Elsevier

Decision Support Systems

Volume 57, January 2014, Pages 417-427
Decision Support Systems

Factors influencing online health information search: An empirical analysis of a national cancer-related survey

https://doi.org/10.1016/j.dss.2012.10.047Get rights and content

Abstract

People are increasingly using the Internet to access health information and the information obtained has an impact on their healthcare outcomes. This paper examines the impacts of IT enablers and health motivators on peoples' online health information search behavior. We characterize users' online health information search behavior along three dimensions: the frequency of online health information search, the diversity of online health information usage, and the preference of the Internet for initial search. Using the 2003 Health Information National Trends Survey (HINTS) data on cancer, we find that ease of access to Internet services and trust in online health information could affect the three dimensional search behavior listed above. While perceived quality of communication with doctors has an impact on diversity of use and preference of use, we surprisingly do not find an impact on the frequency of search for online health information. In addition, our results find that perceived health status could affect both frequency and diversity of search for online health information. But we do not find evidence that perceived health status could lead to a preference for using the Internet as a source for health information.

Highlights

► Ease of access to the Internet could affect the online health information search. ► Trust in online health information could affect people's search behaviors. ► Quality of communication with doctors has no impact on the frequency of search. ► Health status does not lead to a preference for using online health information.

Introduction

Online health information has become one of the most important information sources for people seeking health information in recent years. With the increasing availability of online medical information sources, as well as the desire to take more responsibility for health and controlling costs, a growing number of people are using the Internet to find health related information. According to Pew Internet & American Life Project, 61% of the American adult Internet users searched for health information online and 60% of them said the information found online affects their health care decisions [14]. The health information being searched includes advice and information regarding conditions, symptoms, and treatment options [61]. The advantages of using online health information include cost savings, privacy protection, lack of embarrassment, efficient and effective retrieval of information, and the ability to tailor information to meet one's needs [7], [72]. Online health information searches could improve healthcare outcomes by reducing the health care disparity and encouraging patients' active interaction with doctors [8].

An increasing number of papers on health information systems (IS) have recently been published in the IS field. Most existing IS studies, however, examine topics relating to the adoption and impact of health information technology (IT) from a healthcare provider perspective. IS literature on online health information usage from the patient's perceptive is scanty. Developing an understanding of online health information search behavior may assist government agencies in designing policies which improve the allocation of resources to better disseminate quality health information and to inform patients about its accuracy. In addition, it may provide insights into the design of online health information websites and increase the effectiveness of using online health information. In response to recent calls in the literature for more studies on users' online health information behavior and patterns [1], this paper examines how IT and health factors affect people's online information search behavior. More specifically, we attempt to answer the following questions:

  • Q1

    How can we characterize users' health care information search behavior?

  • Q2

    What factors could affect users' health care information search behavior?

This paper examines people's search for information regarding cancer in particular. Cancer has a high incidence rate (about 1.5 million new cases of cancer were diagnosed in 2010; about 457 per 100,000 people) and mortality rate (for the year 2010, 178.4 deaths per 100,000 people) in the U.S. and diagnosis could generate fear and distress in patients and family members. To cope with this life-threatening illness both physically and psychologically, people (both those who have cancer and those who do not) seek cancer related information, including emotional information, on the Internet [37]. Currently, a vast amount of information on all aspects of cancer is available online, which could be used by cancer patients for treatment decisions, medical consultations and social support [74], as well as by non-cancer patients for prevention, screening and risk evaluation.

The contribution of this paper is two-fold. First, our research contributes to online health information literature by proposing a framework to examine online health information search behavior. The paper also links digital inequality to health inequality and contributes to health communication literature by theorizing and testing how patient–physician communication affects patients' online health information usage. Second, our study examines users' online health information search behavior from three aspects: frequency of search, diversity of search, and preference of information search channel. It provides a more comprehensive view to understanding online health information search.

The remainder of this paper is organized as follows: Section 2 reviews prior research background and Section 3 proposes hypotheses. Data and results are presented in Section 4. The implications, limitations and future research are discussed in Section 5.

Section snippets

Health information seeking

Information seeking is motivated by information needs, which is the perception of knowledge insufficiency [18], [19]. Health information needs include both cognitive needs, which include information for disease prevention and treatment, and affective needs, which include information for coping with illness emotionally [29], [71]. Health information could be used by people with an illness in order to understand their diagnosis and treatment options as well as by healthy people for risk

Research model

In this paper, we develop a conceptual model based upon the theory of information foraging [50]. Information foraging theory studies users' search behaviors on the web and it posits that users' search is motivated by their information needs and the search persists if the new information is relevant and useful. Also, it suggests that searchers tend to maximize the information gained when facing multiple information sources [11], [42], [51]. Searches for online health information differ from

Data

This study uses the 2003 health information national trends survey (HINTS) to test the hypotheses. HINTS is conducted by the National Cancer Institute to study people's health information behaviors (please see [43] for the details of the survey). HINTS data has been used in previous literature to examine a variety of issues related to people's health communications, disease prevention, patient behaviors and cancer education [5], [60].

Since the focus of this study is to investigate users' online

Discussion

In this paper, we studied three aspects of online health information searches—frequency of search, diversity of search, and preference of information channels for the initial search. We attempted to examine the effects of information technology related factors, including access to the Internet and trust in online health information, and health factors, including perceived health status and perceived communication quality with physicians, on users' online health information searches. As

Acknowledgements

The research of the second author is supported by summer grants from the School of Management, University at Buffalo. The research of the third and fourth authors is supported by NSF under grant #0916612. The research of the third author (correspondent author) has also been funded in part by Sogang Business School's World Class University Project (R31-20002), funded by Korea Research Foundation as well as by the Sogang University Research Grant of 2011. The usual disclaimer applies.

Nan Xiao is an Assistant Professor in the Department of Computer Information Systems & Quantitative Methods at the The University of Texas-Pan American. He holds a Ph.D. in MIS from The State University of New York at Buffalo. His research interests include healthcare information systems and information security. His work has been published at ACM Transactions on Management Information Systems and Decision Support Systems.

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  • Cited by (0)

    Nan Xiao is an Assistant Professor in the Department of Computer Information Systems & Quantitative Methods at the The University of Texas-Pan American. He holds a Ph.D. in MIS from The State University of New York at Buffalo. His research interests include healthcare information systems and information security. His work has been published at ACM Transactions on Management Information Systems and Decision Support Systems.

    Raj Sharman is an Associate Professor in the Management Science and Systems Department of the State University of New York at Buffalo. His expertise is in the areas of Patient Safety and Health Care Systems, Information Assurance and the use of biologically inspired computer security models. Disaster Preparedness and Response Management, Technology Valuation and Performance, and Medical Imaging Systems. He has published widely in National and International journals and is the recipient of several grants from university and external agencies, including the National Science Foundation. He received his PhD in Computer Science and a Master of Science degree in Industrial Engineering from the Louisiana State University. He received his Bachelors degree in Engineering and Masters Degree in Management from the Indian Institute of Technology, Bombay, India.

    H. R. Rao (MIS, SUNY @Buffalo) graduated from Purdue University. He has edited four books including “Information Assurance in Financial Services (Idea Group, 2007)”. He has authored or co-authored more than 150 technical papers, and has received best paper and best paper runner up awards at AMCIS, ICIS and ISR. He has received research funding from NSF and DoD. He was a Fulbright fellow in 2004. He is the recipient of the 2007 SUNY Chancellor's award for excellence. He is currently SUNY Distinguished Service Professor of MIS at UB and WCU Visiting Professor of SSME at Sogang University, S. Korea.

    Shambhu Upadhyaya, PhD is a Professor of Computer Science and Engineering at the State University of New York at Buffalo where he also directs the Center of Excellence in Information Systems Assurance Research and Education (CEISARE), designated by the National Security Agency. Prior to July 1998, he was a faculty member at the Electrical and Computer Engineering department. His research interests are in broad areas of information assurance, computer security and fault tolerant computing. He has authored or coauthored more than 250 articles in refereed journals and conferences in these areas. His current projects involve intrusion detection, insider threat modeling, security in wireless networks, and mitigation of malware in social networks. His research has been supported by the National Science Foundation, U.S. Air Force Research Laboratory, the U.S. Air Force Office of Scientific Research, DARPA and National Security Agency. He is a senior member of IEEE.

    An early version of this paper was presented on Feb 11th at the 2011 ISOM Workshop on Healthcare and IS at University of Florida. We thank the workshop attendees for comments that have greatly improved the paper. We also thank the Guest Editors and the referees for their critical comments that have greatly improved the paper.

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