Changing healthcare perception with surveys and research

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SC: conceptualization, data curation, investigation, methodology, software, visualization, analysis, writing of original draft, review and editing. MK: conceptualization, methodology, analysis, supervision, review and editing.

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Npj Digit. Turing, A. Computing machinery and intelligence. Mind LIX, — Whicher, D. Ethics review of survey research: a mandatory requirement for publication? Patient 8, — Yu, K. The third part of the questionnaire focused on what determines whether a health article is of high quality. Respondents were asked to rank the list of criteria they were given see Table 1 on a 5-point Likert scale ranging from 1 completely agree to 5 completely disagree.

Before distributing the questionnaire to each population group, we analyzed the validity of the criteria using a focus group consisting of 25 students and 7 researchers at the School of Public Health University of Haifa, Israel , who rated 3 health articles according to the criteria. We measured their overall percentage of agreement, as well as Krippendorff alpha representing the level of agreement between coders beyond mere chance for each answer [ ].

In the pilot, we distributed the questionnaire to 80 Arab and Jewish members of the general public and HCWs. Subsequently, we focused on adjusting the questions to make them more culturally sensitive.

For example, we used the word regulator in Hebrew, but as that term is not used in Arabic, we modified the word to policy. Similarly, conflict of interest is not a familiar concept in Arabic, so in the interest of clarity, an example was provided. Furthermore, as the general public did not always understand the full meaning of a question, we added clarifying examples.

To recruit as many participants as possible, we used intensive sampling in the first step and distributed the questionnaires via social media platforms WhatsApp, Facebook, and Instagram. After this initial sampling, we continued to recruit participants through snowball sampling [ ] to reach enough participants among HCWs by distributing the questionnaire via specialized HCW Web-based forums and by directly asking them to distribute the questionnaire to additional HCWs they knew.

At interim meetings during the survey, we monitored the social demographic variables and noted a lack of young men among the general public and the HCWs who responded to the survey. As our audience was a deliberate sample, we looked for ways to distribute the survey to more HCWs and turned to health forums. By means of diffusion, the survey was distributed from our inner circles to extended circles. To check whether people intended to change their behavior after being exposed to health information, we used a chi-square test in which the answers are reduced to 3 levels not at all or to a small extent, to a medium extent, and to a high to very high extent.

Chi-square tests for independence were conducted to examine the differences between HCWs and others with regard to information seeking, sources of information, source reliability, and the manner in which the information was read.

Wilcoxon Rank-Sum tests were used to examine the differences between HCWs and the public regarding behavioral change following exposure to information and the criteria for a high-quality article. Regarding the quality criteria for articles, separate chi-square tests were conducted for each criterion to examine the differences between HCWs and others.

To avoid the inflation of a type I error owing to multiple testing, adjusted P values were calculated using the false discovery rate method. A total of respondents participated in the survey. In comparison with the general public, HCWs mainly search on health organization sites and in academic articles, as they consider academic articles more reliable.

The general public seeks more information from social networks and Web-based newspapers and considers social networks, human resources, and HCWs to be more reliable. The differences between HCWs and the general public in their perceptions of the importance of health information quality criteria are statistically significant, with the exception of 2 criteria: the article explains and simplifies professional concepts and the article notes the availability and accessibility of treatment to the general public.

Inclusion of the criteria in the articles is more important for HCWs than for the general public Table 1. The comparison between the criteria rankings of the HCWs and those of the general public shown in Table 1 indicates that both groups ranked the following criteria at the top of the list: intervention drawbacks; tone more scientific than commercial; offers alternatives to medical interventions; based on several articles; and details of the study.

Among the HCWs, the importance of citing results from academic articles was next on the list, whereas the general public ranked this criterion in the tenth place, instead ranking presentation of quantitative findings and not personal stories in the sixth place. Both the HCWs and general public ranked conflict of interest at the bottom of the chart not shown in Table 7.

The new media age has changed the way people seek and consume health information [ 1 , 46 ]. The purpose of this study was to investigate not only how people search for Web-based and newspaper health information but also how they read and understand this information and what criteria they use to assess the quality of journalistic articles.

It is important to examine how people read, understand, and assess the quality of journalistic health articles because health information can influence the way people shape their healthy lifestyles [ 33 , 34 , , ]. The findings of this study confirm the importance of this examination. The findings indicate that HCWs focus their search for health information on health organization sites and in academic articles, whereas the general public tends to search more on social networks and Web-based newspapers.

Public HCWs are accustomed to interacting with the health system on a daily basis and naturally search more on health organization websites [ , ].

Similarly, it is reasonable to assume that in the course of their work, professionals are more likely to use academic articles than the general public [ ]. Moreover, the difference in choice of information sources between HCWs and the general public can also be explained by the level of health literacy. It is reasonable to assume that HCWs have a higher level of health literacy and are more capable of processing and understanding complex medical information than the general public, leading them to place more trust in scientific sources than in social networks or information available on the internet [ 12 , ].

Furthermore, when participants were asked what they consider to be a reliable source, HCWs found academic articles more reliable than did the general public, which found social networks [ 55 , 58 , 59 ], human sources, and HCWs to be more reliable [ 68 , 74 ].

As for information seeking, HCWs found academic articles based on scientific facts to be more reliable than information from social networks. Moreover, they considered information based on scientific evidence from academic journals to be more reliable and to have a more scientific than commercial tone. Nevertheless, when we examined each group separately, differences emerged within each group. Even though HCWs indicated that academic articles are the most reliable, they tended to search more for information on social networks despite considering them very unreliable [ ].

We found a similar discrepancy among the general public, which considered health organizations and academic articles to be very reliable or reliable sources yet used them infrequently to search for health information, preferring social networks, which they considered unreliable.

The research findings confirm our hypothesis that both HCWs and the general public search for health information on social networks more than they do in sources they consider reliable. This discrepancy between perceptions and actual behavior is in line with studies indicating that there are situational factors whose influence is stronger than mere attitudes.

According to Wicker [ ], even though participants believe that health organizations and academic articles are more reliable sources than social networks, in practice, most of them search in sources they consider to be less reliable.

The following 3 explanations attempt to answer why the public seeks information from social networks more than from other sources. That is, they conduct a monologue rather than a dialogue, leading the public to seek more information on social networks. The world of social media has generated a radical transformation in the relationship between government organizations and the public.

Social media have changed the monologue to a dialogue in which anyone with information and access to communications technology can be a content creator and communicator [ ].

Despite this impressive transformation, the use of social media by organizations is still in its infancy. Although the literature indicates that health authorities use social media, it also shows that this use is still very limited, as these tools serve primarily for mass information dissemination similar to traditional mass media instead of for 2-way communication [ - ].

Second, as health organizations do not exercise complete transparency in conveying information, the public turns to social networks to fill in the missing information. Third, among the general public as well as among HCWs, decision making on health matters entails a combination between the automatic emotional system and the rational system. Thus, it is no wonder that despite being aware that social networks are likely to contain misinformation or disinformation, people continue to seek information there [ ].

Studies of the health behavior of public HCWs found that they shared the same concerns and barriers as the general public [ 43 , - ].

Neither public HCWs nor the general public rely only on analytical or evidence-based information academic articles when searching for health information, but also seek information based on experience and emotions, both of which are found mostly on the social networks. In summary, we proposed several possible explanations for the discrepancy we found between what the public and HCWs believe to be reliable and where they actually search for information in practice.

As for the research findings about what criteria the general public uses to judge the quality of journalistic articles compared with the criteria used by public HCWs, statistically significant differences were found between the importance of the criteria except for 2 , indicating that HCWs attributed more importance to the criteria than the public. In addition, when we examined the 6 criteria that were most important to the general public and to HCWs, we found that 4 were important for both groups: drawbacks of the intervention, a tone that is more scientific than commercial, alternatives to medical interventions, and details of the study.

These criteria indicate that the public values providing full information about the negative impacts or limitations of medical interventions as well as existing alternatives, information often absent from the media coverage. Studies have found that media coverage of medications and medical treatments is problematic, primarily in its tendency to provide sensational and an overly enthusiastic coverage of drugs and medical technologies and to emphasize the benefits excessively while ignoring or hardly mentioning the risks, side effects, and costs [ 93 , 94 , 96 , 97 , 98 ] or the limitations of scientific studies advocating the efficacy of these drugs.

In addition to the 4 aforesaid criteria cited both by public HCWs and by the general public as indications of information quality, 2 specific criteria emerged as important to the public. One of them is that the article should mention treatment availability and accessibility. This finding can be explained by the public's wish to know whether the treatment or medication mentioned in the article is accessible to it.

For marketing reasons, press reports often mention medications and interventions that are not accessible to the public [ 92 ]. A second criterion valued by the public is that the article should simplify professional concepts. The importance of communicating professional information in understandable and clear language is a basic principle cited in the health communication and risk communication literature [ , ].

The mental models approach [ ] also emphasizes the importance of understanding and simplifying professional concepts for the general public. Conversely, a criterion the public did not consider important was citing academic sources. The findings also indicate that both HCWs and the general public ranked conflict of interest at the bottom of the list. Studies indicate that for years journalists have relied on information provided to them by organizations and the pharmaceutical industry rather than looking for quotes from academic sources themselves [ 99 , ].

The Statement of Principles of the US Association of Health Care Journalists calls on journalists to disclose relevant conflicts of interest in their sources as a routine part of their work [ ]. Yet, it seems that more often than not, journalists do not report such conflicts of interest [ 97 , 98 , ]. In addition, the lack of discussion about the importance of exposing conflicts of interest leads both public HCWs and the general public not to attach adequate importance to this issue.

This study is not a representative sample of the general population of Israel. It used nonprobability sampling and measuring and was therefore vulnerable to selection bias from the outset. Furthermore, in this study, we did not check the impact of several variables that might affect health-information searching behavior, both of the general public and of health workers, such as age, gender, personal relevance, level of health literacy, and the individual's reasons for the health information search.

Also, as in any study checking behavioral intentions and actual behavior, this study is vulnerable to information bias as the result of biased reporting by the respondents. Our overall goal was to reach the specific target audiences of the general public versus HCWs and compare them, even though it was not a representative sample of those 2 populations. We took a number of steps to minimize sampling bias: 1 we used 3 different media channels, thus increasing the chances for randomization in this sample [ ]; 2 we monitored the data once a week to insure sufficient professional and ethnic representation among the participants.

For example, when we discovered that there was an insufficient number of HCWs, we posted on more medical forums. When we noticed there were not enough participants from the Arab sector, we appealed specifically to this population group and thus broadened the sample; and 3 we used snowball sampling according to which each participant gave the questionnaire to someone else from their group, enabling us to reach more people from the required population groups.

As our study is based on a small subpopulation of HCWs, the choice of the snowball sampling technique seemed to be more appropriate than convenience sampling. In addition, the descriptive statistics suggest that we were able to achieve a diverse sample based on sociodemographic variables. The study findings point to disparities both among HCWs and among the general public in their information-seeking behavior and their evaluations of the reliability of the sources searched.

To reduce these gaps, health organizations must provide attractive materials, make academic articles accessible, and improve their dialogue with the public.

In addition, in the technological age, where information is accessible to all, the quality of articles about health is critically important. Making the criteria cited in this research the norm in health writing is important for all stakeholders who write about health, whether they are professional journalists or citizen journalists in the new media.

The authors wish to thank Ofir Raichman for his comments and suggestions at the early stages of the research and Dr Debby Mir for reading and editing the final version of manuscript. Edited by G Eysenbach; submitted Skip to Main Content Skip to Footer. Article Authors Cited by 5 Tweetations Metrics. Original Paper.

Table 1. Importance of health information criteria to health care workers and to the general public. Criteria Respondents a Health workers General public The article also presents the drawbacks of the intervention.

Table 2. Table 3. Intention to change behavior after receiving health information of personal importance. Question: If you encounter health information that seems important to you, to what extent would you change your behavior following exposure to this information?

Table 4. Seeking information and source reliability: comparison between health care workers and the general public. Table 5. Primary information source and perception of reliability percentage of health care workers. Table 6. Primary information source and perception of reliability percentage of general public.

Table 7. Ranking of top 6 health information criteria among health care workers versus the general public. Group and criteria 5-point Likert scale ranging from 1 completely agree to 5 completely disagree P value a HCWs b Drawbacks of the intervention 4. Multimedia Appendix 1 Questionnaire. Class, race, ethnicity and information needs in post-treatment cancer patients.

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