The effects of preference for information on consumers' online health information search behavior

Age and neurocognition are associated with credibility evaluations of health websites

The internet has become a common means by which many older adults seek out health information. The prevalence of misinformation on the internet makes the search for accurate online health information a more complex and evaluative process. This study examined the role of age and neurocognition in credibility evaluations of credible and non-credible health websites. Forty-one older adults and fifty younger adults completed a structured credibility rating task in which they evaluated a series of webpages displaying health information about migraine treatments. Participants also completed measures of neurocognition, internet use, and health literacy. Results suggested that older adults rated non-credible health websites as more credible than younger adults, but the age groups did not differ in their ratings of credible sites. Within the full sample, neurocognition was associated with credibility ratings for non-credible health websites, whereas health literacy was related to the ratings of credible sites. Findings indicate that older adults may be more likely to trust non-credible health websites than younger adults, which may be related to differences in higher-order neurocognitive functions. Future work might examine whether cognitive-based supports for credibility training in older adults can be used to improve the accuracy with which they evaluate online health information.

Influence of E-consultation on Intention of First-visit Patients to Select Medical Services: Based on a Scenario Survey (Preprint)

BACKGROUND

E-consultation is expected to improve the information level of patients, affect patients' subsequent judgments of medical services, and guide patients to make a reasonable medical selection in the future. Thus, it is important to understand the influence mechanism of e-consultation on patients' medical selection.

OBJECTIVE

This study aims to explore the changes in first-visit patients' understanding of disease and medical resources after e-consultation as well as the choice of follow-up medical services.

METHODS

Patients' medical selection before and after e-consultation was compared using a scenario survey. Based on the service characteristics of the e-consultation platform, representative simulation scenarios were determined, and parallel control groups were set up considering the order effect in comparison. Finally, a total of 4 scenario simulation questionnaires were designed. A total of 4164 valid questionnaires were collected through the online questionnaire collection platform. Patients' perception of disease severity, evaluation of treatment capacity of medical institutions, selection of hospitals and doctors, and other outcome indicators were tested to analyze the differences in patients' evaluation and choice of medical services before and after e-consultation. Additionally, the results' stability was tested by regression analysis.

RESULTS

In scenario 1 (mild case), before e-consultation, 14.1% (104/740) of participants considered their conditions as not serious. After e-consultation, 69.5% (539/775) of them considered their diseases as not serious. Furthermore, participants' evaluation of the disease treatment capacity of medical institutions at all levels had improved after using e-consultation. In scenario 3 (severe case), before e-consultation, 54.1% (494/913) of the participants believed their diseases were very serious. After e-consultation, 16.6% (157/945) considered their diseases were very serious. The evaluation of disease treatment capacity of medical institutions in nontertiary hospitals decreased, whereas that of tertiary hospitals improved. In both mild and severe cases, before e-consultation, all of the participants were inclined to directly visit the hospital. After e-consultation, more than 71.4% (553/775) of the patients with mild diseases chose self-treatment, whereas those with severe diseases still opted for a face-to-face consultation. After e-consultation, patients who were set on being treated in a hospital, regardless of the disease severity, preferred to select the tertiary hospitals. Of the patients with mild diseases who chose to go to a hospital, 25.7% (57/222) wanted to consult online doctors face-to-face. By contrast, 56.4% (506/897) of the severe cases wanted to consult online doctors face-to-face.

CONCLUSIONS

E-consultation can help patients accurately enhance their awareness of the disease and guide them to make a more reasonable medical selection. However, it is likely that e-consultation makes online medical services centralized. Additionally, the guiding effect of e-consultation is limited, and e-consultation needs to be combined with other supporting systems conducive to medical selection to play an improved role.

Making Mobile Health Information Advice Persuasive

As M-Health apps become more popular, users can access more mobile health information (MHI) through these platforms. Yet one preeminent question among both researchers and practitioners is how to bridge the gap between simply providing MHI and persuading users to buy into the MHI for health self-management. To solve this challenge, this study extends the Elaboration Likelihood Model to explore how to make MHI advice persuasive by identifying the important central and peripheral cues of MHI under individual difference. The proposed research model was validated through a survey. The results confirm that (1) both information matching and platform credibility, as central and peripheral cues, respectively, have significant positive effects on attitudes toward MHI, but only information matching could directly affect health behavior changes; (2) health concern significantly moderates the link between information matching and cognitive attitude and only marginally moderates the link between platform credibility and attitudes. Theoretical and practical implications are also discussed.

Alleviating Pregastroscopy Anxiety Using Mobile Social Media Application

Aim

The research aimed to study the effect of using WeChat (a mobile social media application) on pregastroscopy anxiety and the cooperation of patients with different coping styles.

Methods

In order to decrease patients' pregastroscopy anxiety and improve the tolerance of unsedated gastroscopy, WeChat, a widely used mobile social media application, was applied to provide information prior to their endoscopic procedure. Two hundred and thirty patients who underwent initial unsedated gastroscopy in a large teaching hospital in China were classified into two groups based on their coping style: information seekers or information avoiders, using the Information Subscale of the Krantz Health Opinion Survey (KHOS-I). Each of the two groups was prospectively randomly assigned to either receiving the brochure information or conjunctive interactive WeChat-delivered information of gastroscopy. To measure the level of state anxiety, the State Anxiety Scale of Spielberg's State-Trait Anxiety Inventory questionnaire was used. State anxiety, blood pressure and heart rate were measured at enrollment, upon arrival, and before gastroscopy.

Results

Information seekers and avoiders who received information from the brochure and the WeChat platform experienced significantly less state anxiety upon arrival and before gastroscopy. Furthermore, information seekers who received information from the conjunctive WeChat platform had lower frequency of retching, lower scores of nausea and bloating, and better tolerance. Information avoiders who received information from the conjunctive WeChat platform had lower frequency of retching, lower scores of discomfort while swallowing the scope and nausea, and better tolerance. However, we found the percentage of information seekers who preferred no WeChat-delivered pregastroscopy information is greater than WeChat-delivered information at the initial questionnaire. No significant difference was found in blood pressure or heart rate upon arrival and before gastroscopy.

Conclusions

Although people preferred no WeChat-delivered pregastroscopy information, the provision of gastroscopy information through a mobile social media application, such as WeChat, could significantly reduce patients' pregastroscopy anxiety, lower the frequency of retching, reduce the scores of nausea and bloating, and improve tolerance for information seekers. In addition, it could lower the frequency of retching, reduce the scores of discomfort while swallowing the scope and its concurrent nausea, and improve tolerance for information avoiders.

Maladaptive coping with the infodemic and sleep disturbance in the COVID-19 pandemic

COVID-19 is caused by a novel virus with an unknown aetiology. People across the globe are dealing with not only a health crisis but also an 'infodemic', a term coined by the World Health Organization to refer to the avalanche of contradictory information that is arousing widespread confusion and anxiety. This study aimed to examine the prevalence of anxiety and sleep disturbance at the early stage of the pandemic, and unveil the information coping process underlying differential susceptibility to COVID-19 infection anxiety and sleep disturbance. The participants were 1,270 adults (47% men, M_age  = 42.82) from the UK and US who completed initial (Time 1) and follow-up (Time 2) surveys from 16 to 22 March and 18 to 24 May 2020, respectively. The prevalence of probable clinically relevant anxiety was 61% and 45% at the first and second time points, and more than half of the participants in this anxiety group also reported mild to severe sleep disturbance. Moreover, 41% of the participants perceived themselves as not having enough COVID-19-related information and reported higher levels of COVID-19 infection anxiety and sleep disturbance over time than those who perceived themselves as having enough of such information. Moderated mediation analysis identified two groups who were more vulnerable to both psychological problems: high blunters who sought COVID-19-related information online more frequently and high monitors who sought such information offline less frequently. These findings highlight the importance of a good match between information coping style and strategy deployment in dealing with an infodemic surrounding a novel disease.

How Children Search for Health Information Online: An Observational Study

OBJECTIVE

To evaluate whether children could find the correct answers to obesity-related health questions on the Internet and observe the search strategies children use when searching for such information.

METHODS

Twenty-five parent-child dyads, from a southwestern US summer day camp, participated in this cross-sectional study. Parents' health literacy skills were evaluated. Children searched the Internet for 6 questions related to nutrition and physical activity. Search activities were recorded via Camtasia. Quantitative (ie, time spent per question) and qualitative data (ie, themes related to difficulties searching) were extracted by rewatching the recordings.

RESULTS

All parents had either proficient or basic levels of health literacy. The question that had the highest rating for being correctly answered pertained to physical activity recommendations, whereas none of the children were able to find recommended servings of food groups.

CONCLUSIONS AND IMPLICATIONS

Children were not successful in finding correct answers to most of the questions and used ineffective search strategies. Interventions that teach children effective search strategies for health information are needed.

Understanding online health information consumers' search as a learning process

Purpose

This study considers online searching by health information consumers as a learning process. We focus on search sequences, query reformulation, and conceptual changes.

Design/methodology/approach

A qualitative user study (30 participants; three health information seeking tasks) investigated mobile searching behavior. Recorded screen activity, questionnaires, and in-depth personal interview data were collected and analyzed.

Findings

(1) Search platform sequences of health information consumers in search as a learning process were exacted and their features were highlighted. (2) Query sequence and reformulation pattern of health information consumers were exacted and discussed. (3) The types and degree of conceptual changes of health consumers were reflected by their query reformulation behavior and differ from different health information search tasks. (4) Characteristics of health consumers' search as learning process were revealed.

Research limitations/implications

(1) A novel perspective of consumer health information studies was proposed by exacting search platform sequence, query sequence and linking them with conceptual changes during the search as learning process. (2) Conceptual changes in the searching as a learning process are regarded as a measure of search outcome in this study, in which terms extracted from queries were used to reflect conceptual changes in consumers' mind. (3) Our findings provide evidences that types of health information seeking tasks do have significant influences on the search as a learning process.

Practical Implications

The findings of this study can lead to the fit-to-needs of the search platforms, provide advice for information architecture of search list of search platforms, and guide the design of knowledge graph of health information systems.

Originality/value

Potential relationships between information-seeking behavior and conceptual changes in search as a learning process relative to health information were revealed.

What Young Women with Breast Cancer Get Versus What They Want in Online Information and Social Media Supports

Purpose: Young women are high users of social media (SM), but information is lacking on whether online supports including SM meet the needs of young women (<40 years) with breast cancer (YWBC). YWBC are a vulnerable population who experience many psychosocial challenges alongside cancer diagnosis and treatment. This study aimed to gather data on what YWBC get versus what they want in online support. Methods: Semi-structured interviews explored YWBC's perceptions and use of online information/SM, including visions for ideal support. YWBC between the ages of 18-40 were recruited via two urban oncology clinics. Recruitment continued until redundancy of responses was achieved. Results: Thirteen YWBC participated in the study. Some reported benefits of online supports included connection with similar others, emotional support and ease of use. These benefits were balanced by drawbacks, such as a lack of appropriate/credible information and/or distressing information. Respondents spontaneously mentioned coping strategies such as managing information exposure and regulating SM use to mitigate against harms of online supports. Collectively, participants described nine facets of an ideal online support hub, which could function as a one stop shop for informational, practical and emotional supports for YWBC. Conclusion: Developing a multifunction online support hub may help women to find credible and useful information, rapidly, and address current limitations of online supports.

Exploring Health Information-Seeking Preferences of Older Adults With Hypertension: Quasi-Experimental Design

BACKGROUND

Patients' engagement in health care decision making is constituted by at least two behaviors: health information seeking and active involvement in medical decisions. Previous research reported that older adults desire a lot of information, but want to participate in decision making to a lesser degree. However, there is only limited evidence on the effect of desire for health information on seniors' perceived confidence in making an informed choice (ie, decision self-efficacy).

OBJECTIVE

The goal of this study was to investigate the role desire for health information has for older patients. More specifically, it tested whether decision self-efficacy increases as a function of an assisted computer-based information search. Additionally, the study allowed insights into the sources seniors with hypertension prefer to consult.

METHODS

A sample of 101 senior citizens (aged ≥60 years) with high blood pressure in the Italian-speaking part of Switzerland answered a questionnaire before and after an informational intervention was applied. The intervention consisted of offering additional information on hypertension from five different sources and of providing the information the participant desired. Preference for receiving this information was the major independent variable. The main outcome measure was decision self-efficacy (assessed at baseline and posttest). Analyses of covariance were conducted to detect differences between and within who desired additional hypertension-related content (intervention group) and "information avoiders" (control group).

RESULTS

Health care professionals firmly remain the preferred and most trusted source of health information for senior patients. The second most consulted source was the internet (intervention group only). However, among the total sample, the internet obtained the lowest credibility score. A significant increase in decision self-efficacy occurred in seniors consulting additional information compared to information avoiders (F1,93=28.25, P<.001).

CONCLUSIONS

Consulting health information on a computer screen, and assistance by a computer-savvy person, may be a helpful activity to increase perceived confidence in making treatment decisions in seniors with hypertension.

eHealth Search Patterns: A Comparison of Private and Public Health Care Markets Using Online Panel Data

Background

Patient and consumer access to eHealth information is of crucial importance because of its role in patient-centered medicine and to improve knowledge about general aspects of health and medical topics.

Objectives

The objectives were to analyze and compare eHealth search patterns in a private (United States) and a public (United Kingdom) health care market.

Methods

A new taxonomy of eHealth websites is proposed to organize the largest eHealth websites. An online measurement framework is developed that provides a precise and detailed measurement system. Online panel data are used to accurately track and analyze detailed search behavior across 100 of the largest eHealth websites in the US and UK health care markets.

Results

The health, medical, and lifestyle categories account for approximately 90% of online activity, and e-pharmacies, social media, and professional categories account for the remaining 10% of online activity. Overall search penetration of eHealth websites is significantly higher in the private (United States) than the public market (United Kingdom). Almost twice the number of eHealth users in the private market have adopted online search in the health and lifestyle categories and also spend more time per website than those in the public market. The use of medical websites for specific conditions is almost identical in both markets. The allocation of search effort across categories is similar in both the markets. For all categories, the vast majority of eHealth users only access one website within each category. Those that conduct a search of two or more websites display very narrow search patterns. All users spend relatively little time on eHealth, that is, 3-7 minutes per website.

Conclusions

The proposed online measurement framework exploits online panel data to provide a powerful and objective method of analyzing and exploring eHealth behavior. The private health care system does appear to have an influence on eHealth search behavior in terms of search penetration and time spent per website in the health and lifestyle categories. Two explanations are offered: (1) the personal incentive of medical costs in the private market incentivizes users to conduct online search; and (2) health care information is more easily accessible through health care professionals in the United Kingdom compared with the United States. However, the use of medical websites is almost identical, suggesting that patients interested in a specific condition have a motivation to search and evaluate health information, irrespective of the health care market. The relatively low level of search in terms of the number of websites accessed and the average time per website raise important questions about the actual level of patient informedness in both the markets. Areas for future research are outlined.

Exploring the relationship between patients' information preference style and knowledge acquisition process in a computerized patient decision aid randomized controlled trial

Background

We have shown in a randomized controlled trial that a computerized patient decision aid (P-DA) improves medical knowledge and reduces decisional conflict, in early stage papillary thyroid cancer patients considering adjuvant radioactive iodine treatment. Our objectives were to examine the relationship between participants’ baseline information preference style and the following: 1) quantity of detailed information obtained within the P-DA, and 2) medical knowledge.

Methods

We randomized participants to exposure to a one-time viewing of a computerized P-DA (with usual care) or usual care alone. In pre-planned secondary analyses, we examined the relationship between information preference style (Miller Behavioural Style Scale, including respective monitoring [information seeking preference] and blunting [information avoidance preference] subscale scores) and the following: 1) the quantity of detailed information obtained from the P-DA (number of supplemental information clicks), and 2) medical knowledge. Spearman correlation values were calculated to quantify relationships, in the entire study population and respective study arms.

Results

In the 37 P-DA users, high monitoring information preference was moderately positively correlated with higher frequency of detailed information acquisition in the P-DA (r = 0.414, p = 0.011). The monitoring subscale score weakly correlated with increased medical knowledge in the entire study population (r = 0.268, p = 0.021, N = 74), but not in the respective study arms. There were no significant associations with the blunting subscale score.

Conclusions

Individual variability in information preferences may affect the process of information acquisition from computerized P-DA’s. More research is needed to understand how individual information preferences may impact medical knowledge acquisition and decision-making.

Electronic supplementary material

The online version of this article (doi:10.1186/s12911-015-0168-0) contains supplementary material, which is available to authorized users.

Mapping publication trends and identifying hot spots of research on Internet health information seeking behavior: a quantitative and co-word biclustering analysis

BACKGROUND

The Internet has become an established source of health information for people seeking health information. In recent years, research on the health information seeking behavior of Internet users has become an increasingly important scholarly focus. However, there have been no long-term bibliometric studies to date on Internet health information seeking behavior.

OBJECTIVE

The purpose of this study was to map publication trends and explore research hot spots of Internet health information seeking behavior.

METHODS

A bibliometric analysis based on PubMed was conducted to investigate the publication trends of research on Internet health information seeking behavior. For the included publications, the annual publication number, the distribution of countries, authors, languages, journals, and annual distribution of highly frequent major MeSH (Medical Subject Headings) terms were determined. Furthermore, co-word biclustering analysis of highly frequent major MeSH terms was utilized to detect the hot spots in this field.

RESULTS

A total of 533 publications were included. The research output was gradually increasing. There were five authors who published four or more articles individually. A total of 271 included publications (50.8%) were written by authors from the United States, and 516 of the 533 articles (96.8%) were published in English. The eight most active journals published 34.1% (182/533) of the publications on this topic. Ten research hot spots were found: (1) behavior of Internet health information seeking about HIV infection or sexually transmitted diseases, (2) Internet health information seeking behavior of students, (3) behavior of Internet health information seeking via mobile phone and its apps, (4) physicians' utilization of Internet medical resources, (5) utilization of social media by parents, (6) Internet health information seeking behavior of patients with cancer (mainly breast cancer), (7) trust in or satisfaction with Web-based health information by consumers, (8) interaction between Internet utilization and physician-patient communication or relationship, (9) preference and computer literacy of people using search engines or other Web-based systems, and (10) attitude of people (especially adolescents) when seeking health information via the Internet.

CONCLUSIONS

The 10 major research hot spots could provide some hints for researchers when launching new projects. The output of research on Internet health information seeking behavior is gradually increasing. Compared to the United States, the relatively small number of publications indexed by PubMed from other developed and developing countries indicates to some extent that the field might be still underdeveloped in many countries. More studies on Internet health information seeking behavior could give some references for health information providers.

SimQ: real-time retrieval of similar consumer health questions

Background

There has been a significant increase in the popularity of Web-based question-and-answer (Q&A) services that provide health care information for consumers. Large amounts of Q&As have been archived in these online communities, which form a valuable knowledge base for consumers who seek answers to their health care concerns. However, due to consumers’ possible lack of professional knowledge, it is still very challenging for them to find Q&As that are closely relevant to their own health problems. Consumers often repeatedly ask similar questions that have already been answered previously by other users.

Objective

In this study, we aim to develop efficient informatics methods that can retrieve similar Web-based consumer health questions using syntactic and semantic analysis.

Methods

We propose the “SimQ” to achieve this objective. SimQ is an informatics framework that compares the similarity of archived health questions and retrieves answers to satisfy consumers’ information needs. Statistical syntactic parsing was used to analyze each question’s syntactic structure. Standardized Unified Medical Language System (UMLS) was employed to annotate semantic types and extract medical concepts. Finally, the similarity between sentences was calculated using both semantic and syntactic features.

Results

We used 2000 randomly selected consumer questions to evaluate the system’s performance. The results show that SimQ reached the highest precision of 72.2%, recall of 78.0%, and F-score of 75.0% when using compositional feature representations.

Conclusions

We demonstrated that SimQ complements the existing Q&A services of Netwellness, a not-for-profit community-based consumer health information service that consists of nearly 70,000 Q&As and serves over 3 million users each year. SimQ not only reduces response delay by instantly providing closely related questions and answers, but also helps consumers to improve the understanding of their health concerns.