Evaluating the Process of Online Health Information Searching: A Qualitative Approach to Exploring Consumer Perspectives
Open accessAbstract
BACKGROUND: The Internet is a common resource that patients and consumers use to access health-related information. Multiple practical, cultural, and socioeconomic factors influence why, when, and how people utilize this tool. Improving the delivery of health-related information necessitates a thorough understanding of users' searching-related needs, preferences, and experiences. Although a wide body of quantitative research examining search behavior exists, qualitative approaches have been under-utilized and provide unique perspectives that may prove useful in improving the delivery of health information over the Internet. OBJECTIVE: We conducted this study to gain a deeper understanding of online health-searching behavior in order to inform future developments of personalizing information searching and content delivery. METHODS: We completed three focus groups with adult residents of Olmsted County, Minnesota, which explored perceptions of online health information searching. Participants were recruited through flyers and classifieds advertisements posted throughout the community. We audio-recorded and transcribed all focus groups, and analyzed data using standard qualitative methods. RESULTS: Almost all participants reported using the Internet to gather health information. They described a common experience of searching, filtering, and comparing results in order to obtain information relevant to their intended search target. Information saturation and fatigue were cited as main reasons for terminating searching. This information was often used as a resource to enhance their interactions with health care providers. CONCLUSIONS: Many participants viewed the Internet as a valuable tool for finding health information in order to support their existing health care resources. Although the Internet is a preferred source of health information, challenges persist in streamlining the search process. Content providers should continue to develop new strategies and technologies aimed at accommodating diverse populations, vocabularies, and health information needs.
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Patients reported that the internet was often the first source they accessed for health information.
“Patients reported that the internet was often the first source they accessed for health information [37].”
People in countries where patients pay for their healthcare reported online self-diagnosis to be money saving and time efficient.
“For example, people in countries where patients pay for their healthcare reported online self-diagnosis to be money saving and time efficient; they could access health information with ease for free as opposed to waiting for a healthcare appointment and then having to pay a fee [37].”
Self-diagnosing symptoms while remaining anonymous, such as by posting in online health forums, was popular.
“Self-diagnosing symptoms while remaining anonymous such as by posting in online health forums was popular [37, 50] for a number of reasons.”
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Guo, H., Xu, N., Hou, L., & Li, J. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7156 · Cited by 19 · see citing works
“However, consumers have difficulty in expressing their information needs accurately using medical query terms, thus failing to retrieve relevant health information [5,6].”
Health Information Seeking Among Singaporeans: Roles and Collective Contexts
Dutta, M. J., Kaur‐Gill, S., Luk, P., Lin, J., & Lee, S. T. (2017) · Health Communication · doi:10.1080/10410236.2016.1278493 · Cited by 18 · see citing works
“…the sources of health information (e.g., Kim et al., 2015), the procedures of HIS (e.g., Eysenbach & Kohler, 2002; Rozmovits & Ziebland, 2004), offering a linear framework for mapping individuals’ motivations for HIS (e.g., Bernhardt & Felter, 2004; Fiksdal et al., 2014; Powell et al., 2011).”
BackgroundMethodInternet Health Information on Patient’s Decision-Making: Implications, Opportunities and Challenges
Vega, E. S., Zepeda, M., Gutiérrez, E., Martínez, M., Gomez, S. J. G., & Caldera, S. (2023) · Medical Research Archives · doi:10.18103/mra.v11i7.2.4066 · Cited by 17 · see citing works
“29”
Liu, L. (2022) · BMC Public Health · doi:10.1186/s12889-022-14017-8 · Cited by 16 · see citing works
“Very few previous studies have explored the timing of online health information seeking, and most of them were qualitative studies or descriptive statistical analyses [30, 31, 35].”
BackgroundLowndes, A., & Connelly, D. M. (2023) · Digital Health · doi:10.1177/20552076231167004 · Cited by 16 · see citing works
OC-2-KB: integrating crowdsourcing into an obesity and cancer knowledge base curation system
Lossio-Ventura, J. A., Hogan, W. R., Modave, F. P., Guo, Y. M., He, Z., Yang, X., Zhang, H., & Bian, J. (2018) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-018-0635-5 · Cited by 16 · see citing works
“Online health information consumers face a number of access barriers including information overload and disorganization, terminology and language barriers, lack of user friendliness, and inconsistent updates [13, 15, 16].”
BackgroundAvailability of Internet-Based Cognitive-Behavioral Therapies for Depression: A Systematic ReviewPreprint
Buss, J., Steinberg, J. S., Banks, G., Horani, D., Rutter, L. A., Wasil, A. R., Ramírez, I., & Lorenzo‐Luaces, L. (2020) · Behavior Therapy · doi:10.1016/j.beth.2023.06.003 · Cited by 17 · see citing works
Lam, W., Dawson, A. J., & Fowler, C. (2015) · PLoS ONE · doi:10.1371/journal.pone.0143844 · Cited by 15 · see citing works
“The internet is a common access point for people searching for health information [41].”
BackgroundHughes, J., Wilson, W. J., MacBean, N., & Hill, A. E. (2016) · International Journal of Audiology · doi:10.1080/14992027.2016.1210829 · Cited by 15 · see citing works
“During seminars, information is given and discussed via open-ended, loosely structured conversations facilitated rather than controlled by the educator such that all participants are considered to be contributors to a collaborative learning process (Fiksdal et al, 2014).”
BackgroundConsumerism in online health information search and self‐tracking devices
Ertiö, T. P., & Räsänen, P. (2018) · International Journal of Consumer Studies · doi:10.1111/ijcs.12504 · Cited by 15 · see citing works
Deconstructing proxy health information-seeking behavior: A systematic review
Zhang, Y., & Liu, J. (2023) · Library & Information Science Research · doi:10.1016/j.lisr.2023.101250 · Cited by 14 · see citing works
Shakir, S. M. M., Wong, L. P., Abdullah, K. L., & Adam, P. (2019) · Sexual Health · doi:10.1071/sh17198 · Cited by 14 · see citing works
Hersh, W. (2021) · Springer eBooks · doi:10.1007/978-3-030-58721-5_23 · Cited by 14 · see citing works
Schneider, J. A., & Holland, C. P. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.6739 · Cited by 12 · see citing works
“Second, there is very little research into the detailed measurement of eHealth search behavior on a large scale, raising the question of how eHealth search behavior can be analyzed and measured in a systematic and objective manner, using techniques and methods from other online markets [9,10].”
Bol, N., Smets, E. M. A., Burgers, J. A., Samii, S., de Haes, J. C. J. M., & van Weert, J. C. M. (2017) · Journal of Health Communication · doi:10.1080/10810730.2017.1394400 · Cited by 14 · see citing works
“Patients increasingly turn to the Internet to find diseaserelevant information (Fiksdal et al., 2014).”
BackgroundKim, J., Oh, Y. W., & Krishna, A. (2016) · Health Communication · doi:10.1080/10410236.2016.1242040 · Cited by 13 · see citing works
“In the current context of increasing health care cost, the availability of free, diverse, and unlimited health information and advice via the Internet seems to bring opportunities for the lay population (Fiksdal et al., 2014; Hesse et al., 2005; Neuhauser & Kreps, 2003; Simou, 2016).”
BackgroundRubenstein, E. L. (2017) · Library trends · doi:10.1353/lib.2017.0027 · Cited by 13 · see citing works
“When seeking information, consumers typically start with search engines such as Google and Yahoo, or sites devoted to medical information, such as WebMD and MayoClinic.com (Fiksdal et al. 2014; Fox 2011; Fox and Duggan 2013).”
MethodHan, J., Zhang, X., & Meng, Y.-Y. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17103539 · Cited by 13 · see citing works
“Numerous studies have suggested that various types of health information obtained through the Internet play an important role in individuals’ self-diagnosis of disease [21,22], self-treatment of chronic disease [23], doctor-patient relationship regulation [24], and many other behaviors.”
BackgroundAlmaazmi, M. A., Samara, K. A., Jarai, M., Majeed, H., & Barqawi, H. J. (2023) · Healthcare · doi:10.3390/healthcare11050663 · Cited by 12 · see citing works
“The researchers reported that while websites and social media platforms were the most used sources of health information, they were not the most trusted [12].”
BackgroundAboalshamat, K. T. (2023) · BMC Oral Health · doi:10.1186/s12903-023-03547-1 · Cited by 12 · see citing works
Informações on-line como suporte às famílias de crianças e adolescentes com doença crônica
Mazza, V. D. A., de Lima, V. F., Carvalho, A. K. D. S., Weissheimer, G., & Soares, L. G. (2017) · Revista gaúcha de enfermagem · doi:10.1590/1983-1447.2017.01.63475 · Cited by 12 · see citing works
Georgsson, S., & Carlsson, T. (2022) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-022-01873-y · Cited by 11 · see citing works
“population, we used several search strings, screened the first 20 links in each hit list, and retrieved the information presented in the first web page of each link [27, 28].”
MethodHuang, J., Chan, S. C., Ko, S., Tong, E. L. H., Cheung, C. S. K., Wong, W. N., Cheung, N. T., & Wong, M. C. S. (2023) · npj Digital Medicine · doi:10.1038/s41746-023-00807-w · Cited by 12 · see citing works
Çoban, E., & Altay, B. (2024) · Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.joms.2024.03.001 · Cited by 11 · see citing works
Haase, K. R., Gifford, W., Holtslander, L. F., & Thomas, R. L. (2018) · Cancer Nursing · doi:10.1097/ncc.0000000000000619 · Cited by 11 · see citing works
Online interest regarding violent attacks, gun control, and gun purchase: A causal analysis
Gunn, L. H., ter Horst, E., Markossian, T. W., & Molina, G. (2018) · PLoS ONE · doi:10.1371/journal.pone.0207924 · Cited by 11 · see citing works
An evaluation of the quality of online perinatal depression information
Hardman, M. P., Reynolds, K., Petty, S. K., Pryor, T. A. M., Pierce, S. K., Bernstein, M. T., & Furer, P. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-04320-4 · Cited by 10 · see citing works
“The Internet can help users gather health-related information outside of medical appointments, assisting the public to make informed treatment decisions [21, 22].”
BackgroundGrynne, A., Wångdahl, J. M., Fristedt, S., Smith, F., & Browall, M. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-09837-2 · Cited by 10 · see citing works
“This result mirrors those of Fiksdal, Kum-bamu [20], who performed focus group interviews to better understand online health-searching behaviours.”
BackgroundResultA Cognitive-Based Semantic Approach to Deep Content Analysis in Search Engines
Chen, M., & D�cary, M. (2018) · IEEE International Conference on Semantic Computing (ICSC) · doi:10.1109/icsc.2018.00027 · Cited by 10 · see citing works
“, on health or medicine) remains a challenging task [1] [2] [3].”
BackgroundReadability of web-based sources about induced abortion: a cross-sectional study
Georgsson, S., & Carlsson, T. (2020) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-020-01132-y · Cited by 9 · see citing works
Castells, P., & Jannach, D. (2024) · ACM eBooks · doi:10.1145/3674127.3674131 · Cited by 9 · see citing works
Rodrigo, A., Trigueros, P., Jamilis, L., Alegret, M., Rodríguez, O., Tárraga, L., González‐Pérez, A., Kramberger, M. G., Winblad, B. G., Visser, P. J., et al. (2021) · Alzheimer s & Dementia · doi:10.1002/alz.12297 · Cited by 9 · see citing works
“8 Briefly it included: (1) physical and neurological examinations; (2) a neuropsychological assessment; (3) functionality evaluation by means of the Clinical Dementia Rating Scale;18 (4) assessment of resource use; (5) affective symptoms evaluationwith theHospital Anxiety andDepression Scale; (6) standard bloodworkup;…”
MethodOnline information retrieval behaviour and economics of attention
Özmen, M. U. (2015) · Online Information Review · doi:10.1108/oir-05-2015-0139 · Cited by 9 · see citing works
Digital Health for Patients Undergoing Spine Surgery: A Systematic Review
Venkatraman, V., Heo, H. J., Kaplan, S. J., Parente, B. A., & Lad, S. P. (2023) · World Neurosurgery · doi:10.1016/j.wneu.2023.11.035 · Cited by 8 · see citing works
Minimally Invasive Spine Surgery
Bryant, J., Mohan, R., Koottappillil, B., Wong, K., & Yi, P. H. (2018) · Clinical Spine Surgery A Spine Publication · doi:10.1097/bsd.0000000000000602 · Cited by 8 · see citing works
Kerner, B., Crisanti, A. S., DeShaw, J. L., Ho, J.-M. G., Jordan, K., Krall, R. L., Kuntz, M., Mazurie, A., Nestsiarovich, A., Perkins, D. J., et al. (2019) · JMIR Mental Health · doi:10.2196/12848 · Cited by 8 · see citing works
“Searching the internet for information on medical conditions is a well-accepted approach [28].”
BackgroundHigh Satisfaction With a Virtual Assistant for Plastic Surgery Frequently Asked Questions
Ávila, F. R., Boczar, D., Spaulding, A., Quest, D. J., Samanta, A., Torres‐Guzman, R. A., Maita, K. C., Garcia, J. P., Eldaly, A. S., & Forte, A. J. (2022) · Aesthetic Surgery Journal · doi:10.1093/asj/sjac290 · Cited by 7 · see citing works
Late Adolescent User Experiences with Online Sexual Health Resources: A Qualitative Study
Starling, M. S., Cheshire, C., Deardorff, J., & Nuru‐Jeter, A. (2018) · American Journal of Sexuality Education · doi:10.1080/15546128.2018.1505572 · Cited by 7 · see citing works
“Users seeking sexual health information on the web risk encounters with inaccurate, irrelevant, or misleading information, including pornography (Fiksdal et al., 2014).”
BackgroundRaja, A., Amin, S. B., Azeem, B., Raja, S., Aftab, Y., Rafi, M., Abheman, F., Sukhani, K., Mal, P., Ul-Ain, N., et al. (2024) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000002605 · Cited by 11 · see citing works
Aboalshamat, K. T. (2024) · Journal of Medical Internet Research · doi:10.2196/54072 · Cited by 6 · see citing works
“In recent times, accessing medical information through the internet has become a prominent global trend [16-18].”
Google Trends as a resource for bariatric education: what do patients want to know?
Alemán, R., Matute, C. M., Mora, M. F., Gómez, C. O., Blanco, D. G., Menzo, E. L., Szomstein, S., & Rosenthal, R. J. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.08.007 · Cited by 6 · see citing works
Ghweeba, M., Lindenmeyer, A., Shishi, S., Waheed, A., Kofi, M. A., & Amer, S. A. A. M. (2021) · JMIR Formative Research · doi:10.2196/30108 · Cited by 6 · see citing works
“The internet provides a wide range of health topics from healthy eating and fitness to information about self-management of chronic health problems [6,7].”
BackgroundMeasuring the Effectiveness of LDA-Based Clustering for Social Media Data
Khan, A., & Ali, R. (2023) · International Conference on Advances in Intelligent Computing and Applications (AICAPS) · doi:10.1109/aicaps57044.2023.10074399 · Cited by 6 · see citing works
“When any user or their close one is encountered with any medical condition, they start searching for it online by comparing the information available from multiple sources online [2].”
BackgroundHandling of online information by users: evidence from TED talks
Özmen, M. U., & Yucel, E. M. (2019) · Behaviour and Information Technology · doi:10.1080/0144929x.2019.1584244 · Cited by 6 · see citing works
“In that, Zhang et al. (2014) fi nd that content factors are more important than contextual factors, Fiksdal et al. (2014) report information saturation and fatigue as main reasons for stopping information retrieval and Wook and Salim (2014) identify speci fi cation requirements for visual aspects of…”
BackgroundBuss, J., Lorenzo‐Luaces, L., Banks, G., Horani, D., Rutter, L. A., & Wasil, A. R. (2020) · doi:10.31234/osf.io/2jwgd · Cited by 6 · see citing works
Quality of Late-Life Depression Information on the Internet: Website Evaluation Study
Pryor, T. A. M., Reynolds, K., Kirby, P. L., & Bernstein, M. T. (2022) · JMIR Formative Research · doi:10.2196/36177 · Cited by 5 · see citing works
“It may be difficult for individuals to determine whether the information presented is unbiased, accurate, and evidence based [43-46].”
Silva, L. D., Baysari, M. T., Keep, M., Kench, P. L., & Clarke, J. (2022) · Health Promotion Journal of Australia · doi:10.1002/hpja.647 · Cited by 5 · see citing works
Stakeholder Engagement and Collaboration in Health Policy Implementation: Lessons Learned
Kumar, M., & Vinati, V. (2024) · South Eastern European Journal of Public Health · doi:10.52710/seejph.491 · Cited by 5 · see citing works
Marinescu, V., & Rodat, S. (2018) · Romanian Journal of Communication and Public Relations · doi:10.21018/rjcpr.2018.1.251 · Cited by 5 · see citing works
Toxopeus, D. C. M., Pell, C. L., Westrhenen, N. B.-V., Smit, C., Wit, F. W. N. M., Ondoa, P., Reiss, P., & Boender, T. S. (2019) · AIDS Care · doi:10.1080/09540121.2018.1563280 · Cited by 5 · see citing works
“The interview guide was adapted in an iterative manner to decrease the risk of overlooking relevant topics (Fiksdal et al., 2014; Gray 2013; Maxwell, 2008; Strauss & Corbin, 1998).”
MethodGlobal search trends on common vaccine-related information in English on the Internet
Mondal, H., Rampally, V., & Mondal, S. (2020) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1001_19 · Cited by 6 · see citing works
“If the search trends are known, online content can be designed to highlight the issue with a priority basis.[14]”
BackgroundAlemán, R., Patel, S., Frieder, J. S., Navia, J. L., Sheffield, C., & Brozzi, N. A. (2022) · Journal of Cardiac Surgery · doi:10.1111/jocs.16513 · Cited by 5 · see citing works
“To this effect, digital information is considered to be speculative with lack of supporting evidence.(16,27) As seen in Table 1, Google prompts a list of frequently asked questions whenever a user conducts a search that has increasing popularity.”
BackgroundStaffieri, S. E., Kearns, L. S., Sanfilippo, P. G., Craig, J. E., Mackey, D. A., & Hewitt, A. W. (2018) · Translational Vision Science & Technology · doi:10.1167/tvst.7.1.18 · Cited by 5 · see citing works
“It is presumed however that participants whose search strategy could not be tracked also underwent a similar iterative process as has been described in qualitative analyses of online health information–seeking behavior.(38) Interestingly, the most commonly used search terms of participants who determined the appropria…”
ResultPlain Language to Communicate Physical Activity Information: A Website Content Analysis
Paige, S. R., Black, D. R., Mattson, M., Coster, D. C., & Stellefson, M. (2018) · Health Promotion Practice · doi:10.1177/1524839918766062 · Cited by 5 · see citing works
Mining and standardizing chinese consumer health terms
Hou, L., Kang, H., Liu, Y., Li, L., & Li, J. (2018) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-018-0695-6 · Cited by 5 · see citing works
- Authors
- Fiksdal, A. S., Kumbamu, A., Jadhav, A. S., Cocos, C., Nelsen, L. A., Pathak, J., & McCormick, J. B.
- Affiliations
- Mayo Clinic (US)
- Pennsylvania State University (US)
- Corresponding author
- McCormick, Jennifer B
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2014-10-07
- Volume
- 16
- Issue
- 9
- Pages
- e224
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC4285658
- OpenAlex
- W2060711405
- Cited by
- 189
- References
- 29
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 28 · 2023: 20 · 2022: 18 · 2021: 21 · 2020: 17 · 2019: 19 · 2018: 19 · 2017: 17 · 2016: 14 · 2015: 7
- FWCI
- 22.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CORE Scholar (Wright State University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Journal of Bioresource Management (submittedVersion, cc-by)
- Funders
- National Institutes of Health (UL1TR000135)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Physical Sciences › Computer Science › Information Systems › Information Retrieval and Search Behavior
- Health Sciences › Health Professions › Health Information Management › Health, Technology, Consumer Behavior
- Keywords
- health information seeking, customer perspective, search behavior, information saturation, health information needs, patient-provider communication, online health information seeking
- MeSH terms
- Adolescent, Adult, Aged, Female, Health Resources, Humans, Male, Middle Aged, Focus Groups, Internet, Consumer Health Information, Young Adult, Information Seeking Behavior, Health Information Exchange
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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