JMIR Publications

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 identify and conceptualise patient decision-making styles related to the use of online health information, and (b) to differentiate segments according to the influence of online information on patient decision-making and interactions with health professionals.

Objective:

The main objective of this research was to investigate patients' decision-making in relation to online health information and interactions with healthcare practitioners. We also aimed to present a typology of patients based on significant differences in their decision-making.

Methods:

We applied a large-scale cross-sectional research design using a survey. Data, generated using a questionnaire administered by companies specialising in providing online panels, were collected from random samples of baby boomers in the United Kingdom, the United States, and New Zealand. The total sample comprised 996 baby boomers born between 1946 and 1964, who had used the internet in the previous 6 months to search for and share health-related information. Data were analysed using hierarchical cluster analysis and confirmatory factor analysis, as well as one-way ANOVA, chi-square tests, and paired sample t-tests.

Results:

Analyses identified three key decision-making styles which served as the base for four unique and stable segments of patients with distinctive decision-making styles: the Collaborators (229/996, 23%), the Autonomous-Collaborators (385/996, 38.7%), the Assertive-Collaborators (111/996, 11.1%), and the Passives (271/996, 27.2%). Profiles were further developed for these segments according to key differences in the online health information behaviour, demographics, and interactional behaviours of patients. 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 combination Assertive-Collaborative segment prefer to be assertive with health professionals. Finally, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%).

Conclusions:

The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for healthcare practitioners, including better-targeted communication programmes for patients and more successful outcomes for healthcare services long-term.