Privacy Concerns and Configurational Patterns of Health Information Sharing Intention Among Patients with Chronic Diseases in Online Health Communities: An SEM and fsQCA Analysis.

Abstract

Background/objectives: Privacy concerns are negatively associated with health information sharing intention, but their role within combinations of facilitating conditions remains unclear. This study examined variable-level associations and configurational patterns among patients with chronic diseases.

Methods: This single-center, cross-sectional study used a convenience sample of 428 patients who had used online health communities. The outcome was self-reported sharing intention rather than observed disclosure. Covariance-based structural equation modeling (SEM) assessed adjusted associations, and fuzzy-set qualitative comparative analysis (fsQCA) identified configurations sufficient for high or low intention under the selected calibration and thresholds.

Results: The six-construct model was selected after data-dependent modification of an eight-construct candidate model and should therefore be interpreted as exploratory. Attitude toward sharing (β = 0.204), social rewards (β = 0.220), past positive experience (β = 0.220), and trust (β = 0.228) were positively associated with sharing intention (all p < 0.001), whereas privacy concerns were negatively associated with sharing intention (β = -0.119, p = 0.002). No single condition met the necessity threshold. The baseline fsQCA identified five high-intention and two low-intention configurations, although some expressions changed in sensitivity analyses. Low privacy concerns appeared in four high-intention configurations. In the remaining minimized expression, privacy concerns were not retained, so their level was unrestricted. The empirical truth table showed that high privacy concerns and high intention coexisted in some cases, but this does not establish a positive or compensatory contribution of privacy concerns.

Conclusions: In this convenience sample, privacy concerns showed an overall negative association with self-reported sharing intention, while their role in minimized configurations varied with the analytical specification. The findings require independent, multicenter validation and do not establish intervention or platform-design effects.