title: Internet guidance in oncology practice: determinants of health professionals' Internet referral behavior.
abstract: BACKGROUND
  Many cancer patients turn to the Internet to obtain information on their disease. This digital quest is often motivated by a perceived discrepancy between the information received from health professionals and patients' actual informational needs. This discrepancy may be reduced by supplementing standard patient education with reliable online information sources. This study investigates health professionals' opinions, cognitions, and behavior regarding referring cancer patients to Internet-based information.
  
  
  METHODS
  Online and written questionnaires were distributed among Dutch oncology nurses and medical specialists, measuring perception of patients' informational needs, prompted and unprompted Internet referral, and socio-cognitive factors regarding referral behavior.
  
  
  RESULTS
  Health professionals (N = 130) positively appraised Internet use among cancer patients. Despite recognizing patients' needs for additional information (84%) and need for referral to reliable websites (67%), only 20% frequently referred patients to Internet-based information. Prompted Internet referral was higher (64%). Motives for nonreferral included unfamiliarity with websites and uncertainty about information quality. Intentions towards future referral were moderate to high. To translate intentions into referral, health professionals need reminder tools and information on reliability and content of websites. Cognitive determinants of referral behavior included professionals' attitude, self-efficacy, and intentions regarding referral.
  
  
  CONCLUSIONS
  Recognition of patients' information needs does not culminate in Internet referral among health professionals in cancer care. High intentions to change, however, indicate good prospects for future referral. This study yields valuable insights into behavioral determinants of health professionals' Internet referral behavior. Targeting determinants and barriers in future interventions will provide opportunities for optimization of educational practices.
authors.affiliation: Department of Health Promotion, Maastricht University, Maastricht, The Netherlands.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Emond
authors.forename: Jos
authors.initials: J
authors.lastname: de Groot
authors.forename: Wendy
authors.initials: W
authors.lastname: Wetzels
authors.forename: Liesbeth
authors.initials: L
authors.lastname: van Osch
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D020407:Internet; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009369:Neoplasms / Q000523:psychology*; D009426:Netherlands; D005791:Patient Care / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires