce susceptibility to cognitive
biases (Kuvaas & Selart, 2004). Since our scenario
contained more complex and abstract information than
is usually the case in attribute framing research, it can
be assumed that in our context, individuals used more
effortful processing. They may have been better able
to counterbalance the framing information with other
and more relevant information than those using less
effortful processing. Thus, for complex decisions such
as outweighing the PHI disclosure concerning the
perceived risks and benefits, a facilitating effect of
more detailed processing should be more likely than
an inhibiting or biasing effect (Petty & Cacioppo,
1986).
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Argument Strength
Our results revealed that individuals who experienced
persuasive messages with higher argument strength
tended to disclose more PHI. Further, persuasive
messages containing logical arguments for data
collection elicited higher PHI disclosure than
persuasive messages with illogical or no arguments.
In sum, strong arguments are perceived as more
convincing than weak or no arguments (Cialdini et al.,
1981). Yet, interestingly (also illustrated in Figure 3),
persuasive messages that contained illogical
arguments for data collection received higher PHI
disclosure than persuasive messages without
arguments. However, this is in line with other studies
of cognitive processing in IS research (e.g. Curry,
Marshall, & Kawalek, 2014) and psychological
research studies (e.g. Langer et al., 1978), where it is
called placebic information. In terms of theory of
controlled mindless behavior (Langer, 1992), it can be
argued that implementing illogical information
concerning data collection is more effective than giving
no information, since individuals don’t read privacy
policies carefully. A recent study showed that 25
percent never read or immediately agreed to privacy
policy statements (DIVSI, 2015). According to Langer
(1992), arguments can either be processed in a
controlled mindless way or in an automatic mindful
way. Mindlessness occurs when an individual pays no
attention to new, relevant information (Salovaara et al.,
2019). In our case, if the provided reason appears to
be irrelevant, the arguments for data collection are not
examined and evaluated by individuals. Thus, we can
state that the context dependency is ignored and that
the argument concerning PHI disclosure is processed
mindlessly. This means that individuals will
automatically and mindlessly process the arguments
and will ignore the context dependency.
Attribute Framing x Argument Strength
Finally, as our two-way ANOVA analysis showed no
significant effect, we found no interaction between
attribute framing and argument strengths. This result
stands in contrast to studies in other contexts (e.g.
Bartels et al., 2010). We can state that, in the case of
PHI disclosure, adapting only one construct implies
that perceived benefits are enhanced or perceived
risks are reduced, but there is no interaction effect
between the two factors that influence individuals’ risk-
benefit tradeoff perceptions (Wieneke et al., 2016).
However, concerning the effects of attribute framing
and argument strength alone, it would be interesting to
evaluate which information processes are triggered by
these two factors. According to the elaboration
likelihood model (ELM), it can be assumed that the
framed HW attributes will be processed via the central
route (more conscious and thoughtful), since the
45 Volume 51, Number 1, February 2020
information context is complex for the individuals. In
contrast, privacy policy statements and the presented
arguments for data collection will probably be
processed via the peripheral (less conscious and
thoughtful) route, since our results and other research
(DIVSI, 2015) indicated that privacy policies are often
ignored or not read with care.
Implications and Limitations
Implications for Theory
From a theoretical perspective, we responded to the
call by Angst and Agarwal (2009) to identify new
predictors of persuasion in the context on health IT.
We have added new insights about the drivers and
issues of PHI disclosure. While previous research has
dealt with message framing and information quality in
a health-related context, these factors have been
observed separately (Block & Keller, 1995; Shen &
Kollar, 2015). To our best knowledge, we are among
the first to have examined both factors (attribute
framing and argument strength) and their interactions
concerning PHI disclosure. We have added value to
health IT research, since it can be assumed that the
explanation lies in the insecurity regarding the
technology and HW providers’ non-transparent data
processing. For this reason, researchers should use
information processing models, especially ELM, to
clarify the influence of route distinction for persuasive
messages in such highly sensitive data environments.
When we looked at the results of our experiment, we
found PHI disclosure tendencies to be consistent with
the norms of reciprocity. Thus, overlearned social
scripts can be activated not only in a context in which
they do not make sense, but also in a context in which
the trigger for the script makes explicit the non-human
source of the information. As Langer (1992) noted,
mindlessness is distinct from mere overlearning
because the former may result from a single exposure
to a stimulus, as opposed to repeated exposures. In
these cases, information is accepted uncritically,
without attention to other aspects of the situation. In
ELM research, this is called credibility. When placebic
information is stated in neuroscience jargon (e.g. by
relating it to the activation of brain areas), circular
explanations are mistakenly taken for good ones.
Scientific literacy seems insufficient to prevent this
bias type for longer and scientifically stated
explanations: while neuroscience experts correctly
identify the information about brain activation as
irrelevant and non-explanatory, individuals barely
acquainted with neuroscience are as affected as naive
ones (Weisberg, Keil, Goodstein, Rawson, & Gray,
2008).
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Implications for Practice
From a practical perspective, we have shown
persuasive messages’ impacts on individuals’ PHI
disclosure. We revealed that HW providers could
gather more PHI by just using effective combinations
of attribute framing and argument strength (e.g. gain-
framed HW attributes and logical arguments for data
collection) in their product descriptions. Increasing
data disclosure via persuasive messaging
substantially increases a company’s market share and
sales without affecting costs (Bhaskar & Vo, 2012). By
implicitly decreasing the perceived risks, a broader
customer base could be established, especially
among individuals above the age of 40, who have
higher concerns about technology and smart devices
(Becker, Matt, Widjaja, & Hess, 2017). As these
aspects help HW providers to overcome individuals’
privacy concerns on disclosing PHI without actually
improving the product quality, we strongly recommend
judicious judgment in its application. Further, our
results may help health-related organizations with
their data collection efforts without changing or
adjusting the product and service offering, while
keeping user gratification and loyalty high. Our results
advocate how to carefully frame information regarding
HW benefits and privacy policies, because a
persuasive message strongly affects individuals’
attitudes and usage intentions. This is interesting,
since political regulation conditions, such as the EU
General Data Protection Regulation (GDPR), are
being implemented in order to increase transparency
about data storage, disclosure, and usage (European
Commission of Justice and Consumers, 2016; Vo &
Bhaskar, 2012). While such reforms are forcing
providers to increase their openness, they should plan
their communication strategy wisely so as to reduce
predictors of negative attitudes and behaviors.
Otherwise, published critical information about data
processing leads to more negative attitudes toward
technology usage and lower usage intentions.
Limitations and Future Research
Owing to PHI’s high sensitivity, we assumed that PHI
disclosure has high personal relevance, implying that
participant elaboration was presumably high.
However, presenting rigid response options may also
create mind blockages, locking respondents’ attention
to preconceived answers. However, we clearly pointed
out our study’s purpose and guaranteed full anonymity
so as to mitigate such effects. Further, we used a web-
based experiment, since it allows for high control while
providing participants with appealing decision
environment in which rich information on HWs’
purpose and capabilities could be delivered. However,
previous studies have criticized these aspects as
limitations of the web-based experiment methodology
46 Volume 51, Number 1, February 2020
(Hergueux & Jacquemet, 2015). Although web-based
experiments may have weaker experimental controls
compared to laboratory-based experiments and they
have greater associated difficulties to ensure reliability
and internal validity, we used a web-based experiment
so as to provide a more realistic and natural setting for
the participants’ decision processes. As part of this, we
concentrated on a specific HW device to reduce
variance in individuals’ PHI disclosure concerning
different product visions and experiences. However,
future research should evaluate active HW users, as
well as other devices, and may distinguish between
individuals who use a fitness tracker and the
corresponding mobile application and individuals who
refuse to use the mobile app but who own a fitness
tracker. Also, other constructs that influence the
perceived benefit-risk tradeoffs should be tested and
added to the model so as to obtain additional insights.
This is relevant, since research into online persuasion
has revealed that personal factors (e.g. the need for
cognition, self-esteem, or general privacy concerns)
and situational factors (e.g. trust or transparency)
affect individuals’ privacy concerns and disclosure
decisions (e.g. Malhotra et al., 2004; Plachkinova et
al., 2015; Samat & Acquisti, 2017). In line with this, it
would also be important to elaborate whether results
differ subject to individuals’ health status or subject to
their expectations after engaging with a product and a
brand.
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About the Authors
Moritz Becker holds a Ph.D. in Management from
LMU Munich, Germany. His Doctoral thesis addressed
users’ perceptions, processing, and disclosure of
healthcare data. Before joining the Ph.D. program, he
received a master’s degree from the University of
Mannheim. His work has appeared in the Pacific Asia
Journal of the Association for Information Systems and
in the proceedings of the International Conference on
Information Systems and the European Conference
on Information Systems, among others.
Christian Matt is an Assistant Professor of
Information Systems at the University of Bern,
Switzerland. He holds a Ph.D. in Management from
LMU Munich and was a visiting scholar at the National
University of Singapore and the Wharton School of the
University of Pennsylvania. His current research
focuses on digital transformation and value creation,
as well as on digital customer interfaces and
experiences. His work has appeared in Journal of
Management Information Systems, Electronic Markets,
MIS Quarterly Executive, Business and Information
Systems Engineering, and Internet Research, among
others.
49 Volume 51, Number 1, February 2020
Thomas Hess is a Professor of Management
Information Systems at LMU Munich, Germany, where
he also serves as director of the Institute for
Information Systems and New Media and as
coordinator of the Center for Internet Research and
Media Integration. He holds a Ph.D. in management
from the University of St. Gallen, Switzerland. His
research focuses on digital business models and
digital management systems, digital transformation
processes and the management of IT, Internet, and
media companies. His work has appeared in journals
such as Journal of Management Information Systems,
Communications of the ACM, Decision Support
Systems, Information Systems Journal, International
Journal of Electronic Commerce, and others.

Appendix A
Table A.1. Screenshots of the Experimental Treatments (Attribute Framing / Argument Strength)

3x3 Experimental treatments (persuasive messages)

Attribute framing Argument strength

Logical Arguments (LAG)

Gain- oriented (GOF)

No Arguments (NOG)
Neutral-oriented (NF)

Illogical Arguments (IAG)

Loss-oriented (LOF)

The DATA BASE for Advances in Information Systems 50 Volume 51, Number 1, February 2020