Presenting And Interpreting Health Risks And Benefits: The Role Of The Internet

Abstract

The research considers the role of the Internet as an innovative health technology (IHT) with the potential to change the ways in which the risks and benefits of specific pharmaceutical interventions are presented and interpreted. In particular, the research seeks to examine the increasingly popular claim that access to health information via the Internet will result in more 'reflexive' and 'informed' patients and therefore in more equitable patient-provider relationships, where medical expertise can be more successfully challenged. The research sets out to examine such optimistic claims through detailed empirical study of the management of both on- and off-line health information. A longitudinal study is planned to examine the information practices of two groups of 'patient participants' considering the health risks and benefits of two specific pharmaceutical interventions: Viagra and Hormone Replacement Therapy (HRT), chosen to enable a clear focus on gender and ageing, two dimensions of both health and Internet inequalities. The research seeks to identify the factors which facilitate or inhibit the emergence of the 'reflexive' and 'informed' patient through a close examination of the process by which patients seek health information both on- and off-line and employ that information to assess health risks and benefits and negotiate with health care professionals regarding treatment.

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Summary

Background

It is often claimed that Internet access provides people with more and better health information, resulting in more informed patients and therefore more equal relationships between patients and their doctors. Contrary claims suggest that access to a more diverse range of information may result in increased levels of anxiety amongst patients about the risks and benefits of illness and treatment. The research compares the ways in which both Internet users and non-users find information about specific health treatments and use that information in their discussions and negotiations with health care professionals. The study focuses on Viagra and Hormone Replacement Therapy (HRT), to enable a clear focus on gender and ageing, two important dimensions of both Internet and health inequalities.

Research Design

This longitudinal study examines the process by which 'patient participants' access, interpret and employ health information in their negotiations with health care professionals. Participants are recruited at an early stage in their reflections and negotiations regarding the suitability of Viagra and HRT for their particular health problems and are followed up for a period of 6-9 months during their deliberations regarding treatment. Interviews, information diaries and on-line 'logs' will be used to collect data about participants' information seeking strategies. Observation of consultations between patients and health care professionals are also undertaken to provide a further opportunity for assessment of the use of different media in forming a view about the risks and benefits associated with Viagra and HRT, and to assess how patients articulate such knowledge in discussions with their doctors.

Policy and Academic Implications

This interdisciplinary and multidisciplinary research brings together technology studies and health studies with the explicit aim of developing new theoretical frameworks and methodologies for exploring the technology-society relationship in the context of health care settings. In particular, the research explores whether and how 'Internet inequalities' apply specifically to the field of health information and how far health care inequalities are being reinforced or challenged by this new information medium. From health studies, the research will throw light on the changing nature of patient-provider relationships in late modernity, particularly those emphasising the tendency towards the more informed patient and more equitable patient-provider relationships.
The potential value of the research to users outside the academic community will be its ability to throw light on the process by which people seek out and use health information accessed via different media. The research will have policy implications in the following areas:

• Regulation of the Internet: Medical professionals are calling for a 'gold standard' or 'kitemark' for health-related web sites but this is not unproblematic as this may re-establish boundaries of medical expertise currently challenged by the wider diffusion of alternative and lay health knowledges.
• Health education policy: The research results will contribute to the debate about the education needed to support health care consumers in their enhanced role as 'reflexive' and 'informed patients'.
• Internet access: If this is shown to benefit patients/consumers, then the research will contribute to the development of health information policies for people without Internet access.

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Contacts

Dr Flis Henwood

Dr Angie Hart

Ms Julie Smith

Dr Sally Wyatt

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Outputs

Research Findings

Findings are available here - pdf

Journal Papers

Flis Henwood and Ellen Balka, Editorial Comment Special Issue E-Health: The Use of Information and Communication Technologies in the Communication of Health Information and Advice Information, Communication and Society, Volume 7, Number 4, 2004

Wyatt, S., Henwood, F., Hart, A. and Platzer, H. (in press) 'L'extension des territories du patient: Internet et Sante au quotidien' ('Transforming Health? The Internet and everyday Life') Science Sociales et Sante (Publication date: March 2004)

Henwood, F., Wyatt, S., Hart, A. and Smith, J. (2003)'"Ignorance is bliss sometimes": Constraints on the emergence of the "informed patient" in the changing landscapes of health information' Sociology of Health and Illness, Vol 25, No 6, pp589-607.

Wyatt, S., Henwood, F., Hart, A. and Smith, J. (2003)'De digital tweedeling: Internet, gezondheidsinformatie en het dagelijks leven' ('The Digital Divide: The Internet, health information and everyday life'), Amsterdams Sociologisch Tijdschrift 'Sociale realties op het internet', Vol 30, Nos 1&2, pp254-273.

Henwood, F., Wyatt, S., Hart, A. and Smith, J. (2002) 'Turned on or turned off? Accessing health information on the Internet', The Scandinavian Journal of Information Systems, Vol 14, No 2, pp. 79-90.

Conference Papers

Henwood, F. (Oral) Negotiating Gender and ICTs in Health Care. One Day Meeting. 2001, University of Nottingham, UK.

Wyatt, S. (Oral) Gender, Health and the Internet. Van voorlichtingsfloder tot internet. 2001, University of Maastrict.

Henwood, F; Wyatt, S. (Oral) "Turned On or Turned Off"? Accessing Health Information on the Internet. Sociotechnical Approaches Conference. 2001, Rotterdam.

Henwood, F. (Oral) Information for Health Meets Technology Studies. School of Info Management Seminar Series. 2001, University of Brighton.

Henwood, F. (Oral) Negotiating Gender and ICTs in Health Care. New Technologies & Social Welfare. 2001, Nottingham University.

Hart, A; Henwood, F. (Oral) Gender, Health and Information Technology: Reflections from Two Sociological Research Projects.

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News

October 2004

INFORMATION, COMMUNICATION AND SOCIETY
Volume 7, Number 4, 2004
Special Issue
E-Health: The Use of Information and Communication Technologies in the Communication of Health Information and Advice

Flis Henwood (Project on Presenting and Interpreting Health Risks and Benefits: the Role of the Internet) and Ellen Balka have edited and provided the editorial comment on the latest special issue from Information, Communication and Society.
The increasing demand for information on medical and health related topics has led to an explosion in e-health. In particular the Internet, a component of e-health, is seen as the most convenient way to provide this information as it offers the consumer anonymity and a wide choice in how the information is presented.
Changes in health policy are encouraging the emergence of the informed patient - one who is empowered to take responsibility for managing their own treatment by being involved in the decision making and assessment of the risks and benefits of different treatments. Examples of this policy in practice can already be seen in Canada (Health Canada), the UK (NHS Direct Online) and in similar initiatives in Australia and New Zealand.
Within the social sciences there is some support for the idea that the overall expansion in medical knowledge via new media technologies such as the Internet will empower patients - a concept which follows Giddens' notion of the 'reflexive consumer' (Giddens 1991).
The special issue considers one key area of e-health - the use of information and communication technologies (ICTs) in the communication of health information and advice both to patients/public and between members of the public. The articles seek to explore the assumptions embedded in contemporary policy documents that call for greater investments in e-health and explore the extent and nature of Internet use in a range of settings, its relationship to patient empowerment and in the more equitable practitioner-patient relationships.

July 2003

Article from the July 2003 Issue of Future Health Bulletin http://www.headstar.com/futurehealth/

GPS STILL MORE POPULAR THAN THE INTERNET

Health professionals are still the preferred sources of information for women considering Hormone Replacement Therapy (HRT) despite the growth of high profile online services such as NHS Direct Online, a recent study has found.

The research, conducted by researchers at the universities of Brighton and Amsterdam, found that online services tend to complement rather than replace other means of finding health information. Those that do use the internet, according to the research, often have difficulty interpreting the information they find.

The second most preferred source was family members with friends, pharmacists and alternative practitioners also mentioned, followed by the media, including the internet. The most striking difference between the sexes was that the women had wider social networks to talk to about personal health issues, whereas men tend to discuss their own health with doctors and sexual partners only.

The study, 'Presenting and interpreting health risks and benefits: the role of the internet,' (http://fastlink.headstar.com/hrt1) followed the information-finding habits of 32 women and 15 men. It aimed to focus on patient involvement in the health service whereby 'informed patients' are supposed to take a more central role in decision-making about their health.

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