1. Background
The recent years have witnessed a dramatic increase in consumer online health information seeking (Fox & Duggan, 2013). Online health information deserves particular attention because studies on the contents of health-related websites have found high variance in the quality of information available to the public, raising worries about the quality of online information that consumers might come across during their searches (Berland et al., 2001; Bernstam et al., 2008; Eysenbach, Powell, Kuss, & Sa, 2002; Hardey, 2001; Stvilia, Mon, & Yi, 2009). The variability in the accuracy of the information is at least in part the result of one of the distinctive features of the internet, that is that everybody with a connection is potentially able to publish health-related information. Online health information seeking poses thus several major challenges to the users of health information, inasmuch as it requires them to take on an active role in the evaluation of the credibility of the vast amount of often unverified health information that can be found on the internet (Flanagin & Metzger, 2008). Wrong or incomplete information has been shown to be related to adverse health outcomes, such as low participation to screening programs or low adherence to treatments (Cline & Haynes, 2001; van Weert et al., 2011). It becomes evident that more attention needs to be devoted to the issue of the quality of online health information and in particular to people’s ability to evaluate it (Berland et al., 2001; Bernstam et al., 2008; Eysenbach et al., 2002; Hardey, 2001; Stvilia et al., 2009). So far researchers have studied the issue of quality of online health information from two distinct perspectives. A first approach aims at understanding which criteria could be used to assess the quality of online health information and at developing evaluation criteria and guidelines. These could be used by information providers to design quality health-related websites and by users/patients to assess the information they find online. The main goal of this approach is to provide people with high-quality online health information. A second approach is more interested in the user/patient perspective. Such an approach investigates people’s ability to assess online health information, with the goal of understanding whether people have the necessary skills to judge its quality.
2. Study aims
Building on the limitations of current research in the field, the aim of the present study is to get insights into people’s evaluation of the quality of online health information by investigating people’s online health information search process. Particular attention will be devoted to the investigation of differences among people with different health literacy levels as regards awareness of the issue of online health information quality and knowledge and use of both established and other evaluation criteria. Moreover, cross-cultural differences in the perception and evaluation of the quality of online health information will be explored.