M.F. Steehouder

Review: How shall I trust the faceless and the intangible? A literature review on the antecedents of online trust

Trust is generally assumed to be an important precondition for peoples adoption of electronic services. This paper provides an overview of the available research into the antecedents of trust in both commercial and non-commercial online transactions and services. A literature review was conducted covering empirical studies on peoples trust in and adoption of computer-mediated services. Results are described using a framework of three clusters of antecedents: customer/client-based, website-based, and company/organization-based antecedents. Results show that there are many possible antecedents of trust in electronic services. The majority of the research has been conducted in the context of e-commerce; only few studies are available in the domains of e-government and e-health. For many antecedents, some empirical support can be found, but the results are far from univocal. The research calls for more, and particularly more systematic, research attention for the antecedents of trust in electronic services. The review presented in this paper offers practitioners an overview of possibly relevant variables that may affect peoples trust in electronic services. It also gives a state-of-the-art overview of the empirical support for the relevance of these variables.

The Contribution of Teleconsultation and Videoconferencing to Diabetes Care: A Systematic Literature Review

Background A systematic literature review was carried out to study the benefits of teleconsultation and videoconferencing on the multifaceted process of diabetes care. Previous reviews focused primarily on usability of technology and considered mainly one-sided interventions. Objective The objective was to determine the benefits and deficiencies of teleconsultation and videoconferencing regarding clinical, behavioral, and care coordination outcomes of diabetes care. Methods Electronic databases (Medline, PiCarta, PsycINFO, ScienceDirect, Telemedicine Information Exchange, ISI Web of Science, Google Scholar) were searched for relevant publications. The contribution to diabetes care was examined for clinical outcomes (eg, HbA1c, blood pressure, quality of life), behavioral outcomes (patient-caregiver interaction, self-care), and care coordination outcomes (usability of technology, cost-effectiveness, transparency of guidelines, equity of care access). Randomized controlled trials (RCTs) with HbA1c as an outcome were pooled using standard meta-analytical methods. Results Of 852 publications identified, 39 met the inclusion criteria for electronic communication between (groups of) caregivers and patients with type 1, type 2, or gestational diabetes. Studies that evaluated teleconsultation or videoconferencing not particularly aimed at diabetes were excluded, as were those that described interventions aimed solely at clinical improvements (eg, HbA1c). There were 22 interventions related to teleconsultation, 13 to videoconferencing, and 4 to combined teleconsultation and videoconferencing. The heterogeneous nature of the identified videoconferencing studies did not permit a formal meta-analysis. Pooled results from the six RCTs of the identified teleconsultation studies did not show a significant reduction in HbA1c (0.03%, 95% CI = - 0.31% to 0.24%) compared to usual care. There was no significant statistical heterogeneity among the pooled RCTs (χ 2 7= 7.99, P = .33). It can be concluded that in the period under review (1994-2006) 39 studies had a scope broader than clinical outcomes and involved interventions allowing patient-caregiver interaction. Most of the reported improvements concerned satisfaction with technology (26/39 studies), improved metabolic control (21/39), and cost reductions (16/39). Improvements in quality of life (6/39 studies), transparency (5/39), and better access to care (4/39) were hardly observed. Teleconsultation programs involving daily monitoring of clinical data, education, and personal feedback proved to be most successful in realizing behavioral change and reducing costs. The benefits of videoconferencing were mainly related to its effects on socioeconomic factors such as education and cost reduction, but also on monitoring disease. Additionally, videoconferencing seemed to maintain quality of care while producing cost savings. Conclusions The selected studies suggest that both teleconsultation and videoconferencing are practical, cost-effective, and reliable ways of delivering a worthwhile health care service to diabetics. However, the diversity in study design and reported findings makes a strong conclusion premature. To further the contribution of technology to diabetes care, interactive systems should be developed that integrate monitoring and personalized feedback functions.

User-centered evaluation of adaptive and adaptable systems: A literature review

Adaptive and adaptable systems provide tailored output to various users in various contexts. While adaptive systems base their output on implicit inferences, adaptable systems use explicitly provided information. Since the presentation or output of these systems is adapted, standard user-centered evaluation methods do not produce results that can be easily generalized. This calls for a reflection on the appropriateness of standard evaluation methods for user-centered evaluations of these systems. We have conducted a literature review to create an overview of the methods that have been used. When reviewing the empirical evaluation studies we have, among other things, focused on the variables measured and the implementation of results in the (re)design process. The goal of our review has been to compose a framework for user-centered evaluation. In the next phase of the project, we intend to test some of the most valid and feasible methods with an adaptive or adaptable system.

Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care Applications

Background Prior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is interesting to explore how these technologies can be used for supporting self-care. Objective The aim of this study was to determine user-centered criteria for successful application of Internet-based technology used in primary care for supporting self-care. Methods We conducted scenario-based tests combined with in-depth interviews among 14 caregivers and 14 patients/consumers to describe the use of various self-care applications and the accompanying user problems. We focused on the user-friendliness of the applications, the quality of care provided by the applications, and the implementation of the applications in practice. Results Problems with the user-friendliness of the self-care applications concerned inadequate navigation structures and search options and lack of feedback features. Patients want to retrieve health information with as little effort as possible; however, the navigation and search functionalities of the applications appeared incapable of handling patients’ health complaints efficiently. Among caregivers, the lack of feedback and documentation possibilities caused inconvenience. Caregivers wanted to know how patients acted on their advice, but the applications did not offer an adequate feedback feature. Quality of care problems were mainly related to insufficient tailoring of information to patients’ needs and to efficiency problems. Patients expected personalized advice to control their state of health, but the applications failed to deliver this. Language (semantics) also appeared as an obstacle to providing appropriate and useful self-care advice. Caregivers doubted the reliability of the computer-generated information and the efficiency and effectiveness of secure email consultation. Legal or ethical issues with respect to possible misuse of email consultation also caused concerns. Implementation problems were mainly experienced by caregivers due to unclear policy on email consultation and the lack of training for email consultations. Conclusions Patients’ and caregivers’ expectations did not correspond with their experiences of the use of the Internet-based applications for self-care. Patients thought that the applications would support them in solving their health problems. Caregivers were more reserved about the applications because of medico-legal concerns about misuse. However, the applications failed to support self-care because eHealth is more than just a technological intervention. The design of the applications should include a way of thinking about how to deliver health care with the aid of technology. The most powerful application for self-care was secure email consultation, combined with a suitable triage mechanism to empower patients’ self-awareness. Future research should focus on the effectiveness of such Web-based triage mechanisms for medical complaints and on the development of interactive features to enhance patients’ self-care.

A Comprehensive Theoretical Framework for Personal Information-Related Behaviors on the Internet

Although there is near consensus on the need for privacy, the reality is that peoples attitude toward their personal information privacy is complex. For instance, even when people claim that they value their information privacy, they often trade their personal information for tangible or intangible benefits. In this article, the research on different ways in which people respond to risks to privacy is examined. They include information seeking to reduce uncertainty, the withholding of information, and the provision of fabricated information. The impact of trust and inducements on Internet users’ willingness to share personal information is also examined. Thereafter, important postulates from theories in communication, social psychology, and sociology are synthesized into a comprehensive theoretical framework for personal information-related behaviors in the online environment.

Evaluation of User Support: Factors That Affect User Satisfaction With Helpdesks and Helplines

In addition to technical documentation, face-to-face helpdesks and telephonic helplines are a powerful means for supporting users of technical products and services. This study investigates the factors that determine user satisfaction with helpdesks and helplines. A survey, based on the SERVQUAL framework and questionnaire, shows that the SERVQUAL dimensions of customer satisfaction are not applicable in these contexts. Three quality dimensions were found instead: solution quality, the experience of the consultation, and, in the case of a physical environment, the so-called tangibles. Helpdesk customers base their overall quality perceptions mainly on their experiences during a consultation, while helpline customers focus strongly on the quality of the solution offered. The study also found a connection between the perceived helpline quality and the appreciation of the primary service.

The Effects of Motivational Elements in User Instructions

Should instructional texts be purely technical, with a focus on effectiveness and efficiency, or should they also focus on satisfying and motivating users? Good arguments have been made for paying attention to motivational aspects. But only analyses of existing instructions have been published so far, and guidelines for making user instructions motivational have not yet been studied carefully. This article presents motivational strategies and an experiment to test their effects. The results show that motivational elements have little effect on users’ effectiveness and efficiency in performing tasks, their product appreciation, and their self-efficacy, but they do increase users’ appreciation for the instructions.

The effect of the external regulator's absence on children's speech use, manifested self-regulation, and task performance during learning tasks

The present study was conducted to explore the effect of the absence of the external regulators on childrens use of speech (private/social), task performance, and self-regulation during learning tasks. A novel methodology was employed through a computer-based learning environment that proposed three types/units of encouragement with only two sequences of instructional conditions, Verbal-Gesture-Silent (VGS) versus Silent-Gesture-Verbal (SGV). The Knowledge of response (KR) was applied as: verbal KR feedback with verbal encouragement during the verbal unit, visualization-representation of KR without verbal encouragement during the gesture unit, and no KR feedback without any encouragement during the silent unit. Three measurements were used: speech analysis, novel criteria to measure self-regulation and task performance, and a computer-based friendly chat questionnaire to measure childrens satisfaction. Forty preschool children were divided by their teachers between the two conditions equivalently. It was hypothesized that children in the VGS condition were more speech productive, manifested higher self-regulation, task performance, and satisfaction. The results showed significant differential effect on the speech intensity and manifested self-regulation with no significant differential effect on task performance and satisfaction during learning tasks. However, the results were not confirmed Vygotskys view as it were supported (neutralizing, at best) to Piagets view of self-regulation development.

Procedural and declarative information in user instructions: what we do and don't know about these information types

The use and the effects of different information types in user instructions are not completely clear. Research showed that procedural information (information about the actions) is the most important information type during use. Research results about the effects of declarative information (explanatory information) are not conclusive. It is known that users are interested in declarative information, but it is not known in which situations they read this information and in which situations this information affects task performance. Furthermore, it is not clear which different types of declarative information have to be distinguished. In this paper, we describe what is known about different information types in user instructions and what is not yet known. On the basis of our analysis, we propose follow-up experiments and we recommend practitioners to consider the possible advantages and disadvantages of including declarative information in instructions for use.

Some effects of system information in instructions for use

An experiment was carried out to investigate whether it is useful to add system information to procedural information in instructional text. It was assumed that readers of instructions construct both a procedural and a system mental model, and that the latter enables the readers to infer possible missing information in procedural instructions. Moreover, it was assumed that system information would increase the cognitive load during reading and practicing, and that it would affect the appreciation of the instructions as well as the self-efficacy of the reader. The participants in the experiment read instructions and practiced with a fictitious machine before performing a number of tasks and answering a questionnaire. The results indicate that system information increased the cognitive load during reading and decreased self-efficacy, while the instructional text with system information was judged as more difficult. The effect on performance is limited: system information leads to faster performance for correctly completed tasks.