Group items tagged

Those with low health literacy and numeracy may be especially susceptible to misleading information and framing effects [32], whether these are intentional, as in malicious behaviour in an online community, or whether they simply reflect a poor fit between information content, its presentation, and the learner.

For someone recently diagnosed with an illness, prognosis and treatment information are likely to be foreign and even daunting, requiring learning in the context of stress and perhaps fear.

Charles et al. [33] proposed three primary models of decision making: the 'paternalistic' model where the physician makes the decisions, the 'informed or autonomous' model where the physician imparts knowledge to the patient and the patient makes the decision, and the 'shared decision making' model where the process is collaborative

The role assumed by a patient may have an impact on how information sources are weighted. For example, one study found that those who desired the most control in their decision-making stated that their physician was their main information source and many were guided by the doctor's preferences [37].

People's information seeking behaviour (ISB) is complex and often iterative. Research in this area has produced consistent findings that comprise what has been called the "principles of information seeking" [39]; these include that people seek information 1) in familiar and comfortable patterns; 2) often following an informal to formal continuum; and 3) in an opportunistic and situated/contextualized way.

formation seeking is often multi-faceted and complex and is comprised of interactions between individual, environmental and social factors

Williams-Piehota et al. [44] demonstrated that for women at risk of breast cancer, adapting messages about the importance of mammography to receivers' behavioural style increased blunters' likelihood of obtaining a mammogram

In addition, individuals may themselves vary in their information seeking and coping styles, in some cases acting as blunters, while in others as monitors, and this may be due to contextual factors such as the person's understanding of the threat posed to them by the situation [47], and the type of stressor encountered [48].

These theories tend to explain motivation for seeking information but do not account for the desire to do so collaboratively or to find others in a similar circumstance in order to obtain anecdotal or experiential information.

Indeed it has been suggested that "sharing ideas and experiences with others through online health support groups may have health benefits." [53], and online communities have been described as the "...single most important aspect of the web with the biggest impact on health outcomes." [54].

Eng TR, Gustafson DH, Henderson J, Jimison H, Patrick K: Introduction to evaluation of interactive health communication applications. Science Panel on Interactive Communication and Health. Am J Prev Med 1999 , 16:10-5. PubMed Abstract | Publisher Full Text totext()Return to text Eysenbach G, Powell J, Englesakis M, Rizo C, Stern A: Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions. BMJ 2004 , 328:1166. PubMed Abstract | Publisher Full Text | PubMed Central Full Text

Increased participation in online communities strengthens the potential for patients to influence each other's decision making, emphasizing a third decision making dyad: patient-patien

they merely replicate, in a new environment, the patterns and preferences for information seeking seen in non-online environments.

What is new is the increased ability for some people to access "more people like me" in very fast and highly convenient way

It must be noted however, that, as described above, many of the information seeking patterns we now see on the Web are not in fact new

Miller SM: Monitoring versus blunting styles of coping with cancer influence the information patients want and need about their disease: implications for cancer screening and management. Cancer 1995 , 76:167-177. PubMed Abstract totext()Return to text

Individuals with a disease or condition are beginning to emerge as authoritative sources [61].

Wilson J: Acknowledging the expertise of patients and their organisations. BMJ 1999 , 319:771-4. PubMed Abstract | Publisher Full Text | PubMed Central Full Text totext()Return to text

For example, if it is understood that most new learners require a period of time in which they prefer to only read messages online before actively participating, this could be outlined in the instructions for participation

Also of interest is the evolving nature of credibility and the way it is depicted, understood and accepted as more laypeople become recognized as experts and opinion leaders in online environments.

we need to consider ways to better enable and support the exchange of experiential and anecdotal information, and help patients differentiate the different kinds of information to which they may be exposed in these environments

online interactions may simply reproduce existing power structures and may not, in fact, truly empower patients [64,65].

Nettleton S, Burrows R: E-Scaped Medicine? Information, Reflexivity and Health. Critical Social Policy 2003 , 23:165-185. totext()Return to text Henwood F, Wyatt S, Hart A, Smith J: 'Ignorance is bliss sometimes': constraints on the emergence of the 'informed patient' in the changing landscapes of health information. Sociol Health Illn 2003 , 25:589-607. PubMed Abstract | Publisher Full Text totext()Return to text Westbrook JI, Braithwaite J, Georgiou A, Ampt A, Creswick N, Coiera E, Iedema R: Multimethod evaluation of information and communication technologies in health in the context of wicked problems and sociotechnical theory. J Am Med Inform Assoc 2007 , 14:746-55. PubMed Abstract | Publisher Full Text | PubMed Central Full Text totext()Return to text

In summary, some participants did not use CMC at all and one did not trust it as a source. The other three shared that they used this form of communication but not usually to learn about HIV/AIDS treatment information.

When participants were asked about their views and practices regarding the use of CMC, responses were varied, from having no interest in using the technology to finding it quite useful.

Many using the Internet are very savvy about visual media, having already watched copious amounts of television and motion pictures. With few exceptions most have seen countless hours of video in which production quality is very high. Further, many have read large amounts of text-based information, which has been professionally edited and type-set. As a result, some participants in this study may have been negatively impacted components containing imperfections. As one participant (P12) said, "...that's a whole thing about the Internet, it needs a good edit". An interface must be very "clean" before effects or impact of learning on participants can be measured for effect on learning or health improvements [21].

Use of the technology appears to be, in some cases, an adjunct to other offline resources.