Online Health Information Research Articles

VALIDAÇÃO DE WEBSITE PARA IMPLANTAÇÃO DO PROTOCOLO PERIOPERATÓRIO NA PROFILAXIA DE TROMBOEMBOLISMO VENOSO

Introduction: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the leading cause of preventable postoperative deaths. Identifying risk factors based on Virchow’s Triad (blood stasis, hypercoagulability, and endothelial injury) is crucial. Approximately 20% of surgical patients develop VTE, with 7% resulting in fatal PE. The Caprini risk score, used to assess VTE risk, is complex and has limited adherence despite its validation across various specialties. Methodology: The applied research developed the application of a perioperative protocol for VTE prophylaxis in the Vascular Surgery ward of the Hospital Municipal de Marabá. The descriptive and quantitative study was structured via website. The 2013 version of the Caprini score was adopted for risk stratification. Validation of the tool involved 16 experts with inclusion criteria focused on doctors and nurses with experience in the area, where everyone responded to the Likert scale that evaluated 2 major domains of the tool: usability and functionality. Results: Among the 16 evaluators, 56,3% were male and 43,8% female, with an average age of 32,4 years and 7,6 years of experience. The system’s functionality received 97,5% approval, 96,3% of reliability, and 91,3% regarding interface and usability. The utility was well-rated, with 98,8% approving the professional facilitation. Chi-square tests indicated that functionality perception did not vary between physicians and nurses, but utility was significantly influenced by profession. Cronbach’s alpha coefficients indicated high internal consistency: 0,85 for functionality and 0,77 for utility. Discussion: The diverse profiles of the evaluators enriched the website’s validation. Functionality was consistently positively rated, while utility varied by professional role. High internal consistency suggests that the questionnaire is reliable for measuring website performance perceptions. Conclusion: The inclusion of the Caprini protocol in the Tupan Health website demonstrated good performance and high reliability among professionals, facilitating protocol adherence and the prevention of perioperative complications.

A Comparative Study of Access Analysis Service Utilization on Japanese Medical Institutions' Websites with GDPR-Compliant Cases.

The browsing history of a medical institution's website can potentially reveal or identify information about the health condition of the website visitor through browser cookies and fingerprints. In Japan, although the Personal Information Protection Law was revised in April 2022, the use of access analysis services to collect browsing history on medical institution websites has not been investigated. Therefore, this study investigates the actual usage of access analysis services on Japanese medical institution websites and compares it with the current situation in France, which follows the General Data Protection Regulation. The results revealed that the larger the size of the hospital, the higher the percentage of adoption of access analytics services in Japan. However, the implementation of a system for obtaining consent for the use of access analysis in Japan was found to be poor compared to that of French medical institutions. While access analysis tools are used in the websites of several medical institutions in Japan, the implementation of the process of obtaining consent to acquire browsing history is poor.

Why fall for misinformation? Role of information processing strategies, health consciousness, and overconfidence in health literacy.

Health misinformation, defined as false or misleading claims lacking scientific evidence, poses a significant threat to public health. This paper investigates factors associated with the failure to discern misinformation, including health consciousness, information processing strategies, and inaccurate self-assessments of health literacy. Through an online experiment involving 707 English-speaking U.S. participants (mean age = 43 years, 56.2% female), we found that misinformation beliefs about nutrition, vaccination, vaping, and cancer were significantly correlated, implying susceptibility across health topics. Greater susceptibility was associated with higher health consciousness, lower objective health literacy, more elaboration, and more selective scanning. Results provided evidence for the Dunning-Kruger effect and metacognitive monitoring errors, whereby confident individuals were unaware of inadequate health literacy and showed poor misinformation identification. Findings suggest that promoting both health literacy education and cognitive reflection skills among the general adult population could empower them to more critically evaluate online health information.

Exploring Greek Population Attitudes Towards Using Health-Related Websites for Managing Their Health.

The last few years the Internet has evolved into a prominent information source for many people worldwide. Latest research has shown that an ever increasing number of citizens and patients go online in order to access health information and seek support in managing their health, including understanding their condition, adopting life-saving lifestyle adjustments and keeping up with treatment or aftercare guidelines. Due to this rise on the demand of online health information, health-related sites have increased substantially, with each one of them striving to maintain the most comprehensive and reliable source of health and medical information on the Internet. This paper presents a survey conducted among Greek population aiming at exploring participants general attitudes towards using the Internet to access health information as well as their views regarding a specific Greek health-related website, namely Iatronet. To this end, an online Greek version of eHealth Impact Questionnaire has been used which was developed using RedCAP platform.

Comparative analysis of school food policies in Australian jurisdictions: Insights for more effective policy action.

School food policies in Australia have the potential to positively impact healthy eating in schools. While the policies are reviewed regularly, it is unknown if revised school food policies have incorporated the recommendations from a 2020 review of nutrition policies in publicly funded institutions. This review aims to examine the current state of Australian school food policy environment, including national-level guidelines, food safety, allergy, and anaphylaxis management policies. School food policy documents were identified by searching the federal government, and Departments of Health and Education websites of Australian jurisdictions. The L'Abbé framework for monitoring and evaluation of nutrition policies guided the data analysis. Eleven policies/guidelines from Australian national and state/territory governments were reviewed in 2023. Four state/territory policies had major updates since 2020. The consistency of nutrition standards improved across five jurisdictions, although a common nutrient classification system would have allowed better comparison. Implementation guides/tools and supporting resources were provided in all policies although their comprehensiveness varied. Policy monitoring and evaluation guide/tools, and local food procurement were incorporated in two additional policies. School principals were responsible for policy implementation and schools for independent compliance monitoring. Continued improvement in monitoring and evaluation plans, policy review timelines, and support systems for schools is needed to enhance implementation and impact of school food policies. External stakeholder support may help school leadership in more effective policy implementation. SO WHAT?: Limited progress in incorporating recommendations into current school food policies calls for additional support and strategies to enhance policy implementation and monitoring.

Evaluation of the Quality and Readability of Web-Based Information Regarding Foreign Bodies of the Ear, Nose, and Throat: Qualitative Content Analysis.

Foreign body (FB) inhalation, ingestion, and insertion account for 11% of emergency admissions for ear, nose, and throat conditions. Children are disproportionately affected, and urgent intervention may be needed to maintain airway patency and prevent blood vessel occlusion. High-quality, readable online information could help reduce poor outcomes from FBs. We aim to evaluate the quality and readability of available online health information relating to FBs. In total, 6 search phrases were queried using the Google search engine. For each search term, the first 30 results were captured. Websites in the English language and displaying health information were included. The provider and country of origin were recorded. The modified 36-item Ensuring Quality Information for Patients tool was used to assess information quality. Readability was assessed using a combination of tools: Flesch Reading Ease score, Flesch-Kincaid Grade Level, Gunning-Fog Index, and Simple Measure of Gobbledygook. After the removal of duplicates, 73 websites were assessed, with the majority originating from the United States (n=46, 63%). Overall, the quality of the content was of moderate quality, with a median Ensuring Quality Information for Patients score of 21 (IQR 18-25, maximum 29) out of a maximum possible score of 36. Precautionary measures were not mentioned on 41% (n=30) of websites and 30% (n=22) did not identify disk batteries as a risky FB. Red flags necessitating urgent care were identified on 95% (n=69) of websites, with 89% (n=65) advising patients to seek medical attention and 38% (n=28) advising on safe FB removal. Readability scores (Flesch Reading Ease score=12.4, Flesch-Kincaid Grade Level=6.2, Gunning-Fog Index=6.5, and Simple Measure of Gobbledygook=5.9 years) showed most websites (56%) were below the recommended sixth-grade level. The current quality and readability of information regarding FBs is inadequate. More than half of the websites were above the recommended sixth-grade reading level, and important information regarding high-risk FBs such as disk batteries and magnets was frequently excluded. Strategies should be developed to improve access to high-quality information that informs patients and parents about risks and when to seek medical help. Strategies to promote high-quality websites in search results also have the potential to improve outcomes.

From Validation to Assessment of e-Health Literacy: A Study among Higher Education Students in Portugal.

Despite their familiarity with technology, higher education students often lack the critical skills needed to assess the credibility of online health information, potentially impacting their health decisions and well-being. This study aims to validate and assess the e-Health Literacy Scale among those in Portuguese higher education. In addition, this study focused on measuring their e-health literacy levels and investigating how these skills relate to different sociodemographic variables. This cross-sectional study was conducted in two phases. Initially, the test-retest reliability and reproducibility of measured e-health literacy were assessed with a convenience sample of 20 participants. Subsequently, the e-health scale was applied to a group of 245 Portuguese higher education students. The research took place from January 2023 to April 2024. The scale exhibited robust internal consistency and reproducibility. Male gender consistently correlates with higher levels of e-health literacy. Students demonstrate good levels of e-health literacy (24/40), reflecting their ability to effectively navigate and utilize health information online. By integrating strategies to further enhance this literacy into university health programs, students can develop essential skills necessary for making informed decisions about their health. This proactive approach not only empowers students to access reliable health resources but also fosters a culture of health literacy that can positively impact their well-being both during their academic journey and beyond graduation.

Characterizing the Adoption and Experiences of Users of Artificial Intelligence-Generated Health Information in the United States: Cross-Sectional Questionnaire Study.

OpenAI's ChatGPT is a source of advanced online health information (OHI) that may be integrated into individuals' health information-seeking routines. However, concerns have been raised about its factual accuracy and impact on health outcomes. To forecast implications for medical practice and public health, more information is needed on who uses the tool, how often, and for what. This study aims to characterize the reasons for and types of ChatGPT OHI use and describe the users most likely to engage with the platform. In this cross-sectional survey, patients received invitations to participate via the ResearchMatch platform, a nonprofit affiliate of the National Institutes of Health. A web-based survey measured demographic characteristics, use of ChatGPT and other sources of OHI, experience characterization, and resultant health behaviors. Descriptive statistics were used to summarize the data. Both 2-tailed t tests and Pearson chi-square tests were used to compare users of ChatGPT OHI to nonusers. Of 2406 respondents, 21.5% (n=517) respondents reported using ChatGPT for OHI. ChatGPT users were younger than nonusers (32.8 vs 39.1 years, P<.001) with lower advanced degree attainment (BA or higher; 49.9% vs 67%, P<.001) and greater use of transient health care (ED and urgent care; P<.001). ChatGPT users were more avid consumers of general non-ChatGPT OHI (percentage of weekly or greater OHI seeking frequency in past 6 months, 28.2% vs 22.8%, P<.001). Around 39.3% (n=206) respondents endorsed using the platform for OHI 2-3 times weekly or more, and most sought the tool to determine if a consultation was required (47.4%, n=245) or to explore alternative treatment (46.2%, n=239). Use characterization was favorable as many believed ChatGPT to be just as or more useful than other OHIs (87.7%, n=429) and their doctor (81%, n=407). About one-third of respondents requested a referral (35.6%, n=184) or changed medications (31%, n=160) based on the information received from ChatGPT. As many users reported skepticism regarding the ChatGPT output (67.9%, n=336), most turned to their physicians (67.5%, n=349). This study underscores the significant role of AI-generated OHI in shaping health-seeking behaviors and the potential evolution of patient-provider interactions. Given the proclivity of these users to enact health behavior changes based on AI-generated content, there is an opportunity for physicians to guide ChatGPT OHI users on an informed and examined use of the technology.

Differences in Fear and Negativity Levels Between Formal and Informal Health-Related Websites: Analysis of Sentiments and Emotions.

Searching for web-based health-related information is frequently performed by the public and may affect public behavior regarding health decision-making. Particularly, it may result in anxiety, erroneous, and harmful self-diagnosis. Most searched health-related topics are cancer, cardiovascular diseases, and infectious diseases. A health-related web-based search may result in either formal or informal medical website, both of which may evoke feelings of fear and negativity. Our study aimed to assess whether there is a difference in fear and negativity levels between information appearing on formal and informal health-related websites. A web search was performed to retrieve the contents of websites containing symptoms of selected diseases, using selected common symptoms. Retrieved websites were classified into formal and informal websites. Fear and negativity of each content were evaluated using 3 transformer models. A fourth transformer model was fine-tuned using an existing emotion data set obtained from a web-based health community. For formal and informal websites, fear and negativity levels were aggregated. t tests were conducted to evaluate the differences in fear and negativity levels between formal and informal websites. In this study, unique websites (N=1448) were collected, of which 534 were considered formal and 914 were considered informal. There were 1820 result pages from formal websites and 1494 result pages from informal websites. According to our findings, fear levels were statistically higher (t2753=3.331; P<.001) on formal websites (mean 0.388, SD 0.177) than on informal websites (mean 0.366, SD 0.168). The results also show that the level of negativity was statistically higher (t2753=2.726; P=.006) on formal websites (mean 0.657, SD 0.211) than on informal websites (mean 0.636, SD 0.201). Positive texts may increase the credibility of formal health websites and increase their usage by the general public and the public's compliance to the recommendations. Increasing the usage of natural language processing tools before publishing health-related information to achieve a more positive and less stressful text to be disseminated to the public is recommended.

Association Between Korean Adults' Electronic Health Literacy and Active Participation in Health Decision-Making.

This study aimed to investigate the association between Korean adults' electronic health literacy and active participation in health decision-making while communicating with healthcare providers. A total of 421 adults 18 years and older were recruited from a survey panel developed by a survey company and completed an online survey asking about individual characteristics and electronic health literacy. Data were analyzed using descriptive statistics, independent-samples t tests, analysis of variance, and binomial logistic regression analysis. In results, for every one-unit increase in electronic health literacy, the rate of active participation in health decision-making was likely to increase by 3.62 times compared with the rate of passive participation in health decision-making. It was also likely to increase in those with a college degree or higher, those who used both Web sites and YouTube, those who perceived online health information to be useful, those who actively participated as a patient, and those with a desire to actively participate as a patient. To encourage active participation in health-related situations or decision-making processes, educational programs or interventions to improve individuals' electronic health literacy are needed. Healthcare providers must ensure that individuals feel comfortable expressing their preferences, needs, and values.

Application of an Adapted Health Action Process Approach Model to Predict Engagement With a Digital Mental Health Website: Cross-Sectional Study.

Digital Mental Health (DMH) tools are an effective, readily accessible, and affordable form of mental health support. However, sustained engagement with DMH is suboptimal, with limited research on DMH engagement. The Health Action Process Approach (HAPA) is an empirically supported theory of health behavior adoption and maintenance. Whether this model also explains DMH tool engagement remains unknown. This study examined whether an adapted HAPA model predicted engagement with DMH via a self-guided website. Visitors to the Mental Health America (MHA) website were invited to complete a brief survey measuring HAPA constructs. This cross-sectional study tested the adapted HAPA model with data collected using voluntary response sampling from 16,078 sessions (15,619 unique IP addresses from United States residents) on the MHA website from October 2021 through February 2022. Model fit was examined via structural equation modeling in predicting two engagement outcomes: (1) choice to engage with DMH (ie, spending 3 or more seconds on an MHA page, excluding screening pages) and (2) level of engagement (ie, time spent on MHA pages and number of pages visited, both excluding screening pages). Participants chose to engage with the MHA website in 94.3% (15,161/16,078) of the sessions. Perceived need (β=.66; P<.001), outcome expectancies (β=.49; P<.001), self-efficacy (β=.44; P<.001), and perceived risk (β=.17-.18; P<.001) significantly predicted intention, and intention (β=.77; P<.001) significantly predicted planning. Planning was not significantly associated with choice to engage (β=.03; P=.18). Within participants who chose to engage, the association between planning with level of engagement was statistically significant (β=.12; P<.001). Model fit indices for both engagement outcomes were poor, with the adapted HAPA model accounting for only 0.1% and 1.4% of the variance in choice to engage and level of engagement, respectively. Our data suggest that the HAPA model did not predict engagement with DMH via a self-guided website. More research is needed to identify appropriate theoretical frameworks and practical strategies (eg, digital design) to optimize DMH tool engagement.

Tell me what to do first: how behavioural skills drive users’ intention to adopt online health information

PurposeTo gain a deeper understanding of users’ health information adoption and to promote the effectiveness of health information spread in the context of online limited information, this paper aims to examine how the information-motivation-behavioural (IMB) skills model can be used to organize online health information by experimenting how different IMB elements (information, motivation and behavioural skills) affect users’ intention to adopt health information.Design/methodology/approachThe authors conducted an experiment with 48 participants who received health articles with various combinations and sequences of IMB elements, analysing the impact on information adoption intention to share and practice. The authors also examined the mediation effect of information usefulness and the moderating effect of perceived health status.FindingsThe authors found that: users’ adoption intention of information was influenced by the order of used IMB elements, not the number of elements used; users were more likely to adopt information that started with behavioural skills rather than the model-prescribed IMB sequence; and perceived usefulness mediated the relationship between IMB elements and users’ adoption intention, which means users with different levels of health status all pay more attention to information usefulness and practicability.Originality/valueThe study contributes to research on health communication by showing how the IMB model can be applied online to enhance the effectiveness of health information dissemination. It can also help online health communities arrange more effective and engaging health messages to promote users’ willingness to adopt.

The logic behind cyberchondria: Longitudinal relations among risk perception, health anxiety, and online health information seeking

AbstractThe cyberchondria phenomenon presents a significant health concern, yet there remains a relative scarcity of research on the formation mechanisms of cyberchondria and its longitudinal studies. Based on the RISP model and C‐A‐C framework, this study aimed to examine the longitudinal associations between risk perception, health anxiety, and online health information seeking (OHIS) within the context of Chinese social media. We used a three‐wave longitudinal survey with 514 participants at one‐month intervals starting September 2023, employing the Random Intercept Cross‐Lagged Panel Model (RI‐CLPM) for data analysis. At the between‐person level, we solely observed significant negative associations between health anxiety and OHIS. At the within‐person level, (1) positively bidirectional associations were noted among the three main variables; (2) causal relationships were identified between risk perception and OHIS, as well as between health anxiety and OHIS; (3) Health anxiety partially mediated the relationship between risk perception and OHIS, and OHIS fully mediated the relationship between health anxiety at T1 and T3; and (4) multi‐group analyses showed that gender differences in RI‐CLPM were significant, while age differences were insignificant. The results offer theoretical and practical insights for health practitioners, information seekers, and social media platforms.

The Mediating Role of Students' Health Information Literacy Skills: Exploring the Relationship Between Web Resource Utilization and Health Information Evaluation Proficiency.

In an increasingly digital age, students rely heavily on web resources to access health information. However, evaluating the reliability and relevance of such information is crucial for informed decision-making. This study examines the importance of students' health information literacy skills (HILS) as mediators, particularly their ability to utilize web resources and successfully evaluate health information. This research investigates the mediating role of students' HILS in the relationship between their utilization of web resources and their proficiency in evaluating health information. An online survey was distributed to current students at a public university in Bangladesh as part of the data collection process for this study. Using Google Forms, the authors created a structured questionnaire. The survey was distributed through Messenger groups, Facebook pages and email invitations to reach the target audience effectively. The researchers thoroughly analysed the gathered data using structural equation modelling (SEM) techniques and SmartPLS-4 software to look for correlations between the variables. The study revealed that among the 122 participants, a significant number (N = 47) accessed internet health information on an occasional basis, whereas 30 individuals reported using it infrequently. The data revealed that 58 individuals, accounting for 47.5% of the sample, possessed the necessary abilities to access and assess online health information. Additionally, 57 participants, representing 46.7% of the sample, demonstrated proficiency in conducting online health information searches. The measurement model demonstrated good convergent validity, as evidenced by composite reliability (CR)scores and Cronbach's ⍺ values over 0.700 and an average extracted variance (AVE) of 0.500. The structural model demonstrated R2values exceeding 0.1, thus validating its dependable forecasting capability. Notable effects were seen, with f2values of 0.335 and 0.317 for the challenges in accessing and evaluating health information (CAEHI) to health information evaluation (HIE) and CAEHI to HILSrelationships, respectively. The mediation analysis found that HILS act as a mediator between types of web resources (TWRs) and HIE, with TWR having an indirect impact on HIE through HILS. The result supports all hypotheses. Therefore, it is evident that students' HILS mediate the relationship between utilization of web resources and their proficiency in evaluating health information. This study's findings could significantly impact instructional practices meant to raise students' health information literacy. This initiative seeks to enable students to make informed decisions about their health by providing them with the necessary tools to analyse and evaluate health-related information. Research on health information literacy can assist patients and the general public by instructing them on how to assess trustworthy online health resources. Students gave insightful feedback that assisted in shaping the study and guaranteeing its relevancy. If they better comprehend health information literacy, patients and the general public can use web-based resources and critically evaluate health information more accurately.

Navigating Online Health Information: Assessing the Quality and Readability of Dietary and Herbal Supplements for Chronic Musculoskeletal Pain.

Navigating Online Health Information: Assessing the Quality and Readability of Dietary and Herbal Supplements for Chronic Musculoskeletal Pain.

The Winding Path of Depression in Argentina from Awareness to Functional Recovery

Background: Despite the huge global socioeconomic burden of depressive disorders, depression is often underreported and undertreated due to a lower level of awareness from both healthcare providers and payers in many countries. The lack of an evidence-based approach to care delivery has resulted in the inequitable allocation of health resources, causing resource scarcity issues in Argentina. Objective: The aim of this paper is to identify the gaps in evidence related to patients’ journeys and barriers in the existing care ecosystem contributing to poor access to quality care for depression in an Argentine context. Methods: A semi-systematic review of the literature was performed from 2012 to 2021 using Medline, Embase and Biosis and other unstructured sources (Google Scholar, the World Health Organization (WHO) website, Argentina Ministry of Health website, and Incidence and Prevalence Database (IPD) on awareness, screening, diagnosis, treatment, adherence and/or control of depression amongst adults (≥18 years). Any identified data gaps were supplemented with anecdotal data from local experts. Results: Low percentages of adult patients with depression awareness (&lt;25%), screening (&lt;10%), diagnosis (37.5%), received treatment (41.9%), adherence to treatment (37.5%), and control (37.5%) were observed. Conclusion: Ensuring a care continuum while considering full clinical remission with functional recovery as a therapeutic goal and advocacy for patient-centric adjustments in existing mental health policies would be key drivers for improving the depression care scenario.

Navigating Wellness: Chatbot-Powered Solutions for Mental Health

Abstract: Our overall well-being depends heavily on our mental health, which has received more attention in recent years. At the heart of this platform lies a sophisticated chatbot system, meticulously crafted to provide empathetic and responsive interactions with users.this abstract introduces a pioneering mental health website designed to offer comprehensive assistance to individuals seeking to improve their mental well-being. This chatbot serves as a virtual companion, offering a safe space for individuals to express their thoughts, feelings, and concerns without fear of judgment or stigma. Crucially, this website goes beyond mere conversation; it offers real-time solutions to address mental health challenges head-on. Drawing upon evidencebased practices and therapeutic techniques, the platform provides users with actionable strategies to manage stress, anxiety, depression, and other common mental health issues.

Comparison of factors affecting Turkish citizens’ search for online health information before and during the COVID-19 pandemic

BackgroundHealth information consumers can acquire knowledge regarding health problems, combat health problems, make health-related decisions, and change their behaviour by conducting health information searches. This study aims to identify the sociodemographic and economic factors affecting individuals’ search for health information on the internet before and during COVID-19.MethodsIn this study, micro data sets of the Household Information Technologies (IT) Usage Survey conducted by the Turkish Statistical Institute in 2018 and 2021 were used. The binary logistic regression analysis was also used in the study.ResultsIt was determined that age, gender, education level, occupation, social media use, searching for information about goods and services, internet banking use, e-government use, having a desktop computer, having a tablet computer, and region variables were associated with the status of searching for health information on the internet during the COVID-19 period.ConclusionThe main reasons for the increase in health information searches during the COVID-19 epidemic can be attributed to several key factors, such as society’s need for information and meeting its need for information, access to up-to-date health data and increased trust in official sources. The study’s findings serve as a valuable resource for health service providers and information sources attempting to identify the health information-seeking behaviour of the public and to meet their needs in this context.

Patients With Shoulder Labral Tears Search the Internet to Understand Their Diagnoses and Treatment Options

PurposeTo analyze the most frequently searched questions associated with shoulder labral pathology and to evaluate the source type availability and quality. MethodsCommon shoulder labral pathology related search terms were entered into Google and the suggested frequently asked questions were compiled and categorized. Suggested sources were also recorded, categorized, and scored for quality of information utilizing Journal of the American Medical Association (JAMA) benchmark criteria. Statistical analysis was performed to compare the types of questions and their associated sources, as well as the quality of sources. ResultsFive-hundred and thirteen questions and 170 sources were identified and categorized. The most popular topics were Diagnosis/Evaluation (21.5%) and Indications/Management (21.1%.). The most common website types were Academic (27.9%), Commercial (25.2%), and Medical Practice (22.5%). Multiple statistically significant associations were found between specific question categories and their associated source types. The average JAMA quality score for all sources was 1.56 and medical websites had significantly lower quality scores than non-medical sites (1.05 vs 2.12, p<0.001). ConclusionPatients searching the internet for information regarding shoulder labral pathology often look for facts regarding the management of their condition. They use various source types to understand their conditions, with government sources being the highest quality, while medical sites showed statistically lower quality. Across the spectrum of questions, the quality of readily available resources varies substantially.

What Encourages Patients to Recommend Their Doctor After an Online Medical Consultation? The Influence of Patient-Centered Communication, Trust, and Negative Health Information Seeking Experiences

ABSTRACT The doctor-patient relationship in China has become increasingly tense, with patients lacking trust in doctors. Meanwhile, online healthcare flourished, accelerated by the COVID-19 pandemic. This study utilized the direct and indirect pathway model of clinician-patient communication to health outcomes and online trust theory to examine the associations between online patient-centered communication (OPCC), benevolence and ability trust in doctors, negative online health information seeking experiences, and willingness to recommend doctors. The findings revealed that benevolence and ability trust mediated the relationship between OPCC and willingness to recommend doctors. Additionally, when participants had a high level of negative online health information seeking experiences, OPCC had a stronger effect on ability trust; meanwhile, the mediation effect of ability trust between the relationship of OPCC and willingness to recommend was stronger. This study also discussed theoretical and practical implications.