IHT presentation 08/05/01

PRESENTING AND INTERPRETING HEALTH

RISKS AND BENEFITS:THE ROLE OF THE

INTERNET

Flis Henwood, Sally Wyatt and Angie Hart

IHT presentation 08/05/01

Policy context

• Information seen as key resource in health care: ‘Information for Health’, ‘Building the Information Core’ etc.

• ICTs have central role in this ‘information for health’ strategy, for improving health information management at organisational and individual levels

IHT presentation 08/05/01

Consumer health information

• Ease of access to appropriate information seen as central for patient empowerment and consumer involvement in health care decision-making

• ICTs have central role in reducing health inequalities- for example, by overcoming problems of social isolation for some patient groups

IHT presentation 08/05/01

ICT-related projects in IHT programme

• NHS Direct and patient empowerment

• The use of Internet technologies for people with an acquired communications impairment (aphasia)

• Presenting and interpreting health risks and benefits: The role of the Internet

IHT presentation 08/05/01

Brief description

• A qualitative study of the information strategies employed by Internet users and non-users seeking information about the health risks and benefits of HRT and Viagra

IHT presentation 08/05/01

Key questions

• Is Internet empowering for healthcare consumers?

• Does it enable them to better assess health risks and benefits? How, why?

• Does it enable them to better negotiate with healthcare professionals regarding treatments? How, why?

IHT presentation 08/05/01

Which IHT?

• The Internet - having the potential to change the ways in which health risks and benefits are presented and interpreted

• HRT and Viagra - implicated in changing constructions of gender, sexuality and the ageing body

IHT presentation 08/05/01

Linking the two debates: optimistic scenario

• Greater availability of health information (for example, via the Internet) will lead to the emergence of more informed patients

• These ‘informed’ or ‘reflexive’ patients are better able to assess the risks and benefits of alternative treatments for themselves

IHT presentation 08/05/01

Linking the two debates: pessimistic scenario

• Internet inequalities: differential access to the skills, equipment and services required to take advantage of the information carried by new media

• Over-abundance of information available on-line leads to confusion and anxiety - lay users do not have the expertise to evaluate the information

IHT presentation 08/05/01

Internet print-out syndrome

IHT presentation 08/05/01

What we already know about Internet use

• Internet usage continues to grow

• Still relatively low - approx. 30 to 35% of the UK households

• Internet use concentrated amongst younger, well-educated males

• Ethnic minorities have poorer access to Internet than their white counterparts

IHT presentation 08/05/01

Health information on the Internet

• After pornography, health information is the most sought after information on the Internet

• The quality of the information varies considerably

• Medical professionals calling for a ‘gold standard’ or ‘kite mark’ for health-related web sites

IHT presentation 08/05/01

Some key features of the study

• Qualitative study

• Longitudinal study of ‘patient participants’

• Comparative study of Internet users’ and non-users’ ‘information strategies’

• Purposive sampling techniques

• Web content analysis

• Computer-generated logs

IHT presentation 08/05/01

Presentation of risk and benefits

• Comparison of different media re: presentation of risks and benefits of HRT and Viagra

• Advantages of Internet? E.g. hyperlinks to sites with alternative views

• Comparison of HRT and Viagra: discourses re: gender, sexuality and the ageing body

IHT presentation 08/05/01

‘Ask Jeeves’ example: www.ask.co.uk

• What are the risks and benefits of HRT?

• What are the risks and benefits of Viagra?

IHT presentation 08/05/01

Interpretation of risks and benefits

• What can participants’ interactions with different media tell us about their interpretations? (where they start their search, how they navigate the media)

• How do they position themselves re: competing discourses re: gender, sexuality and the ageing body found re: HRT and Viagra

IHT presentation 08/05/01

Negotiations with health care professionals

• How do Internet users and non-users employ health information about the risks and benefits of HRT and Viagra in their negotiations with GPs and other HCPs?

• What are HCPs views on the use of the Internet and other media by patients seeking health information?

IHT presentation 08/05/01

Policy relevance: key issues and debates

• ‘Kite marking’ of health information on the Internet

• The informed patient: expert and lay knowledge

• Education for patients re: their enhanced role as ‘reflexive consumers’

• Education for HCPs re: relationship with ‘informed’ and ‘reflexive’ patients

IHT presentation 08/05/01

User engagement: key groups

• Health Development Agency, Health promotion

• I4H, ‘Information for Patients and Public’

• Health care professionals

• Health educators

• Health libraries

• Lay users

IHT presentation 08/05/01

Presenting and Interpreting Health Risks and Benefits: The

Role of the Internet• Dr Flis Henwoood, School of Information

Management, University of Brighton

• Dr Sally Wyatt, Department of Communications, University of Amsterdam

• Dr Angie Hart, Centre for Nursing and Midwifery Research, University of Brighton