Journal Article

Motivational Framing Strategies in Health Care Information Security Training: Randomized Controlled Trial

Henkenjohann, Richard, Trenz, Manuel, Keller, Thomas, Klein, Julia, Warwas, Julia Isabella, Trang, Simon Thanh-Nam

2025

Overview

Information security is a critical challenge in the digital age, especially for hospitals, which are prime targets for cyberattacks due to the monetary worth of sensitive medical data. Given the distinctive security risks faced by health care professionals, tailored Security Education, Training, and Awareness (SETA) programs are needed to increase both their ability and willingness to integrate security practices into their workflows. This study investigates the effectiveness of a video-based security training, which was customized for hospital settings and enriched with motivational framing strategies to build information security skills among health care professionals. The training stands out from conventional interventions in this context, particularly by incorporating a dual-motive model to differentiate between self- and other-oriented goals as stimuli for skill acquisition. The appeal to the professional values of responsible health care work, whether absent or present, facilitates a nuanced examination of differential framing effects on training outcomes. A randomized controlled trial was conducted with 130 health care professionals from 3 German university hospitals. Participants within 2 intervention groups received either a self-oriented framing (focused on personal data protection) or an other-oriented framing (focused on patient data protection) at the beginning of a security training video. A control group watched the same video without any framing. Skill assessments using situational judgment tests before and after the training served to evaluate skill growth in all 3 groups. Members of the other-oriented intervention group, who were motivated to protect patients, exhibited the highest increase in security skills (ΔM=+1.13, 95% CI 0.82-1.45), outperforming both the self-oriented intervention group (ΔM=+0.55, 95% CI 0.24-0.86; P=.04) and the control group (ΔM=+0.40, 95% CI 0.10-0.70; P=.004). Conversely, the self-oriented framing of the training content, which placed emphasis on personal privacy, did not yield significantly greater improvements in security skills over the control group (mean difference=+0.15, 95% CI -0.69 to 0.38; P>.99). Further exploratory analyses suggest that the other-oriented framing was particularly impactful among participants who often interact with patients personally, indicating that a higher frequency of direct patient contact may increase receptiveness to this framing strategy. This study underscores the importance of aligning SETA programs with the professional values of target groups, in addition to adapting these programs to specific contexts of professional action. In the investigated hospital setting, a motivational framing that resonates with health care professionals' sense of responsibility for patient safety has proven to be effective in promoting skill growth. The findings offer a pragmatic pathway with a theoretical foundation for implementing beneficial motivational framing strategies in SETA programs within the health care sector.

• Publisher: JMIR Publications,JMIR Publications Inc
• Subject: Adult / Behavior / Computer Security - standards / Cybersecurity / Female / Germany / Health Personnel - education / Health Personnel - psychology / Hospitals / Humans / Hypotheses / Male / Medical personnel / Middle Aged / Motivation / Noncompliance / Original Paper / Patients / Professionals / Security management / Values