An Examination of Factors That Affect the Credibility of Online Health Information

INTRODUCTION Every day, millions of readers search among the countless pages of online health information (Baker and colleagues 2003; Bard 2000; Cain and colleagues 2000; Fox and colleagues 2000; Fox and Fallows 2003; Fox and Rainie 2002; Horrigan and Rainie 2002; PSRA 2002; UCLA 2003). They go to the Internet because it is open and available 24 hours a day, because it provides answers to embarrassingly personal questions, and because—unlike our increasingly harried doctors—it never has to cut a visit short. But consumers searching for accurate information online may have an arduous task. Numerous studies have shown that, while there are excellent sources of online health information, many health Web pages have incomplete, spurious, or fraudulent information (Berland and colleagues 2001; CROH 2000; Crocco and colleagues 2002; Eng and EvaluMetrix 2001; FTC 2001; Fahey and Weinberg 2003; Hellawell and colleagues 2000; Latthe 2000; Pandolfi and colleagues 2000; Suarez-Almazor and colleagues 2001; Stephenson 1998; Stone and Jumper 2001; Weisbord and colleagues 1997). Given the poor quality of information on some Web sites, one might wonder how consumers decide what information to trust. While it would be optimal if readers had the ability to accurately assess the quality of online information itself, most lack the necessary expertise and must judge the information quality by other means, such as cues to credibility. Many healthcare organizations, such as the Health on the Net Foundation and the Internet Healthcare Coalition, have published guidelines to help readers judge the credibility of online information, that is, to determine the expertise of the providers of online health information, as well as the motives and goals, or trustworthiness, of these providers. In addition, researchers have used these guidelines, in combination with methods for online audience research, to develop a conceptual framework for creating credible Web sites on medical topics (Swenson and colleagues 2002). Yet little work has been done to determine how consumers actually judge the credibility of online information. Much of the initial research on consumers’ judgments of the credibility of online information focused on e-commerce sites and transactions, such as the willingness of consumers to use their credit cards online (Cheskin Research, and Studio Archetype/Sapient 1999; Cheskin Research 2000; Fogg and colleagues 2001a, 2001b, 2002a; Friedman and colleagues 2000; GVU 1999; Jones and colleagues 2000; Olson and Olson 2000; Resnick and colleagues 2000; Winn and Beck 2002). Recently, researchers have also begun to address the credibility of online health information, primarily through large-scale surveys (Bard 2000; Cain and colleagues 2000; Fogg and colleagues 2002b; Fox and colleagues 2000; Fox and Fallows 2003; Fox and Rainie 2002; HON 1999, 2001; Horrigan and Rainie 2002; PSRA 2002; Stanford and colleagues 2002). Although these surveys provide a valuable foundation for future research, they are limited in that they ask participants to judge imaginary Web pages as opposed to actual Web pages. It is not surprising that the results of these surveys sometimes differ from the few studies that have presented