Posted in #HCSM

How Do Consumers Evaluate the Quality of Online Health Information?

A new study* has set out to identify criteria that consumers use to evaluate the quality of online health information, and the indicators they use to support their evaluation.

Criteria and Indicators Used To Evaluate Online Health Information

The study reports that the most widely reported criteria used by consumers were (1)  trustworthiness, (2) expertise, and (3) objectivity, followed by transparency, popularity, and understandability.

The indicators were related to (1) source (a website or the owner, creator, or sponsor of the site), (2) content, and (3) design. The most widely reported indicators were site owners/sponsors; consensus among multiple sources; characteristics of writing and language; advertisements; content authorship; and interface design.

(1) Source

Mixed attitudes were found toward some indicators representing site owners/sponsors. Firstly, most participants believed that government websites reflect high levels of expertise and good intentions; however, some consumers suspected that the information on government websites is biased due to their agendas and some, particularly younger generations, did not identify themselves with government sources, considering them “less cool” and not relatable

Secondly, people usually considered websites owned by commercial companies less objective and trusted more websites with no commercial interests; nevertheless, popular commercial websites such as WebMD.com were favored by some people for their expertise and comprehensiveness.

Individuals’ prior knowledge and experience of a source were mentioned most frequently as factors that influence quality judgment. Consumers tended to trust sites that they had experience with, because they may already know the source to be credible, have had positive experiences with it, have seen it from advertisements on other media (eg, television and magazine), or are familiar with the organization behind the source.

Trust in Social Media

Consumers had mixed attitudes toward social media sites. Some consumers favored online discussion groups, chat rooms, and listservs because they offered first-person narratives and practical information and support from peers with whom they could identify, but some disliked such sites for their lack of objectivity and expertise.

Concerning Wikipedia, some people questioned its objectivity because information can be edited by anyone on the Web, but some consumers were attracted to its encyclopedic nature and comprehensiveness.

2. Content

Content refers to the information contained in a source as well as the presentation of the information. Eight categories of content-related indicators were identified: substance, writing and language, presentation, references, authorship, audience, date/updating, and advertisements.

The most frequently reported content indicators were about consensus among sources. Content that appears in multiple sources, be it online sources, sources in other media (eg, newspaper, television, books, and academic journals), or health care professionals, is trusted by consumers.

Writing- and language-related factors were the second most frequently reported content indicators. Consumers expect high-quality information to be error-free in spelling and grammar, use straightforward language, and have a clear layout. The use of medical and technical vocabularies had mixed views. For some consumers, high-quality information was easy to understand, that is, it exhibited less use of professional medical vocabularies or provided easy-to-understand definitions of medical jargon; however, for others, the use of technical vocabularies demonstrated expertise and was highly valued

The third most frequently reported indicators were advertisements. Consumers expect quality websites to neither depend on advertisements nor seek to make a profit. Therefore, sites with advertisements were considered less objective.

3. Design

Design refers to the appearance of a website or an app and the user experience (UX) it gives. Four categories of design-related quality indicators were identified: interface design, interaction design, navigation design, and security settings.

The most frequently reported design indicators were related to interface design, mostly visual factors, including the overall appearance of a site, the graphics it includes, and font size.

Interaction design features, including links, interactive functions, and other interactive features (eg, loading time and login requirement), were the second most frequently mentioned quality indicators.

Sites with robust search capabilities (eg, easy to locate and diverse search entrance), offering useful tools (eg, self-management tools), and rendering smooth user-system interaction (eg, providing links to additional relevant sources and not having pop-ups) were perceived as high quality.

Navigation-related indicators such as navigation aids and site maps were the third most frequently mentioned quality indicators.

Key Takeaway For Healthcare Marketers and HCPs

The ability to critically evaluate the quality of health information is an important component of health literacy which is an important determinant of health.

The findings of this study have practical application for designers of online health information for patients. The authors recommend the incorporation of positive indicators (eg, offering authors’ credentials and presenting information in a clear and organized way) and avoidance of negative indicators (eg, dead links and flash media format) to offer users better information seeking experiences.

The fact that the same indicator (eg, government institutions as the source owner) can lead to different quality judgment for different people suggests that designers should also carefully investigate target users’ values and the corresponding criteria that they use to evaluate health information. This calls for active user research and user involvement in the design process.

Related Reading 

Digital Health Checkup: 10 Signs It’s Time To Redesign Your Medical Practice Website 

Evaluating the Quality of Health Information in a Changing Digital Ecosystem

Do Online Health Seekers Trust Social Media? Surprising Results From A New Survey 

What Information Are Parents of Children with Cancer Looking For Online?


* Sun Y, Zhang Y, Gwizdka J, Trace CB, Consumer Evaluation of the Quality of Online Health Information: Systematic Literature Review of Relevant Criteria and Indicators
J Med Internet Res 2019;21(5):e12522

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