1. Opportunities and Challenges: Using the Internet for Prevention Opportunities and Challenges: Using the Internet for Prevention Susannah Fox November 17, 2003

2. Hypothesis: Industrial Age medicine is dead… medical science PHYSICIAN patient non-MD staff

3. NET-SAVVY PATIENT my other health experts other self-helpers my search engine my online support groups my primary doc my favorite health sites my specialist doc my online patient- helpers my online docs qualityware & communityware Hypothesis: …Information Age medicine is here

4. Methodology   Telephone surveys of the U.S. population, including callback surveys of e-patients (2000, 2001, & 2002)   Online survey of e-patients, with an over-sample of chronically ill and caregivers (2002)

5. Findings in a nutshell   More Americans look for health info online than see a doctor on a typical day   Search engines are the starting point, not specialized sites   Email is used for advice and support, esp. for chronically ill & caregivers   Few verify information quality, but many use what they find

6. Who are health seekers?  Half of American adults have looked online for health information (esp. women, 30-49 year-olds, highly educated)  Half of Internet “health seekers” say they will turn first to the Internet for their next health question  Yet 1 in 4 American adults are cut off from the Internet (esp. older, rural, lower income)

7. Low-income: California  45% of low-income CA residents has Internet access, compared to 36% of low- income residents in other states  84% of low-income CA Internet users have searched for health topics, compared to 77% of low-income users in other states  Lesson: lower income and education levels do not automatically preclude Internet health searches

8. Latino: California  58% of California’s English-speaking Latinos have access to the Internet  78% have researched at least one topic online, which is just below the average for all Californian Internet users (83%).  But a national study found that Spanish- speaking Latinos are half as likely to search online for health information.

9. Health status The well Newly diagnosed Chronically ill (Institute for the Future study, 2001)

10. Where e-patients go   Most e-patients start at a search engine like Yahoo or a general site like AOL – not a medical site – and visit two to five sites   Few have one favorite health site

11. How e-patients gather info   Most: Scattershot searches in response to a diagnosis   Some: Targeted email health news or medical updates   Few: Online support groups or email lists for people concerned about a particular health or medical issue

12. What they look for 80% of Internet users have searched for at least one topic: –63% for specific disease –47% for a certain treatment –44% for diet, nutrition, vitamins –36% for fitness –34% for drugs –Plus 10 other topics

13. Success   Eight in ten health seekers find the information they look for online at least most of the time   More than half of search engine users found information within the first three sites they visited   Most health seekers say they had never heard about the Web sites they ended up consulting before they began the search

14. Many take it to heart   61% of health seekers say information they found on the Web has improved the way they take care of themselves   68% said that their last online search affected their decisions about: - how to treat an illness - whether to visit a doctor - whether to ask new questions or get a second opinion

15. Bad information is dangerous   RAND/CHCF: Online advice is incomplete and hard to understand – esp. for Spanish readers   NEJM: Americans receive about half of recommended medical care

16. How e-patients check quality   Most trust the familiar   Most distrust commercialism   2 in 5 check the source   1 in 3 check it out with a medical professional

17. Three types of e-patients   Vigilant: 25% “always” check the source, date, and privacy policy of a health Web site   Concerned: 25% check “most of the time”   Unconcerned: 50% “only sometimes,” “hardly ever,” or “never” check

18. Conclusion   More Americans look for health info online than see a doctor on a typical day   Search engines are the starting point, not specialized sites   Email is used for advice and support, esp. for chronically ill & caregivers   Few verify information quality, but many use what they find

19. Contact me: Contact me: Susannah Fox sfox@pewinternet.org www.pewinternet.org