title: Consumer Use of "Dr Google": A Survey on Health Information-Seeking Behaviors and Navigational Needs.
abstract: BACKGROUND
  The Internet provides a platform to access health information and support self-management by consumers with chronic health conditions. Despite recognized barriers to accessing Web-based health information, there is a lack of research quantitatively exploring whether consumers report difficulty finding desired health information on the Internet and whether these consumers would like assistance (ie, navigational needs). Understanding navigational needs can provide a basis for interventions guiding consumers to quality Web-based health resources.
  
  
  OBJECTIVE
  We aimed to (1) estimate the proportion of consumers with navigational needs among seekers of Web-based health information with chronic health conditions, (2) describe Web-based health information-seeking behaviors, level of patient activation, and level of eHealth literacy among consumers with navigational needs, and (3) explore variables predicting navigational needs.
  
  
  METHODS
  A questionnaire was developed based on findings from a qualitative study on Web-based health information-seeking behaviors and navigational needs. This questionnaire also incorporated the eHealth Literacy Scale (eHEALS; a measure of self-perceived eHealth literacy) and PAM-13 (a measure of patient activation). The target population was consumers of Web-based health information with chronic health conditions. We surveyed a sample of 400 Australian adults, with recruitment coordinated by Qualtrics. This sample size was required to estimate the proportion of consumers identified with navigational needs with a precision of 4.9% either side of the true population value, with 95% confidence. A subsample was invited to retake the survey after 2 weeks to assess the test-retest reliability of the eHEALS and PAM-13.
  
  
  RESULTS
  Of 514 individuals who met our eligibility criteria, 400 (77.8%) completed the questionnaire and 43 participants completed the retest. Approximately half (51.3%; 95% CI 46.4-56.2) of the population was identified with navigational needs. Participants with navigational needs appeared to look for more types of health information on the Internet and from a greater variety of information sources compared to participants without navigational needs. However, participants with navigational needs were significantly less likely to have high levels of eHealth literacy (adjusted odds ratio=0.83, 95% CI 0.78-0.89, P<.001). Age was also a significant predictor (P=.02).
  
  
  CONCLUSIONS
  Approximately half of the population of consumers of Web-based health information with chronic health conditions would benefit from support in finding health information on the Internet. Despite the popularity of the Internet as a source of health information, further work is recommended to maximize its potential as a tool to assist self-management in consumers with chronic health conditions.
authors.affiliation: Curtin University, School of Pharmacy, Curtin University, Perth, Australia.
authors.forename: Kenneth
authors.identifier: http://orcid.org/0000-0003-3022-4868
authors.initials: K
authors.lastname: Lee
authors.forename: Kreshnik
authors.identifier: http://orcid.org/0000-0001-7652-6074
authors.initials: K
authors.lastname: Hoti
authors.forename: Jeffery David
authors.identifier: http://orcid.org/0000-0003-0040-4753
authors.initials: JD
authors.lastname: Hughes
authors.forename: Lynne M
authors.identifier: http://orcid.org/0000-0002-0806-6691
authors.initials: LM
authors.lastname: Emmerton
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D057226:Information Seeking Behavior; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000706:statistics & numerical data*
keywords: Internet; chronic disease; health information; health literacy; information needs; information seeking; online; patient activation; patients; survey