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The Internet and Health Communication: Experiences and Expectations

Editor: Ronald E. Rice, James E. Katz
Publisher: Thousand Oaks, CA: Sage, 2001
Review Published: February 2003

 REVIEW 1: Kathleen M. Golden
 AUTHOR RESPONSE: Ronald E. Rice

We certainly appreciate Dr. Golden’s clear and comprehensive summary of the chapters in our edited book. She was right to point out that the ethnographic case study (Chapter 6) of a woman interested in finding out more about infertility, but who had no prior computer experience, was very revealing – and very fortuitous. (It was both satisfying and very challenging for us to accomplish). We did not know beforehand how this would turn out. Ms. Doe was very generous with her time and experiences. Our two main points from that chapter are, we think, widely generalizable, and not well considered: (1) the presentation of computer technology and online health seeking as a matter of “just press a few keys and you have access to the world’s information” is a very misleading myth; and (2) traditional sources of health information (such as a library, a telephone directory and subsequent telephone calls) also have many flaws and disadvantages, ranging from out of date information, to rudeness from the service providers, to incorrect and illegal procedures. This reinforces a general argument we make elsewhere (Rice, 1999; Katz & Rice, 2002): new communication and information technologies are not better or worse, per se, than traditional means of communication; they both have varying and overlapping advantages and disadvantages. However, traditional channels, including interpersonal, tend to be idealized and converted into “natural artifacts,” thus preventing them from being analyzed and critiqued as deeply as are new media.

The book was developed just as the presence and use of health and medical information on the Internet was taking off. We began two or three years before, with a small conference at Rutgers University School of Communication, Information and Library Studies, followed up with a panel at the International Communication Association, concluding with bringing together experts and researchers from these and other venues. There had been several earlier books on interactive health information systems, but this was probably the first time a comprehensive work focusing on the Internet could have been produced, and probably the last time one could be done that reasonably summarized the work that had gone before. There are now more aspects and issues that should be explored more deeply, and new technologies and web sites being developed to support general and specific health concerns, than could possibly be summarized in one book.

For example, by 2001, 80% of adults using the Internet search for health information online, from among the over 70,000 health-related websites (Cline & Haynes, 2001; Cyber Dialogue, 2000). As part of their ongoing comprehensive surveys of Internet use, the Pew Internet and American Life Project (2002a) reported on use of the Internet for health issues (as of March 2002). They conclude that “many say the Internet has helped them or someone they know and very few report harmful effects from acting on bad information they found online.” They found that 62% of Internet users (72% women, 51% men) have gone online to seek health information, with more going online for medical advice on any particular day than visit health professionals, although this still means that slightly less than half of Internet health information users seek such information more frequently than every few months.

However, most searchers have no particular strategy for searching, and use a search engine instead of a medical site. Three-quarters of such searchers do not follow the recommended protocol on evaluating the source and timeliness of online medical information. Nonetheless, 72% say one can believe all or most online health information. Factors that do lead to skepticism or rejection include commercialization of the web site, inability to determine the source of the information, or inability to determine when the information was last updated. About a third of those who find something relevant bring that to their doctor; when they do, 79% found their doctor to be interested in the online information. Nearly a fifth have used online health information to diagnose or treat a medical condition without consulting a doctor. The Pew Internet and American Life Project reported (2002b), at the end of 2002, that an equal number of Internet users say they would use the Internet the next time they had a medical inquiry as would contact a medical professional (46% and 47%), while 81% of Internet users expect they can find reliable health or medical information online, compared to 45% of non-users.

In decreasing order of frequency, Internet health information seekers in the March survey (Pew, 2002a) looked for a particular illness or condition (93%), nutrition, exercise or weight control (65%), information about prescription drugs (64%), gather information before visiting a doctor (55%), sought information about alternative or experimental treatments or medicines (48%), mental health issue (39%), a sensitive health topic difficult to talk about (33%), or about a particular doctor or hospital (32%). Nearly two-thirds indicate that the Internet has improved how they manage their health at least some, whereas only 2% say they know someone who has been hurt by applying Internet-based health information.

So we are just at the “take-off” point in the development and diffusion of online health communication. Many grant funded projects, new proposals, and pilot projects are applying a wider array of technologies (interactive and personalizing web sites; wireless communication via Personal Digital Assistants and mobile phones; integrated health systems that combine audio, online, print, fax, video and personal counselors and health professionals; moderated online support groups; virtual reality modeling of physical processes; online counseling and social support; etc.). These interact with, and are both constrained by, and supported through, complex social contexts, including partners, relatives, friends, health care professionals, insurance companies, community organizations, and more. So the areas of mediated health communication and medical informatics are extremely exciting, challenging, and significant areas for future research and practice.

Cline, R., & Haynes, K. (2001). Consumer health information seeking on the Internet: The state of the art. Health Education Research, 16, 671-679.

Cyber Dialogue. (2000). Internet industry challenged to provide physicians with valuable online applications, find Deloitte Research and Cyber Dialogue analysis. December 5.

Katz, J.E. & Rice, R.E. (2002). Social consequences of Internet use: Access, involvement and interaction. Cambridge MA: The MIT Press.

Pew Internet and America Life Project. (December 29, 2002b). Most Americans expect to find what they are looking for online in news, health care, government information and shopping.

Pew Internet and American Life Project. (2002a). Vital decisions: How Internet users decide what information to trust when they or their loved ones are sick.

Rice, R.E. (1999). What's new about new media? Artifacts and paradoxes. New Media and Society, 1(1), 24-32.



Ronald E. Rice

<rrice@scils.rutgers.edu>

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