Follow-up -The Pew Internet and American Life Project

[Guest guest]

This is a follow-up on a message from July 31, 2002.

In May of 2002, the Pew Internet & American Life Project published a

report called " Vital decisions. How Internet users decide what

information to trust when they or their loved ones are sick. " The

message about that article was posted here in July 2002 at the

bottom of this message.

Since then the Pew Internet Project had continued to do research on

the effect of the internet on different aspects of American life

including Health Care issues. Here are some links to some recent

articles.

A decade of adoption: How the internet has woven itself into

American life - 1/25/2005

http://www.pewinternet.org/PPF/r/148/report_display.asp

Today's E-Patients: Hunters and Gatherers of Health Information

Online - 9/27/2004

http://www.pewinternet.org/PPF/r/27/presentation_display.asp

The Online Healthcare Revolution and the Rise of e-Patients and e-

Caregivers - 11/3/2003

http://www.pewinternet.org/PPF/r/22/presentation_display.asp

I thought that you might find these articles interesting.

and (3-17-99)

> A friend of mine told me today about an interesting project on How

> Internet users decide what health care information to trust. It

is a

> report done by the Pew Charitable Trust with support from other

> groups and was published in May 2002. The following are some

> selections from the summary of the 43 page report.

>

> Pew Internet & American Life Project

> May 22, 2002

>

> Vital decisions

> How Internet users decide what information to trust

> when they or their loved ones are sick

>

> Principal authors: nah Fox, Director of Research

> Lee Rainie, Director

>

> Pew Internet & American Life Project

> 1100 Connecticut Avenue, NW – Suite 710

> Washington, D.C. 20036

>

> http://www.pewinternet.org/

>

> [The following are limited selections from the 43 page report

> including the summary of findings. The full report is available

for

> free on the internet. The sites location is at

> http://www.pewinternet.org/ ]

>

> Acknowledgment

>

> " This report is built around the phone survey work of the Pew

> Internet & American Life Project done by our polling partner

> Princeton Survey Research Associates that focused on Internet

users

> who look for health information online. The main survey for this

> report involved phone interviews with 500 " health seekers " in

> the summer of 2001. PSRA has done all the project's surveys since

> its inception in January 2000, and its executives and staff have

been

> our creative collaborators in every step of the project's work. "

>

> " This report also contains information and insights from two

online

> focus groups that were put together by Interactive. The

> Medical Library Association contacted us after the release of our

> first report about online health information in November 2000 and

has

> been an invaluable resource since then. Dr. Tom Ferguson, a senior

> research fellow at the Pew Internet Project, helped us to focus

even

> more closely on the consumer experience and contributed key

insights

> at every stage of research. "

>

> " About the Pew Internet & American Life Project The Pew Internet &

> American Life Project creates and funds original, academic-quality

> research that explores the impact of the Internet on children,

> families, communities, the workplace, schools, health care, and

civic

> and political life. The project is an independent, nonpartisan

> organization that aims to be an authoritative source for timely

> information on the Internet's growth and its impact on society.

The

> project is fully funded by The Pew Charitable Trusts. "

>

> [ Other Acknowlegements Follow before the summary of findings ]

>

> Summary of Findings

>

> " In November 2000, the Pew Internet & American Life Project

reported

> that 52 million American adults relied on the Internet to make

> critical health decisions. We now find that 73 million American

> adults use the Internet to research prescription drugs, explore

> new ways to control their weight, and prepare for doctor's

> appointments, among other activities. Many say the Internet has

> helped them or someone they know and very few report harmful

effects

> from acting on bad information they found online. "

>

> " However, there has been a drumbeat of warnings about the quality

of

> online health information and there is cause for concern about

> whether consumers are finding the very best advice online. While

> others have looked at online content and charted its deficiencies,

> the Pew Internet Project focused on users and asked them how they

> decide what information to believe and what advice to act on. If

> indeed there are problems with the quality of online health

> information, do consumers use sensible strategies to separate

> the good from the bad? "

>

> " In a national survey conducted March 1-31, 2002, the Pew Internet

> Project found that 62% of Internet users, or 73 million people in

the

> United States, have gone online in search of health information.

For

> shorthand purposes, we call them " health seekers " throughout

> this report. About 6 million Americans go online for medical

advice

> on a typical day. That means more people go online for medical

advice

> on any given day than actually visit health professionals,

according

> to figures provided by the American Medical Association. "

>

> " Experts say that Internet users should check a health site's

> sponsor, check the date of the information, set aside ample time

for

> a health search, and visit four to six sites. In reality, most

health

> seekers go online without a definite research plan. The typical

> health seeker starts at a search site, not a medical site, and

visits

> two to five sites during an average visit. She spends at least

thirty

> minutes on a search. She feels reassured by advice that matches

what

> she already knew about a condition and by statements that are

> repeated at more than one site. She is likely to turn away from

sites

> that seem to be selling something or don't clearly identify the

> source of the information. And about one third of health seekers

who

> find relevant information online bring it to their doctor for a

final

> quality check. "

>

> " Only about one quarter of health seekers follow the recommended

> protocol on thoroughly checking the source and timeliness of

> information and are vigilant about verifying a site's

> information every time they search for health information. Another

> quarter of health seekers check a site's information " most of

> the time. " Half of all health seekers search for medical advice

> and " only sometimes, " " hardly ever, " or

> " never " check the source or

> date of the information they read online. "

>

> " Health seekers seem to look for specific answers to targeted

> questions and are generally cautious about making decisions based

on

> the information they find. They often use the information in

making

> important decisions about interacting with their doctors, getting

> diagnoses, and treatments. But the ease of using the Internet and

the

> abundance of health information online are not changing their

entire

> approach to health care. "

>

> " Some 72% of online women have gone online for health information,

> compared with 51% of online men. And 71% of Internet users between

50

> and 64 years old have gone online for health information, compared

> with 53% of those between 18 and 29. Those with more education and

> more Internet experience are more likely to search for medical

> advice online. There are no significant differences between

whites,

> African Americans, and Hispanics when it comes to online health

> research. "

>

> " In a special survey of 500 Internet users who go online for

health

> care information, conducted June 19-August 6, 2001, we found the

> following: "

>

> " Disease information, material about weight control, and facts

about

> prescription drugs top the list of interests for health seekers.

We

> also see big increases in use of the Internet for mental health

> information and sensitive medical topics. "

>

> " The list below suggests the variety of things health seekers do

> online. We also asked for the first time about alternative

medicine

> and saw that substantial numbers of Internet users go online for

such

> material. "

>

> " •93% of health seekers have gone online to look for information

> about a particular illness or condition.

> •65% of health seekers have looked for information about

> nutrition, exercise, or weight control.

> •64% of health seekers have looked for information about

> prescription drugs.

> •55% of health seekers have gathered information before visiting

> a doctor.

> •48% of health seekers have looked for information about

> alternative or experimental treatments or medicines.

> •39% of health seekers have looked for information about a mental

> health issue such as depression or anxiety (up from 26% in August

> 2000).

> •33% of health seekers have looked for information about a

> sensitive health topic that is difficult to talk about (up from

16%

> in August 2000).

> •32% of health seekers have looked for information about a

> particular doctor or hospital. "

>

> " A typical health seeker searches for medical information only

> occasionally, and she relies on search engines and multiple sites "

>

> " The typical health seeker is a sporadic user of online medical

> information. More than half of health seekers (58%) do health

> searches every few months or even less frequently. A typical

seeker

> goes online to see what she can find without getting advice about

> where or how to search from anyone, including medical

professionals

> or friends. She visits several sites during a typical search and

does

> not have a favorite site. "

>

> Successful searches, varying impacts

>

> " Even without any outside help, the typical health seeker feels it

is

> quite easy to get the information she needs. Eighty-two percent

say

> they find what they are looking for " most of the time " or

> " always. "

> Fully 61% of health seekers, or 45 million Americans, say the

> Internet has improved the way they take care of their health

> either " a lot " or " some. " This is a significant

> increase from an

> August 2000 Pew Internet Project poll that found that 48% of

health

> seekers, or 25 million Americans, said the Internet improved the

way

> they take care of themselves. "

>

> " One in three health seekers know someone who has been appreciably

> helped by following medical advice or health information they

found

> on the Internet. Just 2% of health seekers know someone who has

been

> seriously harmed by following medical advice or health information

> they found on the Internet. "

>

> " The impact of their online searches In most cases, the

information

> they find online is helpful as they make decisions about how to

take

> care of themselves or loved one. Overall, when we asked these

health

> seekers about their most recent search for information, 68% said

it

> had some impact on their decisions related to their own health

care

> or a loved one's care. About 16% said it had a major impact on

> their own health care routine or the way they helped care for

someone

> else; 52% said the information had a minor impact; 31% said it had

no

> impact at all. "

>

> " Different degrees of vigilance about the information health

seekers

> find on the Web Respondents fall into three broad groups. About

one

> quarter are vigilant about verifying a site's information,

> another quarter are concerned about the quality of the information

> they find but follow a more casual protocol, and half rely on

their

> own common sense and rarely check the source of the information,

the

> date when the information was posted, or a site's privacy policy. "

>

> " Perhaps one of the reasons why health seekers are generally

casual

> in their approach to verifying online information is that they

trust

> the online environment. Fully 72% of health seekers say you can

> believe all or most of the health information online. Indeed, 69%

of

> health seekers say they have not seen any wrong or misleading

health

> info on the Web, while 28% of health seekers say they have seen

bad

> information. "

>

> Credibility killers: Why health seekers turn away from Web sites

>

> " Still, 73% of health seekers have at some point rejected

information

> from a Web site during a health search for one reason or another.

> Here are the major reasons they cite for turning away from a site:

>

> •47% of health seekers have decided not to use information they

> found because the Web site is " too commercial and seemed more

> concerned with selling products than providing accurate

> information. "

> •42% of health seekers have turned away from a health Web site

> because they couldn't determine the source of the information.

> •37% of health seekers have turned away from a health Web site

> because they couldn't determine when the information was last

> updated.

> •Other reasons for turning away: no visible " seal of

> approval, " sloppy or unprofessional design, or the presence of bad

> information (as judged by the health seeker or the health

> seeker's

> own doctor). "

>

> Health seekers still rely on doctors for guidance

>

> " While there is great concern in the medical establishment that e-

> patients are self-diagnosing and self-medicating because of the

> information they can find online, only a modest number of Internet

> users say they are substituting online information for doctor's

> advice. One in five health seekers (18%) say they have gone online

to

> diagnose or treat a medical condition on their own, without

> consulting their doctor. "

>

> " Despite reports that doctors are upset with patients who march

into

> the examining room with Web printouts, our respondents tell a

> different story. When we asked health seekers about their most

recent

> episode of online searching, 37% say they talked to a doctor or

> other health care professional about the information they found

> during their search. Of those who talked to an expert, 79% say

their

> doctor was interested in the information found online. Just 13%

who

> talked to their doctor got the cold shoulder and report that

> the health care professional was " not too interested " or

> " not at all interested. " Of those who chose not to talk to a

> health care professional, most deemed the topic too insignificant

to

> seek expert advice. Just 2% of health seekers who did not talk to

a

> doctor say it was because they didn't think their doctor would

> listen. "

>

> [This is the end of the Summary Section of the report. The table

of

> context section is next followed by the balance of the 43 page

> report ]

>

> Main Report: The search for online medical help

>

> Introduction

>

> " Tens of millions of Americans turn to the Internet when they need

> help with health problems. Health professionals are often

> apprehensive about the reliability of online health information

and

> wonder how consumers can possibly find good advice in the untamed

> wilderness of the Internet. In an environment where any quack can

> create a credible-looking Web site and promote all manner of

> questionable " cures, " how can Internet users know what

> information will most benefit them? What signals of quality should

> they seek? "

>

> " Some experts warn about another danger – that the best

> information is not even on the Internet. An exhaustive study by

the

> California HealthCare Foundation and RAND Health found

> " substantial

> gaps in the availability of key information " relating to breast

> cancer, depression, obesity, and childhood asthma available

through

> English- and Spanish-language search engines and Web sites. 1

Another

> study, funded by the Wood Foundation, echoed

> RAND's cautionary tone after comparing the 25 most popular health

> Web

> sites' adherences to quality codes, peer review, and external

> advisory boards. 2 And the American Medical Association (AMA) has

> taken the position that online health information is never a

> substitute for a physician's experience and training, suggesting

> that

> Americans make a new year's resolution to " trust your

> physician, not a

> chat room. " 3

>

> " Widespread skepticism among medical providers has not deterred

the

> remarkable growth in the number of people seeking medical

information

> online. More Americans research health information online on an

> average day than visit health professionals. About 6 million

> Americans go online for medical advice on a typical day, whereas

the

> American Medical Association estimates that there are an average

of

> 2.75 million ambulatory care visits to hospital outpatient and

> emergency departments per day and an average of 2.27 million

> physician office visits per day. So we set out to examine how

> Internet users search for information, how they establish its

> credibility, and how they decide to act on it. "

>

> " We used several approaches. We surveyed 500 Internet users who go

> online for health care information. This special sample, surveyed

> June 19-August 6, 2001, portrays the overall habits and attitudes

of

> those Americans who use the Internet for medical information and

> advice. We also gained insights from two online focus groups

conducted

> on October 15, 2001, by Interactive. In one group, six

> participants with special needs discussed how they use the

Internet

> to manage their chronic illnesses and care for their loved ones.

In

> the second group, ten participants representing the general

> population discussed how they use the Internet to take better care

of

> themselves and their loved ones. "

>

> [ the main part of the 43 page report follows this section ]

>

>

> Principal authors: nah Fox, Director of Research

> Lee Rainie, Director

>

> Pew Internet & American Life Project

> 1100 Connecticut Avenue, NW – Suite 710

> Washington, D.C. 20036

>

> http://www.pewinternet.org/