PDF Handout of Slides - AcademyHealth

How Older Adults Use the Internet
to Look for Health Information
Kathryn Flynn
Duke University
Maureen Smith
University of Wisconsin
Objective
Jeremy Freese
University of Wisconsin
Harvard University
To determine how psychological
differences are related to the use and
timing of Internet health searches
among older adults
55%
Sample characteristics
55%
80%
89%
Female High School Married Private
Insurance
Source: Wisconsin Longitudinal Study Graduate Survey 2004, N=6,125
9%
Fair/Poor
Health
Introduction
• Many patients want more information than their physicians have
time to provide
• Considerable enthusiasm for Internet’s potential to transform
communication
• Concern about disparities in use
Discussions of differential use have focused on social position
Wide variation in use even among those of “similar” social position
Far less attention to implications of psychological heterogeneity
• Unclear when patients are using the Internet to search for
health information in relation to their outpatient doctor visits
Wisconsin Longitudinal Study (WLS)
• 1/3 random sample of Wisconsin high school graduates
from spring 1957 (n=10,317)
• Surveys conducted in 1957 (in school), 1964 (mail to
parents), 1975 (phone), 1992-3 (phone & mail), and
2003-4 (phone & mail)
• High response rates (>80%)
• WLS graduate sample is
age homogeneous
education truncated
ethnically homogeneous
Explanatory variables
• Personality
Openness
Conscientiousness
Extraversion
Agreeableness
Neuroticism
• Cognitive ability
High school IQ
• Self-reported effort to
stay healthy
• Preferences
Want to be told all
treatment options
Want MD to know entire
medical history
Want treatment choices
Want to make treatment
decisions
1

• Gender
• Marital status
• # children
• Rural or farm origin
• Educational attainment
• Length of relationship
with usual provider of
care
• SF-12
Physical
Mental
Control variables
• Health insurance
• # prescription meds taken
regularly
• Common conditions
Asthma
Cancer
Diabetes
IBS
Heart disease
Stroke
Hypertension
Joint problems
Analysis
• Multinomial logistic regression
Regress searching behavior on explanatory
variables
Predict adjusted probability of each behavior by
explanatory variable with all other variables held
at population mean
State-of-the-art computing, 1957 Internet use in WLS sample, 2004
Internet use in WLS sample, 2004
35%
27%
23%
6%
9%
Source: 2004 WLS Graduate Survey, N=6125
2% have used net for health, but don’t have home PC
No home PC
PC, but no net
Net, but not used
Use net, but not for health
Use net for health
35%
27%
23%
6%
9%
Source: 2004 WLS Graduate Survey, N=6125
No home PC
PC, but no net
Net, but not used
Use net, but not for health
Use net for health
Timing of last health-related search
6%
1%
16%
12%
65%
Source: 2004 WLS Graduate Survey, N=6125
No health searches
Unrelated to visit
Instead of visit
Before visit
After visit
2

Timing of last health-related search
Graduate School High School
7%
26%
15%
52%
Source: 2004 WLS Graduate Survey, adjusted for all variables in the full model, *odds ratio significant at p

Timing of last health-related search
19%
No Cancer Cancer
10%
4%
67%
Source: 2004 WLS Graduate Survey, adjusted for all variables in the full model, *odds ratio significant at p