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      The Criteria People Use in Relevance Decisions on Health Information: An Analysis of User Eye Movements When Browsing a Health Discussion Forum

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      , PhD,M.Sc. (Information M,BBus(Info Systems) , , PhD, , , PhD
      (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications
      information seeking behavior, media, social, Internet, judgment, decision-making, criteria, relevance assessment, consumer health

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          Abstract

          Background

          People are increasingly accessing health-related social media sites, such as health discussion forums, to post and read user-generated health information. It is important to know what criteria people use when deciding the relevance of information found on health social media websites, in different situations.

          Objective

          The study attempted to identify the relevance criteria that people use when browsing a health discussion forum, in 3 types of use contexts: when seeking information for their own health issue, when seeking for other people’s health issue, and when browsing without a particular health issue in mind.

          Methods

          A total of 58 study participants were self-assigned to 1 of the 3 use contexts or information needs and were asked to browse a health discussion forum, HealthBoards.com. In the analysis, browsing a discussion forum was divided into 2 stages: scanning a set of post surrogates (mainly post titles) in the summary result screen and reading a detailed post content (including comments by other users). An eye tracker system was used to capture participants’ eye movement behavior and the text they skim over and focus (ie, fixate) on during browsing. By analyzing the text that people’s eyes fixated on, the types of health information used in the relevance judgment were determined. Post-experiment interviews elicited participants’ comments on the relevance of the information and criteria used.

          Results

          It was found that participants seeking health information for their own health issue focused significantly more on the poster’s symptoms, personal history of the disease, and description of the disease ( P=.01, .001, and .02). Participants seeking for other people’s health issue focused significantly more on cause of disease, disease terminology, and description of treatments and procedures ( P=.01, .01, and .02). In contrast, participants browsing with no particular issue in mind focused significantly more on general health topics, hot topics, and rare health issues ( P=.01, .01, and .01).

          Conclusion

          Users browsing for their own health issues used mainly case-based relevance criteria to relate the poster's health situation to their own. Participants seeking for others’ issues used mostly general knowledge–based criteria, whereas users with no particular issue in mind used general interest– and curiosity-based criteria.

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          Most cited references23

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          User-defined relevance criteria: An exploratory study

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            Trusting Social Media as a Source of Health Information: Online Surveys Comparing the United States, Korea, and Hong Kong

            Background The Internet has increasingly become a popular source of health information by connecting individuals with health content, experts, and support. More and more, individuals turn to social media and Internet sites to share health information and experiences. Although online health information seeking occurs worldwide, limited empirical studies exist examining cross-cultural differences in perceptions about user-generated, experience-based information compared to expertise-based information sources. Objective To investigate if cultural variations exist in patterns of online health information seeking, specifically in perceptions of online health information sources. It was hypothesized that Koreans and Hongkongers, compared to Americans, would be more likely to trust and use experience-based knowledge shared in social Internet sites, such as social media and online support groups. Conversely, Americans, compared to Koreans and Hongkongers, would value expertise-based knowledge prepared and approved by doctors or professional health providers more. Methods Survey questionnaires were developed in English first and then translated into Korean and Chinese. The back-translation method ensured the standardization of questions. Surveys were administered using a standardized recruitment strategy and data collection methods. Results A total of 826 participants living in metropolitan areas from the United States (n=301), Korea (n=179), and Hong Kong (n=337) participated in the study. We found significant cultural differences in information processing preferences for online health information. A planned contrast test revealed that Koreans and Hongkongers showed more trust in experience-based health information sources (blogs: t 451.50=11.21, P<.001; online support group: t 455.71=9.30, P<.001; social networking sites [SNS]: t 466.75=11.36, P<.001) and also reported using blogs (t 515.31=6.67, P<.001) and SNS (t 529.22=4.51, P<.001) more frequently than Americans. Americans showed a stronger preference for using expertise-based information sources (eg, WebMD and CDC) compared to Koreans and Hongkongers (t 360.02=3.01, P=.003). Trust in expertise-based information sources was universal, demonstrating no cultural differences (Brown-Forsythe F 2,654=1.82, P=.16). Culture also contributed significantly to differences in searching information on behalf of family members (t 480.38=5.99, P<.001) as well as to the goals of information searching. Conclusions This research found significant cultural differences in information processing preferences for online health information. Further discussion is included regarding effective communication strategies in providing quality health information.
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              Association of Online Health Information–Seeking Behavior and Self-Care Activities Among Type 2 Diabetic Patients in Saudi Arabia

              Background Health information obtained from the Internet has an impact on patient health care outcomes. There is a growing concern over the quality of online health information sources used by diabetic patients because little is known about their health information–seeking behavior and the impact this behavior has on their diabetes-related self-care, in particular in the Middle East setting. Objective The aim of this study was to determine the online health-related information–seeking behavior among adult type 2 diabetic patients in the Middle East and the impact of their online health-related information–seeking behavior on their self-care activities. Methods A cross-sectional survey was conducted on 344 patients with type 2 diabetes attending inpatient and outpatient primary health care clinics at 2 teaching hospitals in Riyadh, Saudi Arabia. The main outcome measures included the ability of patients to access the Internet, their ability to use the Internet to search for health-related information, and their responses to Internet searches in relation to their self-care activities. Further analysis of differences based on age, gender, sociodemographic, and diabetes-related self-care activities among online health-related information seekers and nononline health-related information seekers was conducted. Results Among the 344 patients, 74.1% (255/344) were male with a mean age of 53.5 (SD 13.8) years. Only 39.0% (134/344) were Internet users; 71.6% (96/134) of them used the Internet for seeking health-related information. Most participants reported that their primary source of health-related information was their physician (216/344, 62.8%) followed by television (155/344, 45.1%), family (113/344, 32.8%), newspapers (100/344, 29.1%), and the Internet (96/344, 27.9%). Primary topics participants searched for were therapeutic diet for diabetes (55/96, 57%) and symptoms of diabetes (52/96, 54%) followed by diabetes treatment (50/96, 52%). Long history of diabetes, familial history of the disease, unemployment, and not seeking diabetes education were the most common barriers for online health-related information–seeking behavior. Younger age, female, marital status, higher education, higher income, and longer duration of Internet usage were associated with more online health-related information–seeking behaviors. Most (89/96, 93%) online health-related information seekers reported positive change in their behaviors after seeking online health information. Overall odds ratio (OR 1.56, 95% CI 0.63-3.28) for all self-care responses demonstrated that there was no statistically significant difference between those seeking health-related information online and non–health-related information seekers. However, health-related information seekers were better in testing their blood glucose regularly, taking proper action for hyperglycemia, and adopting nonpharmacological management. Conclusions Physicians and television are still the primary sources of health-related information for adult diabetic patients in Saudi Arabia whether they seek health-related information online or not. This study demonstrates that participants seeking online health-related information are more conscious about their diabetes self-care compared to non–health-related information seekers in some aspects more than the others.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                June 2016
                20 June 2016
                : 18
                : 6
                : e136
                Affiliations
                [1]Wee Kim Wee School of Communication and Information Nanyang Technological University Singapore
                Author notes
                Corresponding Author: Wenjing Pian wpian1@ 123456e.ntu.edu.sg
                Author information
                http://orcid.org/0000-0002-8676-5519
                http://orcid.org/0000-0002-8072-1072
                http://orcid.org/0000-0003-2706-3901
                Article
                v18i6e136
                10.2196/jmir.5513
                4932243
                27323893
                ed8ab42f-5c37-44ae-970b-683984b53a51
                ©Wenjing Pian, Christopher SG Khoo, Yun-Ke Chang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.06.2016.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 9 January 2016
                : 21 February 2016
                : 28 March 2016
                : 11 April 2016
                Categories
                Original Paper
                Original Paper

                Medicine
                information seeking behavior,media, social,internet,judgment, decision-making,criteria,relevance assessment,consumer health

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