How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews

OBJECTIVES: To describe techniques for retrieval and appraisal used by consumers when they search for health information on the internet. DESIGN: Qualitative study using focus groups, naturalistic observation of consumers searching the world wide web in a usability laboratory, and in-depth interviews. PARTICIPANTS: A total of 21 users of the internet participated in three focus group sessions. 17 participants were given a series of health questions and observed in a usability laboratory setting while retrieving health information from the web; this was followed by in-depth interviews. SETTING: Heidelberg, Germany. RESULTS: Although their search technique was often suboptimal, internet users successfully found health information to answer questions in an average of 5 minutes 42 seconds (median 4 minutes 18 seconds) per question. Participants in focus groups said that when assessing the credibility of a website they primarily looked for the source, a professional design, a scientific or official touch, language, and ease of use. However, in the observational study, no participants checked any "about us" sections of websites, disclaimers, or disclosure statements. In the post-search interviews, it emerged that very few participants had noticed and remembered which websites they had retrieved information from. CONCLUSIONS: Further observational studies are needed to design and evaluate educational and technological innovations for guiding consumers to high quality health information on the web.