Promoting women's health via the World Wide Web

Internet self-diagnosis in hand surgery

BACKGROUND

Some Internet sites have programs that attempt to help patients find their diagnosis based on symptoms. This study tested the null hypothesis that there are no factors associated with correspondence between online diagnosis and the hand surgeon's diagnosis in an outpatient hand and upper extremity surgeons' office.

METHODS

Eighty-six outpatients were prospectively enrolled and used WebMD® symptom checker to guess their diagnosis. We collected demographic information, hours spent on the Internet per week, and the following questionnaires: Pain Catastrophizing Scale (PCS) and Center of Epidemiologic Studies Depression scale (C-ESD).

RESULTS

Thirty-three percent of online diagnoses matched the final diagnosis of the hand surgeon. Factors associated with an online diagnosis corresponding to the hand surgeon's diagnosis included sex (women) and patients who studied their symptoms online prior to the visit. The best multivariable model included sex, more years of education, and prior use of the Internet to research their medical condition and explained 15 % of the variation in correspondence of diagnosis.

CONCLUSIONS

The majority of online diagnoses for hand and upper extremity conditions do not correspond with the diagnosis of the treating hand surgeon. Psychological factors do not influence the correspondence of online diagnosis with the hand surgeon's diagnosis.

LEVEL OF EVIDENCE

Prognostic, level II.

Use of a Pregnancy Support Web Site by Low-Income African American Women

OBJECTIVE

To examine the feasibility and usage pattern of a social support Web site by low-income pregnant African American women.

DESIGN

Descriptive.

SETTING

Homes of participants.

PARTICIPANTS

Nineteen pregnant African American women who were pregnant for the first time, were low risk, and attending a prenatal clinic.

INTERVENTION

Culturally congruent Web site providing information on pregnancy-related health behaviors and other pregnancy issues.

MAIN OUTCOME MEASURES

Number of visits to Web site, most popular pages, content analysis of postings, and e-mails to a nurse.

RESULTS

Participants were able to learn to use the Web site easily. They accessed the discussion board the most frequently, followed by changes during pregnancy by month, ask-a-nurse feature, ultrasound, stories about pregnant women, and spirituality.

CONCLUSIONS

The discussion board is the most effective way to deliver informational social support on a comprehensive social support Web site.

Characteristics of online and offline health information seekers and factors that discriminate between them

Increasing number of individuals are using the internet to meet their health information needs; however, little is known about the characteristics of online health information seekers and whether they differ from individuals who search for health information from offline sources. Researchers must examine the primary characteristics of online and offline health information seekers in order to better recognize their needs, highlight improvements that may be made in the arena of internet health information quality and availability, and understand factors that discriminate between those who seek online vs. offline health information. This study examines factors that differentiate between online and offline health information seekers in the United States. Data for this study are from a subsample (n = 385) of individuals from the 2000 General Social Survey. The subsample includes those respondents who were asked Internet and health seeking module questions. Similar to prior research, results of this study show that the majority of both online and offline health information seekers report reliance upon health care professionals as a source of health information. This study is unique in that the results illustrate that there are several key factors (age, income, and education) that discriminate between US online and offline health information seekers; this suggests that general "digital divide" characteristics influence where health information is sought. In addition to traditional digital divide factors, those who are healthier and happier are less likely to look exclusively offline for health information. Implications of these findings are discussed in terms of the digital divide and the patient-provider relationship.

Women's health and the internet: understanding emerging trends and implications

Internet has become a major information source, yet little is known about why women use the internet for obtaining health information. In this paper, we propose and test three exploratory models to explain internet use for obtaining health information: health and wellness model, health needs model, and search costs model. The health and wellness model is based on the notion that internet has become such an integral part of daily life that health-conscious women use the internet in a pro-active manner for health promotion. The health needs model posits that women with greater health needs or concerns are more likely to use the internet. Finally, the search costs model explores the idea that women may view the internet as a resource for reducing high information search costs. These models were tested using data collected through telephone surveys of women in three southern New Jersey counties in the USA. Consistent with expectations, our findings show that internet use to search for health information is greater among women with higher levels of income and education. There is support for all three models, with surprisingly strong support for the health and wellness model. We conclude that women increasingly rely on the internet to supplement health information received from traditional sources and discuss the implications of our findings for policymakers and health professions.

Creating a pediatric digital library for pediatric health care providers and families: using literature and data to define common pediatric problems

The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.

Creating a pediatric digital library for pediatric health care providers and families: using literature and data to define common pediatric problems

The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.