Heterogeneity in willingness to share personal health information: a nationwide cluster analysis of 20,000 adults in Japan

Abstract Background While Personal Health Records (PHRs) are increasingly adopted globally, understanding public attitudes toward health information sharing remains crucial for successful implementation. This study investigated patterns in willingness to share personal health information among Japan...

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Main Authors: Miho Sassa, Akifumi Eguchi, Keiko Maruyama-Sakurai, Takanori Fujita, Yumi Kawamura, Takayuki Kawashima, Yuta Tanoue, Daisuke Yoneoka, Hiroaki Miyata, Takanori Yamashita, Naoki Nakashima, Shuhei Nomura
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Language:English
Published: BMC 2025-04-01
Series:Archives of Public Health
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Online Access:https://doi.org/10.1186/s13690-025-01599-z
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author Miho Sassa
Akifumi Eguchi
Keiko Maruyama-Sakurai
Takanori Fujita
Yumi Kawamura
Takayuki Kawashima
Yuta Tanoue
Daisuke Yoneoka
Hiroaki Miyata
Takanori Yamashita
Naoki Nakashima
Shuhei Nomura
author_facet Miho Sassa
Akifumi Eguchi
Keiko Maruyama-Sakurai
Takanori Fujita
Yumi Kawamura
Takayuki Kawashima
Yuta Tanoue
Daisuke Yoneoka
Hiroaki Miyata
Takanori Yamashita
Naoki Nakashima
Shuhei Nomura
author_sort Miho Sassa
collection DOAJ
description Abstract Background While Personal Health Records (PHRs) are increasingly adopted globally, understanding public attitudes toward health information sharing remains crucial for successful implementation. This study investigated patterns in willingness to share personal health information among Japanese adults and identified factors influencing their sharing decisions. Methods A nationwide cross-sectional web-based survey was conducted among 20,000 Japanese adults in December 2023. Participants were recruited through quota sampling based on age, gender, and prefecture population ratios from the 2020 National Census. The survey examined willingness to share personal health information with nine types of recipients (healthcare providers, ambulance crew, application providers, family members, local authorities, employers, pharmaceutical companies, government agencies, and research institutions), trust levels in these recipients, and 17 factors influencing sharing decisions across health benefits, convenience, economic incentives, social significance, information details, transparency, and privacy considerations. Clustering analysis using Uniform Manifold Approximation and Projection (UMAP) and Ordering Points to Identify the Clustering Structure (OPTICS) algorithms was performed to identify distinct patterns in sharing preferences. Results Despite low PHR familiarity (88.4% unfamiliar), participants showed willingness to share health information with healthcare providers (65.0%) and family members (65.6%), but expressed lower willingness toward government agencies (28.6%) and research institutions (28.8%). Five distinct clusters were identified: family-only sharers (3.9%), mixed preference sharers (47.9%), comprehensive sharers (12.9%), non-sharers (22.1%), and healthcare-selective sharers (13.2%). Trust levels were highest for family members (85.6%) and healthcare professionals (78.8%), while significantly lower for government agencies (44.2%). Higher education, income, and PHR familiarity were associated with greater willingness to share, while privacy and security concerns were universal across all clusters. Conclusions The heterogeneous patterns in health information sharing preferences suggest the need for tailored PHR implementation strategies that address varying privacy concerns and trust levels across different population segments. Success in PHR adoption requires balanced approaches to trust-building, robust data protection, and targeted communication strategies that acknowledge diverse user needs while promoting the benefits of health data sharing.
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spelling doaj-art-aca9f8d43cd3401b85c6b8fefe5a2cf42025-08-20T03:18:34ZengBMCArchives of Public Health2049-32582025-04-0183111710.1186/s13690-025-01599-zHeterogeneity in willingness to share personal health information: a nationwide cluster analysis of 20,000 adults in JapanMiho Sassa0Akifumi Eguchi1Keiko Maruyama-Sakurai2Takanori Fujita3Yumi Kawamura4Takayuki Kawashima5Yuta Tanoue6Daisuke Yoneoka7Hiroaki Miyata8Takanori Yamashita9Naoki Nakashima10Shuhei Nomura11Department of Global Health Policy, Graduate School of Medicine, The University of TokyoDepartment of Health Policy and Management, School of Medicine, Keio UniversityDepartment of Health Policy and Management, School of Medicine, Keio UniversityDepartment of Health Policy and Management, School of Medicine, Keio UniversityDepartment of Health Policy and Management, School of Medicine, Keio UniversityDepartment of Health Policy and Management, School of Medicine, Keio UniversityFaculty of Marine Technology, Tokyo University of Marine Science and TechnologyInfectious Disease Surveillance Center at the National Institute of Infectious DiseaseDepartment of Health Policy and Management, School of Medicine, Keio UniversityMedical Information Center, Kyushu University HospitalDepartment of Medical Informatics, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Health Policy and Management, School of Medicine, Keio UniversityAbstract Background While Personal Health Records (PHRs) are increasingly adopted globally, understanding public attitudes toward health information sharing remains crucial for successful implementation. This study investigated patterns in willingness to share personal health information among Japanese adults and identified factors influencing their sharing decisions. Methods A nationwide cross-sectional web-based survey was conducted among 20,000 Japanese adults in December 2023. Participants were recruited through quota sampling based on age, gender, and prefecture population ratios from the 2020 National Census. The survey examined willingness to share personal health information with nine types of recipients (healthcare providers, ambulance crew, application providers, family members, local authorities, employers, pharmaceutical companies, government agencies, and research institutions), trust levels in these recipients, and 17 factors influencing sharing decisions across health benefits, convenience, economic incentives, social significance, information details, transparency, and privacy considerations. Clustering analysis using Uniform Manifold Approximation and Projection (UMAP) and Ordering Points to Identify the Clustering Structure (OPTICS) algorithms was performed to identify distinct patterns in sharing preferences. Results Despite low PHR familiarity (88.4% unfamiliar), participants showed willingness to share health information with healthcare providers (65.0%) and family members (65.6%), but expressed lower willingness toward government agencies (28.6%) and research institutions (28.8%). Five distinct clusters were identified: family-only sharers (3.9%), mixed preference sharers (47.9%), comprehensive sharers (12.9%), non-sharers (22.1%), and healthcare-selective sharers (13.2%). Trust levels were highest for family members (85.6%) and healthcare professionals (78.8%), while significantly lower for government agencies (44.2%). Higher education, income, and PHR familiarity were associated with greater willingness to share, while privacy and security concerns were universal across all clusters. Conclusions The heterogeneous patterns in health information sharing preferences suggest the need for tailored PHR implementation strategies that address varying privacy concerns and trust levels across different population segments. Success in PHR adoption requires balanced approaches to trust-building, robust data protection, and targeted communication strategies that acknowledge diverse user needs while promoting the benefits of health data sharing.https://doi.org/10.1186/s13690-025-01599-zPersonal health recordsHealth information sharingCluster analysisDigital healthJapan
spellingShingle Miho Sassa
Akifumi Eguchi
Keiko Maruyama-Sakurai
Takanori Fujita
Yumi Kawamura
Takayuki Kawashima
Yuta Tanoue
Daisuke Yoneoka
Hiroaki Miyata
Takanori Yamashita
Naoki Nakashima
Shuhei Nomura
Heterogeneity in willingness to share personal health information: a nationwide cluster analysis of 20,000 adults in Japan
Archives of Public Health
Personal health records
Health information sharing
Cluster analysis
Digital health
Japan
title Heterogeneity in willingness to share personal health information: a nationwide cluster analysis of 20,000 adults in Japan
title_full Heterogeneity in willingness to share personal health information: a nationwide cluster analysis of 20,000 adults in Japan
title_fullStr Heterogeneity in willingness to share personal health information: a nationwide cluster analysis of 20,000 adults in Japan
title_full_unstemmed Heterogeneity in willingness to share personal health information: a nationwide cluster analysis of 20,000 adults in Japan
title_short Heterogeneity in willingness to share personal health information: a nationwide cluster analysis of 20,000 adults in Japan
title_sort heterogeneity in willingness to share personal health information a nationwide cluster analysis of 20 000 adults in japan
topic Personal health records
Health information sharing
Cluster analysis
Digital health
Japan
url https://doi.org/10.1186/s13690-025-01599-z
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