Use of Online Health Information in a Developing Country: What Does Information Quality Mean to Users?

Abstract

The ubiquity of the internet affords both healthcare professionals and lay users the opportunity to access a wide range of Online Health Information (OHI) resources. However, in the midst of the abundance, the OHI seeker (OHIS), whether medically trained or not, remains the primary decision maker who determines the quality or otherwise of the information consumed. With quality of online information generally being called into question by many researchers who believe that the content is susceptible to abuses, this thesis seeks to understand the thought processes of the OHIS regarding the criteria that guide them in the decision-making process. In addition, trade-offs made in the decision processes are revealed. To do this, five widely acclaimed OHI quality evaluation criteria namely Credibility, Design, Content, Disclosure and Interactivity are drawn from the Journal of American Medical Association (JAMA) Scores, the DISCERN framework and the Health on the Net Foundation Code of Conduct (HONcode) for medical and health web sites. They were used in a choice-based experimental design to gauge the relative importance of these criteria to OHIS. The research is situated in a developing country context where myriad of challenges to healthcare access; long queues, over-crowding and lack of access to medicines in public hospitals, present OHI as attractive option among the literate population. The choice-based conjoint analysis design helped to understand the reasons behind the use of OHI in Ghana and what users’ fears and aversions are to the practice. With a sample size of 650 respondents, the results reveal that OHIS consider the source of the OHI (the author and/or their affiliation), an internal search box feature on the website, accuracy of the OHI content, interactive feature that allows for user feedback and profiling, as measures of OHI quality. The study further audits selected OHI portals to ascertain whether user preferences indicated in this study are being provided, while serving as a latent learning experience for OHIS. Respondents between ages 18 to 24 and 55+ had similar OHI quality preferences as opposed to their counterparts aged 25 to 54. This difference in preferences could be attributed to the level of digital literacy of the various age groups. Taking these into consideration, the average OHIS would need to be supported with accurate information to aid in the decision processes of accessing OHI. Additionally, the results should also guide OHI authors and publishers, portal developers and institutions involved to tailor their content to suit the stated preferences of OHIS. Further, the research should guide stakeholders in Ghana’s E-health sector to conduct background checks on individuals and organizations behind OHI portals, so as to ensure a high level of accuracy and reliability of the content produced. The findings should also serve as foundational knowledge for researchers to begin simulating how the digital health consumer responds to the range of digital health products on offer today, especially those that are used outside the supervision of trained medical professionals. Future research could use a more diverse sample together with other variables such as the type of devices used to access OHI and the social classes of the users.