The use and integration of online information in health decision making

Online health information provides people with access to information, support and advice across a range of different health conditions. Although consumers and healthcare professionals (HCP’s) acknowledge that people regard online health information as a key resource, a number of barriers prevent patients from disclosing and integrating the information into discussions with HCP’s. Existing literature has focused almost exclusively on individuals with long term health conditions and has failed to consider how patients with short term conditions use online health information to support a broader range of health decisions including but not limited to treatment decisions. This thesis set out to specifically address these issues, by a) investigating how online health information is used to support a number of health related decisions across a range of short and long term health complaints, and b) whether intentions to integrate information into appointments with the HCP can be increased. These two research questions were explored using a mixed methods approach across five studies. The research aimed to qualitatively explore how individuals with short term and long term health conditions use online health information to inform a broad range of health decisions, and examine how this information is integrated into appointments with HCP’s. These findings were then confirmed quantitatively with a larger, more diverse sample. HCP’s were then asked about their experiences of internet informed patients and the role that online resources can play in decision making. These findings were fed into the development of an experimental study that aimed to increase intentions to integrate online health information into appointments with HCP’s. The thesis findings showed that online health information informed a number of different health decisions. Specifically, narrative information containing the experiences of others empowered participants to make decisions and increased satisfaction with health decision making. Findings also identified discordance between patients’ perceptions of HCP’s attitudes towards internet informed patients, and the HCP’s actual views, which prevented participants from integrating online health information into their medical appointments. An experimental study aimed to increase patient intentions to discuss online health information with HCP’s, by manipulating versions of narrative health information. Findings showed that narrative information when paired with either a self-reflection component or discussion starter component but not both, increased participants’ intentions to discuss online health information with their HCP. The theoretical and practical implications of these findings are discussed alongside suggestions for future research