近期有越來越多醫療業者或是病患都在使用移動醫療(mHealth)來幫助追蹤和管理健康狀況，但在mHealth產品中，有些資訊無法自動測量而需透過病患自行回報，有些病患會因為特定動機而不願意誠實回報資訊，而此謊報行為可能會導致醫療人員可能會判斷錯誤而無法進行正確的治療，對病患產生健康風險。在資訊管理領域，相比於對檢測欺騙行為的研究，預防的研究相較少。因此我們的研究是關於如何設計出可以預防謊報的mHealth產品，包括預防回報的謊報行為，和回報時的謊報念頭。
為了達成此目標，我們以過去廣泛被使用的恐懼訴求 (Fear Appeal) 當作第一次操控，但考量到恐懼訴求與mHealth此領域的適配性，我們參考反應激活模型(Response Activation Model, RAM) 來開發出預防謊報的回報工具，並以此為第二個操控。我們透過線上系統進行一次性的2x2組間比較實驗。我們研究結果指出，恐懼訴求對於預防謊報行為的效果在mHealth情境下表現比預期不佳。然而，我們參考RAM開發的回報工具有助於在回報時產生誠實的念頭。特別的是，結果指出同時使用恐懼訴求和RAM回報工具可以顯著減少謊報念頭和行為。我們此研究對資訊產品開發公司和mHealth領域具有實際意義。

Mobile health (mHealth) apps are becoming more pervasive as health practitioners and patients seek to track and manage health behavior. However, in mHealth , certain information relies on patients' self-reporting, as it cannot be automatically measured. Unfortunately, some patients may be reluctant to provide honest information due to certain motivations, leading to misreporting behavior. This misreporting can pose significant health risks as healthcare professionals may make incorrect judgments, resulting in inappropriate treatments. In the field of information management, research on preventive measures is relatively scarce compared to studies focused on detecting deceptive behavior.

Therefore, our study aims to explore the design of mHealth products that can prevent misreporting, including both preventive measures against misreporting behavior during reporting and misreporting thoughts during the reporting process. To achieve this, we adopt Fear Appeal, a widely used approach, as the first manipulation. However, considering the suitability of Fear Appeal in the mHealth domain, we reference the Responsive Active Model (RAM) to develop a reporting tool to prevent misreporting, serving as the second manipulation. We conducted a one-time 2x2 between-subjects experimental comparison through an online system.

Our research findings indicate that Fear Appeal's effectiveness in preventing misreporting behavior in the mHealth context is not as expected. Nonetheless, the reporting tool developed based on RAM is helpful in promoting honest thoughts during reporting. Particularly, the results suggest that combining Fear Appeal and the RAM-applied reporting tool significantly reduces misreporting thoughts and behavior.Our results contribute to practical implications for app firms and the mHealth domain.

Table of Contents
摘要.......i
Abstract ....... ii
Table of Contents.......v
Chapter 1. Introduction.......1
Chapter 2. Misreporting Health....... 3
2.1 Health and Misreporting ....... 3
2.2 Why do people misreport health information? .......5
2.3 Fraud vs. Misreporting....... 6
2.4 Detection vs. Prevention of Misreporting ....... 7
2.5 Discouraging Misreporting: Fear Appeal Theory....... 8
2.6 Response Activation Model (RAM) Theory ....... 9
Chapter 3. Enhancing Fear Appeals with RAM.......11
3.1 MHealth Context.......11
3.2 Instrument: Online Tool to Measure Dietary Practice.......12
3.2.1 Overall scenario: talking to doctor about dietary practice.......12
3.2.2 Doctor scenario apply impression management.......13
3.3 Applying Fear Appeal .......15
3.3.1 Designing Fear Appeal.......16
3.3.2 Design considerations of Fear Appeal.......17
3.4 RAM-applied slider bar.......19
3.4.1 Using RAM theory to discourage misreporting.......19
3.4.2 Slider bar apply RAM theory.......20
3.5 Study Design.......22
3.5.1 Dependent variables.......23
3.5.2 Control variables.......24
3.5.3 Procedure.......25
Chapter 4. Hypothesis.......27
4.1 Participant-Reported Diet Information Scores.......27
4.1.1 Diet Score and Fear appeal .......27
4.1.2 Diet Score and RAM based slider.......28
4.1.3 Diet Score and the combination of Fear Appeal and RAM........29
4.2 Participant Reporting Speed.......29
4.2.1 Speed and Fear Appeal .......30
4.2.2 Speed and RAM........30
4.2.3 Speed and the combination of Fear Appeal and RAM.......31
Chapter 5. Methodology.......32
5.1 Pre-test with semi-expert group.......32
5.2 Ethics Approval.......33
5.3 Data Collection.......33
5.4 Manipulation check .......36
Chapter 6. Analysis and Result........38
6.1 PCA Analysis: Retaining All Questions .......38
6.2 Dietary Score and Misreporting.......38
6.3 Response Speed and Misreporting.......42
Chapter 7. Discussion.......45
7.1 Balancing Fear Appeal in mHealth.......45
7.2 The Influence of RAM on Thought Processes .......46
7.3 Powerful Combination of RAM and Fear Appeal.......47
Chapter 8. Future Work and Conclusion.......48
8.1 Limitations and Future Work........48
8.2 Conclusion.......50
Reference .......52
Appendix A. Dietary Behavior Questionnaire.......60
A.1 Original Chinese version.......60
A.2 English translation version.......61
Appendix B. Full experiment pages (English translation).......63
B.1 Full experiment page for FA + RAM group.......63
B.2 Non fear appeal message .......77
B.3 Diet behavior Questionnaire using control slider .......79
Appendix C. Full experiment pages (Chinese version).......81
C.1 Full experiment page for FA + RAM group .......81
C.2 Non fear appeal message .......94
C.3 Diet behavior Questionnaire using control slider .......96

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