The novel coronavirus (COVID-19) pandemic has swept the globe since December 2019 that has imposed several changes on the general population in many aspects of their lives, including their healthcare behavior. Several countries imposed numerous prevention measures to contain the spread of infectious diseases (i.e., quarantines, nationwide lockdowns, social isolation), significantly influencing individuals' way of living and resulting in several behavioral outcomes [1, 2].
Previous studies explored that monitoring self-care positively impacted healthcare management and provided sustainability to healthcare infrastructure [3, 4]. Though employed measures and vaccination led to initial success, positive cases were under control. However, recent studies have shown the effect could continue for a prolonged duration . Thus, better utilization of information communication technologies (ICTs) might improve consideration and management of specific medical conditions, allowing individuals to be more involved in self-care .
Taiwan's government, like other countries, imposed several restrictions, which limited the traditional patients' care, such as face-to-face diagnosis practiced by physicians due to the outbreak of Covid-19 . Innovative healthcare information systems such as PHR can overcome the drawbacks of conventional patient care and support physicians to continue their diagnosis in a secure way using a password-protected secured system . PHR is considered a healthcare information system (HIS) that incorporates individuals' historical and current health information needed to provide and receive better care .
PHR allows physicians to exchange messages and information, including encrypted clinical images for diagnostic purposes, provide medication information, and advise managing health conditions tailored to people's individual needs and circumstances [3, 6]. Supportive functionalities of PHR also help individuals improve their care management by keeping and accessing health information more efficiently and effectively [3, 4]. Physicians but patients can also use PHR to track the communication between health professionals to keep symptom diaries, upload relevant documents and biometric data, and access real-time test results [4, 6]. Additionally, the stand-alone nature of PHR makes it sustainably effective during the pandemic . Therefore, PHR is considered one of the potential solutions to revive patients' care safely and securely.
It is well documented that individuals' CFHIP revolves around healthcare technology innovation. As the healthcare organization adopted new technologies for exchanging individuals' health information, the concern for health information privacy started to accelerate [6, 7]. The increasing amount of requests for health information and intentionally or unintentionally disclosing patient information to third parties increases individuals' privacy concerns regarding storage and access to health information. Thus, PHR has triggered a wave of privacy concerns as individuals feel concerned about their privacy by such services to varying degrees.
Personality traits are an individual's consistent personality across circumstances [8, 9]. A review of technology adoption literature [3, 9] recommended that individuals' personality traits significantly influence technology adoption behavior. Thus, considering that personality traits are an important factor influencing a wide variety of human behaviors and choices [6, 8], it is crucial to explore its influences in the context of healthcare technology adoption.
Consecutively, to test the influence of healthcare privacy concern and the threat of COVID-19 (PTD) on individuals' intention to provide personal health information while using PHR. This study explores the effect of individual differences in terms of personality traits on the formulation of concern for health information privacy. Thus, we are confident that the results of this study can provide insights into how individuals can leverage PHR to manage the associated concerns.
Theoretical foundation, research model and hypotheses
Privacy concern and Health information technology
Warren and Brandies  defined the need to protect people's rights in their landmark article, The Right to Privacy. Privacy refers to a person's ability to control others' access to their personal information . Privacy is violated when individuals cannot maintain their communication with social and physical environments [8,9]. But, privacy concerns are not a new phenomenon; these incidents repeatedly evolve when an individual perceives a threat from an innovative information technology (IT) that develops the surveillance, storage, retrieval, and communication of personal information [8,9].
With the rapid advancement of healthcare technologies, the exchange of patients' information has been cast out to be more convenient. Healthcare providers have better and more sophisticated ways to access and collect personal health information; therefore, gaining an individual's personal health information has become more accessible . So, privacy concerns about health information accelerate tremendously among individuals as a considerable amount of personal health information is interchanged, stored, and shared. Privacy guidelines and standards, Health Insurance Portability and Accountability Act (HIPAA) were introduced to guarantee individuals their health records are fully protected [8,9]. Despite these attempts, a large number of individuals are still reluctant to take the potential benefits from electronic data exchange due to privacy concerns. According to the study findings by the California Health care Foundation, 67 % of the respondents were "to some extent" or "very concerned" about the privacy of their medical records . Thus, an inclusive interception of the privacy dynamics concerning the digitization of health records can only be achieved by looking at the factors that influence an individual's attitudes toward PHR use.
Big Five Personality Traits
According to previous studies, personality variables are significant in decision-making and information system (IS) literature. They clarify our understanding of individuals' information processing styles, attitudes, and behaviors [11,12,13]. On the other hand, as information technology is becoming more and more personalized  nowadays, personality variables can impact how they perceive security . According to the Protection motivation theory (PMT), individuals' personality traits influence their perception of the threat, exploring their attitude toward adoption [11,13,14].
The personality traits are being used in many studies but have led to inconsistent results until the late 1980s. Goldberg  proposed the Big Five Framework, including agreeableness, conscientiousness, neuroticism, extraversion, and intellect, collectively accounted for the significant dimensions upon which individuals differ and predicted important outcomes. Previous studies have proposed that personality traits might impact CFIP to investigate consumers' responses to corporate use of their personal information in previous studies [12,14]. Thus, the present study incorporates personality traits with the CFHIP model to investigate and improve the predictability of how individual trait relates to CFHIP in a health information exchange context that requires self-disclosure of personal health information.
Concern for Health Information Privacy
Although PMT has been primarily used to define different health-behavior issues such as cancer or smoking , the severity of the threat is directly proportionate to life. Generally, the threat is outlined as a cause of danger and can bring harm either physically or mentally to an individual. That can also be applied to an increasingly personal technology, whose damage or vulnerability can match that of saying a health risk such as stress . In the context of healthcare, the extent healthcare providers collect and store individuals' health information, use that information for other purposes, and allow third parties who are unauthorized to access the information are all likely to contribute to the overall level of CFHIP . In other words, an individual considers it highly intrusive when he/she perceives that another individual can access his/her health information discreetly. As the collection of health information about individuals becomes a more usual practice for healthcare providers, individuals find it increasingly difficult to protect his/her information from personal privacy intrusions . However, individuals are likely to bother an extensive range of emotional distress, for example, anxiety, worries, and concern, but their usage of technology could reasonably be questioned, becoming more stressful.
In terms of an individual's concern for information privacy (CFIP), a 15-item instrument included four dimensions, collection, secondary use, unauthorized access, and errors, were developed by Smith et al.  to measure and identify the multi-dimensional nature of consumer CFIP. This instrument endorses that individuals with considerable information privacy concerns identify that (1) unnecessary data is collected; (2) personal information is exercised for undisclosed purposes; (3) personal information is not satisfactorily protected from unauthorized access; and (4) most of the data is inaccurate .
To the best of the authors' knowledge, no study has validated that CFHIP fully mediates the relationship between the threat of COVID-19 and behavioral intention. If the result holds, the healthcare provider can develop strategies and policies to reduce individuals' concerns and improve their behavior to provide personal health information to receive better care. Thus, this current result is significant in the context of HIE, where providing personal health information is indispensable for receiving better treatment.
Perceived threat of COVID-19
According to retrospective studies of the SARS pandemic  and the H1N1 pandemic , the perceived threat is the most immediate psychological response to emerging infectious diseases. After the outbreak of the COVID-19 pandemic, Xin et al.  explored the perceived threat of COVID-19 (PTD) containing three perspectives, namely the likelihood of infection, the severity of the pandemic, and the uncontrollability of the pandemic based on findings from China. Villani et al.  found pandemics impact students' psychological well-being. Duan and Zhu  indicate the COVID-19 pandemic increases concern and concern related to the use of Health information technology (HIT).
Additional research is needed on how individuals were affected by COVID-19 attributed to reduced motivation for the most part due to concern. Further, the pandemic severity measures substantially impacted individuals' lifestyles, negatively affecting their psychological well-being . Thus, the decline in individuals' motivation could be due to insufficient technological knowledge, support, and unable to understand the prerequisite of HIT. The following hypotheses are proposed giving the research framework in Figure 1.
H1: Agreeableness positively associates with individuals’ CFHIP.
H2: Intellect negatively associates with individuals’ CFHIP
H3a: Neuroticism positively associates with individuals’ CFHIP.
H3b: Neuroticism positively associates with individuals’ PTD.
H3c: Neuroticism positively associates with individuals’ behavioral intention.
H4a: Conscientiousness positively associates with individuals’ CFHIP.
H4b: The conscientiousness positively associates with individuals’ PTD.
H4c: Conscientiousness positively associates with individuals’ behavioral intention.
H5a: Extraversion negatively associates with individuals’ CFHIP.
H5b: Extraversion positively associates with individuals’ PTD.
H5c: Extraversion positively associates with individuals’ behavioral intention.
H6. Threat of COVID-19 negatively influences individuals' CFHIP.
H7: Threat of COVID-19 negatively associates with behavioral intention.
H8: CFHIP negatively associates with behavioral intention.
H9: The relationship between threat of COVID-19 and behavioral intention fully mediates by CFHIP.
(Insert Figure 1 here)