How does searching for health information on the Internet affect individuals' demand for health care services?

The emergence of the Internet made health information, which previously was almost exclusively available to health professionals, accessible to the general public. Access to health information on the Internet is likely to affect individuals' health care related decisions. The aim of this analysis is to determine how health information that people obtain from the Internet affects their demand for health care. I use a novel data set, the U.S. Health Information National Trends Survey (2003–07), to answer this question. The causal variable of interest is a binary variable that indicates whether or not an individual has recently searched for health information on the Internet. Health care utilization is measured by an individual's number of visits to a health professional in the past 12 months. An individual's decision to use the Internet to search for health information is likely to be correlated to other variables that can also affect his/her demand for health care. To separate the effect of Internet health information from other confounding variables, I control for a number of individual characteristics and use the instrumental variable estimation method. As an instrument for Internet health information, I use U.S. state telecommunication regulations that are shown to affect the supply of Internet services. I find that searching for health information on the Internet has a positive, relatively large, and statistically significant effect on an individual's demand for health care. This effect is larger for the individuals who search for health information online more frequently and people who have health care coverage. Among cancer patients, the effect of Internet health information seeking on health professional visits varies by how long ago they were diagnosed with cancer. Thus, the Internet is found to be a complement to formal health care rather than a substitute for health professional services

Surfing the internet for health information: an italian survey on use and population choices

BACKGROUND: Recent international sources have described how the rapid expansion of the Internet has precipitated an increase in its use by the general population to search for medical information. Most studies on e-health use investigated either through the prevalence of such use and the social and income patterns of users in selected populations, or the psychological consequences and satisfaction experienced by patients with particular diseases. Few studies have been carried out in Europe that have tried to identify the behavioral consequences of Internet use for health-related purposes in the general population.The aims of this study are to provide information about the prevalence of Internet use for health-related purposes in Italy according to demographic and socio-cultural features, to investigate the impact of the information found on health-related behaviors and choices and to analyze any differences based on health condition, self-rated health and relationships with health professionals and facilities. METHODS: A multicenter survey was designed within six representative Italian cities. Data were collected through a validated questionnaire administered in hospital laboratories by physicians. Respondents were questioned about their generic condition, their use of the Internet and their health behaviors and choices related to Internet use. Data were analyzed using descriptive statistics and logistic regression to assess any differences by socio-demographic and health-related variables. RESULTS: The sample included 3018 individuals between the ages of 18 and 65 years. Approximately 65% of respondents reported using the Internet, and 57% of them reported using it to search for health-related information. The main reasons for search on the Internet were faster access and a greater amount of information. People using the Internet more for health-related purposes were younger, female and affected by chronic diseases. CONCLUSIONS: A large number of Internet users search for health information and subsequently modify their health behaviors and relationships with their medical providers. This may suggest a strong public health impact with consequences in all European countries, and it would be prudent to plan educational and prevention programs. However, it could be important to investigate the quality of health-related websites to protect and inform user

Factors affecting seeking health-related information through the internet among patients in Kuwait

Background: The internet is a powerful worldwide communication medium that provides its users with immediate information irrespective of their location, culture, language and time. E-health service will have a great impact in reducing the costs of health care, increasing satisfaction of patients and health professionals, and minimizing the burden on health facilities.Objective: This study aims to determine the proportion of patients who obtain health-related information through the internet as well as factors that could affect using the internet for seeking health information.Subjects and methods: This study was conducted in six general hospitals in Kuwait. A cross-sectional study was adopted to determine the proportion of patients who obtain health-related information through the internet. It was followed by a case-control study to determine factors that could be associated with online search of health information. A questionnaire was used which included data related to sociodemographic characteristics, clinical history and computer experience. The final analysis included 220 participants.Results: The majority of participants (93.2%) mentioned that they have used the internet for one or more purposes. Only 129 participants (62.9%) used the internet for obtaining health related information. All studied socio-demographic factors, except age and marital state, and computer skills variables had significant effect on on-line search for health information. After adjustment for confounding, only gender, nationality, level of education, and using computer at work were proved to be significant determinants of the outcome of interest.Conclusion: It is important to close the gap in health literacy and increase the use of health information technology to support patient self-management. The creation of an eHealth-literate population should be a priority in Kuwaiti public health policy.Keywords: Health information, Seeking, Interne

Prev Chronic Dis

IntroductionThe World Wide Web is being used increasingly as a resource for accessing health-related information. In our study, we identified types of health-related Web sites visited most often, determined how often patients shared Web-accessed health information with their doctors, and examined factors that encouraged Internet use for locating health-related information. We also compared health-related Internet use among people who did not have any type of chronic disease with people who reported having one or more chronic diseases.MethodsWe merged data from the 2002 and 2003 HealthStyles surveys to generate frequency and descriptive statistics and used multivariate logistic regression to estimate odds ratios.ResultsApproximately 35% of survey participants reported using the Internet to search for health-related information. Among them, the Web sites visited most often included health information portals, government agencies, and nonprofit organizations. About 53% reported that they "sometimes" shared Internet information with their doctors. The most important features of the Internet that would encourage its use for health information were ease of finding and using the information and clarity of the information provided. Internet use differed by sex and age and was strongly associated with income and education. Respondents who reported having a chronic disease (odds ratio [OR] = 1.30; 95% confidence interval [CI], 1.16\u20131.45) were more likely to use the Internet to access health-related information, especially among those with depression (OR = 1.47; 95% CI, 1.27\u20131.71) and high cholesterol (OR = 1.18; 95% CI, 1.02\u20131.37). In addition, respondents who reported having two or more chronic diseases (OR = 1.35; 95% CI, 1.16\u20131.56) were more likely to search for online health information than respondents who reported having no chronic disease.ConclusionPublic health professionals have a unique opportunity to use the Internet as a tool to complement and supplement the health information that the public receives from health care professionals.2006760

Need and scope of global partnership on public health research

BACKGROUND:A large and growing body of "big data" is generated by internet search engines, such as Google. Because people often search for information about public health and medical issues, researchers may be able to use search engine data to monitor and predict public health problems, such as HIV. We sought to assess the feasibility of using Google search data to analyze and predict new HIV diagnoses cases in the United States. METHODS AND FINDINGS:From 2007 to 2014, we collected search volume data on HIV-related Google search keywords across the United States. State-level new HIV diagnoses data were collected from the Centers for Disease Control and Prevention (CDC) and AIDSVu.org. We developed a negative binomial model to predict HIV cases using a subset of significant predictor keywords identified by LASSO. The Google search data were combined with state-level HIV case reports provided by the CDC. We use historical data to train the model and predict new HIV diagnoses from 2011 to 2014, with an average R2 value of 0.99 between predicted versus actual cases, and average root-mean-square error (RMSE) of 108.75. CONCLUSIONS:Results indicate that Google Trends is a feasible tool to predict new cases of HIV at the state level. We discuss the implications of integrating visualization maps and tools based on these models into public health and HIV monitoring and surveillance

Determinants of information behaviour and information literacy related to healthy eating among Internet users in five European countries

Introduction. This study investigates how Europeans seek information related to healthy eating, what determines their information seeking and whether any problems are encountered in doing so. Method. A survey was administered through computer-assisted on-line web-interviewing. Respondents were grouped by age and sex (n=3003, age + 16) in Belgium, Denmark, Italy, Poland, and the UK. Analysis. Descriptive statistics and regression analysis were used to analyse the influence of social, demographic, psychological and economic characteristics on the information seeking of the respondents. Results. Nearly half of those surveyed do not know where to look for information on healthy diets. Men, less well educated, poorer and sicker person know less about where to look for such information and are less likely to attempt finding it. Most of the respondents searching for information on the Internet use Google as a search tool. Conclusions. Individual and environmental factors affect information behaviour and should be taken into account in public campaigns aimed at changing eating habits of the population to increase their effectiveness. More emphasis should be placed on raising health information literacy of the information-poor, men, the uneducated, and the economically disadvantaged

Sociodemographic and health-(care-)related characteristics of online health information seekers: a cross-sectional German study

Nölke L, Mensing M, Krämer A, Hornberg C. Sociodemographic and health-(care-)related characteristics of online health information seekers: a cross-sectional German study. BMC Public Health. 2015;15(1): 31.Background Although the increasing dissemination and use of health-related information on the Internet has the potential to empower citizens and patients, several studies have detected disparities in the use of online health information. This is due to several factors. So far, only a few studies have examined the impact of socio-economic status (SES) on health information seeking on the Internet. This study was designed to identify sociodemographic and health-(care-)related differences between users and non-users of health information gleaned from the Internet with the aim of detecting hard-to-reach target groups. Methods This study analyzed data from the NRW Health Survey LZG.NRW 2011 (n = 2,000; conducted in North Rhine–Westphalia, Germany, via telephone interviews). Logistic regression analysis was used to examine the determinants of online health information seeking behavior. Results 68% of Internet users refer to the Internet for health-related purposes. Of the independent variables tested, SES proved to exert the strongest influence on searching the Internet for health information. The final multivariate regression model shows that people from the middle (OR: 2.2, 95% CI: 1.6–3.2) and upper (OR: 4.0, 95% CI: 2.7–6.2) social classes are more likely to seek health information on the Internet than those from the lower class. Also, women are more likely to look for health information on the Internet than men (OR: 1.5, 95% CI: 1.1–2.1). Individuals with a migration background are less likely to conduct health searches on the Internet (OR: 0.6, 95% CI: 0.4–0.8). Married people or individuals in a stable relationship search the Internet more often for health information than do singles (OR: 1.9, 95% CI: 1.2–2.9). Also, heavy use of health-care services compared to non-use is associated with a higher likelihood of using the Internet for health-related matters (OR: 1.7, 95% CI: 1.2–2.5). Conclusions In order to achieve equity in health, health-related Internet use by the socially deprived should be promoted through measures to increase their level of e-health literacy. Furthermore, longitudinal studies are needed in order to gain reliable data/results on determinants of health-related Internet use

Health Misinformation in Search and Social Media

People increasingly rely on the Internet in order to search for and share health-related information. Indeed, searching for and sharing information about medical treatments are among the most frequent uses of online data. While this is a convenient and fast method to collect information, online sources may contain incorrect information that has the potential to cause harm, especially if people believe what they read without further research or professional medical advice. The goal of this thesis is to address the misinformation problem in two of the most commonly used online services: search engines and social media platforms. We examined how people use these platforms to search for and share health information. To achieve this, we designed controlled laboratory user studies and employed large-scale social media data analysis tools. The solutions proposed in this thesis can be used to build systems that better support people's health-related decisions. The techniques described in this thesis addressed online searching and social media sharing in the following manner. First, with respect to search engines, we aimed to determine the extent to which people can be influenced by search engine results when trying to learn about the efficacy of various medical treatments. We conducted a controlled laboratory study wherein we biased the search results towards either correct or incorrect information. We then asked participants to determine the efficacy of different medical treatments. Results showed that people were significantly influenced both positively and negatively by search results bias. More importantly, when the subjects were exposed to incorrect information, they made more incorrect decisions than when they had no interaction with the search results. Following from this work, we extended the study to gain insights into strategies people use during this decision-making process, via the think-aloud method. We found that, even with verbalization, people were strongly influenced by the search results bias. We also noted that people paid attention to what the majority states, authoritativeness, and content quality when evaluating online content. Understanding the effects of cognitive biases that can arise during online search is a complex undertaking because of the presence of unconscious biases (such as the search results ranking) that the think-aloud method fails to show. Moving to social media, we first proposed a solution to detect and track misinformation in social media. Using Zika as a case study, we developed a tool for tracking misinformation on Twitter. We collected 13 million tweets regarding the Zika outbreak and tracked rumors outlined by the World Health Organization and the Snopes fact-checking website. We incorporated health professionals, crowdsourcing, and machine learning to capture health-related rumors as well as clarification communications. In this way, we illustrated insights that the proposed tools provide into potentially harmful information on social media, allowing public health researchers and practitioners to respond with targeted and timely action. From identifying rumor-bearing tweets, we examined individuals on social media who are posting questionable health-related information, in particular those promoting cancer treatments that have been shown to be ineffective. Specifically, we studied 4,212 Twitter users who have posted about one of 139 ineffective ``treatments'' and compared them to a baseline of users generally interested in cancer. Considering features that capture user attributes, writing style, and sentiment, we built a classifier that is able to identify users prone to propagating such misinformation. This classifier achieved an accuracy of over 90%, providing a potential tool for public health officials to identify such individuals for preventive intervention