Evaluating trust in digital health information portals: symmetric-asymmetric path analysis

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Background/Aims Digital health information portals aim to enhance access to healthcare data and services, combining medical informatics and public health. This study aimed to explore key factors that influence whether patients use these portals, building on existing theories of technology adoption. Methods An online questionnaire was administered to adults living in India who had previous experience of using digital health portals. The questionnaire included 22 items measuring respondents' behavioural intention, trust, self-efficacy, perceived risk and technology-related anxiety regarding the use of digital health portals. Mean scores were calculated for each variable. Correlational analysis and structural equation modelling were conducted to measure the relationships between variables, while fit indices were calculated to assess the model fit. Fuzzy-set qualitative comparative analysis was used to explore the data further. Results A total of 512 survey responses were received. Self-efficacy had the highest mean scores (4.57) while technology-related anxiety had the lowest (2.91). Trust and self-efficacy significantly and positively influenced behavioural intention (P<0.001), while technology-related anxiety significantly and negatively influenced trust (P<0.001). Perceived risk had no significant impact. Trust had a significant mitigating effect on the influence of both self-efficacy and technology-related anxiety on behavioural intention (P<0.001). Conclusions Trust and self-efficacy are crucial factors in the adoption of digital health portals, while technology-related anxiety may discourage adoption. Perceived risk may not affect adoption of digital health portals. Further research is required, exploring the role of social norms in health technology adoption. Implications for practice Practical strategies are needed to ensure that the public are willing to adopt digital health portals on a wide scale. Interventions should focus on building trust and self-efficacy among service users, while reducing anxiety related to the technology. This may be particularly useful among rural populations.

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