What predicts patients' interest in the Internet as a health resource in primary care in England?

Abstract

To identify what factors predict patients' interest in using Internet health information in the light of poor uptake of a free, guided Internet service in one inner-city general practice. Questionnaires were administered over a five-day period to consecutive adult patients attending two Manchester general practices: an inner-city practice serving a relatively deprived patient population where the free Internet service had previously been available, and a suburban practice serving a relatively affluent population. Data were analysed using multiple regression to identify predictors of self-reported interest in using the Internet for health information. A total of 753 (74%) patients completed the questionnaire although analyses were restricted to 660 (65%) cases. Independent predictors of patient-reported interest in getting health information from the Internet were (in order of relative 'importance'): positive outcome expectancy (i.e. the patient's strength of belief that it would enable them to deal better with their health); previous use of health websites; positive 'self-efficacy' (i.e. patients' confidence in their ability to use the technology); higher education; a positive attitude to getting health information from alternative sources; social deprivation; and having school-age children living at home. Level of Internet access was an important determinant of self-efficacy, but home access was the key predictor of outcome expectancy and past use of 'e-health'. Access, demographics and, particularly, motivational factors all influence patients' interest in the Internet as a health resource. Proposals to encourage more widespread use of digital health information need to take account of this complexity and not deal with access issues alone.