title: Indirect effects of contextual factors on patients' consultations with healthcare professionals about health information found online.
abstract: E-health users are encouraged to consult healthcare professionals about the health information they found online because it facilitates e-health users to participate in an informed decision-making process with healthcare professionals on treatment options. However, few studies have examined the path of how e-health users consult healthcare professionals about the health information. Using psychological empowerment, which claims that empowering individuals requires understanding contextual factors that interact with the individuals' intrapsychic factors, this study tested a hypothesis: the contextual factors play an indirect role between patients' perceived poor health and their consultations with healthcare professionals about the health information found online, holding predisposing factors constant.
  
  
  
  The data were collected from the Health Information National Trends Survey and used a subsample of e-health users who used healthcare services during the past year. The subsample (N = 2,297) was analyzed using structural equation modeling (SEM).
  
  
  
  The SEM analysis supported the hypothesized indirect model. Meanwhile, patients with low socioeconomic statuses tended to score high in the outcome measurement of the contextual factors; however, they tended not to consult professionals.
  
  
  
  It is important to acknowledge contextual factors, which encompass communication and relational aspects as well as the process and outcomes of treatments, when empowering e-health users to use e-health tools meaningfully and become empowered in caring for their own health. Particularly, those with low income and education levels were the less powered or powerless patients: they tended not to be competent in having a voice and discussing the health information that they found online with professionals.
authors: Department of Social Work, St. Cloud State University, 720 Fourth Avenue South, St. Cloud, MN, 56301-4498, USA. yyeo@stcloudstate.edu.
authors: Younsook
authors: Y
authors: Yeo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003142:Communication; D054626:Consumer Health Information; D003657:Decision Making; D005260:Female; D006282:Health Personnel; D006801:Humans; D057226:Information Seeking Behavior; D020407:Internet; D008297:Male; D008875:Middle Aged; D011209:Power, Psychological; D011369:Professional-Patient Relations; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: E-health; Health empowerment; Psychological empowerment