The main sociodemographic characteristics of study participants are summarized in Table 1. The mean age of the participants was 36.8 years. The number of female participants (57.1%, 280/490) was marginally higher than the male participants (42.9%, 210/490); 63.4% (311/490) were university graduates, and 61.6% (302/490) were employed.

About 76.9% (377/490) participants rated their general health as good or excellent; meanwhile, only 23.1% (113/490) rated it as poor. Of all the participants, 67.3% (330/490) reported that they had health insurance coverage (either private or government-based coverage). Additionally, 37.1% (182/490) of the participants reported one or more chronic health problems.

The mean time spent searching for OHI was 1.58 (SD 2.13) hours/ week (Table 2). Of all the respondents, more than half (55.4%, 271/490) considered the Internet as a main source for health information, followed by consulting physicians (30.7%, 151/490), whereas TV and radio were the least commonly used sources for health information (3.9%, 19/490). The main reasons for preferring OHI were easy access (47.2%, 231/490) and getting more information about specific health problems (30.8%, 151/490),whereas only 11.6% (57/490) participants preferred OHI because of its ability to preserve the user’s anonymity.

The majority of participants (83.1%, 407/490) rated the quality of OHI as good or excellent, and 16.9% (83/490) rated it as fair, whereas none rated it as poor. About 53.5% (262/490) of participants reported looking for health information for their own health issues, whereas 30.6% (150/490) were looking for health information for someone else, for example, family member or a friend (Table 2).

Table 3 compares personal characteristics of the participants and their use of the Internet as the main source of information, which was significantly higher among female participants (χ²₁=5.8, P=.01), younger age group participants (χ²₁=10.4, P=.001), and participants who reported having chronic health conditions (χ²₁=14.6, P=.001; Table 3). Using the Internet as the main source of health information was significantly higher among participants who reported behavioral changes from the obtained (χ²₁=9.1, P=.002, Table 3).

Participants reported seeking OHI for one or more of a broad range of health topics. About 63.8% (312/490) of the participants indicated that they sought information about nutrition and 41.9% (205/490) of the participants reported using the Internet to find information about chronic health conditions, whereas 23.7% (116/490) searched for sexual health information and 22.6% (110/490) participants searched for mental health issues (Figure 1).

Table 4 shows the results of the multiple regression analysis with personal characteristics as independent variables and the frequency of using OHI as a dependent variable. In model 1, the regression coefficient of the independent variables age (beta=−0.16), gender (beta=.02), and level of education (beta=.13) were statistically significant. The model showed that younger participants spent more time on searching OHI than older participants. Model 1 can predict 23.2% of the variance in using OHI among the participants .

Adding the self-reported general health status in regression model 2, a statistically significant increase in R²(from 0.23 to 0.28, P<.05) occurred. The direction and the significance effect of age, gender, and education remain the same as in model 1. Adding the use of the Internet as a main source of health information in regression model 3, a further statistically significant increase occurred in the variance in frequency of using OHI (R²=.29, P<.05). The regression coefficients were statistically significant for the following independent variables (P<.05): age, gender, levels of education, and having a chronic health problem.

Overall, 31.0% of the variance in frequency of using OHI can be predicted by the personal characteristics of Internet users (F=9.94, P<.05, Model 4). The multiple regression analysis showed that the main predictors are being female, of younger age, having a higher level of education, reporting good general health, having a chronic health problem, and using the Internet as a main source of health information.

In our study, we explored characteristics and behaviors of Egyptian OHI seekers. Our findings showed that the main personal characteristics associated with more frequent OHI searching were younger age, female gender, higher education, and reporting good general health.

The study participants represent a small sample of Egyptian Internet users who seek OHI. We have no data of those who declined to take part in the study or those who had not searched OHI at any given time. Accordingly, the results of the study can be generalized only to Egyptian OHI seekers. Participants’ answers to the questionnaire were self-reported and could not be independently verified. None of the participants rated the quality of OHI as poor, which may be because participants who took part in the study were active users of a health website.

In relation to the association between gender and OHI-seeking behavior, our findings show that female participants (57.1%) have looked for OHI more frequently than male participants (42.9%). This may arise from curiosity about their own health, as women seem to be more involved in decisions about their health [26]. Similar results were reported by Rice et al, which shows that the female gender is an important predictor for OHI-seeking behavior [12]. However, this should be seen in the context that according to a 2013 report from the Egyptian MCIT, a minority (44.4%) of Egyptian Internet users were females, whereas 56.6% were males [5].

The report also stated that 72% of Egyptian Internet users ranged between 15-44 years old, whereas only 19% were aged 45 years or older [5]. In this study, we found that younger participants sought OHI more frequently than older participants. The reason for that may be that younger OHI seekers are more familiar with Internet use [25]. Similarly, Nolke et al reported that the probability of seeking OHI in German participants decreased with increasing age [27].

Participants’ level of education also had a considerable impact on OHI seeking behavior. In our study, participants with higher educational level spent more time seeking for OHI. This is to be expected given that 73% of Egyptian Internet users were university graduates [5]. Cotten et al found that OHI seekers tended to have higher levels of education than those who did not seek OHI, which confirms a link between educational level and OHI seeking [28].

Our findings also show that OHI seekers with good self-reported general health were likely to search for OHI more frequently than those with poor general health. Maybe because more than 50% of the participants were less than 35 years old, this meant that they were more likely to be in good general health. Similarly, Weaver et al found that healthier people use OHI more frequently in a proactive manner for health promotion or to maintain a healthy lifestyle [8]. However, Cotten et al found that healthier persons seek OHI less frequently than those with poor general health [28].

We found that people who reported one or more chronic health problems were more likely to search for OHI more frequently than people without any chronic health conditions. This link between having a chronic health problem and the frequency of OHI seeking is supported by some researchers, whereas others did not find a significant association [10,29-32]. The reason for this discrepancy is not clear but it might be argued that the two groups used OHI differently: healthy participants focused on improving their lifestyles, whereas people with chronic illness sought to improve their current health condition.

In this study, participants reported seeking OHI for a broad range of health topics including nutrition, sexual health, chronic health problems, and mental health. We found that nutrition-related health information is the most common topic sought on the Internet especially by female participants. This finding can be seen in the context of increased prevalence of nutrition-related health problems among Egyptian adults [33]. As reported in the DHS report in 2015, 30% of Egyptian adults are overweight or obese, and 6.8% of Egyptian children under the age of 5 years were malnourished (eg, micronutrients deficiency or anemic) [34,35].

Despite the ease of finding health information on the Internet, it may be difficult to judge the reliability of this health information. This may explain the variability in the level of trust in OHI [17]. Most OHI seekers in Arabic countries rely on health sites maintained mainly by the private sector rather than by ministries of health or other public services. Arabic language health information websites need a substantial improvement of their quality in order to improve their trustworthiness [6]. However, most of our participants rated the quality of the OHI accessed as “good” or “excellent.” For some, this may be linked to lack of trust in health professionals as much as increased trust in OHI sites.

The Internet has become an important tool with the potential to improve information dissemination and health care delivery to consumers. Continuing efforts to maximize the potential of this tool could have great value for users. The great range of health topics as well as the easy access to OHI has made the Internet a major and growing source of health information for Egyptian Internet users. We found that personal characteristics of OHI seekers such as younger age, females, higher levels of education, and having generally good health make a difference in how frequently they access the Internet for health information. An understanding of personal characteristics may inform education of OHI seekers to help them to take an active role in improving their health and engaging with treatment plans; however, more research is needed to identify whether these characteristics can be confirmed in a representative sample of Egyptian Internet users.

It is also concerning that most providers of Arabic language OHI are privately owned and therefore, their priority may be increasing advertising revenue rather than providing reliable information. There is a need for public funding for quality controlled websites, for example, equivalent to the United Kingdom’s National Health Service (NHS) Choices. Cooperation from health care providers is also needed in supporting their patients with reliable resources and assisting them to properly evaluate the quality of information available on the Internet in order to promote efficient, reliable, and appropriate OHI use for Internet users.