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      An Ecological View of Internet Health Information Seeking Behavior Predictors: Findings from the CHAIN Study

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          Abstract

          Objective:

          The purpose of the study was to further elucidate proximal and distal demographic and social predictors of Internet Health Information Seeking Behavior (IHISB) among a cohort of HIV+ individuals through an ecological framework.

          Methods:

          The Community Health Advisory & Information Network (CHAIN) project is an ongoing prospective study of a representative sample of persons living with HIV/AIDS in New York City and the Tri-County region. The study sample was drawn from a two-stage randomized technique with the clients of 43 medical and social service organizations with 693 HIV+ participants. Bivariate correlations were computed between IHISB and independent demographic variables in ecological blocks. Multivariate hierarchical logistic regression was used to test association between blocks of variables and IHISB.

          Results:

          Among the surveyed respondents (n=645) 50.3% indicated that they used the Internet. Being above the poverty line, having less than a high school education, and having fewer neighbors were statistically significant predictors of IHISB related to HIV.

          Conclusions:

          The benefits of accessing the Internet may influence health behavior and may be considered a target for interventions that aim to increase access to health related information online. Coupled with increased access, is the need for increased patient education interventions, and creative managed care approaches to ensure that information gleaned from online sources is interpretable and accurate in order to benefit the lives of those living with HIV/AIDS.

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          Most cited references27

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          Toward an experimental ecology of human development.

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            Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey.

            The context in which patients consume health information has changed dramatically with diffusion of the Internet, advances in telemedicine, and changes in media health coverage. The objective of this study was to provide nationally representative estimates for health-related uses of the Internet, level of trust in health information sources, and preferences for cancer information sources. Data from the Health Information National Trends Survey were used. A total of 6369 persons 18 years or older were studied. The main outcome measures were online health activities, levels of trust, and source preference. Analyses indicated that 63.0% (95% confidence interval [CI], 61.7%-64.3%) of the US adult population in 2003 reported ever going online, with 63.7% (95% CI, 61.7%-65.8%) of the online population having looked for health information for themselves or others at least once in the previous 12 months. Despite newly available communication channels, physicians remained the most highly trusted information source to patients, with 62.4% (95% CI, 60.8%-64.0%) of adults expressing a lot of trust in their physicians. When asked where they preferred going for specific health information, 49.5% (95% CI, 48.1%-50.8%) reported wanting to go to their physicians first. When asked where they actually went, 48.6% (95% CI, 46.1%-51.0%) reported going online first, with only 10.9% (95% CI, 9.5%-12.3%) going to their physicians first. The Health Information National Trends Survey data portray a tectonic shift in the ways in which patients consume health and medical information, with more patients looking for information online before talking with their physicians.
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              Consumer health information seeking on the Internet: the state of the art.

              R. Cline (2001)
              Increasingly, consumers engage in health information seeking via the Internet. Taking a communication perspective, this review argues why public health professionals should be concerned about the topic, considers potential benefits, synthesizes quality concerns, identifies criteria for evaluating online health information and critiques the literature. More than 70 000 websites disseminate health information; in excess of 50 million people seek health information online, with likely consequences for the health care system. The Internet offers widespread access to health information, and the advantages of interactivity, information tailoring and anonymity. However, access is inequitable and use is hindered further by navigational challenges due to numerous design features (e.g. disorganization, technical language and lack of permanence). Increasingly, critics question the quality of online health information; limited research indicates that much is inaccurate. Meager information-evaluation skills add to consumers' vulnerability, and reinforce the need for quality standards and widespread criteria for evaluating health information. Extant literature can be characterized as speculative, comprised of basic 'how to' presentations, with little empirical research. Future research needs to address the Internet as part of the larger health communication system and take advantage of incorporating extant communication concepts. Not only should research focus on the 'net-gap' and information quality, it also should address the inherently communicative and transactional quality of Internet use. Both interpersonal and mass communication concepts open avenues for investigation and understanding the influence of the Internet on health beliefs and behaviors, health care, medical outcomes, and the health care system.
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                Author and article information

                Journal
                Open AIDS J
                Open AIDS J
                TOAIDJ
                The Open AIDS Journal
                Bentham Open
                1874-6136
                18 October 2013
                2013
                : 7
                : 42-46
                Affiliations
                [1 ]University of Washington. School of Medicine, USA
                [2 ]Columbia University, Mailman School of Public Health, USA
                [3 ]Brigham Young University, USA
                Author notes
                [* ]Address correspondence to this author at the University of Washington, School of Medicine, USA; Tel: 425-223-7567; E-mail: joshuakc@ 123456uw.edu
                Article
                TOAIDJ-7-42
                10.2174/1874613601307010042
                3821080
                24222812
                c54f1962-f20f-4162-b46f-58bc4312f5b9
                © Calvert et al.; Licensee Bentham Open.

                This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

                History
                : 5 June 2013
                : 16 August 2013
                : 26 August 2013
                Categories
                Article

                Infectious disease & Microbiology
                internet health information seeking behavior,plwha,hiv/aids,ecological model.

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