Reducing disparities in the access and use of Internet health information. A discussion paper

doi:10.1016/j.ijnurstu.2006.05.007

International Journal of Nursing Studies

Volume 44, Issue 7, September 2007, Pages 1270-1278

https://doi.org/10.1016/j.ijnurstu.2006.05.007 Get rights and content

Abstract

Internet health information is rated highly by users and is used to compensate for gaps in health information provided by health professionals. Greater understanding of health issues and changes to personal health management has been reported as a consequence of Internet use. However, there are significant disparities in the access and use of Internet health information linked to income, education and ethnicity. In this paper a case is presented that on-line health information particularly benefits the already privileged in terms of health care; well-educated people with access to economic resources. Several intervention points are suggested to improve Internet health information accessibility and use for all population groups. Interventions at an institutional level include improving equity of Internet access through the provision of free services at strategic sites and improving the readability and cultural acceptability of health information. Individually focused interventions involve skill development to enable effective navigation of Internet sites, identification of patient and families’ information needs and support to develop evaluation skills. The effectiveness of these interventions in reducing disparities is reliant on nurses and other health professionals’ expertise in accessing, evaluating and using Internet health information in their clinical practise. On-line health information is a powerful medium for quick and dynamic knowledge distribution. The challenge for nurses and other health professionals is directing that knowledge to the groups most disadvantaged in the current health care systems, with an agenda of reducing inequalities in access to health information.

Section snippets

What is already known about the topic?

•
Internet health information use is rapidly increasing along with Internet resources.
•
Internet health information is rated highly by many users and changes in personal health management have been reported.
•
Internet access is related to income, education and ethnicity.
•
Internet health information varies in terms of quality and readability.

What this paper adds

•
A case is made for the linkage between Internet access disparities and broader health inequalities.
•
Nursing interventions aimed at improving equity in accessing and using Internet health information have been developed based on a synthesis of research findings and other literature.

Internet health information and personal health management

Before the case can be made that all health professionals need to be knowledgeable advocates of Internet health information to ensure equity of access and usage, it is important to establish if Internet health information has a beneficial effect on personal health management. In this section the growing body of research evidence documenting users’ perceptions of the value and effect of Internet health information is discussed.

Research findings show that Internet health information does effect

Internet health information and health professional expertise

A strong theme in the literature pertaining to health information on the Internet is the health professional role in assisting patients and families locate and evaluate reliable, relevant and current health information of the Internet (Anselmo et al., 2004; Eberhart-Phillips et al., 2000; Pucci, 2003). Yet, while there is rapidly increasing access to Internet health information, there is still little evidence that nurses and other health professionals routinely provide systematic support to

Inequities in Internet access

While the Internet may, in a technical sense, enable unprecedented access to health information, economic factors determine who benefits and who does not benefit from this technology. In Canada, income is the most important factor dictating Internet access, outweighing the other factors of education, location, gender and age (Reddick et al., 2001). In the United Kingdom, the wealthiest 10% of households are more than seven times more likely to use the Internet as compared to the poorest 10% of

Nursing interventions to improve equity in the use of Internet health information

The evidence discussed in the last section suggests that Internet health information is part of a system which sustains current health inequalities between populations, disparities underpinned by differential access to education and linked social economic resources. Ongoing action by nurses, along with other health professionals, is required to disrupt ingrained ways of manufacturing and delivering Internet health information and improve equity in information access and use. Nurses can make a

Conclusion

There is a danger that Internet health information is part of the broader forces driving health inequalities rather than being a medium for the democratisation of health knowledge. Conscious effort is required to ensure that advances in health services work to reduce health disparities between different population groups. The interventions suggested in this article are framed within a context of socioeconomic disparities between population groups that mediate access to health resources. Ongoing

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Today, a considerable number of electronic health resources are available online for users. These online sources act as a powerful medium in the dissemination of health knowledge (Gilmour, 2007). With the increased use of the internet and mobile technology, this information can be accessed easily anytime, anywhere (Robb and Shellenbarger, 2014).
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It is agreed that it is necessary for medical personnel to be able to search for valid and reliable health information (Stellefson et al., 2011). In particular, nurses should have such skills to help their patients utilize eHealth information, and to correct any misunderstanding of their diseases that could result from misinterpretation of information found on the internet, perhaps even on un-trusted sites (Gilmour, 2007). Nursing students will be in the same position, where it is important for them, as future health professionals, to have a set of skills that enables them to search for eHealth information, and to appraise and use it to support their health-related decisions (Brown and Dickson, 2010; McDowell and Ma, 2007; Stellefson et al., 2011).
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Reducing disparities in the access and use of Internet health information. A discussion paper

Abstract

Section snippets

What is already known about the topic?

What this paper adds

Internet health information and personal health management

Internet health information and health professional expertise

Inequities in Internet access

Nursing interventions to improve equity in the use of Internet health information

Conclusion

Nurse Education Today

American Journal of Obstetrics and Gynaecology

CHEST

Annals of Oncology

Writing and designing readable patient education materials [Electronic version]

Nephrology Nursing Journal

Cystic fibrosis on the Internet: a survey of site adherence to AMA Guidelines

Pediatrics

Patient power? [Electronic Version]

British Medical Journal

Medical textbooks: can lay people read and understand them? [Electronic version]

Library Treads

HIV-AIDS Patients’ evaluation of health information on the Internet: the digital divide and vulnerability to fraudulent claims [Electronic Version]

Journal of Consulting and Clinical Psychology

21st century house call: the Internet and the world wide web

Holistic Nursing Practice

Using the Internet for patient education

Orthopaedic Nursing

eHealth technology and Internet resources

Journal of Cardiovascular Nursing

Developing health website quality assessment guidelines for the voluntary sector: outcomes from the Judge project [Electronic version]

Health Information and Libraries Journal

The Internet's challenge to health care provision: a free market in information will conflict with a controlled market in health

British Medical Journal

Analysis of cases of harm associated with use of health information on the Internet [Electronic version]

Journal of American Medical Association

Patients’ use of the Internet for medical information [Electronic version]

Journal of General Internal Medicine

The Internet as a research and dissemination resource

Health Promotion International

Internet use amongst New Zealand general practitioners

New Zealand Medical Journal

The Internet and access to evidence: how are nurses positioned?

Journal of Advanced Nursing

Towards quality management of medical information on the internet: evaluation, labelling, and filtering of information

British Medical Journal

Use of the Internet by women with breast cancer

Journal of Medical Internet Research

Examination of instruments used to rate quality of health information on the Internet: chronicle of a voyage with an unclear destination

British Medical Journal

“E-health”: The Internet and the transformation of patients into consumers and producers of health knowledge [Electronic version]

Information, Communication and Society

Editorial comment [Electronic version]

Information, Communication and Society