Understanding how and when patients use nonphysician sources of health information ls important to facilitate shared decision making within provider outpatient visits. However. little is known about which older adults seek health information on the internet or when. Olikll$C~lrllrE: To determine how patient characteristics are related to seeking health information online and to the timing of these searches in relation to doctor visits. PARTICIPA~I~: Six thousand two hundred and seventy-nine respondents (aged 63 to 66 years) who completed the 2004 round of phone and mail surveys (70% response) as part of the Wisconsin Longitudinal Study Graduate Sample. II~_,~ISI/REIIIENI~: Self-reported use of the internet to search for health information and timing of use. I~P_~I.1I,~I~: One-third of respondents had searched online for information about their own health or health care. Half of these searched for health information unrelated to their last doctor visit, while 1/3 searched after a visit, and 1/6 searched before. Among respondents with internet access at home or work, years of education (odds ratio [OR] = 1.09, confidence interval [CI] =1.06 to 1.13) and openness-toexperience (OR = 1.26, CI = 1.16 to 1.36) were positively associated with searching online for health information irrespective of timing in relation to doctor visits. Compared with those who had never sought health information online, sicker individuals (especially those with cancer, OR = 1.51. CI = 1.14 to 1.99) were more likely to seek information online after a doctor visit. Attitudinal and personality factors were related to seeking health information online before or unrelated to a visit. There are important differences in the timing of online health information searches by psychological and health characteristics among older adults with internet access. KEY WORDS: medical informatics; aging; decision making; doctorpatient relationships; survey research. DOI: 10.1111/j. 1525-1497.2006.00622.x J GEN INTERN MED 2006 21:1295-1301 p atients' desire for health information is well established. 1,2 However, physicians are often unable to satisfy patients' need for information, as the U.S. health care system was designed to deliver tests, procedures, and drugs rather than knowledge, a At the same time, increased patient autonomy in making treatment decisions is encouraged. 4 The trend toward fuller patient participation in health care decision making has resulted in specific recommendations in medical school curricula to promote shared decision making between providers and patients. 5 Yet, one study testing a well-established model of shared decision making 6 showed little evidence Understanding how patients use nonphysician sources of health information is important to facilitating shared decision making within doctor visits. There is substantial evidence that patients obtain health information from sources other than physicians. 8-12 Given the explosion of the internet as a means of sharing information, it is not surprising that it is an increasingly common source of health information as well. 11'1a'14 Patients who have researched their conditions on the internet report improved understanding of health care issues, 15 and many feel empowered by their expertise. 16 Still, many people do not use the internet to look for health information. Previous research suggests that females, younger people, and those with more education or higher incomes are more likely to seek health information online; 8'la' 17-19 however, these differences are not explained by access alone (the so-called digital divide). 2° Even among people with internet access there are still differences between those who use it to seek health information and those who do not. While some studies have suggested positive associations between better health and using the internet to gather health information, 8' 13.17 others suggest the opposite effect of health status, 15 with those self-reporting fair or poor health more frequently using the internet for health information and subsequently discussing the information found online with their health care provider. 21 Previous studies have also shown motivational factors (e.g., high risk for disease, outcome expectancy, self-efficacy) to predict using the internet as a health information resource. 2a-2s Previous research has examined who seeks health information online, but less is known about when patients turn to the internet for health information and whether characteristics of the patient or the doctor-patient relationship are related to the timing of this search. Preparing for an upcoming health care visit by seeking information online before that visit may help patients participate in decision making during a visit. Conversely, seeking information after a visit may suggest that patients need more information or support than they received at their health care visit. Seeking information online instead of visiting a doctor could be problematic given the variable quality of health information on the internet. 26 Formal strategies that physicians can use to assist patient participation in health care decision making (e.g., decision aids) may be more successful if we better understand how patients are using nonphysician sources of health information, such as the internet, to seek health information. We examine use of the internet to look for health information as well as the timing of use in relation to a doctor visit using Manuscript
One survey study showed that one third of the older adults turn to the Internet for health information about health care issues REF .
When do older adults turn to the internet for health information? Findings from the wisconsin longitudinal study
Journal of General Internal Medicine
Journal of General Internal Medicine
Medicine