A Self-Determination Perspective on Online Health Information Seeking: The Internet vs. Face-to-Face Office Visits With Physicians

This study elucidates the experiential and motivational aspects of online health information beyond the theoretically limited instrumental perspective that dominates the extant literature. Based on a sample of 993 online health information seekers in India, the survey found that online health information seeking offers individuals greater autonomy, competence, and relatedness compared to face-to-face office visits with physicians. According to self-determination theory, individuals are motivated to act by a sense of volition and experience of willingness, validation of one’s skills and competencies, and feeling of connection with others who shaped one’s decisions. These 3 psychological needs, which motivate individuals to pursue what they innately seek as human beings, help explain why individuals turn online for health information. T tests showed that all 3 self-determination theory constructs —autonomy, competence, and relatedness—were higher for online health information seeking than for face-to-face office visits with physicians. A regression analysis found that 2 variables, autonomy and relatedness, explained online health information seeking. Competence was not a significant factor, likely because of competency issues faced by individuals in interpreting, understanding, and making use of online health information. The findings, which do not suggest that online health information seeking would displace physicians as many have feared, offer promise for an integrated system of care. Office visits with physicians would necessarily evolve into an expanded communicative space of health information seeking instead of an alternative channel for health information.

[1]  M. Kilpatrick,et al.  Physical Activity Motivation: A Practitioner's Guide to Self-Determination Theory , 2002 .

[2]  Chul-Joo Lee,et al.  Does the Internet Displace Health Professionals? , 2008, Journal of health communication.

[3]  Heather Hemming,et al.  An Exploration of Search Patterns and Credibility Issues among Older Adults Seeking Online Health Information* , 2011, Canadian Journal on Aging / La Revue canadienne du vieillissement.

[4]  Marie R. Haug,et al.  Deprofessionalization: An Alternate Hypothesis for the Future , 1972 .

[5]  E. Deci,et al.  A self-determination multiple risk intervention trial to improve smokers’ health , 2006, Journal of General Internal Medicine.

[6]  I. Katz,et al.  Parental Support and Adolescent Motivation for Dieting: The Self-Determination Theory Perspective , 2015, The Journal of psychology.

[7]  E. Deci,et al.  Testing a self-determination theory intervention for motivating tobacco cessation: supporting autonomy and competence in a clinical trial. , 2006, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[8]  R. Ryan,et al.  Self-determination theory , 2015 .

[9]  E. Deci,et al.  Self-Determination Theory Applied to Health Contexts , 2012, Perspectives on psychological science : a journal of the Association for Psychological Science.

[10]  E. Deci,et al.  Self-determination theory and physical activity: The dynamics of motivation in development and wellness , 2009 .

[11]  B. Feldman,et al.  Online Health Information Seeking Among Jewish and Arab Adolescents in Israel: Results From a National School Survey , 2013, Journal of health communication.

[12]  R. J. Cline,et al.  Consumer health information seeking on the Internet: the state of the art. , 2001, Health education research.

[13]  Jemma Edmunds Testing a Self-Determination Theory-Based Teaching Style in the Exercise Domain , 2006 .

[14]  Ronald E. Rice,et al.  The internet and health communication : experience and expectations , 2001 .

[15]  Mark J Edwards,et al.  Testing a self-determination theory model of children’s physical activity motivation: a cross-sectional study , 2013, International Journal of Behavioral Nutrition and Physical Activity.

[16]  E. Deci,et al.  The "What" and "Why" of Goal Pursuits: Human Needs and the Self-Determination of Behavior , 2000 .

[17]  P. M. Wilson,et al.  Understanding motivation for exercise: A self-determination theory perspective. , 2008 .

[18]  E. Deci,et al.  Handbook of Self-Determination Research , 2002 .

[19]  Kennon M. Sheldon,et al.  The self‐determination theory perspective on positive mental health across cultures , 2012, World psychiatry : official journal of the World Psychiatric Association.

[20]  Vishal Soodan,et al.  Transforming physical to digital marketplace-E-retail: An Indian Perspective , 2014 .

[21]  K W Gish,et al.  The Patient Informatics Consult Service (PICS): an approach for a patient-centered service. , 2001, Bulletin of the Medical Library Association.

[22]  J. Landry,et al.  Self-Determination Theory as an Organizing Framework to Investigate Women'S Physical Activity Behavior , 2002 .

[23]  S. Hardy,et al.  Adolescent Motivations to Engage in Pro-Social Behaviors and Abstain From Health-Risk Behaviors: A Self-Determination Theory Approach. , 2015, Journal of personality.

[24]  R. Moser,et al.  Surveys of physicians and electronic health information. , 2010, The New England journal of medicine.

[25]  M. Haug A re-examination of the hypothesis of physician deprofessionalization. , 1988, The Milbank quarterly.

[26]  Suzanne Bakken,et al.  Online Health Information Seeking Behaviors of Hispanics in New York City , 2013 .

[27]  S. A. Iverson,et al.  Impact of Internet Use on Health-Related Behaviors and the Patient-Physician Relationship: A Survey-Based Study and Review , 2008, The Journal of the American Osteopathic Association.

[28]  H. Halvari,et al.  Motivational Predictors of Change in Oral Health: An Experimental Test of Self-Determination Theory , 2006 .

[29]  Marylène Gagné,et al.  The History of Self-Determination Theory in Psychology and Management , 2014 .

[30]  E. Deci,et al.  A self-determination theory approach to psychotherapy: The motivational basis for effective change. , 2008 .

[31]  E. Deci,et al.  Self-determination theory in health care and its relations to motivational interviewing: a few comments , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[32]  Howard Eisner,et al.  Information Age , 2008, Wiley Encyclopedia of Computer Science and Engineering.

[33]  Christopher P. Niemiec,et al.  The smoker's health project: a self-determination theory intervention to facilitate maintenance of tobacco abstinence. , 2011, Contemporary clinical trials.

[34]  Josipa Kern,et al.  Internet health-information seekers in Croatia—who, what, and why? , 2006, Medical informatics and the Internet in medicine.

[35]  E. Deci,et al.  Facilitating health behaviour change and its maintenance: Interventions based on Self-Determination Theory , 2008 .

[36]  Jeroan J. Allison,et al.  Internet health information seeking is a team sport: Analysis of the Pew Internet Survey , 2013, Int. J. Medical Informatics.

[37]  J. Powell,et al.  The Characteristics and Motivations of Online Health Information Seekers: Cross-Sectional Survey and Qualitative Interview Study , 2011, Journal of medical Internet research.

[38]  Anke Oenema,et al.  I Move: systematic development of a web-based computer tailored physical activity intervention, based on motivational interviewing and self-determination theory , 2014, BMC Public Health.

[39]  Mohan J. Dutta-Bergman,et al.  Developing a Profile of Consumer Intention to Seek Out Additional Information Beyond a Doctor: The Role of Communicative and Motivation Variables , 2005, Health communication.

[40]  J. Cyrus A Review of Recent Research on Internet Access, Use, and Online Health Information Seeking , 2014 .

[41]  Elizabeth Murray,et al.  The Impact of Health Information on the Internet on Health Care and the Physician-Patient Relationship: National U.S. Survey among 1.050 U.S. Physicians , 2003, Journal of medical Internet research.

[42]  R. Ryan,et al.  Exercise, physical activity, and self-determination theory: A systematic review , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[43]  G. Curtis,et al.  Need Satisfaction and Well-Being , 2013 .

[44]  E. Deci,et al.  Self-determination, smoking, diet and health. , 2002, Health education research.

[45]  R. Ryan,et al.  MOTIVATION, AUTONOMY SUPPORT, AND ENTITY BELIEFS: THEIR ROLE IN METHADONE MAINTENANCE TREATMENT , 2004 .

[46]  Christopher E. Beaudoin,et al.  Health information seeking, diet and physical activity: An empirical assessment by medium and critical demographics , 2011, Int. J. Medical Informatics.

[47]  P. Klemm,et al.  The Internet: friend or foe when providing patient education? , 2008, Clinical journal of oncology nursing.

[48]  P. Teixeira,et al.  A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: rationale and intervention description , 2008, BMC Public Health.

[49]  Marylène Gagné,et al.  The Oxford Handbook of Work Engagement, Motivation, and Self-Determination Theory , 2015 .

[50]  Peter J. Schulz,et al.  Online Health Information Seeking in the Context of the Medical Consultation in Switzerland , 2010, Qualitative health research.

[51]  Christopher P. Niemiec,et al.  Reducing the Health Risks of Diabetes , 2009, The Diabetes educator.

[52]  K C Lun,et al.  The Internet as a source of health information among Singaporeans: prevalence, patterns of health surfing and impact on health behaviour. , 2003, Annals of the Academy of Medicine, Singapore.

[53]  James Hereford,et al.  Patients, physicians, and the Internet. , 2002, Managed care quarterly.

[54]  M. McKnight Information prescriptions, 1930-2013: an international history and comprehensive review. , 2014, Journal of the Medical Library Association : JMLA.

[55]  N. Tustin,et al.  The Role of Patient Satisfaction in Online Health Information Seeking , 2010, Journal of health communication.

[56]  R. Kravitz,et al.  Reasons for and predictors of patients' online health information seeking following a medical appointment. , 2014, Family practice.

[57]  B. Gerber,et al.  The Patient-Physician Relationship in the Internet Age: Future Prospects and the Research Agenda , 2001, Journal of medical Internet research.

[58]  Joan L. Duda,et al.  Testing a self‐determination theory‐based teaching style intervention in the exercise domain , 2008 .

[59]  D Sutcliffe,et al.  Untangling the web. , 1989, Community outlook.

[60]  Ronald E. Rice,et al.  Influences, usage, and outcomes of Internet health information searching: Multivariate results from the Pew surveys , 2006, Int. J. Medical Informatics.

[61]  Marylène Gagné,et al.  Facilitating autonomous motivation for smoking cessation. , 2002, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[62]  Christina M. Sabee,et al.  Exploration of the Construct of Reliance Among Patients Who Talk with Their Providers About Internet Information , 2007, Journal of health communication.

[63]  Yuk Yee Yan Online Health Information Seeking Behavior in Hong Kong: An Exploratory Study , 2010, Journal of Medical Systems.

[64]  Sally J. McMillan,et al.  Strengthening the Safety Net for Online Seniors: Factors Influencing Differences in Health Information Seeking Among Older Internet Users , 2008, Journal of health communication.

[65]  Information prescriptions: a barrier to fulfillment. , 2007, Journal of the Medical Library Association : JMLA.

[66]  Nikos Ntoumanis,et al.  Adherence and well-being in overweight and obese patients referred to an exercise on prescription scheme: a self-determination theory perspective , 2007 .

[67]  C. Dube,et al.  Untangling the Web--the impact of Internet use on health care and the physician-patient relationship. , 2007, Patient education and counseling.

[68]  M. McMullan Patients using the Internet to obtain health information: how this affects the patient-health professional relationship. , 2006, Patient education and counseling.

[69]  Ronald E. Rice,et al.  The internet and health care : theory, research, and practice , 2006 .