Investigating Cyberchondriac Behaviors on the Internet: Implications for E-Health 2.0
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Abstract
Background: As more people go online for health care information, it is pertinent to question the trustworthiness of online health care information in Web 2.0, and investigate whether continued usage will create cyberchondriac behaviours (CB), leading to negative implications for e-health.
Objectives: Compared to middle-aged and senior adults, young adults (18-35 years), the most internet-savvy user group in Singapore, are found to be more knowledgeable and active in accessing online health care information. Hence, the study focused on young adults in Singapore and addressed these questions:
1.What are key reasons behind young adults’ usage of online health care information?
2. To what extent do young adults trust online health care information and exhibit CB?
3.What social and demographic factors might be associated with continued usage of online health care information, trust and CB?
Method: A theory-based approach was used to study the key factors contributing to CB. Using randomized sampling, we undertook a survey of young adults who were frequent users of the Internet. Using a 7-point Likert scale, the survey instrument measured: (1) cyberchondriac and hypochondriac behaviours using the Whitley Scale developed by Pilowsky; (2) perceptions of content efficacy, i.e., perceived usefulness (PU) of healthcare information; and (3) perceptions of system efficacy, i.e., perceived ease of use (PEOU) of health care websites.
Results: Respondents (n=77 used Internet for healthcare purposes) averaged about 5 – 6 hours of Internet usage daily, and accessed information for healthcare purposes (M = 3.69, SD = 1.59). Although there is a strong preference to face-to-face interaction with health professionals, some key reasons behind usage of online, health-related information include high self-efficacy, accessibility of healthcare websites and time saved.
Cyberchondria Measure was reliable (M = 3.94, SD = 1.64, α = 0.898). Level of trust was moderate (M = 3.99, SD = 1.20), overall impressions of PU (M = 4.75, SD = 1.08) and PEOU (M = 4.91, SD = 1.08) were high. Significant correlations were found between trust and PU (r = .56, p<.01), and trust and PEOU (r = .49, p<.01).
Trust was found to lead to 4 types of CB: (a) reading up online healthcare information (F(5,71) = 2.43, p<.05); (b) liking to find out more about their health symptoms and illnesses online (F(5,71) = 3.34, p<.05); (c) believing that they can accurately diagnose their own illness using online information (F(5,71) = 3.26, p<.05); and the importance of seeking a doctor for a second opinion after practicing self diagnosis (F(5,71) = 4.27, p<.05). General Linear Model shows that trust in healthcare information with their continuance to use healthcare websites as a covariate led to 7 types of CB.
Through the structural use of Non-Parametric Correlation Test, and one-way ANOVA, our findings also show that while young adults found online healthcare information useful and easy to use, they did not trust online healthcare information readily. Due to space constraints, more details of social and demographic data on continued usage of the online healthcare information, trust and CB will be discussed at the conference.
Conclusions: Although the study was focused on young adults in Singapore, the study can be extended to include young adults from other countries. We believe the findings are useful to medical and healthcare professionals, managers of software companies and policy-makers in reviewing existing policies, laws and regulations of healthcare websites, such that any flaws or loopholes can be identified, and early interventions can be made to ameliorate CB.
Objectives: Compared to middle-aged and senior adults, young adults (18-35 years), the most internet-savvy user group in Singapore, are found to be more knowledgeable and active in accessing online health care information. Hence, the study focused on young adults in Singapore and addressed these questions:
1.What are key reasons behind young adults’ usage of online health care information?
2. To what extent do young adults trust online health care information and exhibit CB?
3.What social and demographic factors might be associated with continued usage of online health care information, trust and CB?
Method: A theory-based approach was used to study the key factors contributing to CB. Using randomized sampling, we undertook a survey of young adults who were frequent users of the Internet. Using a 7-point Likert scale, the survey instrument measured: (1) cyberchondriac and hypochondriac behaviours using the Whitley Scale developed by Pilowsky; (2) perceptions of content efficacy, i.e., perceived usefulness (PU) of healthcare information; and (3) perceptions of system efficacy, i.e., perceived ease of use (PEOU) of health care websites.
Results: Respondents (n=77 used Internet for healthcare purposes) averaged about 5 – 6 hours of Internet usage daily, and accessed information for healthcare purposes (M = 3.69, SD = 1.59). Although there is a strong preference to face-to-face interaction with health professionals, some key reasons behind usage of online, health-related information include high self-efficacy, accessibility of healthcare websites and time saved.
Cyberchondria Measure was reliable (M = 3.94, SD = 1.64, α = 0.898). Level of trust was moderate (M = 3.99, SD = 1.20), overall impressions of PU (M = 4.75, SD = 1.08) and PEOU (M = 4.91, SD = 1.08) were high. Significant correlations were found between trust and PU (r = .56, p<.01), and trust and PEOU (r = .49, p<.01).
Trust was found to lead to 4 types of CB: (a) reading up online healthcare information (F(5,71) = 2.43, p<.05); (b) liking to find out more about their health symptoms and illnesses online (F(5,71) = 3.34, p<.05); (c) believing that they can accurately diagnose their own illness using online information (F(5,71) = 3.26, p<.05); and the importance of seeking a doctor for a second opinion after practicing self diagnosis (F(5,71) = 4.27, p<.05). General Linear Model shows that trust in healthcare information with their continuance to use healthcare websites as a covariate led to 7 types of CB.
Through the structural use of Non-Parametric Correlation Test, and one-way ANOVA, our findings also show that while young adults found online healthcare information useful and easy to use, they did not trust online healthcare information readily. Due to space constraints, more details of social and demographic data on continued usage of the online healthcare information, trust and CB will be discussed at the conference.
Conclusions: Although the study was focused on young adults in Singapore, the study can be extended to include young adults from other countries. We believe the findings are useful to medical and healthcare professionals, managers of software companies and policy-makers in reviewing existing policies, laws and regulations of healthcare websites, such that any flaws or loopholes can be identified, and early interventions can be made to ameliorate CB.
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