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Relatively little is known about the extent to which young adults use the Internet as a health information resource and whether there are factors that distinguish between those who do and do not go online for health information.
The aim was to identify the sociodemographic, physical, mental, and reproductive health factors associated with young women’s use of the Internet for health information.
We used data from 17,069 young women aged 18-23 years who participated in the Australian Longitudinal Study on Women’s Health. Multivariable logistic regression was used to estimate the association between sociodemographic, physical, mental, and reproductive health factors associated with searching the Internet for health information.
Overall, 43.54% (7433/17,069) of women used the Internet for health information. Women who used the Internet had higher odds of regular urinary or bowel symptoms (OR 1.44, 95% CI 1.36-1.54), psychological distress (very high distress: OR 1.24, 95% CI 1.13-1.37), self-reported mental health diagnoses (OR 1.16, 95% CI 1.09-1.23), and menstrual symptoms (OR 1.25, 95% CI 1.15-1.36) than women who did not use the Internet for health information. Internet users were less likely to have had blood pressure checks (OR 0.85, 95% CI 0.78-0.93) and skin cancer checks (OR 0.90, 95% CI 0.84-0.97) and to have had a live birth (OR 0.74, 95% CI 0.64-0.86) or pregnancy loss (OR 0.88, 95% CI 0.79-0.98) than non-Internet users.
Women experiencing “stigmatized” conditions or symptoms were more likely to search the Internet for health information. The Internet may be an acceptable resource that offers “anonymized” information or support to young women and this has important implications for health service providers and public health policy.
The affordability and availability of the Internet make it a convenient resource that is increasingly used to offer information, support, and services to the population regarding their health. Recent estimates from the United States and Europe suggest that almost half of adults seek health information online [
Going online for health information may be useful for a broad range of health issues. The Internet offers diversity in health information and support with numerous websites, blogs, and online support groups all dedicated to various aspects of health. Of the few studies examining the health status of those who search the Internet for health information, those experiencing socially embarrassing or “stigmatizing” symptoms or conditions (eg, urinary incontinence and mental health conditions) [
In this paper, we describe the health information sources used by a national sample of young Australian women aged 18-23 years. We aim to identify the sociodemographic, physical, mental, and reproductive health factors associated with searching the Internet for health information to inform health care services and support for young women.
The Australian Longitudinal Study on Women’s Health (ALSWH) is a national study focusing on the biological, psychological, social, and economic factors relevant to women’s health [
In 2012-2013, ALSWH recruited a new cohort of young women born 1989-1995 and aged 18-23 years when they were first surveyed. Women were eligible if they lived in Australia, had a valid Medicare number, and if they consented to data linkage (linking survey data with administrative health data). Approval for the study was obtained from the Human Research Ethics Committee of the University of Newcastle and the University of Queensland, as well as the Department of Human Services and the Department of Health. Further details of the survey methodology are available from the study website [
Participants were recruited from October 2012 to December 2013 through conventional (ie, radio interviews and magazine advertising) and online social media (including YouTube videos), with full details reported elsewhere [
A question asking women, “Where do you get information about your health? (mark all that apply),” was used to categorize women into those who did and did not use the Internet as a source of health information. Women chose from 10 information sources (eg, Internet, family, doctor, television/radio/ magazines/posters/leaflet, other) and those who reported using the Internet (solely or in conjunction with other sources) were classified as “Internet users” and the remaining women were classified as “non-Internet users.” We also calculated the number of health information sources used by summing together women’s responses to the list of 10 sources (yes=1; no=0), creating an ordinal variable ranging from 0-10.
We collected information on age (in years), area of residence based on an index of distance to the nearest urban center (major cities, inner regional, outer regional, remote/very remote) [
Women were asked to rate their general health (excellent, very good, good, fair or poor) and to report chronic health conditions (eg, diabetes, heart disease, cancer). Women reporting urinary/bowel symptoms (eg, urine that burns or stings, leaking urine, hemorrhoids, constipation), mental health conditions (eg, depression, anxiety, other), and who used preventative health services (eg, blood pressure or skin cancer checks in the last two years) were classified as “yes” or “no.”.
Women reported if they ever had a live birth, pregnancy loss (ectopic pregnancy, miscarriage, termination for medical or personal reasons, stillbirth), sexually transmitted infection (chlamydia, genital herpes, genital warts, human immunodeficiency virus [HIV] / acquired immune deficiency syndrome [AIDS], hepatitis B/C), or received a diagnosis of endometriosis or polycystic ovary syndrome, or had a Papanicolaou test in the last 2 years (yes/no). Women reporting menstrual symptoms “sometimes” or “often” in the last 12 months (eg, vaginal discharge, heavy periods, severe period pain) were categorized as suffering these symptoms regularly and classified as “yes” vs “no.”
Bivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between sociodemographic, physical, mental, and reproductive health factors and searching the Internet for health information. Sociodemographic variables were entered into a multivariable logistic regression model to examine their association with Internet use for health information. The ORs for the association between physical, mental, and reproductive health factors and Internet use, adjusted for key sociodemographic characteristics, were estimated by multivariable logistic regression models. Data analysis was conducted using SAS version 9.4 (TS1M0) for Windows (SAS Institute Inc, Cary, NC, USA).
On average, women aged 18-23 accessed 3 sources of information for their health. Doctors (77.01%, 13,145/17,069) followed by family members (61.87%, 10,561/17,069) were the major sources of health information. The Internet and friends were identified by 43.55% (7433/17,069) and 43.25% (7383/17,069) of women, respectively, followed by school, university, and Technical and Further Education (TAFE; 39.55%, 6750/17,069), conventional media (32.18%, 5495/17,069; includes television, radio, magazines, posters, leaflets), and to a lesser extent, nurses (14.49%, 2474/17,069). A minority of women (5.90%, 1007/17,069) reported other sources of health information (results not shown).
Overall 43.55% (7433/17,069) of women identified the Internet as a source of health information (either alone or in conjunction with other sources) with the remaining 56.45% (9636/17,069) of women using non-Internet sources only. Stratifying by Internet use made little difference to the overall pattern of health sources accessed (
Being older, having a university education, living in a major city, being in a relationship (never married), and not living with parents were significantly associated with using the Internet for health information (
Sources of health information accessed by young women who do and do not use the Internet as a health information resource.
Sociodemographic characteristics of women who do and do not use the Internet as a health information resource (N=17,069).
Sociodemographics | Internet | Non-Internet | Internet use | ||
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n=7433 | n=9636 | OR (95% CI) | AORa (95% CI) | |
Age (years), mean (SD) | 20.7 (1.67) | 20.4 (1.69) | 1.10 (1.08-1.12) | 1.08 (1.06-1.11) | |
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<Year 12 | 477 (6.43) | 794 (8.39) | 0.79 (0.70-0.89) | 0.79 (0.69-0.89) |
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Year 12 | 3170 (42.70) | 4171 (44.09) | 1 | 1 |
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Certificate/diploma | 1808 (24.35) | 2620 (27.70) | 0.91 (0.84-0.98) | 0.83 (0.77-0.90) |
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University | 1969 (26.52) | 1875 (19.82) | 1.38 (1.28-1.49) | 1.17 (1.07-1.27) |
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Major city | 5773 (77.91) | 7076 (73.68) | 1 | 1 |
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Inner regional | 1114 (15.03) | 1717 (17.88) | 0.80 (0.73-0.86) | 0.82 (0.76-0.90) |
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Outer regional | 444 (5.99) | 707 (7.36) | 0.77 (0.68-0.87) | 0.79 (0.70-0.90) |
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Remote/very remote | 79 (1.07) | 104 (1.08) | 0.93 (0.69-1.25) | 0.96 (0.71-1.29) |
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Never married-single | 2771 (37.32) | 3733 (39.46) | 1 | 1 |
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Never married-in a relationship | 4031 (54.30) | 4913 (51.93) | 1.11 (1.04-1.18) | 1.09 (1.02-1.16) |
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Engaged/married | 558 (7.52) | 744 (7.86) | 1.01 (0.90-1.14) | 0.96 (0.85-1.09) |
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Separated/divorced/other | 64 (0.86) | 70 (0.74) | 1.23 (0.87-1.73) | 1.31 (0.92-1.85) |
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Easy/not bad | 2955 (39.82 | 3623 (38.31) | 1 | 1 |
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Difficult some of the time | 2619 (35.29) | 3403 (35.98) | 0.94 (0.88-1.01) | 0.95 (0.87-1.02) |
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Difficult all of the time/impossible | 1847 (24.89) | 2432 (25.71) | 0.93 (0.86-1.01) | 0.98 (0.91-1.07) |
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Living with parents | 3639 (49.04) | 4843 (51.21) | 1 | 1 |
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Not living with parents | 3782 (50.96) | 4615 (48.79) | 1.09 (1.03-1.16) | 1.05 (0.98-1.12) |
a Mutually adjusted for other variables in the model.
The association between physical, mental, and reproductive health and using the Internet as a health information resource (N=17,069).
Health-related variables | Internet, n (%) | Non-Internet, n (%) | Internet use | ||
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n=7433 | n=9636 | OR (95% CI) | AORa (95% CI) | |
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Self-rated general health |
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Excellent/very good | 3191 (42.93) | 3987 (42.10) | 1 | 1 |
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Good | 2982 (40.12) | 3884 (41.01) | 0.96 (0.90-1.03) | 1.02 (0.95-1.09) |
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Fair/poor | 1260 (16.95) | 1599 (16.88) | 0.98 (0.90-1.07) | 1.08 (0.99-1.18) |
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None | 3496 (47.04) | 4425 (46.73) | 1 | 1 |
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1 | 2673 (35.97) | 3407 (35.981) | 0.99 (0.93-1.06) | 0.99 (0.93-1.06) |
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≥2 | 1263 (16.99) | 1638 (17.30) | 0.97 (0.90-1.06) | 0.97 (0.89-1.06) |
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Never/rarely | 3782 (50.89) | 5656 (59.73) | 1 | 1 |
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Sometimes/often | 3650 (49.11) | 3814 (40.27) | 1.43 (1.35-1.52) | 1.44 (1.36-1.54) |
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No | 1096 (14.75) | 1288 (13.61) | 1 | 1 |
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Yes | 6332 (85.25) | 8177 (86.39) | 0.91 (0.83-0.99) | 0.85 (0.78-0.93) |
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No | 5297 (71.32) | 6608 (69.87) | 1 | 1 |
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Yes | 2130 (28.68) | 2850 (30.13) | 0.93 (0.87-1.00) | 0.90 (0.84-0.97) |
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Psychological distress |
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Low | 1451 (19.54) | 2078 (21.95) | 1 | 1 |
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Moderate | 2178 (29.33) | 2814 (29.72) | 1.11 (1.02-1.21) | 1.13 (1.04-1.24) |
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High | 2173 (29.26) | 2458 (25.96) | 1.27 (1.16-1.38) | 1.34 (1.23-1.47) |
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Very high | 1625 (21.88) | 2118 (22.37) | 1.10 (1.00-1.21) | 1.24 (1.13-1.37) |
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No | 4188 (56.36) | 5559 (58.70) | 1 | 1 |
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Yes | 3243 (43.64) | 3911 (41.30) | 1.10 (1.04-1.17) | 1.16 (1.09-1.23) |
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Live birth |
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No | 7063 (95.20) | 8835 (93.45) | 1 | 1 |
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Yes | 356 (4.80) | 619 (6.55) | 0.72 (0.63-0.82) | 0.74 (0.64-0.86) |
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No | 6777 (91.30) | 8516 (90.01) | 1 | 1 |
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Yes | 646 (8.70) | 945 (9.99) | 0.86 (0.77-0.95) | 0.88 (0.79-0.98) |
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No | 7196 (96.81) | 9295 (96.46) | 1 | 1 |
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Yes | 237 (3.19) | 341 (3.54) | 0.90 (0.76-1.06) | 0.89 (0.75-1.05) |
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No | 7023 (94.48) | 9082 (94.25) | 1 | 1 |
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Yes | 410 (5.52) | 554 (5.75) | 0.96 (0.84-1.09) | 0.93 (0.82-1.07) |
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No | 6549 (88.13) | 8420 (88.91) | 1 | 1 |
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Yes | 882 (11.87) | 1050 (11.09) | 1.08 (0.98-1.19) | 1.06 (0.96-1.16) |
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Never/rarely | 1165 (15.67) | 1729 (18.26) | 1 | 1 |
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Sometimes/often | 6268 (84.33) | 7742 (81.74) | 1.20 (1.11-1.30) | 1.25 (1.15-1.36) |
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No | 3796 (51.11) | 4990 (52.72) | 1 | 1 |
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Yes | 3631 (48.89) | 4475 (47.28) | 1.07 (1.00-1.13) | 0.94 (0.88-1.01) |
a Adjusted for age, education, area of residence, and marital status.
This study describes the sources of health information accessed by young Australian women and identifies the sociodemographic, physical, mental, and reproductive health factors associated with searching the Internet for health information. Our findings suggest that although the majority of young Australian women rely on their doctor for health information, a large proportion (43.55%, 7433/17,069) also access health information online. Several other studies, including a previous survey of Australian women across a wide age range [
Consistent with several other studies [
Women reporting “stigmatized” conditions or symptoms were more likely to search the Internet for health information. Consistent with other studies [
Few studies have examined the relationship between health status and searching the Internet for health information and the evidence is somewhat inconsistent. In our study, we found that women with children, those who had experienced pregnancy losses, and those accessing preventive health services were least likely to use the Internet. These are all women who are likely to be in contact with health care professionals, so their need for health information may already be met. In contrast, we found no association between self-rated general health or chronic conditions and Internet use for health information. Although other studies have reported that use of computer-based resources or online support groups are associated with more visits to a health care professional [
Although we assessed women’s health status, we did not ask women about recent visits to a health care professional. Therefore, we cannot determine the impact of the Internet on health care use. Further, although we focused on women’s use of information for their own health, other studies suggest that some people will use the Internet to seek information for another’s health. This may be an important avenue for future research with young women as they transition through adulthood, particularly motherhood.
Internet availability and use has increased dramatically in Western countries in the last decade. Our findings suggest that the Internet may be an acceptable resource for young women experiencing stigmatized or sensitive health issues, which has important implications for the effectiveness of professionally supported self-care programs [
Australian Longitudinal Study on Women’s Health
acquired immune deficiency syndrome
human immunodeficiency virus
sexually transmitted infection
Technical and Further Education
The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women’s Health, the University of Newcastle and the University of Queensland. We are grateful to the Australian Government Department of Health for funding and to the women who provided the survey data. IJR was supported by the Australian National Health and Medical Research Council (grant number: APP1000986). GDM is funded by the Australian Research Council Future Fellowship (FT120100812).
IJR conducted the statistical analyses and drafted the manuscript. GDM, DL, and AJD contributed to all stages of the study, interpretation of the results, and critical revision of the manuscript for intellectual content. All authors read and approved the final manuscript.
None declared.