Internet For Health-related Information Research Articles

IJCM_417A: Internet health information seeking and its effect on patient-doctor relationship and satisfaction among patients attending a tertiary care hospital in Mangalore

Background: The doctor-patient relationship is a fundamental and essential component of healthcare that plays a critical role in patient outcomes, trust, and overall quality of care. Internet-based health information has been found to have both positive and negative effects on patients. Objectives: To assess the internet health-seeking behaviour among patients, and its effect on the doctor-patient relationship Methodology: In this facility-based cross-sectional study, 110 patients were assessed regarding their internet health-seeking behaviour and its effect on the doctor-patient relationship. Patient-Doctor Depth-of-Relationship Scale and Patient Satisfaction Questionnaire – Short form (PSQ-18) was used to assess the relationship. A comparison of patient satisfaction scores and doctor-patient relationship scores among those who use the internet for seeking health-related information with those who do not was done by independent t-test and P < 0.05 will be considered to be a statistically significant difference. Results: Sixty-seven-point three per cent use the internet for health-related information. Most of the patients felt satisfied with their medical care but there was still some scope of improvement in the domains of communication and the time devoted by the doctor to the patient. The overall level of patient satisfaction was above average. Our study also showed that 77.2% of the study participants had a good relationship with their doctor. Conclusion: In our study, we found that the internet using study participants were found to have an above average satisfaction with their doctors.

A CROSS-SECTIONAL STUDY TO ASSESS AWARENESS AND USAGE OF GOVERNMENT OF INDIA'S M-HEALTH APPS BY SMARTPHONE USERS IN MAHARASHTRA

Background: M-Health (or mobile health) is commonly dened as the provision of health services through mobile technologies. In 2016 Indian government launched various m-health applications under National Health Portal and also launched Ayushman Bharat Digital Mission with various digital initiatives to reach universal coverage of Health. Methods and Material:Across-sectional study using an online population-based survey was carried out in Maharashtra on smartphone users aged 18 and above, using the virtual snowball sampling technique until a sample size of 193 was reached. A predesigned and pretested self-administered questionnaire on GOI's m-health apps was used as a study tool. Results:Among respondents 69% were male and 30% were female respondents and a majority of the respondents were in the age group of 18-28 years (53.36%). The majority 60% of respondents spend approx. 4 hours of time on the internet daily. Awareness of GOI's m-health apps was seen in only 28% of the study population. Awareness and usage were seen maximum for Arogya setu, Cowin, UMANG & ABHA compared to other apps. There is no signicant association between awareness with Gender, Age, Education & number of hours spent on the internet. Conclusions: Despite people spending time on the internet for health-related information & activities, Awareness of GOI's m-health apps is low. The level of awareness is an important factor for utilization of these GOI's m-Health apps irrespective of gender, age, and education differences.

AB033. SOH22ABS030. Readability and quality assessment of internet-based patient education materials related to deep vein thrombosis (DVT)

Background: Access to health-related internet information has increased dramatically during the past decade. A significant proportion of this information has been demonstrated to be set at too high a level for general comprehension. The goal of this study was to evaluate the readability and quality of information available on the internet relating to deep vein thrombosis (DVT).

Sharing health information across online platforms: A systematic review

ABSTRACT Advanced Web 2.0 communication technologies have facilitated health-related information (HRI) sharing on the Internet. Especially, the COVID-19 pandemic and lockdowns around the world have forced more people to turn to the Internet for HRI. A better understanding of users’ sharing content and sharing behavior can help communicators improve health literacy, raise community awareness, and facilitate social support exchanges. This paper reports the results of a systematic review of online HRI sharing literature, including key research topics, theories and methods used in past studies, and key factors of sharing behavior across online platforms. Following the PRISMA procedure for a systematic review, 58 articles were identified and analyzed using keyword matching, thematic analysis, and expert review. Guided by the platform theory, our findings differentiated five types of online platforms that differently influenced online users’ sharing content and sharing purposes, including micro-blogs, social network sites, online health communities, social question and answer sites, and Wikis. The findings also clarify five main research topics and applicable theories used in each topic, including personal health sharing, health-related knowledge sharing, general health message diffusion, outcomes of HRI sharing, and exploratory research. Key factors of sharing behavior and potential sharing outcomes are also reviewed and summarized in the research framework developed from the motivation theory. Our study contributes to the understanding of online sharing behavior and provides implications for health communicators to develop effective health campaigns. Potential research directions are also identified and discussed.

Readability and quality assessment of internet-based patient education materials related to deep vein thrombosis.

Access to health-related internet information has increased dramatically during the past decade. A significant proportion of this information has been demonstrated to be set at too high a level for general comprehension. The goal of this study was to evaluate the readability and quality of information available on the internet relating to deep vein thrombosis (DVT). A search for 'DVT' and 'Deep Vein Thrombosis' was performed on five most commonly accessed search engines. Top hundred websites were reviewed. Website authorship was classified. Each site was assessed using the recognized quality and readability scoring systems. The presence of the health on the net foundation code of conduct (HON-code), a reported quality-assurance marker, was noted. The majority of web sites (45%) were academic or physician compiled. Only 36% of the websites were HON-code certified. HON-code certified sites achieved significantly greater DISCERN and Journal of the American Medical Association (JAMA) scores. Seventy-three percent of the websites were above the recommended sixth-grade readability level. Flesch--Kincaid readability test (FRES) of more than half of the websites (56%) was below 60, which makes them fairly difficult to read by general public. Internet information relating to DVT is of variable quality and largely set at an inappropriate readability level. Given this variability in quality, healthcare providers should direct patients to known sources of reliable, readable online information. Identification of reliable sources may be aided by known markers of quality such as HONcode certification and to educate them to use academic and physician-provided sites which have been shown to contain better-quality information. Moreover, academic and physician-compiled websites should be written in a fashion appropriate for general public consumption.

Analisis Faktor Penerimaan Media Internet sebagai Sumber Informasi Kesehatan dengan Model UTAUT dan HBM

People are increasingly turning to the internet for health-related information. It is very easy to perform or obtain health-related services or information on the internet using different types of devices. This study's goal is to assess public acceptance of the internet as a source of health information by combining the Unified Theory of Acceptance and Use of Technology (UTAUT) with the Health Belief Model (HBM). SEM techniques were used to analyze data collected from 324 respondents via online questionnaires. Two factors from the HBM model: self efficacy (SE) and cues to action (CA) were found as the strongest factors behind the acceptance of the internet as a source of health information. Two other factors from UTAUT model; Social Influence (SI) and Performance Expectancy (PE) also had significant effects, albeit not as strong, on the acceptance of internet media as a source of health information. This study's findings also point to the possibility of incorrect self-medication when excessive perceived self-efficacy (SE) is combined with symptoms as cues to action (CA) and social influence (SI) when looking up health information online

Older age and online health information search behaviors: The mediating influence of executive functions

ABSTRACT Introduction Searching the internet for health-related information is a complex and dynamic goal-oriented process that ostensibly places demands on executive functions, which are higher-order cognitive abilities that can deteriorate with older age. This study examined the effects of older age on electronic health (eHealth) search behavior and the potential mediating influence of executive functions. Method Fifty younger adults (≤ 35 years) and 41 older adults (≥50 years) completed naturalistic eHealth search tasks involving fact-finding (Fact Search) and symptom determination (Symptom Search), a neurocognitive battery, and a series of self-report questionnaires. Results Multiple regression models controlling for potentially confounding psychiatric symptoms, health conditions, literacy, and demographic variables revealed that older adults were slower and less accurate than younger adults on the eHealth Fact Search task, but not on the eHealth Symptom Search task. Executive functions mediated the relationship between age and Fact and Symptom Search accuracy, independent of basic processing speed and attention. Parallel mediation models showed that episodic memory was not an independent mediator of age and search accuracy for either eHealth task once speed/attention and executive functions were included. Conclusions Older adults can experience difficulty searching the internet for some health-related information, which is at least partly attributable to executive dysfunction. Future studies are needed to determine the benefits of training in the organizational and strategic aspects of internet search for older adults and whether these findings are applicable to clinical populations with executive dysfunction.

Attitude and potential benefits of modern information and communication technology use and telemedicine in cross-sectoral solid organ transplant care

Situations like the COVID-19 pandemic urgently require the implementation of eHealth for vulnerable patient populations. Here we quantitatively evaluate use and potential of modern information and communication technology (ICT) in solid organ transplant (SOT) recipients. We conducted a structured, questionnaire-based, cross-sectional study that was addressed to patients after kidney, liver, pancreas, or combined transplantation. We focused on: sociodemographic data, present use of digital technologies in daily life and for health reasons, patients’ eHealth literacy, and their overall attitude towards eHealth. A total of 234 patients completed the questionnaire. Most of the patients (90%) have a web-enabled computer, 78.2% have a smartphone, and 71.8% regularly search the internet for health-related information. Sixty-eight percent would like to receive discharge summaries online, and 54% would like to chat online with their physicians. Even though ICT use in daily life was age-related, no significant difference could be shown for health reasons or the type of transplanted organ. Modern ICT use is predominantly accepted for health reasons by SOT recipients. Regardless of the transplanted organ, a deeper integration of eHealth has potential for improving cross-sectoral care. To successfully implement eHealth technologies in cross-sectoral care future research should include online physician–patient communication, data security, data safety, and the aspects of quality and safety of care.

Perceived Usefulness and Effects of Online Health Information among Users amid Covid19; Is there any role of demographics?

Since March 11, 2020, when WHO declared Covid19 as a worldwide pandemic, a drastic change in the lives of individuals and nations can be witnessed. The constrained mobility and restricted capacity of local governments in providing health care services resulted as an increased dependence of people on alternate sources of information and guidance regarding their health. This has transformed the ways people take care of their health and make health related decisions for themselves or their dear ones. This article contributes to the growing body of research on new media by exploring the role of internet as a source of health information, specifically through the lens of Uses and gratification and Dependency theory. A questionnaire-based online survey collected data from users belonging to different age and income groups regarding needs, perceived usefulness and cyberchondric effects of OHI among them. Findings revealed websites and discussion forums as to be most extensively used sources of OHI followed by Facebook and YouTube. To get information and updates of Covid19, to take precautionary measures for Covid19 and to check for the symptoms of Covid19 were reported as major needs by the users. The ratio of the usage of internet for health-related information about health issues other than Covid19 was also significantly higher. To avoid in person, visit to physician, ubiquity, and quick and easy retrieval of information from divers’ sources were the reported reasons for this increased usage. Results demonstrate that during Covid19, both the usage of internet as an alternative source of HI needs and its perceived usefulness was significantly higher. Statistical analysis revealed difference in perceived usefulness of OHI during Covid19 due to gender, income, education and health status of the respondents. Similarly, the study revealed a strong positive relationship between Usage and Perceived usefulness of OHI. The strong relationship between Usage and psychological effect show ever was found to marginalize the significance of OHI.

The Impact of COVID-19 on Urological Cancer: An internet Search Volume Analysis

Objectives: Health services have been disrupted due to Coronavirus disease 2019 (COVID-19). With patients, unable to access face to face healthcare, many turn to sources such as the Internet for health-related information. Other patients ignore all other health related issues and focus on the threat posed by a pandemic. This study sought to analyse the Internet health-seeking behaviour related to urological cancer of patients in the United Kingdom (UK) during the COVID-19 Pandemic. Methods: Internet search volumes over a 3-month period, during the UK pandemic, were analysed using Google TrendsTM to obtain a search volume index (SVI) and compared to an equivalent pre COVID-19 period. The SVI measures relative search volume and was obtained for “Prostate Cancer”, “Kidney Cancer”, “Bladder Cancer” and Testicular Cancer” searches. Results: The average SVI for Prostate Cancer before the COVID-19 pandemic was 49.3, compared to 42.6 during the pandemic (p=0.001). Kidney cancer had an average SVI of 45.5 before the pandemic compared to 35.4 during the pandemic (p <0.001). Similar results were obtained for Bladder and Testicular Cancer. There was a 23% decrease in SVI for urological cancer searches during the pandemic compared to before the pandemic (p <0.001). Conclusions: The decline in searches for urological cancer during the pandemic may have implications. Patients maybe ignoring new cancer related symptoms which could result in late diagnoses, public health campaigns are required. Patients with cancer may not be utilising online resources available to them and healthcare professionals should reach out to patients at a time when face-face interaction is limited.

Effect of Health Information Websites on Healthcare Facility Visits in the Eastern Province of Saudi Arabia

Introduction: The internet has been widely available with 18 million users in Saudi Arabia alone. The rapid growth of internet use has proven to affect healthcare. The main objective was to determine a correlation between health-related information (HRI) website use & healthcare facility visits in the Eastern Province of Saudi Arabia.Methodology: This study was designed as a survey-based cross-sectional study involving the population of the Eastern province of Saudi Arabia. Data was collected by distributing a validated survey via an online survey application over a 4-month period. It consisted of demographic data and questions concerning internet use for HRI. Logistic regression was used to establish a correlation between internet use for HRI & healthcare facility visits and to see influencing factors.Results: From the 1095 replies, 788 fit our inclusion criteria. 90% of our subjects have used the internet for HRI using mainly General medical websites 47.9%, Social Media 20.17%, Forums 19.16%, and government websites 12.69%. We found 52.27% have used HRI websites to diagnose & treat their own medical conditions without professional medical advice. Visiting healthcare facilities after reading online HRI occurred 62.2% of the time, while the remaining did not due to being reassured of their condition. Outpatient clinics were most visited at 57.63% followed by ER & Pharmacy visits at 21.11% each. Those who have used the internet for HRI were more likely to visit a healthcare facility than those who haven't (OR(95%CI)) 2.05(1.24-3.36) (p-value<0.05).Conclusions: There seems to be a correlation between HRI website use & healthcare facility visits, which is influenced by the level of education & occupation status.

Studying health-related internet and mobile device use using web logs and smartphone records.

Many people use the internet to seek information that will help them understand their body and their health. Motivations for such behaviors are numerous. For example, users may wish to figure out a medical condition by searching for symptoms they experience. Similarly, they may seek more information on how to treat conditions they have been diagnosed with or seek resources on how to live a healthy life. With the ubiquitous availability of the internet, searching and finding relevant information is easier than ever before and a widespread phenomenon. To understand how people use the internet for health-related information, we use data from a sample of 1,959 internet users. A unique combination of data containing four months of users’ browsing histories and mobile application use on computers and mobile devices allows us to study which health websites they visited, what information they searched for and which health applications they used. Survey data inform us about users’ socio-demographic background, medical conditions and other health-related behaviors. Results show that women, young users, users with a university education and nonsmokers are most likely to use the internet and mobile applications for health-related purposes. On search engines, internet users most frequently search for pharmacies, symptoms of medical conditions and pain. Moreover, users seem most interested in information on how to live a healthy life, alternative medicine, mental health and women’s health. With this study, we extend the field’s understanding of who seeks and consumes health information online, what users look for as well as how individuals use mobile applications to monitor their health. Moreover, we contribute to methodological research by exploring new sources of data for understanding humans, their preferences and behaviors.

The Impact of Internet Usage and Knowledge-Intensive Activities on Households' Healthcare Expenditures.

This paper examines the impact of the internet usage and knowledge intensive activities on households’ healthcare expenditures Similarly, the paper aims to recognize and understand, from a value-creation perspective, the correlation between: internet access of households (IA), individuals frequently using the internet (IU), individuals searching on internet for health-related information (HI), payments made by households for healthcare (PHH), expressed as euro per inhabitant and employment in knowledge-intensive activities (KIA). The approach utilized in the present study consists of two steps. First, a theoretical framework was conducted to determine the existing relationship between major variables. Next, the Vector Autoregressive (VAR) approach was applied in a case study at European level to prove the three hypothesis we consider. By analyzing the connection between the major variables, a positive and long- lasting impulse response function was revealed, followed by an ascending trend. This suggests that a self-multiplying effect is being generated; and it reasonable to assume that the more individuals use the Internet, the more electronic acquisitions occur. We can thus reasonably conclude that the improvement of the internet usage and knowledge intensive activities on households’ healthcare expenditures process is strongly dependent on people’s capability. Improving IU and KIA is the new reading key in the decision-making process in health system approach.

Abstract P6-11-06: The association of health literacy with internet usage for breast cancer patient education

Abstract Introduction: As more breast cancer educational resources are transitioned from printed materials to online formats, it is important to identify the patients that are at risk for low health literacy and who still need access to printed materials. The purpose of this study is to evaluate breast cancer patient health literacy and internet access in the South Texas region and to establish how they prefer to learn about their condition and surgical options. Methods: A 15-item questionnaire was given to patients with newly diagnosed breast cancer at the University Texas Health San Antonio Mays Cancer Center including a validated 3-question health question health literacy assessment, defining patients with high (HHL) or low health literacy (LHL). Patients enrolled in the study were 21 years old or older and planning to undergo mastectomy or lumpectomy for ductal carcinoma in situ, stage I, II, III, or prophylaxis (n=112). Patients who had cancers other than breast cancer were not eligible to participate. Questionnaires were included in the analysis if they were greater than 90% completed. Relationships between demographics, and type of media use were assessed. Results: English was the preferred language for 79.5% of the patients followed by Spanish for 17.9%. Seventy nine percent of breast cancer patients had high health literacy while 21% had low healthy literacy. LHL was associated with high school level education (High school: 83%, College: 17%, p=0.001) and patients with LHL were less likely to access the Internet for healthcare information, (LHL: 28%, HHL 69%, p< 0.001). After adjusting for differences: language, education, age, and cancer stage, possession of a smartphone and access to Internet at home was not associated with Internet use for healthcare information. Regardless of level of education, patients preferred receiving information via printed materials (High school: 60.2%, College: 71%, p=0.581). Neither groups preferred using supplemental videos (High school: 79% and College: 89%, p=0.58). There was no correlation between the level of education and the number of resources patients used to gain knowledge about their breast cancer and reconstructive options (Spearman correlation = 0.111). Conclusion: The majority of South Texas breast cancer patients do have access to the internet but still prefer written materials over online resources. This preference was not driven by patients’ language, educational level, or access to the internet or a smartphone. However, patients that had low health literacy were less likely to use the internet for health related information. As more healthcare information is being digitized, access to printed materials and traditional methods of education should still be available to avoid disparities in health education delivery. Further study will be done to determine the reason for preference of written over online educational materials and the utility of implementing interventions such as courses to teach patients about utilization of online resources. Citation Format: Bao-Quynh Julian, Efstathios Karamanos, Kari Eugenia Smith, Maryam Elmi, Amita Rashmikant Shah. The association of health literacy with internet usage for breast cancer patient education [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-11-06.

Primary Health Care Nurses' Experiences of Consultations With Internet-Informed Patients: Qualitative Study.

BackgroundMost people in modern societies now use the Internet to obtain health-related information. By giving patients knowledge, digital health information is considered to increase patient involvement and patient-centered interactions in health care. However, concerns are raised about the varying quality of health-related websites and low health literacy in the population. There is a gap in the current knowledge of nurses’ experiences with Internet-informed patients.ObjectiveThe objective of this study was to explore primary health care nurses’ experiences of consultations with patients who present health-related information from the Internet.MethodsThis is a qualitative study based on interviews with 9 primary health care nurses. Data were analyzed using qualitative content analysis. Results are reported according to the consolidated criteria for reporting qualitative research guidelines.ResultsThe phenomenon of Internet-informed patients was considered to change the usual rules in health care, affecting attributes and actions of patients, patterns of interactions in consultations, and roles of nurses and patients. Three categories were identified: (1) Facing the downsides of Googling, (2) Patients as main actors, and (3) Nurse role challenged. Although the benefits of health-related Internet information were described, its negative consequences were emphasized overall. The problems were mainly ascribed to inaccurate Internet information and patients’ inability to effectively manage the information.ConclusionsOur study suggests ambivalent attitudes among nurses toward health-related Internet information. In order to promote equitable care in the digital era, increased awareness in health care about useful strategies for overcoming the difficulties and embracing the benefits of conferring with Internet-informed patients seems to be a legitimate goal.

Health-Related Internet Information Both Strengthens and Weakens Parents’ Potential for Self-Care—A Mixed-Methods Study on Parents’ Search Patterns

Today’s parents belong to the digital generation and regularly use the Internet as a source of information. Parents’ quests for health-related online information comprise an effort to manage sympto ...

EHealth literacy, Internet and eHealth service usage: a survey among cancer patients and their relatives.

The aim of our study was to investigate Internet and eHealth usage, with respect to eHealth literacy, by cancer patients and their relatives. Using a standardized questionnaire we asked patients who attended lectures on complementary medicine in 2016. We received 142 questionnaires. The frequency of general Internet usage was directly associated with younger age and better Internet connection. Younger participants were not only more confident in allocating health-related Internet information into reliable or unreliable facts, but also more confident and capable of gaining medical knowledge through eHealth services. A regular use of eHealth services facilitated the decision-making process. Reading ability was associated with a better understanding regarding eHealth offers. In a modern health care system, emphasis should be on skills contributing to eHealth literacy among patients to improve their ability to profit from eHealth offers and improve health care.

Community pharmacists' perspectives of online health-related information: A qualitative insight from Kuala Lumpur, Malaysia.

The Internet is a resource used by health professionals as well as the public to access health information. Within this context, little is reported on community pharmacists' (CPs') perceptions of online health-related information. The objective of this study was to explore the attitudes of Malaysian CPs towards online health-related information. A qualitative research method was adopted with face-to-face interviews, using a semi-structured interview guide. Purposive and snowball sampling techniques were used to recruit a convenient sample of CPs who were practising in the Federal Territory of Kuala Lumpur, Malaysia. All interviews were audio recorded and transcribed verbatim. The data were analysed by the research team using a thematic content analysis framework. Eleven CPs participated in the study. Participants reported that online health-related information was accessible, useful, fast, and in some respects, the Internet is a unique source of information. It was reported that there was a need to establish websites for trusted information. CPs also reported that training was needed in Internet searching and website evaluation skills. Most information accessed by CPs related to drugs and diseases and to knowledge-based information. Barriers to efficacy of Internet usage were related to the reliability and volume of information available on the Internet. Frequent use of online health-related information among CPs was reported. Many CPs supported the use of the Internet for health-related information but certain reservations were also reported. An analysis of the reasons for information seeking and barriers suggests that a wider range of influences on health information seeking should be investigated.

Implantable Medical Device Website Efficacy in Informing Consumers Weighing Benefits/Risks of Health Care Options

As more individuals turn to the Internet for health-related information and technology increases the availability and use of implantable medical devices (IMDs), the websites marketing these devices will increase. Healthy People 2020 mandates increased understandability and usability of health-related websites. This project used social cognitive theory (SCT) and health literacy constructs from the Institute of Medicine and National Institutes of Health to analyze eight IMD websites. Despite current recommendations, none of the websites considered for this study offered content of an appropriate reading level in conjunction with the United States average of eighth grade, and 75% of the sites failed to satisfy more than one health literacy construct. Most of the websites lacked many of the SCT constructs. More attention is needed to improve the usability of these and future IMD websites to simultaneously meet the goal of marketing IMDs and the Healthy People 2020 goals to educate patients and promote public health.

Understanding Health and Health-Related Behavior of Users of Internet Health Information.

Little is known about how actual use of Internet health-related information is associated with health or health-related behavior. Using a nationally representative sample of 34,525 from 2012, this study examined the demographics of users of Internet health-related information (users), reports estimates of association with several health and behavioral outcomes adjusting for demographic factors, and analyzed the sample by education level, race, gender, and age. Analysis of a large nationally representative sample shows evidence that users of health-related information (users) on the Internet are younger, more educated, more likely to be insured, more likely to be female, and less likely to be African American. After adjusting for demographic differences, users are more likely to have been diagnosed with hypertension, cancer, stroke, and high cholesterol, but no evidence of current hypertension, weight-related issues, or being in fair or poor health. Users are less likely to smoke and among smokers are more likely to attempt quitting. Users are more likely to exercise, get a flu shot, pap smear, mammogram, HIV test, colon cancer screening, blood pressure check, and cholesterol check, but likely to be heavy drinkers. With few exceptions, results appear robust across gender, age groups, level of education, and ethnicity. Use is generally positively associated with prior diagnosis for several conditions and behaviors related to improved health, but I find no relationship with existing health status. The association between use of health-related Internet information and health-related behavior seems robust across levels of education, age, gender, and race.