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The Internet offers great opportunities for consumers to be informed about their health. However, concerns have been raised regarding its impact on the traditional health consumer-health professional relationship. Our recent survey of 400 Australian adults identified that over half of consumers required some form of navigational support in locating appropriate Web-based health information. We propose that support provided by health professionals would be preferred by consumers; this preference is regardless of whether consumers have a need for navigational support. Secondary analysis of the survey dataset is presented here to quantify consumer-reported support preferences and barriers when navigating Web-based health information.
We aimed to quantitatively identify consumers’ support preferences for locating Web-based health information and their barriers when navigating Web-based health information. We also aimed to compare such preferences and barriers between consumers identified as needing and not needing support when locating Web-based health information.
Chi-square (χ2) tests identified whether each listed support preference differed between subgroups of consumers classified as needing (n=205, 51.3%) or not needing (n=195, 48.8%) navigational support; degree of association, via phi coefficient (φ) tests, were also considered to ascertain the likely practical significance of any differences. This was repeated for each listed barrier. Free-text responses regarding additional support preferences were descriptively analyzed and compared with the quantitative findings to provide a richer understanding of desired support for health information searches.
Of the 400 respondents, the most preferred mode of navigational support was involvement of health professionals; this was reported by participants identified as needing and not needing navigational support. While there was a significant difference between groups, the degree of association was small (χ21 [N=400]=13.2;
Despite concerns in the literature that the popularity of the Internet could compromise the health consumer-health professional relationship, our findings suggest the contrary. Our findings showed that health professionals were found to be the most commonly preferred mode of navigational support, even among consumers classified as not needing navigational support. Further research into how health professionals could assist consumers with Web-based health information seeking could strengthen the health consumer-health professional relationship amidst the growing use of “Dr Google.”
The relationships between health care consumers and health care professionals have changed over recent decades [
The Internet provides consumers with an avenue to source, query, and publicly debate health information, as well as to self-diagnose and self-manage medical conditions. Concerns have been raised among health care professionals about the potentially negative impact of Web-based health information on the relationships between health care consumers and health care professionals [
Apart from concerns about the influence of the Internet on health care, the issues of variable quality and comprehensibility of available Web-based health information need to be addressed [
Appropriate searching and utilization of Web-based health information requires adequate health literacy [
In order to inform tailored interventions to assist consumers with acquiring quality and relevant Web-based health information, our earlier research qualitatively explored consumers’ Web-based health information-seeking behaviors and the range of preferences for support with navigating Web-based health information [
This study builds on our qualitative study [
This study also aims to qualitatively explore additional navigational support preferences to provide a richer understanding of desired support for health information searches.
This study is a secondary analysis of the raw dataset from our previous survey [
Ethical approval for the research, including the current analyses, was granted by the Curtin University Human Research Ethics Committee (HR06/2013).
The target population of our previous survey study [
As defined in our previous survey, “navigational needs” refers to “individuals who report having difficulty finding, and would like support in locating, desired Web-based health information” [
Statistical analyses were conducted using IBM SPSS version 23. Descriptive statistics were used to identify preferred navigational modes of support (Objective 1) and the most commonly-reported barriers when navigating desired Web-based health information (Objective 2). Chi-square tests of independence (χ2) were utilized to identify whether each support preference and barrier differed among the groups of consumers identified with and without a need for navigational support, with phi (φ)-coefficient tests of degrees of association to indicate the potential practical significance of these differences (Objective 3) [
As described in our previous paper [
In terms of determining participants’ navigational support preferences, participants were asked, “Which of the following ideas would help you find health-related information that you need?” The most commonly reported mode of support, by both participants with and without navigational needs, was health care professionals (
Support preferences for navigating Web-based health information (N=400).
Modes of support | No navigational needs, |
Navigational needs, |
Total, |
Health care professionals to recommend websites (χ21 [N=400]=13.2; |
112 (57.4) | 153 (74.6) | 265 (66.3) |
An icon on each website to indicate whether it is from a trustworthy source (χ21 [N=400]=8.8;
|
96 (49.2) | 131 (63.9) | 227 (56.8) |
Blocking of unreliable websites (χ21 [N=400]=6.8; |
82 (42.1) | 113 (55.1) | 195 (48.8) |
Improvement in the layout of websites (χ21 [N=400]=12.8; |
35 (17.9) | 69 (33.7) | 104 (26.0) |
Workshops on how to find trustworthy health-related information on the Internet (χ21 [N=400]=3.9;
|
17 (8.7) | 31 (15.1) | 48 (12.0) |
Other | 9 (4.6) | 4 (2.0) | 13 (3.3) |
aRespondents could select multiple options (percentages do not total 100%).
bPercentages are based on the 195 participants with no navigational needs.
cPercentages are based the 205 participants with navigational needs.
Elaborating on the “other” option, the majority of additional modes of support suggested by participants reiterate and elaborate on one or more of the response options listed in
...maybe a handout of trusted web site addresses (specific to the condition discussed) could be given to the patient at the time of the visit to the doctor? This would make it easy for the patient to find out more specific information regarding their condition and know that the information they are reading is trustworthy and relevant.
Participants also suggested that a centralized health portal or database containing relevant and quality health information could be beneficial:
A large, centrally managed, government endorsed database of conditions, treatments, side effects and associated forums, institutes/foundations might be helpful. Unbiased, Australian, featuring advice from eminent specialists, and importantly, featured stories showing perspectives from sufferers on how they manage their conditions. I still find myself having to get my information from American sites quite often.
A few participants expressed a desire for medically-related search engines. One participant (ID197) said, “Google should have a doctor’s section (where you can read everything that is medically related).” Another participant (ID198) posed the question, “Search engine purely for medical research?”
Other participants expressed a desire for greater online communicative features. As one participant (ID171) expressed it, “Online chat services, just like hotline.” Another participant (ID236) felt that a “Website comprised of common information and online chat function” would be helpful.
Although few participants quantitatively indicated that they would welcome workshops to help them find health information on the Internet (
With the ability for anyone to put any information on the internet i [sic] think there is a lot of ill-informed information on the internet. It really depends on what your beliefs are about health as to what information is useful. I think there should be more information on what people should be asking their doctor or other health professionals in order to get the best information for them. Perhaps more sites on checklists on things to consider with your health and sources of information, what to ask, alternative options for health information.
Participant ID296’s response also suggests the need to be educated on how to have more productive interactions with health care professionals.
Of the 400 participants, only 13/400 (3.3%) indicated that they never experienced difficulty finding relevant health information on the Internet.
Perceived barriers to navigating Web-based health information (N=387).
Perceived barriers | No navigational needs, |
Navigational needs, |
Total, |
There is a large number of websites available on the Internet (χ21 [N=387]=4.4; |
80 (44.0) | 112 (54.6) | 192 (49.6) |
Information obtained from different websites sometimes does not match up (χ21[N=387]=16.1; |
65 (35.7) | 115 (56.1) | 180 (46.5) |
The information I come across contains a lot of medical terms or jargon. | 55 (30.2) | 77 (37.6) | 132 (34.1) |
I do not know what I am looking for. | 24 (13.2) | 37 (18.0) | 61 (15.8) |
There appears to be a lack of information specific to my needs. | 18 (9.9) | 25 (12.2) | 43 (11.1) |
Other | 27 (14.8) | 11 (5.4) | 38 (9.8) |
aRespondents could select multiple options (percentages do not total 100%).
bPercentages are based on the 182 participants with no navigational needs.
cPercentages are based on the 205 participants with navigational needs.
Health care professionals were reported to be the most commonly selected option to assist health care consumers in finding credible information on the Internet. Specifically, participants indicated a desire for health care professionals to recommend suitable websites. Amidst some health care professionals’ concerns that consumers’ use of the Internet for health information could negatively impact the relationships between health care consumers and health care professionals [
A desire for health care professionals’ support was significantly more likely to be reported by participants with navigational needs. Given that our previous study [
This study identified a number of perceived barriers when navigating Web-based health information. Specifically, the volume of available information on the Internet and the inconsistency of information obtained from different sources were identified as the two most commonly reported barriers across consumers with and without navigational needs. However, these two barriers were significantly more likely to be reported by participants with navigational needs, suggesting the need for greater efforts to be focused on addressing these barriers among consumers with navigational needs. In particular, a moderate association was found between the lack of consistency in information obtained from different sources among participants with navigational needs; this finding appears logical given the plethora of Web-based health information that can result in confusion and may not be directly comparable or may contain conflicting information or advice [
When compared with previous studies, the overabundance of Web-based health information has indeed been reported as a potential issue with using the Internet as a channel for obtaining health information, as indicated in a review by Cline and Haynes [
The need to filter information was also recognized by participants who suggested a centralized portal for health information, provision of handouts with a list of trusted websites, and a “Google-esque” search engine that only displays medically-related health information from reputable sources. When compared with the responses listed in
A key strength of this study is the “within-method” triangulation [
Our structured, third party–administered questionnaire limited clarification and confirmation of free-text responses with participants. However, the use of a number of free-text responses and within-method data triangulation enabled a richer understanding of the phenomena beyond the understanding that would have been obtained if only quantifiable response options had been used [
As this study is a secondary analysis of a raw dataset, the methodological limitations recognized in our earlier paper [
The findings of this study suggest that future studies exploring consumers’ health information-seeking behaviors should explore the concept of information overload and its effects on individuals having different levels of eHealth literacy. The concept of information overload, while investigated at length in other disciplines such as management [
The likely acceptability of assistance from health care professionals is also worthy of further investigation. It is unclear whether health care professionals feel sufficiently skilled and confident to inform consumers about suitable information sources on the Internet for specific health conditions. Further research could explore health care professionals’ ability to assess consumers’ levels of eHealth literacy and subsequently direct them to suitable, reliable Internet sources. Given the increasing popularity of mobile-based health care and the advent of mobile apps [
Regardless of how health care professionals might assist consumers in navigating Web-based health information, it is important to recognize that consumers’ preferences for seeking or obtaining health information vary, and this difference can influence health behaviors. For example, a study by Williams-Piehota et al found that female participants with a lower desire for seeking health information were less likely to participate in a mammography after being given detailed information about mammograms as compared with when they were given concise information [
This study explored consumer-perceived barriers to navigating desired Web-based health information and consumers’ navigational support preferences. Our findings identified that the volume of available information and the inconsistency of information obtained from different information sources were the most commonly identified barriers. Despite concerns that the Internet and consumer sovereignty could negatively impact the relationships between health care consumers and health care professionals, our findings suggest the contrary, as health care professionals were reported as the most commonly selected option for providing navigational support. Further exploration of how health care professionals could assist consumers with their Web-based health information-seeking could see the strengthening of this relationship amidst the growing use of the Internet for obtaining health information.
The authors acknowledge the staff members of Qualtrics for coordinating the recruitment for the survey. KL was supported by an Australian Postgraduate Award during the design and data collection phases of the study.
KL conceived and designed the study with assistance from LE, KH, and JH. KL performed the statistical analyses, interpreted the findings, and drafted the manuscript. All the authors were involved in reviewing and revising the manuscript.
None declared.