Navigating the maze of online health information: the experiences of people with chronic health conditions

In recent years, the UK has seen a dramatic increase in people seeking health information via the internet, and the development of a range of health related websites and online information tools that promise to improve the future of healthcare. According to recent UK health policy, the increased availability of health information via the internet will lead to the emergence of ‘Expert patients’ and a health system based around patient-led care. The suggestion made by the Department of Health, is that engaging patients in their healthcare decisions, by adopting more of a partnership relationship between patient and care giver, would result in joint decisions, and greater sense of agency and empowerment for patients. This belief is not without its problems. High volumes of unregulated electronic information mean it is often hard to source, and is often of poor quality. In addition, a shift in the information power balance between patient and practitioner has faced hostility. This presentation will report on the progress of current PhD research looking into how people are using online health information, and operating as information enabled consumers. This has so far been achieved by adopting a mixed methods questionnaire in order to gain a breadth of knowledge of the area. This project is currently in the stage one data analysis stage. Once this data has been analysed, the findings will be utilised in order to conduct a phenomenological depth study into interesting phenomena arising in stage one and therefore developing a deeper understanding of the meaning of information seeking, and a description of the overall experience. The overall aim of this study is to achieve a greater understanding of the experiences of people with chronic illness information seeking. The broad description of how people operate a can be used to not only inform the questioning in stage two, but will also help give a more detailed description of the overall experiences by outlining how people operate. A further objective of the research is to be able to make practical use of the findings in stage one and two by making recommendations about what should be included in healthcare professionals’ education as a result

Will the development of Web 2.0 technology result in a preference for quantity over quality?

Over the last decade the world has experienced a rapid increase in the number of people using the internet for health information seeking and interaction. This increased demand for internet heath information has led to the emergence of large volumes of unstructured and unregulated medical information found on the web. This web-based information is seldom the subject of systematic investigation for its accuracy and appropriateness for patients, highlighting the need for additional research into the field. The rapid development of the internet as a communication tool, and the accumulation of large volumes of information, makes locating valid information extremely difficult especially for those who lack ability to use computers and technology efficiently. A 1997 study examining 40 websites providing advice on the management of a feverish child found that only four of the websites adhered to published guidelines. These high volumes of unregulated internet health information are partly due to there being no agreed standard for the assessment and to ensure accuracy of information presented on the web. This paper addresses the issue of quality of online health information, and asks, as we move forward and develop technologies which emphasise content creation, will the issue of quality of online health information be exacerbated? The emergence of Web 2.0 has facilitated many new online activities which could not have previously been achieved by the world wide web (Web 1.0) technology. Often referred to as the 'social web', it looks to increase social interaction by sharing content which is more easily generated and published by users. Many researchers believe this has implications for the future of healthcare, by enhancing the connection between patients, clinicians and health information. The use of blogs, podcasts and wikis can help to both communicate health information, and increase social support by providing a potentially anonymous space within which online interaction can take place. It also allows the information seeker to rapidly become the information provider, and share healthcare knowledge and experiences quickly and easily. However, this benefit of Web 2.0 technology may also be seen as a limitation when discussing information quality. For example, although health related Wiki's and blogs are an excellent way to share health information, their content can be added and edited by anyone, with a significant number being fuelled by lay users, most often with no professional experience of the health topic they are writing about. This paper aims to discuss that while the benefits of using Web 2.0 to develop communication in healthcare and health education are clear, it is also necessary to consider potential issues, such as quality, which may be more present in Web 2.0's application to healthcare than other uses. This issue is made relevant due to the possibility of high volumes of inaccurate and misleading information being potentially disastrous within a health care setting, as it can be extremely distressing and potentially damaging for some health information seeke

"It gave me relief...it gave me confidence" - the online health information seeking experiences of adults with chronic health conditions.

Background- The recent modernisation of the United Kingdom (UK) National Health Service (NHS) has included a number of sizeable reforms that have emphasised partnership relationships between patients and professionals, and the importance of individuals taking a more active role in their care. Many of these changes have been specifically geared towards patients with chronic health conditions, who are recognised as imposing the largest strain on health services worldwide. This modernisation has occurred in parallel with a huge increase in the number of people within the UK who are turning to the internet for health information in order to become more informed about their health and treatment regimes. Despite this increase in the prevalence of online health information (OHI) seeking, relatively little is known about how people seek OHI and the impact it has on their lives and relationships with others. Overall Study Aim- This study sought to understand the OHI seeking experience of individuals with chronic health conditions by using an innovative mixed-methods approach to collect a breadth and depth of relevant information on the topic. Design – One hundred participants were recruited from local support groups for various chronic health conditions. The participants in the first stage of the study completed one of two questionnaires, depending on whether or not they had sought OHI in the past. The design and focus of stage two of the study was guided by the findings from stage one, and subsequently focused on the experiences of older adults with chronic health conditions seeking OHI. A descriptive phenomenological approach was adopted in order to provide rich descriptions of patients’ experiences. Six participants were purposefully selected from a parallel sample to the stage one respondents. Findings- The results from stage one provided a breadth of information about the OHI seeking experience for people with chronic health conditions. Findings suggested that health professionals were still the most important source of health information for users and non-users of OHI; that patients had an awareness of the inconsistencies in terms of OHI quality; and identified the perceived ease with which useful and relevant OHI was located. A further key finding was that high age, low education levels and low internet usage not only acted as barriers to OHI seeking for participants, but also had a negative impact on participants’ perceptions of the positive outcomes of OHI seeking, such as confidence in decision-making or engaging in discussions with health professionals. Moreover, some non-users demonstrated that they felt they were “too old” to engage in OHI seeking. Stage two findings demonstrated 5 key themes: patients taking responsibility for their health; their expectations of OHI; explicit confidence in their own ability to discern OHI and concern for others to do the same; the selective nature of OHI sharing between patients, and patients and health professionals; and the reinforcement of social sharing networks where positive and useful OHI is shared freely. Conclusion- Although older adults within this sample were less likely to engage in, and perceive the positive outcomes of OHI seeking than their younger counterparts, some older adults were successfully engaging in the OHI seeking experience, and perceiving the constructive effects of this experience such as empowerment. Furthermore both stages of the research demonstrated the valuable role health professionals play in supporting patients seeking OHI. Implication- This study demonstrates a need for health professionals to actively support patients in seeking OHI. In doing so, this could reinforce OHI seeking behaviour, and assist patients in effectively searching for and appraising OHI

Toward a Conceptualization of Mixed Methods Phenomenological Research

Increasingly, researchers are recognizing the benefits of expanding research designs that are rooted in one tradition (i.e., monomethod design) into a design that incorporates or interfaces with the other tradition. The flexibility of phenomenologically driven methods provides one such example. Indeed, phenomenological research methods work extremely well as a component of mixed methods research approaches. However, to date, a mixed methods version of phenomenological research has not been formally conceptualized. Thus, the purpose of this article is twofold. First, we provide a philosophical justification for using what we call mixed methods phenomenological research (MMPR). Second, we provide examples of MMPR in practice to underline a number of potential models for MMPR that can practically be used in future research

Surveying the Landscape of Mixed Methods Phenomenological Research

As the popularity and scope of mixed methods research (MMR) develops, there is increasingly a need to map the growing body of literature in order to provide more inclusive frameworks of this form of research. Whilst mixed methods phenomenological research (MMPR) has been recently conceptualized, there is a lack of systematic evidence that outlines how this approach is being adopted by researchers. Thus, the purpose of this article was to explore the current implementation of MMPR within empirical research studies in order to provide a clearer picture of how, why, and where this research approach is being adopted. Findings demonstrated that whilst the prevalence of MMPR is increasing, the majority of this work is conducted within the health sciences and prioritises the phenomenological phase. Further, a model of the five key purposes of conducting MMPR is proposed. Finally, it is concluded that MMPR articles often fail to outline adequately their methodological procedures

Perfect pregnancy? Pregnant bodies, digital leisure and the presentation of self

Pregnant women are increasingly engaging with social media as a form of digital leisure. In doing so, they subject themselves to normalised images of pregnant bodies communicating unrealistic ideals. Instagram is a culturally communicative and visual platform and a pervasive context in which to explore body discipline and regulation. The current research utilised discourse analysis to explore dominant discourse surrounding pregnant women’s bodies through their self-presentation on Instagram, uncovering potential areas of challenge and resistance. Content was selected from 60 user-generated posts from 16 pregnant women’s personal accounts on Instagram. Results explore themes of ‘The “Perfect Pregnancy and Middle-class, Consumptive Ethic”’, ‘Doing Exclusive Heteronormative Pregnant Femininity’ and ‘Self-surveillance & Hyper-visibility of the Digital Fleshy Pregnant Body’. These themes identified how pregnant women embody dominant discourse regarding neo-liberalism, consumption, traditional medicine, heteronormativity, and hegemonic masculinity, and use this to engage in self-surveillance, policing, and monitoring of their pregnant bodies. A final theme Rejecting the ‘Perfect Pregnancy’, Reworking (and Reproducing) Dominant Ideals’ is uncovered, outlining alternative posts by the women that offer resistance to the dominant discourse, however examples are infrequent and lack evidence of conscious and overt politicisation. Future research should focus on pregnant women’s self-interpretation of social media engagement and the pregnant bodies excluded from this discourse

"It gave me relief ... it gave me confidence" : the online health information seeking experiences of adults with chronic health conditions

Background- The recent modernisation of the United Kingdom (UK) National Health Service (NHS) has included a number of sizeable reforms that have emphasised partnership relationships between patients and professionals, and the importance of individuals taking a more active role in their care. Many of these changes have been specifically geared towards patients with chronic health conditions, who are recognised as imposing the largest strain on health services worldwide. This modernisation has occurred in parallel with a huge increase in the number of people within the UK who are turning to the internet for health information in order to become more informed about their health and treatment regimes. Despite this increase in the prevalence of online health information (OHI) seeking, relatively little is known about how people seek OHI and the impact it has on their lives and relationships with others. Overall Study Aim- This study sought to understand the OHI seeking experience of individuals with chronic health conditions by using an innovative mixed-methods approach to collect a breadth and depth of relevant information on the topic. Design – One hundred participants were recruited from local support groups for various chronic health conditions. The participants in the first stage of the study completed one of two questionnaires, depending on whether or not they had sought OHI in the past. The design and focus of stage two of the study was guided by the findings from stage one, and subsequently focused on the experiences of older adults with chronic health conditions seeking OHI. A descriptive phenomenological approach was adopted in order to provide rich descriptions of patients’ experiences. Six participants were purposefully selected from a parallel sample to the stage one respondents. Findings- The results from stage one provided a breadth of information about the OHI seeking experience for people with chronic health conditions. Findings suggested that health professionals were still the most important source of health information for users and non-users of OHI; that patients had an awareness of the inconsistencies in terms of OHI quality; and identified the perceived ease with which useful and relevant OHI was located. A further key finding was that high age, low education levels and low internet usage not only acted as barriers to OHI seeking for participants, but also had a negative impact on participants’ perceptions of the positive outcomes of OHI seeking, such as confidence in decision-making or engaging in discussions with health professionals. Moreover, some non-users demonstrated that they felt they were “too old” to engage in OHI seeking. Stage two findings demonstrated 5 key themes: patients taking responsibility for their health; their expectations of OHI; explicit confidence in their own ability to discern OHI and concern for others to do the same; the selective nature of OHI sharing between patients, and patients and health professionals; and the reinforcement of social sharing networks where positive and useful OHI is shared freely. Conclusion- Although older adults within this sample were less likely to engage in, and perceive the positive outcomes of OHI seeking than their younger counterparts, some older adults were successfully engaging in the OHI seeking experience, and perceiving the constructive effects of this experience such as empowerment. Furthermore both stages of the research demonstrated the valuable role health professionals play in supporting patients seeking OHI. Implication- This study demonstrates a need for health professionals to actively support patients in seeking OHI. In doing so, this could reinforce OHI seeking behaviour, and assist patients in effectively searching for and appraising OHI.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Young People’s Experiences of Engaging With Fitspiration on Instagram: A Gendered Perspective

Background: Fitness inspiration or fitspiration is a term used to describe web-based images of fit people, people in the gym, health foods, or inspirational quotes relating to diet and fitness being shared and consumed via visual social media. The popularity of this content is most notable via the Instagram platform. Currently, the majority of fitspiration research has focused on women’s experiences; however, increasingly, studies have pointed to the need to explore the gendered ways by which people engage with this content. Objective: The aim of this study is to explore how young men and women engage in fitspiration content on Instagram and provide a gendered analysis of how and why they consume this content. Methods: This study used a cross-sectional web-based survey (N=1213) of UK-based fitspiration users aged 18-24 years consisting of closed-ended questions to capture quantitative data. Results: The majority actively using Instagram for fitspiration (therefore eligible participants) were women (826/1175, 70.30%). Men were more likely to view content posted by athletes (χ 2 1, N=1153=71.8; P=.001) and bodybuilders (χ 2 1, N=1153=32.8; P<.001), whereas women were more likely to view content related to weight loss (χ 2 1, N=1153=36.8; P<.001), diet plans (χ 2 1, N=1153=11.9; P<.001), and celebrities’ content (χ 2 1, N=1153=33.5; P<.001). Men were more likely to use fitspiration as a source of inspiration to exercise to gain muscle or get stronger (χ 2 1, N=1147=17.9; P<.001), whereas women were more likely to use fitspiration as inspiration for healthy eating (χ 2 1, N=1147=37.7; P<.001), or to exercise to diet or lose weight (χ 2 1, N=1147=13.5; P<.001). Women were more likely to engage in passive behaviors such as viewing content on their feed (χ 2 1, N=1139=7.9; P=.005) or scrolling through accounts (χ 2 1, N=1139=15.2; P<.001), whereas men were more likely to engage in active consumption by tagging fitspiration accounts in posts (χ 2 1, N=1139=7.2; P=.007), commenting on posts (χ 2 1, N=1139=8.1; P=.004), and posting fitspiration content (χ 2 1, N=1139=6.4; P=.01). Conclusions: Female fitspiration consumers engaged with content that reinforced the feminine thin but shapely ideal, whereas male users sought out content that reinforced the masculine muscular ideal. Male users were more likely to engage actively with content (eg, posting fitspiration content), while female users were more likely to engage passively (eg, scrolling through accounts, posts, or images). Future research should consider how fitspiration consumption reflects and reproduces oppressive gender ideology

Women’s Experiences of Embodied Identity through Active Leisure

This article contributes to the small yet emerging body of literature that provides an analysis of active leisure to propose how it may provide existential possibilities for empowerment and the wellbeing for women. We have specifically explored women's experiences since it is broadly accepted that we experience our bodies in gendered ways. In this article, which combines theoretical discussion and qualitative empirical data from in-depth interviews with a female power lifter, we draw upon phenomenologically informed dwelling-mobility theory to explore examples of how active leisure provides these opportunities for wellbeing through the experiential lifeworld dimensions of embodiment and identity. Our discussion demonstrates that active leisure provides a pathway for women to have more empowering body experiences by developing an embodied identity that provides a sense of “I am my body” or “my body can.

Fan responses to ownership change in the English Premier League: Motivated ignorance, social creativity and social competition at Newcastle United F.C.

Over recent years there has been a significant increase in foreign ownership within the English Premier League, with ‘sportswashing’ being identified as a key motive for some new club owners. Whilst the effects of changes of ownership have received considerable focus, especially in terms of their impacts upon the club, less attention has been paid to the status of the owners themselves, how any perceived sportswashing strategy impacts upon fans, and how that impact is managed, especially in terms of the strategies that are used by fans to maintain a sense of identification. This paper focuses on the takeover of one Premier League football club, Newcastle United, and explores fan responses to its high-profile and controversial takeover by the Saudi Arabian Public Investment Fund (PIF). The paper explores the identity-maintenance strategies used by fans to maintain a positive association with the club using existing frameworks related to social creativity and social competition, as well as through the application of a novel strategy that has yet to be explored within the sport fan literature, that of motivated ignorance. The results demonstrate that whilst social creativity and social competition strategies are evident, motivated ignorance also provides an additional mechanism through which social identities may be protected from identity threa