Skip Navigation

Health Information Seeking

Definition

Health information seeking represents intentional, active efforts to obtain specific information above and beyond the normal patterns of media exposure and use of interpersonal sources (Atkin, 1973; Griffin, Dunwoody, & Neuwirth, 1999). It includes "any non-routine media use or interpersonal conversation about a specific health topic and thus includes behaviors such as viewing a special program about a health-related treatment, using a search engine to find information about a particular health topic on the Internet, and/or posing specific health-related questions to a friend, family member, or medical practitioner outside the normal flow of conversation" (Niederdeppe, Hornik, Kelly, et al., 2007, p. 155).

Health information seeking is distinguished from information scanning (e.g., Morris, Rooney, Wray, & Kreuter, 2009; Niederdeppe, et al., 2007), which is information acquisition from routine or habitual media use and interpersonal communication. Information scanning is seen as less active and less goal-directed than information seeking.

Recent research conceptualizes health information seeking both as a predictor and as an outcome variable. For example, health information seeking may foster therapeutic effects for those with cancer, such as increased knowledge about cancer, better coping, less stress, more social support, and appropriate changes in lifestyle (e.g., Shim, Kelly, & Hornik, 2006; van der Molen, 1999).

As an outcome variable, health information seeking can be impacted by demographics and individual differences, such as a person's information needs (Baker, 1995; Bennenbroek, Buunk, Van der Zee, & Grol, 2001; Boberg et al., 2003; Borgers et al., 1993; Cameron et al., 1994; Connell & Crawford, 1988; Ford, Coups, & Hay, 2006; Lock & Wilson, 2002), ethnicity (e.g., Kakai, Maskarinec, Shumay, Tatsumura, & Tasaki, 2003; Nguyen & Bellamy, 2006), and media preferences (e.g., James, James, Davies, Harvey, & Tweddle, 1999).

Czaja, Manfredi, and Price (2003) found increased information seeking among cancer patients was associated with patients who discussed information with their physicians.

Most often, health information seeking behaviors are associated with positive attitudes, knowledge, and behaviors. For example, Dutta-Bergman (2004) found consumers who seek medical information on the Internet were more likely to be health conscious, hold stronger health beliefs, and engage in health activities compared with consumers who did not search the Internet.

Maibach, Weber, Massett, et al. (2006), note consumers continue to receive the majority of their health information from traditional media and interpersonal sources (e.g., television, doctor, books, magazines, etc.), and certain consumers seek their health information exclusively from traditional sources (Gollop, 1997; Tu & Hargraves, 2003).

Yet, recent research on health information seeking frequently focuses on the Internet perhaps due to the availability of unprecedented, comprehensive consumer health informatics-based and tailored mobile health services. Some of this research focuses on the motivation to use consumer health informatics services provided by the National Institutes of Health (NIH), such as the Cancer Information Service (CIS) and the Center for Health Enhancement Systems Studies (CHESS), MedlinePlus.gov, as well as health apps for mobile devices.

Some of the research that specifically assesses consumer health information-seeking behavior on the Internet includes: Bass, Ruzek, Gordon, et al., 2006; Cline & Haynes, 2001; Dutta-Bergman, 2003, 2004; Gaie, 2006; and Silberg et al., 1997.

Health information seeking also is included in national overview data sets that assess broad consumer health information trends, such as the National Cancer Institute's Health Information National Trends (HINTS.cancer.gov) survey and the more frequently updated Pew Center for American Life's consumer health utilization research (http://pewinternet.org/Topics/Activities-and-Pursuits/Health.aspx?typeFilter=5). Both of these services provide downloadable data sets for research use, which encourages secondary analyses of their data.

Bass et. al. (2006) add health information seeking, whether through the Internet or traditional channels, generally reflects motivated behaviors. A health consumer's motivation may stem from a recent diagnosis or a new physical problem that fosters interest in self-care or caregiving. In turn, the role of health information seeking (among persons who are not health care providers) may be as a patient, a family member, a friend, or a caregiver. For example, Echlin & Rees (2002) assessed how persons in diverse life roles search for information about a personal cancer diagnosis or treatment decision (e.g., Echlin & Rees, 2002).

Suggested Measure

Unfortunately, there is no single, widely adopted measure of health information seeking. The most common approaches to measure health information seeking include:

  1. Using questions from the aforementioned Health Information National Trends Survey (HINTS)
  2. Recording key strokes by people using on-line information services
  3. A general single item measure
  4. A general multiple-item measure
  5. Measuring contacts to cancer information services.

The comparative value of each of these approaches is best determined by focusing on the objectives of a particular research project, the available technological expertise, and the project's budget.

Health Information National Trends Survey questions.

Niederdeppe, Frosch, and Hornik (2008) used two questions from the 2003 HINTS:

  1. Have you ever looked for information about cancer from any source?

    Participants who said (if "yes", then asked):

  2. About how long ago was that?

For their study, Niederdeppe, Frosch, and Hornik focused on whether an individual sought information within a week of their interview (or study participation).

Ling, Klein, and Dang (2006) employed two items from the 2003 HINTS:

  1. Have you ever looked for cancer information from any source?
  2. Excluding your doctor or other health care provider, has someone else ever looked for information about cancer for you?

In a study that assessed correlates of awareness of CIS, other services at NIH as well as other scientific agencies, Squiers, Bright, Finney Rutten et al. (2006) used the following two questions to assess health information seeking, and treated each as single items.

  1. Have you ever looked for cancer information from any source?
  2. Excluding your doctor or other health care provider, has someone else ever looked for information about cancer for you?

    Respondents who reported they had access to the internet (and who reported searching for health information) were asked how frequently they searched within the last 12 months. Squiers et al., added the question:

  3. Have you ever visited an Internet web site to learn specifically about cancer?

Shim, Kelly, & Hornik (2006) created an Information Seeking variable based on responses to the questions:

  1. Have you looked for information about cancer from any source?
  2. About how long ago was that?

Information seekers were categorized as such if respondents provided affirmative responses to both questions. Study respondents were categorized as a "nonseeker" if he/she answered one or both questions negatively.

2. Several studies measured health information seeking by capturing participants' use of CHESS by recording their Internet activities w/code name, date time, and URL of every web page request on the web server (e.g., Han, Hawkins, Shaw, Pingree, McTavish, and Gustafson, 2009; Han, Wise, Kim, et al., 2010; Lee & Hawkins, 2010). Some of the latter research also automatically recorded participants' keystrokes for CHESS use. In addition, some of the latter research conceptualized the degree of CHESS use (and health information seeking) as the number of days a participant accessed four different types of CHESS' services.

3. Dutta-Bergman (2005) measured "autonomous health information seeking," defined as a patient's willingness to seek additional health information beyond the doctor. This was measured by a single item:

I rely on a number of sources for health information, besides my doctor.

The item was measured on a 6-point scale ranging from 1 (definitely disagree) to 6 (definitely agree).

4. Maibach, Weber, Massett, et al. (2006) analyzed data from the Porter Novelli's HealthStyles 1999 and 2003 databases. They measured health information seeking but because they used these items within a larger cluster analysis, no composite index was computed and thus, no α was reported. The items were:

  1. I don't have time to bother learning a lot of health information
  2. I make a point to read/watch stories about health
  3. I don't pay attention to health information unless it's about a problem I have
  4. When sick, I try to get information about my disease
  5. I like to get health information from a variety of sources
  6. When I take medicine, I try to get as much information about benefits and side effects
  7. Before making a decision about my health, I find out everything I can about this issue

Each item was measured on a 1-5 Likert scale, where 1 = Strongly Disagree and 5 = Strongly Agree.

Stephens, Rimal, and Flora (2004) measured health information seeking with a three-item composite index:

They asked how frequently respondents read:

  1. Health and doctor's columns
  2. News articles on health
  3. Food and recipe information

Responses were coded on a 5-point scale ranging from "ignored" to "read all" and averaged into an index, = .78.

5. Finally, Waters, Sullivan, and Finney Rutten (2009) defined health information seeking as contacting the Cancer Information Service (NCI; toll-free information service) via telephone, or through LiveHelp (instant messaging service).

Reliability

Although only one of the aforementioned studies that measured health information seeking reported a reliability estimate (Stephens, Rimal, & Flora, 2004), the methods used in some of the other cited studies did not lend themselves to reliability measures. For example, two of the aforementioned measures were based on fairly direct observation of a specific behavior, either observation of Internet use through data collected by a web browser, or through calling or instant messaging a health information service.

References

Atkin, C. K. (1973).

Instrumental utilities and information seeking. In P. Clarke (Ed.), New models for communication research (pp. 205242). Beverly Hills, CA: Sage

Baker, L. M. (1995, 57 April).

A new method for studying patient information needs and information seeking patterns. In Proceedings of the International Symposium on Health Information Research (pp. 6775). Sheffield: University of Sheffield, Department of Information Studies, Centre for Health Information Management Research.

Bass, S.B., Ruzek, S.B., Gordon, T.F., Fleisher, L., McKeown-Conn, N., & Moore, D. (2006).

Relationship of internet health information use with patient behavior and self-efficacy. Experiences of newly diagnosed cancer patients who contact the National Cancer Institute's Cancer Information Service. Journal of Health Communication, 11(2), 219-236.

Bennenbroek, F.T.C., Buunk, B.P., Van der Zee, K.I., & Grol, B. (2001).

Social comparison and patient information: What do cancer patients want? Patient Education and Counseling, 47, 5-12.

Boberg, E.W., Gustafson, D.H., Hawkins, R.P., Offord, K.P., Koch, C., Wen, K.-Y., Kreutz, K., & Salner, A. (2003).

Assessing the unmet information, support and care delivery needs of men with prostate cancer. Patient Education and Counseling, 49, 233-242.

Borgers, R., Mullen, P. D., Meertens, R., Rijken, M., Eussen, G., Plagge, I., Visser, A. P., & Blijham, G. H. (1993).

The information seeking behaviour of cancer outpatients: A description of the situation. Patient Education and Counseling, 22, 3546.

Cameron, P., Corbett, K., Duncan, C., Hegyi, K., Maxwell, H., & Burton, P. F. (1994).

Information needs of hospital patients: A survey of satisfaction levels in a large city hospital. Journal of Documentation, 50, 1023.

Cline, R. J. W. & Haynes, K. M. (2001).

Consumer health information seeking on the Internet: The state of the art. Health Education Research, 16(6), 671692.

Connell, C. M. & Crawford, C. O. (1988).

How people obtain their health information: A survey in two Pennsylvania counties. Public Health Reports, 103, 189195.

Czaja, R., Manfredi, C., & Price, J. (2003).

The determinants and consequences of information seeking among cancer patients. Journal of Health Communication, 8, 529562.

Dutta-Bergman, M. (2003).

Developing a profile of consumer intention to seek out health information beyond the doctor. Health Marketing Quarterly, 21(2), 91112.

Dutta-Bergman, M. (2004).

Health attitudes, health cognitions and health behaviors among Internet health information seekers: Population-based survey. Journal of Medical Internet Research, 6(2), e15.

Dutta-Bergman, M. (2005).

Developing a profile of consumer intention to seek out additional information beyond a doctor: The role of communicative and motivation variables. Health Communication, 17, 116.

Echlin, K. N., & Rees, C. E. (2002).

Information needs and information-seeking behaviors of men with prostate cancer and their partners: A review of the literature. Cancer Nursing, 25, 3541.

Ford, J.S., Coups, E.J., & Hay, J.L. (2006).

Knowledge of colon cancer screening in an national probability sample in the United States. Journal of Health Communication, 11(S1), 19-35.

Gaie, M. (2006).

An evolving user-oriented model of internet health information seeking. AMIA Symposium Proceedings, 279-283.

Gollop, C. J. (1997).

Health information-seeking behavior and African American women. Bulletin of Medical Library Association, 85(2), 141146.

Griffin, R. J., Dunwoody, S., & Neuwirth, K. (1999).

Proposed model of the relationship of risk information seeking and processing to the development of preventive behaviors. Environmental Research, 80, S230S245.

Han, J.Y., Hawkins, R.P., Shaw, B.R., Pingree, S., McTavish, F., & Gustafson, D.H. (2009).

Unraveling uses and effects of an interactive health communication system. Journal of Broadcasting & Electronic Media, 53(1), 112-133.

Han, J.Y., Wise, M., Kim, E., Pingree, R., Hawkins, R.P., Pingree, S., McTavish, F., & Gustafson, D.H. (2010).

Factors associated with use of Interactive Cancer Communication System: An application of the Comprehensive Model of Information Seeking. Journal of Computer Mediated Communication, 15, 367-388.

James, C., James, N., Davies, D., Harvey, P., & Tweddle, S. (1999).

Preferences for different sources of information about cancer. Patient Education and Counseling, 37, 273-282.

Kakai, H., Maskarinec, G., Shumay, D.M., Tatsumara, Y., & Tasaki, K. (2003).

Ethnic differences in choices of health information by cancer patients using complementary and alternative medicine: An exploratory study with correspondence analysis. Social Science & Medicine, 56(4), 851862.

Lee, S.Y., & Hawkins, R. (2010).

Why do patients seek an alternative channel? The effects of unmet needs on patients' health-related internet use. Journal of Health Communication, 15(2), 152-166.

Ling, B.S., Klein, W.M., & Dang, Q. (2006).

Relationship of communication and information measures to colorectal cancer screening utilization: Results from HINTS. Journal of Health Communication, 11(S1), 181-190.

Lock, K.K., & Wilson, B. (2002).

Information needs of cancer patients receiving chemotherapy in an ambulatory-care setting. Canadian Journal of Nursing Research, 34, 83-93.

Maibach, E.W., Weber, D., Massett, H., Hancock, G.R., & Price, S. (2006).

Understanding consumers' health information preferences: Development and validation of a brief screening instruments. Journal of Health Communication, 11, 717-736.

Morris, D.S., Rooney, M.P., Wray, R. J., & Kreuter, M.W. (2009).

Measuring exposure to health messages in community-based intervention studies: A systematic review of current practices. Health Education & Behavior, 36, 979-998.

Niederdeppe, J., Hornik, R., Kelly, B., Frosch, D., Romantan, A., Stevens, R., Barg, F., Weiner, J., & Schwarz, S. (2007).

Examining the dimensions of cancer-related information scanning and seeking behavior. Health Communication, 22, 153167.

Niederdeppe, J., Frosch, D.L., & Hornik, R.C. (2008).

Cancer news coverage and information seeking. Journal of Health Communication, 13, 181-199.

Nguyen, G.T., & Bellamy, S.L. (2006).

Cancer information seeking preferences and experiences: Disparities between Asian Americans and Whites in the Health Information National trends Survey (HINTS). Journal of Health Communication, 11, 173-180.

Shim, M., Kelly, B. & Hornik, R. (2006).

Cancer information scanning and seeking behavior is associated with knowledge, lifestyle choices, and screening. Journal of Health Communication, 11(S1), 157-172.

Silberg, W. M., Lundberg, G, D., & Musacchio, R. A. (1997).

Assessing, controlling and assuring the quality of medical information on the Internet. Journal of American Medical Association, 277, 12441245.

Squiers, L, Bright, M.A., Finney Rutten, L.J., Atienza, A.A., Treiman, K., Moser, R.P., Hesse, B. (2006).

Awareness of the National Cancer Institute's Cancer Information Service: Results from the Health Information National trends Survey (HINTS). Journal of Health Communication, 11(S1), 117-133.

Stephens, K.K., Rimal, R.N., & Flora, J.A. (2004).

Expanding the reach of health campaigns: Community organizations as meta-channels of the dissemination of health information. Journal of Health Communication, 9(S1), 97-111.

Tu, H. T. & Hargraves, J. L. (2003).

Seeking health care information: Most consumers still on the sidelines. Issue Briefs, Center for the Study of Health Systems Change, 61, 14.

van der Molen, B. (1999).

Relating information needs to the cancer experience: 1. Information as a key coping strategy. European Journal of Cancer Care (Engl.), 8(4), 238-244.

Waters, E.A., Sullivan, H.W., & Finney Rutten, L.J. (2009)

Cancer prevention information-seeking among Hispanic and non-hispanic users of the National Cancer Institute's Cancer Information Service: Trends in telephone and LiveHelp use. Journal of Health Communication, 14(5), 476-486.