From screens to sensors: a contextual integrity approach to understanding privacy norms across mobile health contexts

The increasing reliance on digital technologies in health care brings unique privacy risks to individual users. Guided by the framework of contextual integrity (CI), this study examined how privacy norms compare across four mobile health technological contexts: telehealth, online patient portals, mobile health applications, and wearable devices. Analysis of 34 semi-structured interviews revealed context-specific actors, information types, and transmission principles, and identified instances that represent points of departure from entrenched privacy norms. In addition, we found that people use privacy heuristics—evoked by CI parameters—to guide their privacy evaluations. Findings theoretically contribute to CI by identifying parameters in the novel context of mobile health and by proposing privacy heuristics as the explanatory mechanism underlying the evaluation of privacy norms. Practically, findings can inform more user-centered mobile health design and communication practices.