The Influence of Self-Efficacy, Trust, Perceived Costs and Healthcare-Environment on Compliance With the Data Protection and Privacy Act by Health Workers in Uganda

Despite existing regulations, compliance with Uganda's Data Protection and Privacy Act (DPPA) remains challenging, as studies focus only on technical and organizational aspects, neglecting behavioral and contextual factors. Furthermore, the limited number of health workers, low awareness of the DPPA, high costs of compliance, and a lack of trust within hospitals exacerbate these challenges. This study investigates the influence of self-efficacy, trust, perceived costs, and the healthcare-environment on DPPA compliance among healthcare workers in Uganda. It also explores the moderating effects of gender and work experience on the relationship between self-efficacy and compliance. Using quantitative methods, data were collected from 309 healthcare workers across three hospitals through a self-administered questionnaire. Regression analysis revealed that perceived costs (β = 0.240, p < 0.0001) were the strongest predictor of compliance, followed by trust (β = 0.193, p < 0.0001), healthcare environment (β = 0.178, p < 0.0001) and self-efficacy (β = 0.121, p = 0.022) was positively associated with compliance. Gender (β = 0.119, p = 0.024) significantly moderated the self-efficacy-compliance relationship, with women exhibiting higher adherence to protocols, while work experience did not exhibit a significant moderating effect. The findings suggest that healthcare institutions in Uganda should invest in gender-specific training programs to enhance self-efficacy, build organizational trust, and reduce perceived compliance costs. Establishing supportive healthcare environments with clear policies and dedicated privacy officers is critical for promoting DPPA compliance. This study is among the first quantitative and empirical study to assess self-efficacy, trust, costs of compliance and healthcare-environment on DPPA compliance in Ugandan health context using social cognitive theory, theory of planned behavior, rational choice theory and institutional theory, a multi-theoretical approach offering valuable insights for healthcare policy and management in resource-constrained settings.