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| 46.
Barnes MD, Penrod C,
Neiger BB, Merrill RM, Thackeray R, Eggett DL, et al.
Measuring the relevance of evaluation criteria among health
information seekers on the Internet. Journal of Health
Psychology 2003;8:71-82. [Appropriateness] |
578
adults who were employees of Idaho National Engineering
and Environmental Labs who were enrolled in the Occupational
Medicine Health Promotion Program; 57% male, 84% attended
at least some college |
Health
information: lab computer with Internet |
Three
publicly available Web sites about cold and flu information
|
Participants
first ranked 12 criteria in importance for evaluating health
information. Then they used those criteria to evaluate
three preselected Web sites that had been chosen on the
basis of low, medium, and high quality. |
Ranking
of the criteria, rating of the Web sites |
Participants
ranked criteria related to credibility of information and
reliability of source as most important with design and
aesthetics seen as least important. When rating actual
Web sites, six criteria proved to be significant predictors
of quality: content, design and aesthetics, currency of
information, intended audience, contact addresses, and
user support. Those younger than age 50 were better able
to select the high-quality site. |
| 47.
Beebe TJ, Asche SE,
Harrison PA, Quinlan KB. Heightened vulnerability and
increased risk-taking among adolescent chat room users:
results from a statewide school survey. Journal of
Adolescent Health 2004;35:116-23. [Applicability]
|
40,376
ninth grade students who had Internet at home, of which
19,511 reported accessing chat rooms |
Social
support: home computer with Internet |
World
Wide Web |
Data
from the Minnesota Student Survey were analyzed to determine
demographic, psychological, environmental, and behavioral
differences between chat room users versus nonusers. |
Psychological,
environmental, and behavioral factors; Internet activities
|
Chat
room use was consistently, positively, and significantly
associated with adverse psychological and environmental
facts and engagement in risk behaviors among ninth grade
boys and girls. Other Internet activities, such as use
of e-mail or games, did not show a consistent pattern of
positive associations with these factors. Cannot infer
causality: possible that teens who need support are trying
to attain it via the chat rooms. |
| 48.
Birru MS, Monaco VM,
Lonelyss C, Drew H, Njie V, Bierria T, et al. Internet
usage by low-literacy adults seeking health information:
an observational analysis. Journal of Medical Internet
Research 2004;6:e25. [Appropriateness] |
Eight
adults with low literacy; mean age 41.5; seven African
American, one Asian |
Health
information: lab computer with Internet |
World
Wide Web |
All
participants had a computer skills session. Then participants
were asked to use Internet and Google to research information
on three health-related questions, using a think-aloud
protocol. Then they were asked to navigate a specific Web
site. |
Search
engine usage, ability to answer questions, information
accessed, attitudes |
Most
found generating search terms challenging, difficulty remembering
to space between words, some difficulty with spelling;
generally retained navigational skills learned in skills
session; difficulty generating independent queries and
answering specific questions. Participants at times able
to locate answers, but could not put into their own words,
thus suggesting comprehension difficulties. Average reading
level of sites accessed was 10th grade. Seven of eight
accessed sponsored sites. All were at least moderately
comfortable with their searching experience. Seven of eight
felt it was easy to locate trustworthy information. All
were enthusiastic about improving skills and using computers. |
| 49.
Block G, Miller M, Harnack
L, Kayman S, Mandel S, Cristofar S. An interactive
CD-ROM for nutrition screening and counseling. American
Journal of Public Health 2000;90:781-5. [Acceptability]
|
281
adults |
Nutrition:
clinic-based computer with CD-ROM |
Interactive
program designed to assess fat and fiber intake; compare
to recommendations; and provide tailored information to
intake, stage of change, and lifestyle habits |
Users
interacted with the program, then completed questionnaire;
followup phone calls made 2 to 4 weeks later. |
Satisfaction,
new learning, goal setting, and attainment |
Large
majority found the program easy to use, would recommend
it to a friend, thought it could be longer; 78% reported
learning something new. 60% had selected a personal goal.
Of those who could be reached for followup, 50% tried to
reach their goal. |
| 50.
Bowen DJ, Ludwig A,
Bush N, Meischke J, Wooldridge JA, Robbins R. Early
experience with a Web-based intervention to inform risk
of breast cancer. Journal of Health Psychology 2003;8:175-86.
[Acceptability] |
Study
1: Utilization: 268 women; 88% white, 56% college degree.
Study 2: Interviews with nonusers: 83 women |
Cancer:
home computer with Internet |
WIRES:
a multicomponent Web site that includes information tailored
to personal risk, exercise, eating habits, mammogram history,
and age. Components include information, interactive features
(“make a commitment” quizzes), contact with
study staff, discussion forums. |
This
study included an analysis of usage by those who actually
used the Web site along with identification of predictors
or usage, and interviews with nonusers. |
Quality
of life, healthcare coverage, risk factors for breast cancer,
perceived risk, usage patterns |
Usage:
by week 3, only 21.5% of users had logged into the Web
site. After a cue at 3 weeks, usage increased to 37.2%.
By 3 months, 47.6% had logged into the Web site. An additional
cue at 3 months increased usage by 3.4%. By 6 months, usage
was 58.7%. Average length of visit was 30 minutes. Most
frequently used pages were home page, personal risk information,
exercise and healthy eating pages, then pages on breast
cancer, risk factors, and Tamoxifen use. Main reason for
not logging in was being too busy. Most difficult part
of getting online was finding time. Women with higher incomes
and employed full time were less likely to use Web site.
Women with higher mental health scores were more likely
to use the Web site. Those with lower perceptions of their
general current health were less likely to use the Web
site. Those with higher perceptions of risk were more likely
to use Web site. |
| 51.
Cimino JJ, Li J, Mendonca
EA, Sengupta S, Patel VL, Kushniruk AW. An evaluation
of patient access to their electronic medical records via
the WWW. Proceedings of the American Medical Informatics
Association Symposium 2000:151-5. [Acceptability]
|
Eight
adults recruited from private practices of internists at
NY Presbyterian Hospital. Only five were actual users;
the others did not participate after consent. |
Patient-provider
interaction: home computer with Internet |
PatCIS
gives patients access to their electronic medical record,
allowing them to add data, review online health information,
and apply their own clinical data to guideline programs
that offer health advice. System supports security functions
and records user activities. User functions: data entry
data review, education, advice, comments, and help. |
Review
of system usage logs—sessions were analyzed by the
success of the login, number of functions used during the
sessions, duration of the sessions, and whether the user
logged out. |
User
logs |
Logged
in 243 times, 33 logins failed due to incorrect password
or code, 14 sessions had OK login but no other activity.
No illegal logins. 196 logins used one or more functions.
Log out used 122 times, not 74 times. Most frequently used
function: checking lab data 140 times (71%), reports 40
times. Data entry functions: vitals entered 31 times, diabetes
information 14 times. Educational functions (links) used
35 times, advice functions 6 times. No adverse reports
received from physicians. |
| 52.
Colvin J, Chenoweth
L, Bold M, Harding C. Caregivers of older adults: advantages
and disadvantages of Internet-based social support. Family
Relations 2004;53:49-57. [Acceptability] |
63
caregivers recruited from 15 Web sites; 89% women, mean
age 54.9 years; 59% not employed outside the home; spent
88 hours/week caregiving; 12.6 hours on Internet |
Social
support for caregivers: home computer with Internet |
Web
sites offering social networks |
Surveyed
caregivers of older adults who used Internet support groups.
|
Advantages
and disadvantages of online social support |
Advantages
cited: anonymity and nonjudgmental atmosphere; asynchrony;
able to personalize use of computer-mediated communication
(can lurk if desired and delete content); allows expansion
of network. Disadvantages: absence of physical presence,
social cues; desire for more intimacy; desire to give/receive
tangible support; anonymity (not being sure if people are
really who they say they are); technical problems; loss
of anonymity so they screen what they say; online cliques.
Disadvantages cited by small numbers, 24% did not cite
any, five left blank. |
| 53.
Czaja SJ, Rubert, MP.
Telecommunications technology as an aid to family caregivers
of persons with dementia. Psychosomatic Medicine
2002;64:469-76. [Acceptability] |
44
caregivers of family members with dementia: 21 Cuban American,
23 white; 34 female; mean age 67.5; 62% with income <30,000;
41% high school or less |
Social
support for caregivers: home computer-integrated telephone
system |
CTIS
is an information-network that uses computer-telephone
technology. It uses screen phones and allows both text
and voice messages. Phone system allows users to conference
call, join phone support group, leave/send messages to
family and care providers; provides caregiver resources,
respite functions for patients. |
Participants
used telephone system for 6 months, then completed survey.
|
Usability,
satisfaction |
Generally,
participants liked the system and found it easy to use.
System use averaged 49 calls/caregiver. Most used function
was calling family members. 80% participated in the discussion
group. 82% of those liked participating in the discussion
groups, and 86% found participation valuable. Several caregivers
could participate who could not get to face-to-face support
groups. |
| 54.
Davis JJ. Disenfranchising
the disabled: the inaccessibility of Internet-based health
information. Journal of Health Communication 2002;7:355-67.
[Access] |
NA
|
Health
information: lab computer with Internet |
Web
sites about health and illness |
500
Web sites representing common illnesses/conditions were
evaluated for accessibility for visually impaired users
who use automated screen readers. |
Accessibility
|
Only
19% of sites were found to be accessible. 64.7% failed
because of inability to satisfy a single Priority 1 criteria
as specified by the Web Accessibility Initiative of the
World Wide Web Consortium. Most failed to provide text
descriptions of graphic elements or provided inadequate
descriptions. |
| 55.
Epstein YM, Rosenberg
HS, Grant TV, Hemenway N. Use of the Internet as the
only outlet for talking about infertility. Fertility
and Sterility 2002;78:507-14. [Applicability] |
589
adults; 99.1% female, >85% at least some college education
|
Infertility:
home computer with Internet |
Web
site for the International Council on Infertility Information
Dissemination |
Survey
was completed by visitors to the Web site. Researchers
then compared two groups: those whose only support was
online (OO) and those with additional support (AO). |
Diagnostic
and treatment information; medication usage; current treatment
status; Internet activity; perceived consequences of Internet
activity; self-assessment of ways of dealing with infertility;
current social and emotional well-being; depression |
Greater
proportion of OO than AO are not college educated, have
no health insurance coverage for infertility, and have
a lower household income. OOs spend more hours/day on the
Internet for any activity and infertility-related activity;
1/5 of each group are lurkers. Both groups report that
their participation has had important cognitive, behavioral,
and relationship consequences (switching to a specialist,
learning how to deal with doctors, decreasing communication
about infertility with partner [OO more than AO]). OOs
are more depressed, consider infertility more stressful,
report poorer coping strategies for dealing with infertility,
worry more, are less satisfied with important relationships,
perceive that they receive less support. Lower income predicted
greater depression. Time spent on Internet did not predict
depression. |
| 56.
Erwin BA, Turk DL, Heimberg
RG, Fresco DM, Hantula DA. The Internet. Home to a
severe population of individuals with social anxiety disorder?
Journal of Anxiety Disorders 2004;18:629-46. [Applicability]
|
434
participants recruited from Internet sites on social anxiety;
291 women, 140 men, 3 no response; also 229 who sought
face-to-face treatment and 36 controls without psychological
distress |
Anxiety:
home computer with Internet |
World
Wide Web |
Surveyed
Internet users with social anxiety disorders, those who
sought face-to-face treatment, and controls. |
Internet
use, clinical and impairment variables |
Internet
survey respondents reported greater severity of and impairment
due to social anxiety disorder than treatment-seeking sample.
They reported positive (more social support, developing
increased confidence) and negative effects of Internet
use (fewer face-to-face social bonds, more comfortable
interacting on Internet than in person). |
| 57.
Escoffery C, McCormick
L, Bateman K. Development and process evaluation of
a Web-based smoking cessation program for college smokers:
innovative tool for education. Patient Education and
Counseling 2004;53:217-25. [Acceptability] |
35
college students from one campus; 20 women, 15 men |
Smoking
cessation: home computer with Internet |
Kick
It!: a four-session program of smoking cessation information,
support (ask an expert, message boards, personal stories).
Information tailored by stage of change. Each available
for 2 weeks. |
Users
interacted with site, then completed surveys or were interviewed.
|
Process
information, quit rate |
14.3%
(5) participants quit at end of intervention; at 6-month
followup, 25.7% quit. Quit rates of this program were as
good as and better than other reports of face-to-face and
online interventions. Users rated reading the text, taking
quizzes, and using the links as the top activities. Limited
use of ask-the-expert and message boards. Participants
found the program somewhat useful, interesting, valuable,
and personally relevant. Many found it easy to use. Log
files and usage self-report showed 82.4% agreement, with
some users reporting attending one more session than logs
indicated. Interviews also yielded mostly positive feedback. |
| 58.
Eysenbach G, Kohler
C. How do consumers search for and appraise health
information on the World Wide Web? Qualitative study using
focus groups, usability tests, and in-depth interviews.
British Medical Journal 2002;324:573-7. [Availability,
Appropriateness] |
21
adults in focus groups (5 men, 16 women; mean age 37);
17 adults in usability study and interviews (6 men, 11
women; mean age 38) |
Health
information: lab computer with Internet |
World
Wide Web |
Focus
groups, usability study in which participants used the
Internet to find answers to specific researcher-generated
health questions and individual interviews |
Self-report
and performance of how they search for health information
and determine its credibility |
Users
reported that Web sites from official authorities, with
professional layout, understandable and professional writing,
and citation of scientific references, were the most often
mentioned criteria. Observation showed all users started
with search engine, most used suboptimal search strategy;
usually chose one of first displayed results. Users could
answer all but 7 of the 136 total questions, but quality
of answers was not assessed. Also, users did not attend
to the source of the information while searching. |
59.
Fallows D. Search
engine users: Internet searchers are confident, satisfied
and trusting—but they are also unaware and naive.
Pew Internet & American Life Project, 2005. Available
online at www.pewinternet.org.
/PPF/r/146/report_display.asp. [Availability] |
1,399
adult Internet users |
Health
information: home computer with Internet |
NA
|
Survey
of Internet users |
Search
engine use and satisfaction |
84%
of Internet users have used search engines, 92% who use
search engines are confident, and 87% report successful
search experiences most of the time. |
