JMIR Publications

ABSTRACT

Background:

Parents often search the web for health-related information for themselves or on behalf of their children, which may impact their health-related decision making and behaviors. In particular, searching for somatic symptoms like headaches, fever, or fatigue is common. However, little is known about how psychological and relational factors relate to characteristics of successful symptom related Internet searches. To date, only few studies have used experimental designs with pre and post search assessments and inclusion of concurrent assessment of psychological factors and search behavior data.

Objective:

First, to examine the features of online health-related search behaviors based on video-coded observational data. Second, to investigate which psychological and relational factors are related to successful symptom search appraisal. Third, to examine the differences in search-related outcomes among self-seekers and by-proxy seekers.

Methods:

In a laboratory setting, parents living in Austria (N = 46) with a child aged between 0-6 years were randomized to search their own (n = 23), or their child’s (n = 23) most recent somatic symptom online. Online activity was recorded and transcribed; search queries were coded and quantified for analyses. Correlational analysis was conducted on health anxiety, eHealth literacy, attitude towards online health information, relational variables, state of stress, participants’ search appraisals and quantitative properties of the search session. A series of independent sample t‐tests were examined for group comparison on participants’ search appraisals and search characteristics.

Results:

Across both groups, searches were carried out for 17 different symptom clusters. Almost all parents started with Google (44/46, 95.65%), and a majority used initial elaborated key phrases with more than one search keyword (38/45, 84.44%) and performed on average 2.95 (SD = 1.83) search queries per session. Search appraisal was negatively associated with health anxiety (rs = −.39, p = .007), stress after the search (rs = −.33, p = .02) and number of search queries (rs = −.29, p = .04), but was not significantly associated with eHealth literacy (rs = .22, p = .13). Of note, eHealth literacy was strongly and positively correlated with satisfaction during the search (rs= .50, P < .001), but did not significantly correlate with search characteristics, i.e., search duration (rs= .08, P = .56), number of performed search queries (rs= .20, P = .17) or total clicks (rs= .14, P = .32). No differences were found between parents searching for their own symptoms and parents searching for their child’s symptoms.

Conclusions:

We present explorative insights into various relevant dimensions of appraisals for symptom-based information seeking on the web. Consistent with prior literature, health anxiety was found to be relevant for understanding search outcomes. Contrary to expectations, eHealth literacy was neither related to search appraisal nor to search characteristics. Interestingly, we did not find significant differences between self vs. by-proxy seekers, suggesting similar search and evaluation patterns in parents. Further research with large-scale studies is needed to provide evidence-based recommendations for expedient online health information seeking among parents and the general public.