@Article{info:doi/10.2196/jmir.3945,
author="Perez, Susan L
and Paterniti, Debora A
and Wilson, Machelle
and Bell, Robert A
and Chan, Man Shan
and Villareal, Chloe C
and Nguyen, Hien Huy
and Kravitz, Richard L",
title="Characterizing the Processes for Navigating Internet Health Information Using Real-Time Observations: A Mixed-Methods Approach",
journal="J Med Internet Res",
year="2015",
month="Jul",
day="20",
volume="17",
number="7",
pages="e173",
keywords="dual processing; information seeking; Internet search; health information",
abstract="Background: Little is known about the processes people use to find health-related information on the Internet or the individual characteristics that shape selection of information-seeking approaches. Objective: Our aim was to describe the processes by which users navigate the Internet for information about a hypothetical acute illness and to identify individual characteristics predictive of their information-seeking strategies. Methods: Study participants were recruited from public settings and agencies. Interested individuals were screened for eligibility using an online questionnaire. Participants listened to one of two clinical scenarios---consistent with influenza or bacterial meningitis---and then conducted an Internet search. Screen-capture video software captured Internet search mouse clicks and keystrokes. Each step of the search was coded as hypothesis testing (etiology), evidence gathering (symptoms), or action/treatment seeking (behavior). The coded steps were used to form a step-by-step pattern of each participant's information-seeking process. A total of 78 Internet health information seekers ranging from 21-35 years of age and who experienced barriers to accessing health care services participated. Results: We identified 27 unique patterns of information seeking, which were grouped into four overarching classifications based on the number of steps taken during the search, whether a pattern consisted of developing a hypothesis and exploring symptoms before ending the search or searching an action/treatment, and whether a pattern ended with action/treatment seeking. Applying dual-processing theory, we categorized the four overarching pattern classifications as either System 1 (41{\%}, 32/78), unconscious, rapid, automatic, and high capacity processing; or System 2 (59{\%}, 46/78), conscious, slow, and deliberative processing. Using multivariate regression, we found that System 2 processing was associated with higher education and younger age. Conclusions: We identified and classified two approaches to processing Internet health information. System 2 processing, a methodical approach, most resembles the strategies for information processing that have been found in other studies to be associated with higher-quality decisions. We conclude that the quality of Internet health-information seeking could be improved through consumer education on methodical Internet navigation strategies and the incorporation of decision aids into health information websites. ",
issn="1438-8871",
doi="10.2196/jmir.3945",
url="http://www.jmir.org/2015/7/e173/",
url="https://doi.org/10.2196/jmir.3945",
url="http://www.ncbi.nlm.nih.gov/pubmed/26194787"
}