Internet and Health

Project summary

1. Background

The recent years have witnessed a dramatic increase in consumer online health information seeking (Fox & Duggan, 2013). Online health information deserves particular attention because studies on the contents of health-related websites have found high variance in the quality of information available to the public, raising worries about the quality of online information that consumers might come across during their searches (Berland et al., 2001; Bernstam et al., 2008; Eysenbach, Powell, Kuss, & Sa, 2002; Hardey, 2001; Stvilia, Mon, & Yi, 2009). The variability in the accuracy of the information is at least in part the result of one of the distinctive features of the internet, that is that everybody with a connection is potentially able to publish health-related information. Online health information seeking poses thus several major challenges to the users of health information, inasmuch as it requires them to take on an active role in the evaluation of the credibility of the vast amount of often unverified health information that can be found on the internet (Flanagin & Metzger, 2008). Wrong or incomplete information has been shown to be related to adverse health outcomes, such as low participation to screening programs or low adherence to treatments (Cline & Haynes, 2001; van Weert et al., 2011). It becomes evident that more attention needs to be devoted to the issue of the quality of online health information and in particular to people’s ability to evaluate it (Berland et al., 2001; Bernstam et al., 2008; Eysenbach et al., 2002; Hardey, 2001; Stvilia et al., 2009). So far researchers have studied the issue of quality of online health information from two distinct perspectives. A first approach aims at understanding which criteria could be used to assess the quality of online health information and at developing evaluation criteria and guidelines. These could be used by information providers to design quality health-related websites and by users/patients to assess the information they find online. The main goal of this approach is to provide people with high-quality online health information. A second approach is more interested in the user/patient perspective. Such an approach investigates people’s ability to assess online health information, with the goal of understanding whether people have the necessary skills to judge its quality.

2. Study aims

Building on the limitations of current research in the field, the aim of the present study is to get insights into people’s evaluation of the quality of online health information by investigating people’s online health information search process. Particular attention will be devoted to the investigation of differences among people with different health literacy levels as regards awareness of the issue of online health information quality and knowledge and use of both established and other evaluation criteria. Moreover, cross-cultural differences in the perception and evaluation of the quality of online health information will be explored.

 

Method

The study is a replication in different countries of a qualitative study conducted by Nicola Diviani in Switzerland.(Collaborating partners:Nicola Diviani, PhD (n.diviani@uva.nl), Corine Meppelink, MSc (c.s.meppelink@uva.nl), and Julia van Weert, PhD (j.c.m.vanweert@uva.nl). University of Amsterdam, The Netherlands.Judy Mullan, PhD (jmullan@uow.edu.au). University of Wollongong. Australia.Eva Haukeland Fredriksen, PhD (ehf@hib.no). Høgskolen i Bergen, Norway. ( leader of the Norwegian part of the study).Tobba Sudmann, PhD ( tsu@hib.no). Høgskolen i Bergen, Norway

Methods

A series of in-depth interviews will be conducted among people with previous experience in online health information seeking in each of the participating countries. In order to be eligible for inclusion in the study, respondents have to be aged between 18 and 75 and have previous experience with online health information seeking. Recruitment will take place through ads describing the study posted via social network sites and flyers strategically distributed in local supermarkets, adult literacy centers, and job centers to maximize diversity in terms of socio-economical background.

Half of the sample will be composed by people with high health literacy and the other half by people with low health literacy (as defined by their Newest Vital Sign scores). Around 40 interviews per country have been foreseen in order to account for differences regarding age and Internet experience within the groups. The exact number of interviews will be determined by the researchers in each country depending on when data saturation will be reached.

As regards the procedure, participants will in a first phase asked several open-ended questions regarding their past experiences with online health information seeking. Questions will focus on reasons, expected outcomes, barriers, facilitators and actual outcomes of their search for information. In order to assess to which extent the quality of online health information is an issue for the participants, specific questions about credibility and about cues or evaluation strategies will be asked only in the second part of the interview.