The Role of Online Communication in Building Trust in Medical Knowledge
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Abstract
Background: This project is part of a Special Priority Program of the Deutsche Forschungsgemeinschaft (DFG) ‘Science and the General Public: Understanding fragile and conflicting evidence’. The project deals with the fact that the Internet provides a plethora of health-related information in a diversity of online-communication arenas (e. g. online newspapers, medical databases, collaborative encyclopedias or blogs), which rely on different mechanisms and criteria to select, filter and provide medical information. Online health information can promote health-related knowledge, attitudes and behaviour. However, especially in cases of life-threatening diseases, such as cancer, scientific evidence might be tentative, conflicting and fragile. The amount of potentially conflicting information requires internet users to build trust in sources of medical knowledge to select personally relevant information.
Objective: Based on a theoretical model of trust in medical knowledge, we assume that instead of searching and assessing all relevant information on their own, laypeople develop metacognitive strategies of building trust. These strategies allow them to judge the trustworthiness of medical knowledge indirectly by judging the trustworthiness of the selection mechanisms of the communication arena. The study aims at understanding to which extent people are inclined to trust different online-based communication arenas, what reasons they give for the trustworthiness of particular arenas and what ideas they have about the selection mechanisms of the different arenas.
Methods: The findings are based on six focus group discussions: Two with breast cancer patients (≥ 50 years and <50 years) and two with prostate cancer patients (≥ 60 years and < 60 years) who have been diagnosed in the previous six month; two additional focus groups with relatives of cancer patients have been conducted. The transcripts have been analysed with a focus on informational needs, the use of and trust in medical information in different online-communication arenas.
Results: Trust in medical knowledge was not limited to medically qualified Websites, but rather depends on a combination of (a) what kind of medical knowledge a person is searching for and (b) the particular arena and its selective mechanisms. Depending on their particular informational needs and their (not always explicit) expectations regarding the selection mechanisms, patients and their relatives used different communication arenas.
Conclusions: A theoretical framework of trust in medical knowledge as trust in selection mechanisms of the communication arena proves to be useful to understand the selective use and acquisition of medical knowledge by laypersons on the Internet. Trust in health information in the Internet differs due to what expectations people have concerning different online-communication arenas. Further studies on the use of online health information should differentiate between different communication arenas and different types of medical knowledge.
Objective: Based on a theoretical model of trust in medical knowledge, we assume that instead of searching and assessing all relevant information on their own, laypeople develop metacognitive strategies of building trust. These strategies allow them to judge the trustworthiness of medical knowledge indirectly by judging the trustworthiness of the selection mechanisms of the communication arena. The study aims at understanding to which extent people are inclined to trust different online-based communication arenas, what reasons they give for the trustworthiness of particular arenas and what ideas they have about the selection mechanisms of the different arenas.
Methods: The findings are based on six focus group discussions: Two with breast cancer patients (≥ 50 years and <50 years) and two with prostate cancer patients (≥ 60 years and < 60 years) who have been diagnosed in the previous six month; two additional focus groups with relatives of cancer patients have been conducted. The transcripts have been analysed with a focus on informational needs, the use of and trust in medical information in different online-communication arenas.
Results: Trust in medical knowledge was not limited to medically qualified Websites, but rather depends on a combination of (a) what kind of medical knowledge a person is searching for and (b) the particular arena and its selective mechanisms. Depending on their particular informational needs and their (not always explicit) expectations regarding the selection mechanisms, patients and their relatives used different communication arenas.
Conclusions: A theoretical framework of trust in medical knowledge as trust in selection mechanisms of the communication arena proves to be useful to understand the selective use and acquisition of medical knowledge by laypersons on the Internet. Trust in health information in the Internet differs due to what expectations people have concerning different online-communication arenas. Further studies on the use of online health information should differentiate between different communication arenas and different types of medical knowledge.
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