Previously submitted to: JMIR mHealth and uHealth (no longer under consideration since Feb 03, 2025)
Date Submitted: Dec 16, 2024
Open Peer Review Period: Feb 3, 2025 - Feb 3, 2025
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Discreet initial trust construction in Internet healthcare services: the dual role of organizational and role signals
ABSTRACT
Background:
The deepening development of Internet healthcare from empowering “non-core healthcare” to empowering “core healthcare” has brought about a “double-addition” paradox, which increases both value and risk, thus making the role of patient trust, especially initial trust, in Internet healthcare services more prominent. This makes the role of patient trust, especially initial trust, in Internet healthcare services more prominent.However, it is unclear what “observable” trust signals contribute to the generation of initial trust in Internet healthcare services.
Objective:
This study aims to explore the “observable” trust signals that drive the generation of prudent initial trust in Internet healthcare services and their roles by constructing and testing a trust signaling framework of prudent initial trust based on initial trust theory and signaling theory.
Methods:
A national online cross-sectional questionnaire was administered to those with experience in online medical care (N=2027), and the results were analyzed using descriptive statistics with optimal scale regression statistics.
Results:
Organizational competence (β= 0.43, p < .001) and role competence (β= 0.41, p < .001) had the greatest impact on cautious initial trust in Internet healthcare services; organizational goodwill (β= 0.30, p < .001) and role goodwill (β= 0.31, p < .001) had a greater impact on cautious initial trust in Internet healthcare services.Competence signaling had a greater impact on initial trust than goodwill signaling. Trust propensity played a moderating role in organizational signaling (β= -0.06, p < .01) versus role signaling (β= -0.08, p < .001) on cautious initial trust in Internet healthcare services.
Conclusions:
Initial trust in Internet healthcare services is mainly driven by “observable” trust signals, i.e., both organizational and role signals.Organizational signals consisting of organizational competence and organizational goodwill played a transmission effect in the generation of cautious initial trust in Internet healthcare services, and role signals consisting of role competence and role goodwill played a competence effect.In the future, the design of competitive mechanisms, user thinking, value incentives and authenticity audits should be used to promote platforms and online doctors to consistently send trust signals of their competence and goodwill.These results clarify the directions that Internet healthcare services should focus on from the perspective of prudent trust, while proposing a trust signaling impact theory for initial trust.
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