Motivations for nutrition information-seeking behavior among Belgian adults: a qualitative study

Health communicators increasingly struggle with disseminating evidence-based nutrition information in a media landscape filled with unreliable and contradictory nutrition information [1, 2]. One way to maximize health communication efforts could be by tailoring communication strategies to individuals’ needs [3]. Needs are key factors that determine whether and how people gather, process, and apply information [4]. Needs influence and shape the entire information-seeking process and contribute to differential media effects [5, 6]. Therefore, a comprehensive understanding of needs driving information-seeking behavior is required to develop effective communication strategies.

Current research in the field of nutrition information-seeking behavior (NISB), which can be defined as actively seeking nutrition information via on- and offline media, has discovered that the Internet is a popular source of nutrition information and that especially women and higher-educated people seek nutrition information [7, 8]. However, little is known on needs driving nutrition information behavior.

To investigate needs driving information behavior, several research traditions are of relevance. First, from an information science perspective (for a comprehensive overview see Case [9]), it has been argued that the term “information needs” is misleading and that a need for information sprouts from a need to fulfill more basic human needs [4]. Based on works in the field of psychology, three categories of human needs are distinguished being physiological (e.g. nutrition, shelter), affective (e.g. need for attainment), and cognitive (e.g. need to plan, learn a skill). Equally, the salience of a gap has been recognized as a starting point for information seeking [10]. This gap hypothesis has been expanded upon by Dervin who takes a sense-making approach by arguing that an information need derives from a user’s desire to make sense of a current situation using whatever the user considers to be information [11]. Under this sense-making approach, users described several uses for information such as companionship, support, pleasure, and a new way of looking at things [12]. Closely related to Dervin’s sense-making approach is the work of Kulthau. According to Kulthau, uncertainty and anxiety reduction form the primary motivators of information seeking [13]. Kulthau further emphasizes the importance of affective states as users progress through their search process and advocates a holistic view on information seeking. Second, a conceptually related field of research is the field of health information-seeking behavior (HISB). Studies within the domain of HISB suggest that people seek online health information to reduce uncertainty, out of a need for acknowledgement and perspective, to supplement their knowledge, for the added benefit of online anonymity, and to bypass barriers associated with traditional sources of health information [14‐18]. Third, from a mass communication perspective, uses and gratifications theory (UGT) has an extensive history of examining needs that drive media use [6].

Within UGT, the audience is viewed as actively selecting and using media to fulfil psychological and social needs [6], which corresponds to the active nature of NISB. Uses and gratifications theory has previously been used in the context of health information-seeking behavior via websites [19], magazines [20], and YouTube [21], but has not yet been applied to the specific context of nutrition.

The aim of this study was to explore motivations for NISB from a media use perspective, specifically UGT.

A qualitative study design has been used and the consolidated criteria for reporting qualitative research (COREQ) [22] were used in the reporting of this study (Additional file 1).

A total of 42 people met the eligibility criteria and were invited for participation. Of the 42 eligible candidates, twenty took part in the study. The sample consisted primarily of highly educated women (n = 15) aged 26–50 years who sought nutrition information once a week or more (Table 1). The interviews ranged in duration between 51 and 66 min with an average of 58 min. Categories of motivations for NISB emerging from the data were health management, cognitive needs, affective needs, social integrative needs, and personal identity. Even though there was considerable overlap between the various categories, each motivation was discussed in the subsection deemed most appropriate. Motivations were aggregated across different nutrition topics since the data showed insignificant variation over topics. To identify participants’ contributions, each quote includes an identification number.

This study is novel in its approach by extending applications of UGT from the context of health information seeking to the nascent research field of NISB. Previous UGT research recognized information gathering, identity formation, social contact, and entertainment as motivations for media use [34]. The current study expands UGT by including concepts from (educational) psychology (i.e., interest, curiosity, locus of control, autonomy) and by distinguishing novel motivations such as health management and a need for confirmation. By employing a qualitative methodology, this study provides a deeper understanding of what motivates individuals to seek nutrition information, which is crucial for health communication professionals seeking to develop tailored communication strategies.

Five categories of motivations for NISB were distinguished: health management, cognitive needs, affective needs, social integrative needs, and personal identity. Health management emerged as an often-mentioned motivator for NISB. Participants expressed a need for nutrition information to improve their health and to prevent future health issues. The fact that people turn to nutrition can be explained by well-researched associations between dietary behavior and health outcomes [35]. Little over half of participants had a medical history which fostered nutrition information seeking. The presence of health problems might have increased their perceived health risk, which has been associated with increased health-related information seeking [36]. Arguably, an increased perceived health risk could have been concomitant with anxiety leading participants to seek information as a means of anxiety reduction. This would be in line with the work of Kulthau who recognized anxiety reduction as key motivator for information seeking [13]. Additionally, participants displayed an internal locus of control, which has been linked to higher levels of health information seeking [37]. Another motivator in the context of health management was a need for autonomy with participants expressing a need to feel in control of their health. Autonomy is recognized within self-determination theory as one of three basic human needs, along with competence and relatedness [38]. Prior research has found that supporting autonomy contributes positively to physical and psychological health [39]. This need for autonomy resembles prior research stating the role of information seeking as a means for self-actualization and self-control [11]. Future communication strategies could aid in the fulfilment of this need by offering nutrition information in an autonomy-supportive way. For example, by using non-controlling language, offering choices, and emphasizing personal responsibility [40]. Other behavior change techniques that support autonomy are providing a meaningful rationale (e.g., by informing people about health consequences of dietary behaviors), setting graded tasks and goal setting [41].

Regarding cognitive needs, interest and curiosity have been withheld as separate motivations for NISB, which is an extension to UGT. The finding that interest emerged as a motivator for NISB may be related to our recruitment method in which we specifically sought individuals with an interest in nutrition. Interest can also be viewed as a form of enduring involvement, which in the context of health has been coined “health consciousness” [42]. People with a high level of health consciousness are intrinsically motivated to stay or become healthy and to actively seek health information [42, 43].

The finding that curiosity (i.e. the experience of a gap in knowledge combined with the belief that this gap can be reduced) incited information seeking echoes notions from the field of information science where the experience of a gap has been distinguished as precursor of information seeking [10, 12]. In the context of health information seeking, curiosity has equally been recognized as a motivator of information seeking, with curiosity often being sparked during passive information scanning [44]. Our findings indicated that certain conditions needed to be met for participants to transition from a passive information scanning process to an active information seeking process. Specifically, participants needed to believe that obtaining this information would benefit them and/or their surroundings and the information needed to carry personal significance. These findings are in line with the comprehensive model of information seeking which distinguishes positive efficacy beliefs and personal relevance as antecedents of information seeking [20]. Another model that is relevant in this context is the elaboration likelihood model (ELM) [45]. The ELM proposes two routes of information processing: a central route and a peripheral route. Central route processing occurs when people are motivated and capable. This type of information processing results in stronger and more durable attitudes and behavior changes. Alternatively, information can be processed via the peripheral route, which is associated with minimal cognitive effort, is more reliant on heuristics and has only a short-standing impact on attitudes and behavior changes. It has been suggested that information scanning leads to peripheral route processing and information seeking to central route processing [46]. Therefore, to maximize the effect of nutrition communication on dietary behavior, future communication strategies should focus on triggering information seeking (central route processing) during routine information scanning (peripheral route processing). Encouraging central route processing can be achieved by enhancing either individuals’ motivation or capabilities for information processing. Motivation can be enhanced by tailoring messages such that they become personally relevant to the recipient [47]. For example, the Netherlands Nutrition Centre has a popular mobile app in which people can track their dietary behavior and personalized advice is offered based on this information [48]. Additionally, messages can be shaped in a way that maximize the ability of the recipient, such as being easy to understand offered without distractions, and self-paced [47]. Regarding the first point, there is evidence to suggest that the reading level of nutrition information materials exceed recommended reading levels for public health communication [49, 50]. In Flanders, Belgium where this study was conducted, 15% of adults are low literate, meaning they struggle with basic literacy skills necessary for optimum personal development and full participation in society (e.g. reading, writing) [51]. Additionally, low literacy is associated with poor health outcomes [52] further highlighting a need to target public health promotion efforts at low literate adults. Regarding the second point, research has shown that reading comprehension plummets when people are distracted [53]. It has been suggested that especially the architecture of the digital environment hinders deep learning by rapidly exposing people to small bits of information embedded within a distracting context [54].

Another way in which the ability of the recipient can be maximized is by increasing their level of critical nutrition literacy. Critical nutrition literacy refers to skills related to the critical appraisal of nutrition information [55] and it is imperative to effectively contextualize scientific evidence. Not all scientific evidence is created equal [56], meaning it is up to individuals to separate fact from fiction. By enhancing critical appraisal skills, individuals become empowered to do this and to decide for themselves the influence novel nutrition information has on their dietary behavior. Thus, given the importance of autonomy-supportive communication, improving critical nutrition literacy could be a key objective of future communication strategies. However, there is currently a need for research that can focus efforts on improving critical nutrition literacy.

Enjoyment, inspiration, relaxation, diversion, and confirmation were distinguished as affective needs driving nutrition information seeking. These findings, except for a need for inspiration, are in line with earlier UGT research studying motivations of health-related YouTube use [21]. Additionally, these motivators are akin to those recognized in earlier sense-making research [11]. It is surprising to find relaxation and diversion as motivators for NISB given that the focus of this research was on active information-seeking behavior. Within UGT, a distinction is made between ritualized and instrumental media use [57]. Ritualized media use is driven by motivations such as diversion, passing time, habit, and relaxation. This contrasts with instrumental media use which is goal-directed, utilitarian, and aimed at satisfying informational needs. In the context of active nutrition information seeking, one would expect to primarily find instrumental media use. One possible explanation for the abundance of ritualized media use in the interviews is the notion that information scanning is far more prevalent than information seeking [58]. Even though this was not the focus of this research, participants reported that information seeking often stemmed from information scanning. It is conceivable that when participants indicated seeking nutrition information to relax or as a diversion, they were in fact scanning nutrition information. However, the high prevalence of information scanning is not necessarily negative: scanned information still has a positive impact on individuals’ health behaviors and knowledge [59], which might be explained by peripheral route processing [47]. Future communication strategies could use this knowledge by widely disseminating content optimally suited for information scanning. For example, by developing content that uses experts, which will cue the “expert heuristic” and can result in short-term persuasion [47]. More research is needed to examine the influence of nutrition information scanning on nutrition knowledge and subsequent dietary behavior.

Participants also expressed a need for confirmation, which may reflect the current media landscape in which there is an abundance of conflicting nutrition information [1]. The latter can lead to feelings of confusion and backlash in some individuals [60]. Need for confirmation can also be considered the polar opposite of uncertainty reduction, which has been recognized as a key motivator for information seeking [13].

Nutrition information seeking also fulfilled several social integrative needs. First, participants sought and shared nutrition information to fulfil a need for connection. Additionally, sharing nutrition information also encouraged subsequent nutrition information seeking. Arguably, seeking and sharing information are two different matters, but as our data and previous research in the field of information science show, the concepts are heavily intertwined in the context of information seeking [9]. Furthermore, prior research has shown that social exchange of information makes people more aware of the importance of health-related behaviors, leading them to seek more information [43]. Second, nutrition information seeking, and sharing was driven by a need for social support in sustaining or altering nutrition-related behavior. This finding is consistent with prior research applying UGT to the context of health information seeking [19, 21] and to research in the field of sense-making [11]. Social support has been linked to favorable dietary behaviors through the enhancement of self-efficacy [61] and is therefore recognized as an effective behavior change technique [41]. Future communication strategies could aid in the mobilization of social support by including sharing functionalities that facilitate peer education, strengthen existing social networks and promote the formation of new social networks [62]. For example, several nutrition-related apps currently on the market already have integrated functionalities to strengthen existing and form new social networks [63]. Users of these apps can share their achievements with friends via social media (e.g. Facebook) and can create new connections with other users of the app. Lastly, our participants sought nutrition information to help and/or convince others, which is in line with previous research concerning health information seeking [23].

Regarding personal identity, the main motivations for nutrition information seeking were identity expression and identity defense. Regarding identity expression, participants sought nutrition information to reinforce their values and beliefs. This led to a strengthened self, which in turn facilitated identity expression. These results echo prior research by recognizing the role of information seeking as means to gain self-control and to facilitate self-expression and self-actualization [4, 11]. Online media is especially attractive for seeking reinforcement since complex algorithms tailor information to people’s needs, which may foster false beliefs if individuals are steered toward incorrect information [64]. It is known that novel information should not be too discrepant from the recipient’s beliefs to maximize its persuasive effect [62]. Therefore, for future communication strategies, it may be a balancing act to provide nutrition information that is both evidence-based and not too discrepant from incorrect pre-existing beliefs. A possible way of achieving this is related to the aforementioned method of tailoring: current beliefs can be assessed before novel nutrition information that lies within the realm of acceptability is offered. The second motivation related to personal identity was identity defense, where participants showed an increased need for nutrition information when they felt their identity was under threat. This is not surprising, as some participants alluded to making dietary choices that could be considered deviant from the norm (e.g., abstaining from eggs, alcohol, or meat). Given the cultural significance of dietary choices and the importance of social conventions around food [65], people that deviate from the norm can experience social pressure to defend their choices [66]. Future communication strategies could help people who aspire to healthy and sustainable diets by providing them with coping strategies to deal with possible negative reactions from their social contacts.

The present study used a qualitative approach to explore underlying needs driving NISB from a UGT perspective. Findings suggest NISB is driven by motivations such as health management, personal identity, and cognitive, affective, and social integrative needs. Future health communication strategies should pay more attention to underlying motivations other than only those related to information gathering to positively influence people’s nutrition knowledge.