Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 2, 2019
Open Peer Review Period: Jul 2, 2019 - Jul 9, 2019
Date Accepted: Oct 17, 2019
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Online health information and patient decision-making: Identifying a new typology of patients
ABSTRACT
Background:
While previous research shows broad differences in the impact of online health information on patient-practitioner decision-making, specific research is required (a) to measure patient decision-making styles associated with the use of online health information, and (b) to distinguish practice-relevant and addressable segments of patients based on the influence of online information on their decision-making.
Objective:
This study investigates the decision-making styles of patients who seek online health information, with the overall purpose of investigating online health information behaviour and decision-making in relation to healthcare professionals. We also aimed to profile a typology of patients based on significant differences in their decision-making.
Methods:
The research applied a mixed-methods research design using both qualitative and quantitative data. First, we tested proposed patient decision-making styles associated with online health information seeking (collaborative, autonomous, and assertive) using data from focus groups and semi-structured in-depth interviews, combined with items developed from the literature. Ten items relating to patient-sourced online health information and decision-making were incorporated in a large-scale cross-sectional study using an online survey. Data were collected from baby boomers (born 1946-1964) in the United Kingdom, United States, and New Zealand, resulting in a total of 996 completed usable questionnaires.
Results:
Using the pilot survey (n=60), an exploratory factor analysis supported the three patient decision-making styles indicated by the literature and the qualitative research. Then, analysis of data generated by the cross-national online survey identified four unique and stable segments: the Collaborators, the Autonomous-Collaborators, the Assertive-Collaborators, and the Passives. Profiles were developed for these segments based on differences in the online health information, decision-making, and interactional behaviours of patients.
Conclusions:
The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for healthcare practitioners. For example, the typology demonstrates that collaborative decision-making is dominant among patients, either in its pure form or in combination with autonomous or assertive decision-making. In other words, the majority of patients (725/996, 72.8%) shows significant collaboration in their decision-making with healthcare professionals. However, at times, patients in the combination Autonomous-Collaborative segment prefer to exercise individual autonomy in their decision-making and those in the Assertive-Collaborative segment are assertive with health professionals. In addition, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%) relative to healthcare professionals.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.