JMIR Publications

ABSTRACT

Background:

Web-based patient education is increasingly offered to improve patients’ ability to learn, remember, and apply health information. Efficient organization, display, and structural design, i.e. information architecture (IA), can support patients’ ability to independently use web-based patient education. However, the role of IA in the context of web-based patient education has not been examined systematically.

Objective:

To support intervention designers in making informed choices that enhance patients’ learning, the current paper describes a randomized experiment concerning the effect of IA on the effectiveness, use, and user experience of a patient education website and examines the theoretical mechanisms that explain these effects.

Methods:

Middle-aged and older adults with self-reported hip or knee joint complaints were recruited to use and evaluate one of three patient education websites. Each website contained the same textual content based on an existing leaflet but differed in the employed IA design (tunnel, hierarchical, or matrix design). Participants rated the websites on satisfaction, engagement, relevance, control, trust, and novelty and completed an objective knowledge test. Analyses of variance and structural equation modelling were used to examine the effects of IA and construct a theoretical model.

Results:

We included 215 participants in our analysis. IA did not affect knowledge gain (P=.361) or overall satisfaction (P=.069) directly. However, tunnel (M=3.22, SD=0.67) and matrix (M=3.17, SD=0.69) architectures were found to provide more emotional support compared to hierarchical architectures (M=2.86, SD=0.60) (P=.002). Furthermore, increased perceptions of personal relevance in the tunnel IA (β=.11) were found to improve satisfaction (β=.17) indirectly. Increased perceptions of active control in the matrix IA (β=.18) also improved satisfaction (β=.27) indirectly. The final model of IA effects explained 74.3% of the variance in satisfaction and 6.8% of the variance in knowledge and achieved excellent fit: χ2(17,215)=14.684, P=.618, RMSEA=0.000 [CI 0.000-0.053], CFI=1.00, SRMR=0.044.

Conclusions:

Web-based patient education designers should employ tunnel IA to guide users through sequentially ordered content or matrix IA to offer users more control over navigation. Both improve user satisfaction by increasing user perceptions of relevance (tunnel) and active control (matrix). Hierarchical IA designs are not recommended, as hierarchical content is perceived as less supportive, engaging, and relevant which may diminish the usage, and in turn the effect of the educational intervention.