Accepted for/Published in: JMIR Formative Research
Date Submitted: May 17, 2024
Date Accepted: Feb 8, 2025
Warning: This is an author submission that is not peer-reviewed or edited.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.
An interface between ehealth, health literacy and health-related behavior: Qualitative interview study on laypersons experiences with a mobile symptom checker app
ABSTRACT
Background:
Symptom checkers are designed to support their users in recognizing medical symptoms and recommending courses of action. The applications are not yet reliable for self-triage and diagnostics. Users (e-)health literacy plays a role in how symptom checkers are used, but it is unclear how the process from symptom via application input to consulting health care works.
Objective:
The aim of this study is to describe symptom checker use from the perspective of laypersons. Three research questions are addressed: 1) How do users describe the process of using symptom checkers? 2) What are entry points and possible outcomes of symptom checker app use? 3) How are health literacy and e-health literacy expressed during the use of SCA?
Methods:
As part of the CHECK.APP project, 15 medical laypersons were interviewed about their experiences with a specific symptom checker using an interview guideline. The transcripts of the interviews were analyzed using the integrative basic procedure. It combined an analysis of social positioning and agency with Achtziger and Gollwitzer's Rubicon model as concrete heuristics.
Results:
App use corresponds to a cyclic process. Its initiation depends on biographical, social and contextual factors. Users employed symptom checkers for three purposes: Information gathering, action recommendation and communication. They integrate various social, personal and digital resources in their health-related behavior. Their evaluation of the use process depends on context factors, app output and the result of their health-related behavior.
Conclusions:
Health literacy and e-health literacy are expressed at each step of the process, showing that symptom checkers rely heavily on users’ health literacy. To be more effective, symptom checkers should be more transparently integrated in health care. Clinical Trial: German Clinical Trials Register (DRKS) DRKS00022465
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