Disclosure Of Health Information Research Articles

When Parents Request Nondisclosure: Rights of Adolescents to Access Their Health Information and Implications of the 21st Century Cures Act Final Rule.

AbstractDespite broad ethical consensus supporting developmentally appropriate disclosure of health information to older children and adolescents, cases in which parents and caregivers request nondisclosure continue to pose moral dilemmas for clinicians. State laws vary considerably regarding adolescents' rights to autonomy, privacy, and confidentiality, with many states not specifically addressing adolescents' right to their own healthcare information. The requirements of the 21st Century Cures Act have raised important ethical concerns for pediatricians and adolescent healthcare professionals regarding the protection of adolescent privacy and confidentiality, given requirements that chart notes and results be made readily available to patients via electronic portals. Less addressed have been the implications of the act for adolescents' access to their health information, since many healthcare systems' electronic portals are available to patients beginning at age 12, sometimes requiring that the patients themselves authorize their parents' access to the same information. In this article, we present a challenging case of protracted disagreement about an adolescent's right to honest information regarding his devastating prognosis. We then review the legal framework governing adolescents' rights to their own healthcare information, the limitations of ethics consultation to resolve such disputes, and the potential for the Cures Act's impact on electronic medical record systems to provide one form of resolution. We conclude that although parents in cases like the one presented here have the legal right to consent to medical treatment on their children's behalf, they do not have a corresponding right to direct the withholding of medical information from the patient.

Pathos or logos? How governance legitimacy perception influences individual privacy trade-offs during COVID-19 pandemic

The COVID-19 pandemic has brought attention to the delicate balance between individual privacy concerns and the governance of public health emergencies. Governments are leveraging a wide range of digital methodologies to acquire individual-level data for purposes such as contact tracing, isolation protocols, and surveillance, all aimed at effectively mitigating the deleterious consequences of the epidemic. However, the surrender of individual health information depends on individuals’ perception of the legitimacy of governance. In this research, our objective is to examine how individuals’ perceptions of the legitimacy of governance impact their decisions regarding privacy disclosure. This study stands out by dissecting cognitive and moral legitimacy of governance, uniquely examining their influence on individuals’ altruistic privacy disclosure during a crisis. Unlike previous research, our approach offers a more nuanced understanding of the interplay between governance legitimacy and privacy concessions. From July 15th to August 14th, 2022, amid the 2022 lockdown in Shanghai, China, this study utilizes surveys with established measurement scales, alongside structural equation modeling (SEM), to explore the relationship between individuals’ perceptions of government legitimacy in managing the pandemic and their willingness to compromise health information. The study distinguishes between moral legitimacy (pathos) and cognitive legitimacy (logos). The results find that both cognitive and moral legitimacy positively influence altruism, thus enhancing the efficacy of voluntary disclosure of personal health information to government agencies for pandemic governance. However, it is noteworthy that education level moderates the impact of these two dimensions of legitimacy on altruism. This research provides empirical evidence to enhance our understanding of how different dimensions of citizens’ perceptions of governance legitimacy in crisis situations shape their attitudes and behaviors towards privacy trade-offs.

A study on the factors influencing the intention to receive booster shots of the COVID-19 vaccine in China based on the information frame effect.

In the response to and prevention and control of the Novel coronavirus pneumonia, the COVID-19 vaccine does not provide lifelong immunity, and it is therefore important to increase the rate of booster shots of the COVID-19 vaccine. In the field of information health science, research has found that information frames have an impact in changing individual attitudes and health behaviors. This study focuses on the effects of different influencing factors on the public's willingness to receive the booster shots of the COVID-19 vaccine under two information frameworks. An online questionnaire was conducted to explore the effects of demographic characteristics, personal awareness, social relationships, risk disclosure, perceived booster vaccination protection rate, and duration of protection under the assumption of an information framework. T test and one-way analysis were used to testing the effect of variables. (1) The persuasion effect under the gain frame is higher than that under the loss frame (B = 0.863 vs. B = 0.746); (2) There was no significant difference in subjects' intention of booster vaccination in terms of gender, age, income, occupation, educational background and place of residence. Whether family members received booster vaccination was strongly correlated with their intention of vaccination under the loss framework (p = 0.017, M = 4.63, SD = 0.664). (3) The higher the understanding of COVID-19, the higher the degree of compliance with the government's COVID-19 prevention and control measures, and the higher the willingness to strengthen vaccination; (4) Risk disclosure has a significant impact on people's willingness to receive COVID-19 booster shots (M = 2.48, under the loss framework; M = 2.44, under the gain framework); (5) Vaccine protection rate and duration of protection have an impact on people's willingness to vaccinate. Increased willingness to vaccinate when the protection rate of booster vaccine approaches 90% (M = 4.76, under the loss framework; M = 4.68, under the gain framework). When the vaccine protection period is 2 years, people are more willing to receive a booster vaccine; and the willingness to receive a booster shot is stronger under the loss framework (M = 4.60, SD = 0.721, p = 0.879). The impact of the information framework on COVID-19 vaccination intentions is different, and the disclosure of relevant health information should focus on the impact of the information framework and content on the public's behavior toward strengthening vaccination. Therefore, in the face of public health emergencies, public health departments, healthcare institutions, and other sectors can consider adopting the Gainful Information Framework tool to disseminate health information to achieve better persuasion and promote public health behavior change enhancing public health awareness, and promoting universal vaccination.

Developing “The Health After Cancer Podcast” to amplify cancer survivors’ voices through digital storytelling

BackgroundCancer survivors experience complex medical and psychosocial challenges after a cancer diagnosis, leading to unmet informational and emotional needs. There is a paucity of cancer survivorship educational resources co-created by survivors and medical professionals. ObjectiveOur aim was to create an educational resource for cancer survivors, caregivers, and medical professionals that would leverage digital storytelling to address survivorship topics. Patient involvementOur content and production team included cancer survivors, clinicians, educators, and design experts. All content was co-created by cancer survivors and medical experts. MethodsWe conducted an environmental scan of existing cancer survivorship educational resources in academic and public domains. Applying human-centered design principles, we incorporated patient perspectives through advisory board meetings and focus groups and identified a podcast as the preferred medium. We selected content and speakers, produced the podcast, and developed a corresponding website. ResultsBased on patient recommendations, podcast episodes address mental health, fear of cancer recurrence, relationships, parenting, relating to a new body, care transitions for adult survivors of childhood cancer, disclosing health information, and financial burden of cancer. Podcast guests were invited based on lived or learned experience in these domains. Thirteen guests (survivors, experts) and four hosts (two cancer survivors, two oncologists) co-created 15 podcast episodes. Podcast guests found the storytelling experience to be powerful and therapeutic. DiscussionDigital storytelling is a scalable and accessible educational tool for communicating complex survivorship concepts that can amplify survivors’ voices and increase awareness among survivors and clinicians. Co-creation of educational resources for cancer survivorship by survivors and professionals is a feasible and innovative educational strategy. Practical ValueA podcast created by and for cancer survivors in partnership with medical experts highlights opportunities for peer-to-peer digital storytelling to foster community among survivors and caregivers. FundingPodcast production was supported by the Stanford Comprehensive Cancer Center.

Social structural factors influencing personal health information disclosure

As a general behavior in civil social life, how can personal health information disclosure be affected by social structural factors when using the health application? This study used the Social Capital Theory to examine the personal health information behavior. Nationally representative cross-sectional survey data generated by the China Family Panel Studies(CFPS) in 2020 was utilized(N = 8628). Logistic regression analysis was employed to analyze the data. After controlling for age, gender, and education covariates, social interaction had no significant impact on health APP information disclosure behavior (OR=0.988),there is a significant positive relationship between trust(OR=1.282)/ reciprocity perception(OR=1.134) and health APP information disclosure behavior. More relational social capitals can enhance individual social trust, maintain reciprocity perception, maintain the balance and stability of social exchange relations.This study extends the application of social capital theory in the study of personal health information disclosure, providing theoretical support for the democratization process of social health governance.

Privacy Concerns About Sharing General and Specific Health Information on Twitter: Quantitative Study.

Twitter is a common platform for people to share opinions, discuss health-related topics, and engage in conversations with a wide audience. Twitter users frequently share health information related to chronic diseases, mental health, and general wellness topics. However, sharing health information on Twitter raises privacy concerns as it involves sharing personal and sensitive data on a web-based platform. This study aims to adopt an interactive approach and develop a model consisting of privacy concerns related to web-based vendors and web-based peers. The research model integrates the 4 dimensions of concern for information privacy that express concerns related to the practices of companies and the 4 dimensions of peer privacy concern that reflect concerns related to web-based interactions with peers. This study examined how this interaction may affect individuals' information-sharing behavior on Twitter. Data were collected from 329 Twitter users in the United States using a web-based survey. Results suggest that privacy concerns related to company practices might not significantly influence the sharing of general health information, such as details about hospitals and medications. However, privacy concerns related to companies and third parties can negatively shape the disclosure of specific health information, such as personal medical issues (β=-.43; P<.001). Findings show that peer-related privacy concerns significantly predict sharing patterns associated with general (β=-.38; P<.001) and specific health information (β=-.72; P<.001). In addition, results suggest that people may disclose more general health information than specific health information owing to peer-related privacy concerns (t165=4.72; P<.001). The model explains 41% of the variance in general health information disclosure and 67% in specific health information sharing on Twitter. The results can contribute to privacy research and propose some practical implications. The findings provide insights for developers, policy makers, and health communication professionals about mitigating privacy concerns in web-based health information sharing. It particularly underlines the importance of addressing peer-related privacy concerns. The study underscores the need to build a secure and trustworthy web-based environment, emphasizing the significance of peer interactions and highlighting the need for improved regulations, clear data handling policies, and users' control over their own data.

Disclosing the Health Value through Integrated Report: An Explorative Research

This study aims to investigated if the integrated report, according to the IIRC (International Integrated Reporting Council) Framework, has the potential to disclose health information and to address citizens&amp;rsquo; expectations. An explorative case was conducted in an Italian public hospital follows the action research approach. Semi-structured interviews were asked by researchers to reach a deep understanding of the phenomenon under study. The results show that Integrated Reporting is able to disclose the value created: the health outcome. There is a need for Integrated Reporting Framework adjustments for health sector purposes: in relation to some capitals of the framework, to the concept of value created in its particular emphasis on health outcome for patients and to the need to find a more effective communication method. The absence of stakeholder engagement activities in the Integrated Reporting adoption process influences the attractiveness of the document. In fact, the Integrated Reporting user appears to be only the financing institution.This study aims to investigated if the integrated report, according to the IIRC (International Integrated Reporting Council) Framework, has the potential to disclose health information and to address citizens&amp;rsquo; expectations. An explorative case was conducted in an Italian public hospital follows the action research approach. Semi-structured interviews were asked by researchers to reach a deep understanding of the phenomenon under study. The results show that Integrated Reporting is able to disclose the value created: the health outcome. There is a need for Integrated Reporting Framework adjustments for health sector purposes: in relation to some capitals of the framework, to the concept of value created in its particular emphasis on health outcome for patients and to the need to find a more effective communication method. The absence of stakeholder engagement activities in the Integrated Reporting adoption process influences the attractiveness of the document. In fact, the Integrated Reporting user appears to be only the financing institution.

Association between patient-provider communication and withholding information due to privacy concerns among women in the United States: an analysis of the 2011 to 2018 Health Information National Trends Survey

BackgroundElectronic medical record software is common in healthcare settings. However, data privacy and security challenges persist and may impede patients’ willingness to disclose health information to their clinicians. Positive patient-provider communication may foster patient trust and subsequently reduce information nondisclosure. This study sought to characterize information-withholding behaviors among women and evaluate the association between positive patient-provider communication and women’s health information-withholding behavior in the United States.MethodsData were pooled from the 2011 to 2018 Health Information National Trends Survey. We used descriptive statistics, bivariate, and logistic regression analyses to investigate whether positive patient-provider communication significantly impacted health information-withholding behaviors. Data from 7,738 women were analyzed.ResultsAbout 10.8% or 1 in 10 women endorsed withholding health information from their providers because of privacy or security concerns about their medical records. After adjusting for the covariates, higher positive patient-provider communication scores were associated with lower odds of withholding information from the provider because of privacy and security concerns (aOR 0.93; 95% CI = 0.90–0.95). Additionally, we found that age, race/ethnicity, educational status, psychological distress, and smoking status significantly predicted women’s willingness to disclose health information.ConclusionsFindings suggest that improving positive patient-provider communication quality may reduce women’s privacy and security concerns and encourage them to disclose sensitive medical information.

The Influence of Perceived Provider Empathic Communication on Disclosure Decision-Making

ABSTRACT Provider empathy is a crucial component in establishing therapeutic provider–patient relationships. The benefits of increased perceptions of empathy can support patient psychological adjustment to their cancer as well as patients’ comfort and confidence in disclosing to providers, ultimately promoting patient engagement. Guided by the disclosure decision-making model, this manuscript explores how perceptions of empathy influence patient psychological adjustment and how those variables influence patient disclosure efficacy. The model ultimately predicts patient sharing and withholding of information during the medical interaction. This study tested a mediation model to investigate how current (n = 111) and former (n = 174) breast cancer patients’ psychological adjustment mediates the relationship between patient perceptions of oncologist empathic communication and efficacy to disclose health information to their oncologist and their disclosure enactment in sharing and withholding. Overall, former patients compared to current patients had more positive perceptions of their oncologist’s empathic communication, had better psychological adjustment, felt more self-efficacy to disclose to their oncologist, and shared more and withheld less information from their oncologist (p < .05 in all cases). Structural equation modeling revealed good fit to the data for both current and former patients such that more perceived empathic communication was associated with more efficacy for disclosure, which was associated with more sharing and less withholding. Additionally, there was an indirect relationship from perceptions of empathic communication to disclosure efficacy through patients’ psychological adjustment to the diagnosis. Results reinforce the importance of providers’ empathic communication for cancer patients’ psychological adjustment because patient sharing and withholding of information remain crucially important to achieving holistic care across the cancer trajectory.

Factors affecting patient and public perceptions of the adoption of electronic health record sharing: A Hong Kong study

Background and ObjectivesThe disclosure of personal health information in electronic health records (eHR) highlights privacy and security concerns that are complicated by the digitization and interoperability of health records. Hong Kong’s Electronic Health Record Sharing System (eHRSS), introduced in March 2016, enables eHR sharing among public and private health services upon the consent of patients. Based on a September 2021 survey, this study examined the specific context of Hong Kong, patient and public perceptions on the security and privacy of eHR sharing, correlation of trust with personal privacy and security concerns, and how perceptions affect health care-related decisions. MethodsUsing a random sample of householders aged 45–70 years, the study conducted a questionnaire survey on respondents’ awareness, perceived benefits, and obstacles to participating in the eHRSS, and the impact of their perceptions on health care-related decisions. A focus group discussion with 13 participants further explored views on the security of Hong Kong’s eHRSS and their readiness to support the system. ResultsThe study analyzed data from 400 responses. The findings showed a low degree of awareness of the eHRSS. Privacy and security concerns were impeding factors in the sharing of information; half of the respondents reported being concerned over their personal health information being part of the eHRSS. The majority (86.9%) expressed conditional support for the sharing of information. Despite their concerns on security and privacy, 66.5% and 77.9%, respectively, would not withhold information nor postpone the seeking of medical care based on those concerns. Participants in the focus group expressed concerns regarding eHRSS registration, data leaks, information accuracy, and the potential prejudice that may result in discrimination and inequality in health care provision. ConclusionsSatisfaction with the health care services played a role in the trust reposed in the Hospital Authority and health care providers and institutions. Security and privacy were decisive factors in respodents’ refusal to seek care from physicians who had violated their privacy. Respondents expressed greater interest in sharing their information if measures were in place for anonymization and punishing data misuse. Ensuring rights of control toward information sharing would inspire greater confidence among patients.

A preliminary study on the barriers and facilitators to improving the health, safety, and well-being of aging heavy vehicle drivers

Introduction. Managers from road freight transportation organizations were interviewed on barriers and facilitators to implementation of occupational health, safety, and well-being interventions for aging heavy vehicle drivers. As aging drivers are more likely to be seriously injured or die in a work-related incident than younger drivers, it is important to recognize strengths and weaknesses throughout the system to identify intervention that addresses their specific needs. Method: A Systems Theoretic Accident Model and Processes (STAMP) control structure was constructed to chart the controllers, controls, and feedback channels in the system to identify gaps in health, safety, and well-being intervention in the system. The STAMP control structure also charted the barriers and facilitators within levels across the system. Eleven managers were recruited into the study representing a range of road freight transportation organizations throughout Australia. Results: Interview data revealed that barriers and facilitators existed at most levels of the system. Facilitators included advice from external agencies, support from upper management, modern technology, and regular social communication with drivers. Barriers were a lack of guidance on aging issues, operational conflicts with health and safety objectives, and the drivers’ fear of disclosing health information associated with their driving role. In regards to formalized intervention in place to support aging heavy vehicle drivers, the system is reliant on fitness to drive medical assessments based on age and jurisdiction. Conclusions: As there was generally a lack of senior direction cited from the upper levels of the system on aging issues, there was much variation across the study on how aging risks are managed in the workplace for heavy vehicle drivers. Practical Applications: This study recommends that managers across the road freight transportation industry receive formalized aging-awareness health and safety training in how to manage work-related driving hazards for aging heavy vehicle drivers.

Determining factors affecting the user's intention to disclose privacy in online health communities: a dual-calculus model.

As a new type of medical service application for doctor-patient interaction, online health communities (OHCs) have alleviated the imbalance between the supply and demand of medical resources in different regions and the problems of "difficult and expensive access to medical care", but also raised the concern of patients about the risk of disclosure of their health privacy information. In this study, a dual-calculus model was developed to explore users' motivation and decision-making mechanism in disclosing privacy information in OHCs by combining risk calculus and privacy calculus theories. In OHCs, users' trust in physicians and applications is a prerequisite for their willingness to disclose health information. Meanwhile, during the privacy calculation, users' perceived benefits in OHCs had a positive effect on both trust in doctors and trust in applications, while perceived risks had a negative effect on both trusts in doctors and trust in applications. Furthermore, in the risk calculation, the perceived threat assessment in OHCs had a significant positive effect on perceived risk, while the response assessment had a significant negative effect on perceived risk, and the effect of users' trust in physicians far exceeded the effect of trust in applications. Finally, users' trust in physicians/applications is a mediating effect between perceived benefits/risks and privacy disclosure intentions. We combine risk calculus and privacy calculus theories to construct a dual-calculus model, which divides trust into trust in physicians and trust in applications, in order to explore the intrinsic motivation and decision-making mechanism of users' participation in privacy disclosure in OHCs. On the one hand, this theoretically compensates for the fact that privacy computing often underestimates perceived risk, complements the research on trust in OHCs, and reveals the influencing factors and decision transmission mechanisms of user privacy disclosure in OHCs. On the other hand, it also provides guidance for developing reasonable privacy policies and health information protection mechanisms for platform developers of OHCs.

Assessing Resident Well-Being: Ethical Considerations for Researchers When Conducting Qualitative Wellness Research With Resident Populations.

Assessing Resident Well-Being: Ethical Considerations for Researchers When Conducting Qualitative Wellness Research With Resident Populations.

Policy Preferences Regarding Health Data Sharing Among Patients With Cancer: Public Deliberations.

Precision health offers the promise of advancing clinical care in data-driven, evidence-based, and personalized ways. However, complex data sharing infrastructures, for-profit (commercial) and nonprofit partnerships, and systems for data governance have been created with little attention to the values, expectations, and preferences of patients about how they want to be engaged in the sharing and use of their health information. We solicited patient opinions about institutional policy options using public deliberation methods to address this gap. We aimed to understand the policy preferences of current and former patients with cancer regarding the sharing of health information collected in the contexts of health information exchange and commercial partnerships and to identify the values invoked and perceived risks and benefits of health data sharing considered by the participants when formulating their policy preferences. We conducted 2 public deliberations, including predeliberation and postdeliberation surveys, with patients who had a current or former cancer diagnosis (n=61). Following informational presentations, the participants engaged in facilitated small-group deliberations to discuss and rank policy preferences related to health information sharing, such as the use of a patient portal, email or SMS text messaging, signage in health care settings, opting out of commercial data sharing, payment, and preservation of the status quo. The participants ranked their policy preferences individually, as small groups by mutual agreement, and then again individually in the postdeliberation survey. After deliberation, the patient portal was ranked as the most preferred policy choice. The participants ranked no change in status quo as the least preferred policy option by a wide margin. Throughout the study, the participants expressed concerns about transparency and awareness, convenience, and accessibility of information about health data sharing. Concerns about the status quo centered around a lack of transparency, awareness, and control. Specifically, the patients were not aware of how, when, or why their data were being used and wanted more transparency in these regards as well as greater control and autonomy around the use of their health data. The deliberations suggested that patient portals would be a good place to provide additional information about data sharing practices but that over time, notifications should be tailored to patient preferences. Our study suggests the need for increased disclosure of health information sharing practices. Describing health data sharing practices through patient portals or other mechanisms personalized to patient preferences would minimize the concerns expressed by patients about the extent of data sharing that occurs without their knowledge. Future research and policies should identify ways to increase patient control over health data sharing without reducing the societal benefits of data sharing.

The Illusion of Health Privacy in Obstetrics-Gynecology.

Many health professionals and patients erroneously believe that professional ethics and laws protect the privacy of sensitive records in obstetrics-gynecology. The Health Insurance Portability and Accountability Act Privacy Rule permits disclosure of health records without authorization for public health, law enforcement, and other reasons. Individuals also may be compelled to authorize the release of their records in applying for employment, life insurance, or government benefits. Disclosure of sensitive health information has increased because of comprehensive electronic health records, patient-developed data from mobile devices, consolidation of medical practices, and law enforcement interest in reproductive health records attributable to the change in abortion laws.

Understanding Disclosure of Health Information to Workplace Friends.

The purpose of this study was to learn about the process of disclosing health information to a coworker friend using the lens of Communication Privacy Management Theory. The study explores emerging themes regarding health information disclosure and predicts associations between privacy, social support, risk, stigma, and the willingness to disclose health information to a friend at work. Employees were asked to recall a time they shared health information with a coworker friend and report about the interaction via open-ended items and scales on a survey. The study found that as emotional support, instrumental support, perceived risk, and stigma of the information increased, so did the tendency to disclose to a coworker friend. Increased privacy of the information was associated with a decrease in the tendency to disclose. A thematic analysis of the open-ended results also revealed that employees shared information associated with personal on-going health problems to seek support, to relate to their coworker friends, and to maintain their friendship. The findings also indicated that employees were likely to receive social support from their coworker friends even if they were not seeking it.

Quality of Chinese government environmental health information disclosure during COVID-19 pandemic: Satisfaction survey on University students.

Government played a vital role during the COVID-19 pandemic by disclosing related environmental health information to the public. A satisfaction survey is often used to evaluate the public's satisfaction of the government's information disclosure while reflecting problems in the current disclosure system. As University students generally have better cognitive skills, they efficiently received related information during the pandemic, and therefore 717 questionnaires completed by University students were selected for this study. During the pandemic, the quality of the government's environmental health information disclosure system ranked at 13.89, marginally higher than average. Moreover, the timeliness and content adequacy of the disclosure system ranked at a level slightly above average. By adopting Hayes PROCESS Model 4 and 8, this study found that there is a direct impact of environmental health knowledge and environmental health awareness on satisfaction. Furthermore, University students' environmental health knowledge and awareness enhanced satisfaction through the mediating effect of self-reported environmental behavior. Finally, this study attempted to discover the conditions under which environmental health knowledge and awareness would have a greater direct and indirect influence on satisfaction, that is, the reverse moderating effect of household income level. In addition, this paper offers policy recommendations to enhance quality of government environmental health information disclosure system.

"Should I Tell My Leader or Not?"-Health-Oriented Leadership and Stigma as Antecedents of Employees' Mental Health Information Disclosure Intentions at Work.

To investigate how health-oriented leadership and stigma facilitate or impede employees' disclosure intentions to leaders. In two studies-an experimental vignette (n = 73) and a cross-sectional study (n = 220)-we manipulated or measured health-oriented leadership, transformational leadership, and organizational stigma and compared different reasons for disclosure (mental health problems and severe error) to separate general and specific disclosure decisions. Health-oriented leadership fostered disclosure above and beyond transformational leadership. High organizational stigma was associated with lower disclosure. Health-oriented leadership had a stronger effect on disclosing mental problems than on disclosing a severe error and slightly mitigated the negative relationship between stigma and disclosure in study 1. Findings were not influenced by employees' current mental health status. Our findings highlight the importance of health-oriented leadership as a facilitator and organizational stigma as a barrier to disclosure intentions.

Reevaluating Gendered Language in Surgery.

Reevaluating Gendered Language in Surgery.

Testing a Model of Disclosure, Perceived Support Quality, and Well-Being in the College Student Mental Illness Context: A Weekly Diary Study

ABSTRACT Prominent disclosure models elucidate decisions to disclose health information, yet explanations for disclosure consequences remain underdeveloped. Drawing on Chaudoir and Fisher’s disclosure process model, this study aims to advance understandings of how disclosure to a parent contributes to well-being for college students with mental illness. We tested a mediational model in which, at the within-person level, perceived support quality explains the association between on-going disclosure of mental illness-related experiences and well-being. Participants were 163 college students who self-identified as having mental illness and who completed six consecutive, weekly surveys. A multilevel analysis showed that increases in disclosures of mental illness-related experiences, relative to participants’ mean level, were associated with enhanced well-being via perceptions of higher quality support, above and beyond between-person differences. This study contributes to the literature by offering an explanation for the effects of disclosure on well-being and underscores the importance of capturing disclosures over time.