Life of Sophia Wong of Yor Health Comments and Reviews
Collaborate J Med Res. 2017 Jul-December; 6(2): e24.
How, When and Why People Seek Health Information Online: Qualitative Study in Hong Kong
Monitoring Editor: Gunther Eysenbach
Joanna TW Chu, PhD,1 Human being Ping Wang, PhD,2 Chen Shen, PhD,iii Kasisomayajula Viswanath, PhD,4, v Tai Hing Lam, MD, 
3 and Sophia Siu Chee Chan, PhDtwo
1 National Institute for Health Innovation, School of Population Health, Kinesthesia of Medical and Wellness Sciences, The University of Auckland, Auckland, New Zealand
2 School of Nursing, The University of Hong Kong, Hong Kong, Cathay (Hong Kong)
3 School of Public Health, The University of Hong Kong, Hong Kong, China (Hong Kong)
iv Centre for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, United States
5 Department of Social and Behavioral Sciences, Harvard Th Chan School of Public Wellness, Cambridge, MA, United States
Tai Hing Lam, School of Public Wellness, The University of Hong Kong, Patrick Manson Building, No 7, Sassoon Road, Hong Kong,, People's republic of china (Hong Kong), Phone: 852 39179287, Fax: 852 2855 9528, Electronic mail: kh.ukh@htlrmrh.
Joanna TW Chu
1 National Institute for Health Innovation, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
Homo Ping Wang
2 Schoolhouse of Nursing, The Academy of Hong Kong, Hong Kong, China (Hong Kong)
Chen Shen
three School of Public Health, The Academy of Hong Kong, Hong Kong, China (Hong Kong)
Kasisomayajula Viswanath
4 Center for Customs-Based Research, Dana-Farber Cancer Institute, Boston, MA, United States
5 Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Cambridge, MA, United states of america
Tai Hing Lam
iii School of Public Health, The University of Hong Kong, Hong Kong, Communist china (Hong Kong)
Sophia Siu Chee Chan
2 School of Nursing, The University of Hong Kong, Hong Kong, People's republic of china (Hong Kong)
Received 2016 Nov 16; Revisions requested 2017 Feb 23; Revised 2017 Mar 26; Accepted 2017 Oct 30.
- Supplementary Materials
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Multimedia Appendix 1.
Themes and subthemes from the focus groups (North=49).
GUID: A07F606B-5D76-4019-AFB5-A7A998F0E60A
Abstract
Background
The Internet has go an established source for health information. The number of individuals using the Internet to search for health information, ranging from salubrious lifestyle communication to treatment and diseases, continues to grow. Scholars have emphasized the need to give greater voice and influence to health consumers. Hong Kong, being one of the virtually technologically advanced and connected cities in the earth, has one of the highest Cyberspace penetration rates in the world. Given the famine of research in an Asian context, Hong Kong is an fantabulous platform to study individuals' perceptions (eg, benefits and limitations on seeking health information online and how the information is used) on health information seeking.
Objective
The aim of this paper was to study individuals' perceptions on health data seeking and to document their Internet information–seeking behaviors.
Methods
Five focus groups (northward=49) were conducted from November 2015 to January 2016 with individuals across different age groups (xviii years or above). Focus group contents were audiotaped, transcribed, and analyzed using thematic analysis techniques.
Results
Older (55+ years) and less educated respondents were less likely to apply the Cyberspace to search for health information. Among individuals who obtained health information via the Internet, regardless of the severity of the health issue, the Internet was always the first source for data. Limited physician consultation time and barriers to accessing professional wellness services were the principal reasons for using the Internet. Convenience and coverage were regarded as the main advantages, whereas credibility and trustworthiness of wellness information were noted equally limitations. The utilise of Web-based health information varied among individuals; hence, the implications on the medico-patient relationship were mixed.
Conclusions
The prevalent and increasing utilize of the Internet for wellness information seeking suggests the need for wellness intendance professionals to understand how it can be optimally utilized to improve health outcomes. Strategies for communicating and disseminating credible health data in a form that users tin empathize and use are essential. Due to the rapid technological and related behavioral changes, online health information seeking and its effects need to be closely monitored.
Keywords: Internet, information seeking behavior, consumer health information, focus groups
Introduction
Hong Kong is one of the most technologically avant-garde and connected cities in the earth. According to the Hong Kong Monthly Digest of Statistics (HKMDS), 2013, the estimated number of Internet users was 5.751 million in a population size of approximately vii.188 one thousand thousand. Net access is available most everywhere via broadband and Wi-Fi (39,796 public Wi-Fi hotspots in the city; Office of the Telecommunications Authority, 2015). Co-ordinate to the Census and Statistics Department (CSD) Hong Kong, 2014, more than 80% of households take personal computers connected to the Internet, with broadband penetration rates among the highest in the world. Ninety-six percentage of mobile telephone users access the Cyberspace on a daily footing. The most commonly cited purpose of using the Net is information searching (HKMDS, 2013). Acquiring health data from the Internet is also increasingly prevalent [1]. Individuals can obtain a wide range of information from healthy lifestyle advice to treatment and diseases [two,three].
Health information seeking relates to the ways in which individuals obtain information, including information about their health, wellness promotion activities, risks to one's health, and affliction [iv]. Health information accessed via the Internet has enabled individuals to become more agile collaborators in their own health [5]. The breadth and nature of health information obtained influences individual's noesis, beliefs, and attitudes toward a specific health beliefs [half-dozen]. The Cyberspace every bit a medium has the capacity to help change and promote health behaviors [7,8]; yet, the quality of the information varies widely [9-xi]. The anonymity of content publishers and low rigor in monitoring and filtering Web-based content are some of the reported challenges from the abundance of inaccurate or misleading information [eleven,12]. Notwithstanding, this shift toward individuals becoming more than informed and empowered in managing their own health have implications on the ways they interact with professionals and the health care system [v].
Internationally, increasing studies take been conducted into agreement individuals' perceptions on Internet health information seeking [nine,13-15]. Nonetheless, there is a dearth of research on users' perceptions on the benefits and limitations on seeking wellness information via the Net and how the data is used in a Chinese context. There are likely to be differences among perceptions of wellness, telecommunications infrastructure, and patterns of inequalities in that of the West and East [16]. The increasing use of the Internet has raised important questions virtually the relationship between cultures and technologies.
Furthermore, scholars accept repeatedly emphasized the need to give greater voice and influence to health consumers [three]. Much attention in the literature has focused on identifying who actively seeks or who does not seek health information, the frequency of employ, and satisfaction with health information seeking [17-20]. There is a need for more qualitative research to examine how and why individuals obtain health information, where they go to retrieve such data, and how the health information is used. Qualitative research allows for greater exploration of reported behaviors in users. This allows for in-depth insights into the participants' experiences, underlying motivations, and thoughts and feelings associated with wellness-seeking behaviors that are oft non captured through quantitative methods [21,22]. Focus groups are normally used in qualitative research equally this method encourages interaction among participants, besides equally free and open disclosure in a group context. It enables the researchers to have straight contact with key informants and allows researchers to gain substantive information in an easy and efficient style [23]. Grouping interaction offers valuable data on the extent of consensus and multifariousness amongst the participants and allows the researcher to ask the participants themselves for comparisons among their experiences and views [23]. Health information seeking is a common shared feel, and thus, the use of focus grouping provides an opportunity for participants to collaborate and share rich sources of information that would otherwise not be obtained through individual interviews. Given the dearth of research in an Asian context, Hong Kong thus provides an excellent platform to explore individuals' perceptions on wellness information seeking, where the utilise of the Internet and Web access devices is highly prevalent. This report, therefore, aimed to examine individuals' perception on health information seeking and their related behaviors. This newspaper also reports on user's perceptions of the advantages and disadvantages of seeking health information via the Cyberspace and the application of the information obtained.
Methods
Study Design
Ethics approval was obtained from the institutional review board of the University of Hong Kong/Hospital Authorisation Hong Kong West Cluster. Five focus groups were conducted on Hong Kong adults from November 2015 to January 2016, with numbers in each grouping ranging from 9 to 11. Before recruitment, we proposed to conduct five focus groups based on recommendations from the literature on qualitative methods [24]—which allows flexibility in increasing or decreasing the number of focus groups subsequently data drove has begun, and the focus group can stop when the point of data saturation is reached. Hence, nosotros debriefed and reviewed the notes to reflect on each session earlier conducting the side by side session. By the fifth focus group, we were convinced that nosotros had reached data saturation and stopped.
Data Collection
This study was part of a larger inquiry project entitled the Hong Kong Family unit and Health Information Trends Survey (FHInTS) that examined the full general public opinions and behaviors on family health, information use, and health advice under the FAMILY Project at the School of Public Health, the University of Hong Kong. Details of the survey design have been reported elsewhere [25]. To facilitate the side by side stage of the enquiry project, which included a random telephone-based household survey, focus groups were conducted to (1) obtain input and refine the survey and (2) elicit insights and perspectives on health data seeking. This paper reports on individuals' perception on wellness information seeking and their related behaviors.
Recruitment of participants was conducted by the Public Opinion Program (POP), a renowned survey agency in Hong Kong. Eligible participants were individuals residing in Hong Kong, aged 18 years or above, and fluent in Cantonese. A total of 3443 invitations were sent out to POP panel members either past e-mail or telephone (panel members were recruited through a consent question at the end of random telephone surveys. All members within a selected household were invited to enroll into the panel). Of the 82 participants who expressed interest, 49 participants participated.
Participation was voluntary, and written informed consent was obtained from the participants before the start of the focus grouping. Each focus group lasted for approximately xc minutes and was managed by a panel of two members, specifically one moderator and one notetaker. An interview guide with prompts was developed to encompass a range of key issues related to the research questions. Initially, five questions were asked:
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What is your general perception on seeking health data online?
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What are the benefits on seeking wellness data online?
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What are the limitations on seeking wellness information online?
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How do you search for information?
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How is the information used?
Afterwards conducting the first focus group, transcripts and notes taken were reflected on before conducting the next 1 (including listening to audio tape, reading notes, and debriefing with the enquiry team); this resulted in an additional question for the subsequent sessions: (6) How do you apply the health information obtained with your health professional?
The moderator was gratuitous to give-and-take and sequence questions in the most appropriate manner and to pursue areas in greater depth. Participants also completed a questionnaire on demographic characteristics. Participants who attended the focus grouping sessions were given HK $150 (US $1=HK $seven.8) greenbacks for their travel expenses and equally a token of appreciation. Refreshments were made available.
Information Analysis
All focus groups were conducted in Cantonese, audiotaped, and transcribed verbatim into Chinese past experienced researchers at Pop. Reviewing the entire transcripts would correspond a significant increase in costs and fourth dimension. As recommended by Poland [26], a random modest sample of transcript from each focus grouping was reviewed. This determined the extent to whether a full review of the residual of the transcripts was needed. A research assistant who was not involved in conducting the focus groups checked 10% of the transcripts of each focus grouping. No major errors were noted, and therefore, we were confident that the transcripts were of high quality. Thematic analysis [27] was used to identify, clarify, and report patterns (themes). First, the transcripts were read in detail, and wide themes were noted. Then an in-depth analysis was conducted using a procedure of abiding comparisons in which differences and similarities were analyzed to identify master themes and subthemes. Another member of the inquiry squad and the first author (JTWC) cross-checked, discussed, and agreed on the coding of the data and confirmed that the themes identified reflected the information. In the upshot that researchers differed in their coding decisions, themes were reanalyzed and checked against other coded data until a consensus was reached. The transcriptions were in Chinese, and the assay was conducted based on the Chinese transcript. Themes that emerged were subsequently translated into English language by the researcher who was bilingual and near-native in English and native in Chinese. Dorsum translation was used for quality command check past an contained inquiry assistant. This involved translating the English themes and quotes into the Chinese linguistic communication. This ensured that the translated version reflects the item content of the original version. The quotes in the paper were from the English translation of the original Chinese transcripts.
Results
Participant Characteristics
The characteristics of the sample are shown in Table 1. The majority of participants were male person (53.1%, 26/49) and married (51.1%, 25/49). A similar proportion was spread among the age groups. Almost one-half (51%, 25/49) had a tertiary teaching and were currently working, with 63.3% (31/49) earning more than the average household income of HK $20,200 (CSD, 2013).
Table 1
Demographic characteristics of the participants.
| Characteristics | n (%) | |
| Sexual activity (N=49) | | |
| | Men | 26 (53) |
| | Women | 23 (47) |
| Age group, years (N=47) a | | |
| | xviii-24 | ix (19) |
| | 25-34 | viii (17) |
| | 35-44 | 8 (17) |
| | 45-54 | six (13) |
| | 55-64 | viii (17) |
| | 65+ | eight (17) |
| Education attainment (N=47)a | | |
| | Primary or beneath | 2 (four) |
| | Secondary | 14 (30) |
| | Tertiary or higher up | 31 (66) |
| Marital status (N=47) a | | |
| | Single | 19 (40) |
| | Married | 24 (51) |
| | Divorced or widowed | 4 (nine) |
| Employment status (Due north=48)b | | |
| | Full-fourth dimension | 16 (33) |
| | Role-time | five (10) |
| | Cocky-employed | five (10) |
| | Unemployed | 22 (46) |
| Monthly household income (North=38) c | | |
| | <10,000 | 7 (eighteen) |
| | 10,000-19,999 | 7 (18) |
| | 20,000-29,999 | eight (21) |
| | 30,000-39,999 | 4 (11) |
| | xl,000+ | 12 (32) |
Main themes and subthemes were identified and grouped into 5 categories. These include (1) Perceptions on seeking health data via the Internet, (ii) Perceived benefits of the Internet, (3) Perceived limitations of the Internet, (4) Strategy to navigate the Internet for health information, and (5) Implications of seeking health information via the Internet. These are described below with translated quotations that attempted to preserve the intent of the speaker. The quotations were taken from a number of respondents and were identified based on groups (G1, G2, and so on), and participants (A, B, C, and and then on). Multimedia Appendix 1 details the themes and subthemes identified.
Perceptions on Seeking Health Information via the Internet
A majority (92%, 45/49) of respondents indicated that they did seek Spider web-based data and that they had sought health information via the Internet within the last 12 months. The main type of information that was sought includes healthy lifestyle advice (healthy eating and physical exercise) and prevention of chronic or infectious diseases. A majority (97%, 47/49) of these respondents agreed that the Net was often the first medium they used to seek health information. As 1 respondent noted:
I recall unless you are not familiar with the Internet, otherwise, it'southward ever the first place to become.
Group three, Participant G
In regards to why they used the Cyberspace, all respondents agreed that it was for the want for greater understanding, clarity, and confirmation of the health issue. This was the case regardless of whether they were seeking information for themselves or for someone else.
As noted past a male respondent:
My family members are elderly, I need to have some information first earlier persuading them to become see a doctor.
Group 2, Participant D
However, for a minority of respondents (eight%, four/49), specially for those older than 55 years, traditional health services (eg, doctors and professionals) was a first indicate of call if they had a health trouble. Merely when traditional health services failed would they plough to the Internet to seek alternative handling methods. Regardless of the severity of the health topic, older respondents preferred more traditional resource (eg, doctors and professionals, family and friends, printed newspapers, and radio or television) than the Internet. For instance, a adult female (aged 55+ years) noted that:
Amidst my friends, around our age, for us to actually seek online, it really has to be an illness that even the doc or you have had it for a long time, sought assistance from a lot of places only withal have non found a way to cure it. And so (y'all) may then search online and come across if there is anything that might help.
Group 5, Participant I
1 of the reasons for non seeking wellness information via the Net was that information technology was difficult for respondents. Some (50%) of the older respondents claimed that they feel overwhelmed and nervous with using the Cyberspace and that it was difficult to notice information. Whereas some (50%) needed help to access Spider web-based information, others felt that a lot of endeavor was required to seek health information via the Internet:
I feel that [searching on the Net] is bothersome. Sometimes when you lot search...I, myself, am not very practiced at searching. Then going about it more than direct (request family unit/friends/professional) is faster.
Group v, Participant I
Perceived Benefits of the Internet
When asked almost the benefits of seeking Web-based data, iv common themes emerged. These included convenience, coverage of vast information, cocky-awareness, and being able to share experience and form support groups. Convenience was noted as the principal benefit of seeking health information via the Cyberspace and was agreed by all respondents. The convenience of Spider web-based wellness data encompassed the ease and speed of admission, at any time, and from whatever location. This was assorted with accessing traditional wellness services. For example, a female respondent noted that:
The Internet is really piece of cake to use, you can use it anytime. Unlike doctors or health clinics, I tin't telephone call them and ask them at work, and after work, they are all airtight. But with the Internet, you can search the information during work, and even subsequently work, you can utilise your mobile phone to go on the Internet to search. I think this is really convenient and because it'south the Internet, it offers yous more sources and opinions.
Group 3, Participant G
Many (78%, 38/49) of the respondents (including those that do not seek information via the Internet) stressed their limited time in doc consultations and the often lack of time to talk over or elaborate on certain issues. The Internet was thus perceived to be particularly useful for expanding on the information received from the doctor. An example was provided by a male respondent:
Often, doctors don't have the time to speak with you at length, because if he/she gives you 15 minutes, information technology is already a lot. For example, with cancer, lymphoma, even if he/she has a report afterwards you take been tested, I recall if you make him/her explain for v minutes, it will exist a painful process for him/her, right? Typically, professionals, they volition usually tell yous a few things, only non a detailed explanation, so it is necessary for me to rely on the Internet for notwithstanding many hours (I need to understand the issue).
Group three, Participant D
With the convenience of the Internet, respondents were also able to obtain a vast corporeality of information, and they often obtained more information than their initial search topic, thus allowing them to aggrandize their knowledge. The ability to access a vast amount of data was noted by a majority (71%, 35/49) of the respondents equally a perceived benefit. For example, a male participant noted:
When you search (on the Internet) you lot get a lot of related information. For example, if I was initially just searching for the cause of diabetes, in that location would too be links to diets for diabetes and other related issues. I probably never thought about these (related information) prior to searching the Net.
Group 3, Participant F
For some (44%, 21/49), the Net raised their awareness on sure health problems and immune them to attend to their wellness problems early. Respondents, particularly younger participants (aged 18-35 years), felt that the Internet allowed them to become more active seekers for their own wellness. This was expressed by a female participant:
I recollect the best advantage of going online to expect for information is that I take the initiative to go online to look for information. For instance if I go to mind to a health lecture on health information, it is actually led past one speaker, the things he speaks about, are the things I absorb. Just the Net is as large as the globe, I can choice and cull what I want, this is the reward I feel, but of course information technology also has its disadvantages.
Group 4, Participant H
Female respondents (20%, 10/49), in particular, spoke of the Net every bit a medium that allows individuals with similar health concern or background to share and support one some other:
It is actually psychological support on some level, I feel, I am getting some support, and also I tin can really come across that [their condition] and [my condition] are similar, so "Oh, they are okay, and then I should be okay too", it is this kind of feeling.
Group two, Participant K
Perceived Limitations of the Internet
Despite the benefits, several limitations were noted by respondents nigh seeking Web-based health information. Specifically, trustworthiness, frustration and fear, and nontailored information were recurring themes that ran through all the focus groups. The quality and trustworthiness of the information on the Net was a master concern for all of our respondents, particularly for those that did non seek information via the Net (viii%, four/49). Even for young participants, finding credible health data via the Internet was not straight forrard. As a male respondent noted:
I think there is too much information on the Internet, and sometimes you exercise non know if the information is right or incorrect, so you need to read and know everything yourself, possibly it is easier to trust if you go to some more professional websites, right? With forums, mayhap even believing 10% of it is problematic, and so at that place is too much information, but it is very easy to search, simply you lot need to filter information technology yourself. That means y'all still have to use some fourth dimension to filter.
Group four, Participant C
Respondents with lower education level attainment were more probable to report frustration during Web-based health data seeking. For instance, the sheer volume of information was sometimes perceived equally "daunting" and might crusade defoliation. A bulk (71%, 35/49) of the respondents felt that the wellness data obtained could be misleading and may exaggerate the wellness problem, intensify broken-hearted feelings, and filibuster seeking professional services. This frustration and fright from the sheer volume of wellness information applies to a range of health bug, including lifestyle data to life-threatening diseases:
At that place is so much data. For example, if I wanted information on good for you diet and how to lose weight, when yous search, heaps and heaps of data comes upwards. So information technology's really hard to determine which to use, let alone whether it's actually suitable for me or non, or even whether it's trustworthy.
Grouping 2, Participant H
I think for some, if they demand to accept an operation and want to know more about it, they search the Internet. But some of the data regardless of it existence true or non, may freak them out. They may filibuster having the performance and instead seek alternative non-traditional wellness services.
Group 3, Participant B
Furthermore, a couple of the respondents (31%, 15/49) felt that any advice provided over the Internet was limited by the fact that it was not based on the individual's condition and knowledge of their past history:
Health information online is non tailored, and so what works for i may not work for another, and I actually don't know whether information technology works for me.
Group 2, Participant J
Strategy to Navigate the Internet for Health Information
A recurring theme that was identified through all the focus groups was the strategies employed in navigating Web-based health information. Nearly all (97%) of the health information seekers began their search process with search engines. Google was the virtually common search engine used; withal, most (51%) did not go beyond the first two pages of citations following the search:
For the search results from a Google search engine search, if you compare the showtime three to five results and they are mostly like with few differences, then y'all will not want to go through the try of reading the sixth.
Grouping ii, Participant J
A part of navigating the Internet involved how to make up one's mind what information or websites to utilize and trust. Choosing a apparent website was regarded every bit a mutual sense activeness; however, when asked about the details, respondents had trouble in articulating their choice process. Nevertheless, some respondents (31%, 15/49) were able to limited sources of health information that they would not select. For example, respondents agreed that they tended non to trust corporate websites, specifically those of pharmaceutical companies or those that conspicuously advertise products. Respondents also reported looking for the land of origin of the information and had more confidence in websites from Taiwan or away than websites from China Mainland. They preferred information that originated from what they considered to be impartial and reputable sources such equally government, professional, or disease-focused organizations, or academy websites. Whereas all respondents agreed that the Hong Kong government websites were credible, all of them felt that information technology provided very picayune data:
You will have a await at where the site comes from, you will have a look at if its layout has a lot of games, you tin can feel that it is commercial...I tend to believe sites from Taiwan or abroad, and I do not actually believe those from China, Mainland.
Group ii, Participant Chiliad
Respondents also noted that to farther determine which health information is credible, information would be compared across several websites, and only when they appeared similar would respondents perceive it to be trustworthy:
I rarely search using Mainland Chinese websites, and besides, I usually go to at least 4 or 5 sites, I usually do this, I only trust information technology if "Oh, they are like". I volition non focus on one site, and completely trust it, I definitely volition non.
Grouping 2, Participant B
Implications of Seeking Health Information via the Internet
Respondents provided insights into using the wellness information obtained via the Internet for decision making. A number of respondents used the health information to understand a bailiwick or topic better and/or to make up one's mind whether they needed to run across a medico and to decide what questions to ask their doctors. Specifically, 31% (15/49) respondents felt that the Internet allowed them to become informed users and be able to share decisions with their wellness professionals. For a majority (92%, 45/49) of the respondents, the doctor'due south authority remains crucial and sometimes becomes even more important, as they sought clarification or understanding on the information gained from the Cyberspace:
At least after reading [it online] yourself you lot know how to inquire the doctor virtually it, if you practice not read, then you will not know how to even begin asking.
Grouping 1, Participant A
For case as we said just now, if my arm is numb, I would non have known why before, merely maybe now after going on the Internet and reading more, maybe whichever side of the encephalon has had a stroke, so I will immediately become to the doctor, and I will notice out. Yes, you tin can say that [the Internet's] preventive nature may actually increase the chances of me going to the medico.
Group v, Participant D
On the other manus, a minority (4%, 2/49) of the respondents expressed that they could use the data obtained to claiming the advice given by their wellness service providers. This challenge was an explicit response to not believing the health professionals:
The medico isn't always right, so you need to use the data (obtained from the Internet) to keep questioning them.
Grouping five, Participant I
Regardless of the severity of the wellness issue, for respondents that did seek Spider web-based data, they agreed that the Internet was ever the first source for information. In cases where the health business organisation was not perceived as severe, respondents preferred to self-manage based on the information obtained from the Internet. In cases where the concern was severe, traditional wellness service was still preferred. Yet, traditional service was frequently accessed later respondents had searched the Internet for information:
I experience that you need to accept a look at the question of how important information technology is. For case, I might be very fat, need to lose weight, and need to possibly look at the calories in food, so I might get online, considering these things are relatively not so harmful to myself, so it might be worth trusting. But if my kidney is really painful, my stomach is really painful, or such, I might go online and have a look at what the reasons are for these things, and and then I will all the same become and consult a doc.
Group 5, Participant D
Overall, data from the Internet was generally perceived to be supplementary material and that the Internet is non a replacement to accessing traditional health services:
Going on the Internet to look for health information, to me, is supplementary and auxiliary. Sometimes the doctor might non explain in enough detail, then [yous] find some supplementary information on the Internet, information technology mainly performs an profitable function.
Group 3, Chiliad
Discussion
Principal Findings
The aim of this study was to gain a better understanding on individuals' perceptions on health information seeking on the Internet and their related behaviors. The findings from a Chinese population highlight several important issues that could inform other rapidly developing regions with increasing Internet employ.
Mirroring Western studies [28,29], younger respondents (18-45 years sometime) were more than likely to use the Internet as a source for health information. Consistent with the literature, the Net was valued for its convenience, breadth of information, and the capacity to provide peer back up and social interaction [iii]. Forth with the reported advantages of the Net, respondents besides noted the inherent disadvantages (eg, credibility and sheer book of information). The difficulty with navigating the Internet acted as a barrier for older respondents to seek Web-based wellness information.
Our findings align with the theory of planned beliefs, which posits that intentions predict behavior, and intentions are in turn predicted past attitude. Generally, all of our respondents expressed the intention in knowing more about wellness issues. However, younger respondents tended to consult the Internet before seeking medical consultation. In this written report, this was the example regardless of the severity of the wellness effect. Respondents attributed this tendency to seek Spider web-based information to the limited fourth dimension of consultations they received from their doctors. On the reverse, doctor consultation remained every bit the first indicate of contact for older respondents. This behavior was mainly attributed to the paternalistic view that "doctors know best" and the distrust of the health data on the Internet. It'due south also important to annotation that the Cyberspace was viewed as a supplement to health care rather than a replacement for professional intendance by all of our respondents. Understanding individuals' intentions and health information seeking behavior is important as it can assist in the development of recommendations and policies to guide more effective help seeking and self-management among individuals, leading to improve health outcomes. Our findings shed light on the critical conventionalities that guided individuals, particularly the elderly, in the decision to appoint in Web-based health-data seeking.
For some female person respondents, the Net further provided social support and reassurance on wellness issues. Previous studies take reported that patients' feelings, psychological problems, families, social problems, expectations of their doctors, ideas about their illnesses, and fears are rarely discussed between the dr. and the patient [thirty]. Our findings advise the potential of the Net to offer support to a large group of health consumers where they can share their personal health and affliction experiences; they can offer special insights and reflections from the lived experiences of their specific health conditions that doctors may not be able to provide.
It is worthy to note that the initial enquiry questions did not focus on health information seeking and its related impact on the doctor-patient relationship. However, following the first focus group, it was apparent to us that this was an important attribute to consider, and nosotros and then added a new question. Previous studies in Hong Kong noted that doctors were more powerful in terms of medical handling and advice, in which during consultation, patient autonomy and cocky-management of affliction are not usually advocated [31]. Our findings, nonetheless, suggest a shift toward a more counterbalanced relationship between the md and the patient. Immature respondents, in particular, noted that health data obtained from the Net immune them to be more than informed and able to share decisions with and question their health professionals. This is consistent with studies that have observed a more powerful and autonomous patient when one is equipped with more than medical and health information [19,20]. This is especially salient in a Chinese culture where there is often a bureaucracy and power-imbalance between the medico and patient. As individuals are feeling more empowered, and are more inclined toward existence involved in their wellness and health decision making, it may impact and change the way in which individuals interact with their health professionals. Futurity research into the office of health information and the impact on doc-patient human relationship will be important every bit technology and patient demand continues to evolve.
All of our respondents were conscious that there was an abundance of poor-quality Web-based health information. Indeed, previous studies accept raised concerns for the quality of health information on the Net and noted that the potential impairment from inaccurate wellness data sources may be significant [12,32]. Health information from unqualified sources may lead to inappropriate treatments or delays in seeking necessary health services [12]. It is therefore important to devise means to help individuals to choose information that is informative, credible, and useful. Health professionals may also consider ways to introduce and discuss Web-based wellness information with their patients. This may alleviate concern about the quality and overwhelming information and could take a positive touch on the patient's wellness care decisions and outcomes.
Our findings also suggest that although the Internet is an easily available source of health information, it may as well create inequalities in health information accessibility, specially amid the elderly, those with low income, and those with low educational attainment. It is of import to note that the rapid advocacy of technology tin can create a digital divide, where there are many individuals who practise non possess the necessary skills or the devices needed to navigate the Internet and search for apparent health information. We also observed that this group of individuals relied on traditional mode of health information delivery (ie, doctors). This is of concern, as these groups are those that are more than likely to accept health bug but are less probable to access health care services. This group may farther exist disadvantaged as wellness intendance providers are increasingly transitioning to digital and Net technologies for disseminating wellness information. There is a need to consider how health information can be disseminated to this group of individuals.
Limitations
Transferability of these findings is limited to populations like to participants in this report. Although every effort was made to recruit a diverse sample, our sample was of college socioeconomic status. Hereafter studies are needed to examine the perceptions of those with lower socioeconomic condition. Individuals younger than 18 years were non included in our sample. Given that children and adolescents are growing upwardly fast in the digital age, understanding their perceptions may farther our noesis on their wellness information–seeking behaviors. Finally, certain behaviors appeared to be intuitive and were therefore difficult to clear. For instance, some of our respondents were not able to describe their search and appraisal processes. Observational strategies may need to be employed in hereafter studies to examine how health data via the Cyberspace is obtained and used.
Conclusions
The rapid development of information technology (IT) has increased the importance and relevance of questions related to wellness data seeking via the Cyberspace. Our report has revealed that older and less educated individuals were less likely to apply the Internet to look for health data and had more challenges in benefiting from Web-based health information. We accept also identified that the most predisposed to searching for health information on the Internet were motivated past limited dr. consultation time and barriers to accessing professional wellness services. Strategies for communicating and disseminating credible wellness data in a form that all users tin can empathise and apply are urgently needed. These include taking into business relationship the diverseness of individual skills in both searching and critically evaluating information, as well as the skills to use digital devices and should attain those who adopt not to use the Internet for health information. Understanding how these skills—often referred to as digital health literacy—are related to adoption and usage of IT is necessary and should be useful for exploring health information needs in diverse socioeconomic groups. Studies on how seeking health information affect behaviors are also needed so that targeted interventions can exist developed to improve wellness outcomes. The findings from the focus groups were used to fine-tune our FHInTS survey, which had since been adult, and information collection has been ongoing. Questions regarding the medium to access Web-based health information, credibility of information sources, possession of devices, access to health services, and demographics have all been refined or incorporated to provide a better understanding on wellness information–seeking behaviors amid adults in Hong Kong. Due to the rapid technological and related behavioral changes, Web-based wellness data seeking and its effects demand to be closely monitored.
Acknowledgments
The project was funded past the Hong Kong Jockey Lodge Charities Trust. The authors would like to give thanks the participants who participated in the focus groups and Pop for coconducting the focus groups. The authors would also similar to thank all members of the FAMILY Project team.
Abbreviations
| CSD | Census and Statistics Department |
| FHInTS | Family and Health Data Trends Survey |
| HKMDS | Hong Kong Monthly Digest of Statistics |
| IT | it |
| Popular | Public Opinion Programme |
Multimedia Appendix 1
Themes and subthemes from the focus groups (N=49).
Footnotes
Conflicts of Involvement: None declared.
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5743920/
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