Background
Methods
Search strategy
Inclusion and exclusion criteria
Study selection process
Data extraction and synthesis
Data extraction
Deductive categories of information-seeking behaviour (Wilson’s model) | ||
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Main categories | Subcategories | Definition [8] |
Types of information-seeking behaviour | Passive attention | ‘Such as listening to the radio or watching television programmes, where information acquisition may take place without intentional seeking’ |
Passive searching | ‘Signifies those occasions when one type of search (or other behaviour) results in the acquisition of information that happens to be relevant to the individual’ | |
Active searching | Active searching is ‘where an individual actively seeks out information’ | |
Ongoing searching | ‘Where active searching has already established the basic framework of knowledge, ideas, beliefs or values, but where occasional continuing search is carried out to update or expand one’s framework’ | |
Intervening variables | Psychological | Psychological intervening variables include, e.g. cognitive dissonance, cognitive and emotional characteristics |
Demographic | Demographic intervening variables cover, e.g. age and sex | |
Role-related or interpersonal | Role-related or interpersonal intervening variables cover, e.g. social systems, requirements and level of responsibility | |
Environmental | Environmental intervening variables cover, e.g. time, geography and national cultures | |
Source characteristics | Source characteristics cover, e.g. access, credibility and the channel of communication |
Data synthesis
Critical appraisal and risk of bias
Results
Author/Year | Design/Method | Recruitment setting | Sample size | Population | Study focus | Findings | Critical appraisal | Number of criteria* | |||
---|---|---|---|---|---|---|---|---|---|---|---|
Age | Sex | Type of DM** (and duration) | Region | ||||||||
Quantitative studies | |||||||||||
Enwald et al. 2012 [22] | Cross-sectional study (questionnaire within an experimental study) | Register of the University of Oulu, medical records of health centres | n = 72 | Mainly >60 | f, m | Risk of T2D (defined as pre-diabetes) | Finland | Relation between physiological measurements (BMI, fitness level) and information needs and information behaviour | BMI and fitness level of pre-diabetic patients are associated with information- seeking behaviour | + | 2 pp, 8p, 0 m, 0NR, 9NA |
Giménez-Pérez et al. 2015 [38] | Cross-sectional study (questionnaire) | Endocrinology unit of a university hospital | n = 289 | Average 43 | f, m | T1D for at least 1 year | Spain | Health-related use of Internet technologies | Use of new Internet technologies among patients with T1D is low, e-mail preferred channel of communication with HCP | + | 2 pp, 8p, 0 m, 0NR, 9NA |
Hyman et al. 2012 [10] | Cross-sectional study (questionnaire) | Poster, community health centre, DM education centre, specialized clinic, Canadian Diabetes Association | n = 184 | Average: Immigrants 51,2, Canadian-born 52,3 | f, m | Self-reported T2D | Canada (Toronto) | Self-management, health service use and information-seeking behaviour of recent immigrants and Canadian-born | Differences in performing self-management (regular blood glucose and foot checks) and perception of health service between immigrants and Canadian- born | + | 3 pp, 6p, 0 m, 1NR, 9NA |
Jamal et al. 2015 [36] | Cross-sectional study (question-naire) | University Medical City (teaching hospitals) | n = 344 | Adults (>16 years old) | f, m | T2D | Saudi Arabia (Riyadh) | Online health information-seeking behaviour of people with T2D | Physicians and television preferred sources | + | 3 pp, 5p, 0 m, 2NR, 9NA |
Kalantzi et al. 2015 [5] | Cross-sectional study (questionnaire) | Outpatient clinic | n = 203 | Adults (>18 years old) | f, m | T1D, T2D | Greece (Athens) | Information-seeking behaviour of people with DM, information needs, Internet use, obstacles to information seeking | Diet and complication are most important needs; the physician is a preferred source; Internet is not that important; most frequently barriers mentioned are costs and lack of time | + | 2 pp, 7p, 1 m, 0NR 9NA, |
Lui et al. 2014 [41] | Baseline phase of a longitudinal study (questionnaire) | Australian government initiative | n = 3652 | 56-70 | f, m | T2D | Australia (Queensland) | Correlation between health and social characteristics and Internet use | Internet use associated with age, socioeconomic characteristics, duration, poor metabolic control and comorbidities | + | 4 pp, 6p, 0 m, 0NR, 9NA |
Nordfeldt et al. 2005 [23] | Cross-sectional study (questionnaire) | Paediatric clinics | n = 90 | 5-20 | f, m | T1D for at least 1,5 years | Sweden | Internet health information seeking behaviour of children and adolescents with T1D, motivation, satisfaction | Many use internet for health information seeking and share it with others. ‘Searchers’ with shorter duration. Need for more and better Internet information | + | 4 pp, 4p, 0 m, 2NR, 9NA |
Robertson et al. 2005 [24] | Cross-sectional study (questionnaire) | Diabetes centres | n = 70 | 16-79 | f, m | T1D, T2D | United Kingdom (Glasgow) | Information source of people with DM, satisfaction | Verbal information from healthcare professional is preferred, Internet use connected with age and educational level | +/- | 0 pp, 6p, 3 m, 1NR, 9NA |
Sayakhot and Carolan-Olah 2016 [42] | Cross-sectional study (questionnaire) | Diabetes clinic | n = 116 | 18-43 | f | GDM | Australia (Victoria) | Information sources and satisfaction of women with GDM | HCP, diabetes groups and Internet preferred sources; correlation between age and place of birth and Internet use; mostly satisfied with process of diagnosis | + | 2 pp, 8p, 0 m, 0NR, 9NA |
Shaw and Johnson 2011 [25] | Cross-sectional study (questionnaire) | Flyers in primary care clinics and libraries | n = 57 | Adults (>21 years) | f, m | T2D | USA (Suburban, rural south-eastern) | Online health information seeking behaviour of people with DM | Majority use Internet for health information seeking; many use social networks like Facebook or MySpace and discuss in chats | - | 0 pp, 6p, 4 m, 0NR 9NA |
Yamamoto et al. 2011 [26] | Cross-sectional study (questionnaire) | Diabetes clinics | n = 137 | 20-75 | NR | T1D for at least 6 months | Japan | Information about islet transplantation in people with T1D, associated factors, sources | Main sources are magazines and broadcast media; physicians are a preferred source of information, but mostly they do not have sufficient information about islet transplantation | + | 4 pp, 5p, 1 m, 0NR, 9NA |
Zare-Farashbandi et al 2016 | Cross-sectional study (questionnaire) | Ten health centres under the super-vision of the Deputy of Health of Isfahan Province | n = 362 | 20-82 | f,m | Risk of T2D (defined as pre-diabetes), GDM, T2DM | Iran (Isfahan) | Effect of contextual factors on the health information–seeking behaviour of people with diabetes | An association between the time passed since diagnosis and information-seeking behaviour. | + | 0 pp, 8p, 0 m, 2NR, 9NA |
Qualitative studies | |||||||||||
Connolly and Crosby 2014 [27] | Focus group | Qualified health centre | n = 25 | Average 54 | f, m | Not defined | Hawaii | E-health literacy of individuals from a medically underserved area in Hawaii | Low e-health literacy level, often access to Internet without use for health information seeking, often ability to handle when information missing | + | 8/14 |
Fergie et al. 2015 [37] | Interview | Online, organizations for young adults, other participants | n = 20 T2DM n = 40 people with common mental health disorders | 18-30 | f, m | Not defined | United Kingdom (Glasgow) | Online information seeking behaviour of young people with DM or common mental health disorders | Internet preferred source of information for many participants; differences between professionally produced and social media sites | + | 12/14 |
Kilgour et al. 2015 [39] | Interview | Tertiary referral hospital | n = 13 | 29-41 | f | GDM | Australia (Queensland) | Postnatal follow-up and communication experiences of women with GDM | Need for accurate information and possibility to discuss information with HCP | ++ | 13/14 |
Longo et al. 2010 [9] | Focus group (5-8 participants each session) | Clinic | n = 46 | 48-77 | f, m | T1D, T2D | American midwestern city | Health information seeking and use, information source, active seeking and passive seeking | Passive attainment of information is important; Internet for active seeking, relationships and healthcare professionals help to understand information | + | 12/14 |
Low et al. 2016 [40] | Interview, Focus group | Public and private primary care clinics | n = 12 n = 9 family member n = 5 Health care professionals | 50-62 | f, m | T2D | Malaysia | Influence of social networks on help-seeking behaviour of people with T2D | Important influences from family, friends, HCP | ++ | 13/14 |
Meyfroidt et al. 2013 [29] | Focus group (6 groups) | Community health centre, solo and group practices | n = 21 | 41-85 | f, m | T2D | Belgium (Brussels) | Seeking and use of information sources of people with DM, active and passive seeking over time | General practitioner is the most important source, healthcare professionals are most reliable | ++ | 14/14 |
Milewski and Chen 2010 [30] | Interview | Outpatient clinic, flyers | n = 19 | NR | f, m | T2D | USA (Southern California) | Information seeking behaviour of people with DM, barriers of information use | 5 barriers identified: ‘Motivation fade over time’, ‘Passively Seeking Information’, ‘Inconsistency of Information’, ‘Generality of Information’, ‘Loss of Information’ | + | 11/14 |
Moonaghi et al. 2014 [28] | Interview | NR | n = 15 | Average 51 | f, m | T2D for at least a year | Iran (Tabriz) | Health information-seeking behaviour of Iranian DM patients | Social context important for decision making and information seeking behaviour | ++ | 13/14 |
Newton et al. 2012 [31] | Interview (N = 25), focus group (N = 12), questionnaire (N = 6) | DM support group | n = 37 | Mainly >60 | f, m | T2D | England/UK (Inner London district) | Information seeking and use of mainly older people with DM from a structurally lacking area, motivation, sources | Seeking and use is influenced by social resources and context, which are important for effective and high quality care. Second most important factor is the duration of disease | + | 9/14 |
Wilson 2013 [32] | Survey (questionnaire) | Email of insulin pump therapy group | n = 30 | 22-64 | f,m | T1D, T2D | United Kingdom (Glasgow) | Internet health information seeking of people with long-term DM | Internet used for general questions, healthcare professionals for more specific needs | - | 5/14 |
Mixed-methods studies | |||||||||||
Morgan and Trauth 2013 [33] | Interviews | Database of Pennsylvania State University Institute for Diabetes and Obesity, investigator contacts | n = 30 | Adults (>18 years) | f, m | T1D, T2D for at least a year | USA (Central Pennsylvania and Southern Maryland) | Online health information seeking and the demographic influence using a theoretical model | Seeking behaviour is influenced by different factors such as access to healthcare providers, seeking success or the social network | + | 9/21 (8NA, 1NR) |
Sparud-Lundin et al. 2011 [34] | Survey (questionnaire) | Antenatal clinics | n = 105 | 30-36 | f | T1D | Sweden | Online health information seeking behaviour, use and information needs of childbearing women, expectations for future online possibilities | Many women with T1D seek health information online, particularly during pregnancy, precise expectations of web-based support | + | 8/21 (8NA) |
St Jean 2012 [12] | Questionnaire, interviews, card-sorting techniques | University websites, flyers at clinics and support group meetings | n = 34 | 32-81 | f, m | T2D | USA, (Michigan) | Information behaviour of people with DM, associated factors, that facilitate or hinder their diabetes-related information seeking and use | Participants often did not know their information needs until they found information about it. Some mentioned avoidance in the beginning. Different factors, time included, influencing information seeking behaviour | ++ | 11/21 (8NA) |
St Jean 2014 [13] | Questionnaire, interviews, card-sorting techniques | University websites, flyers at clinics and support group meetings | n = 34 | 32-81 | f, m | T2D | USA, (Michigan) | Information behaviour of people with DM, associated factors, that facilitate or hinder their diabetes-related information seeking and use | The new type of card-sorting technique was well accepted by the study participants; the combination of the card-sorting technique and think aloud protocol within this technique generated contextually rich data about people's diabetes course | + | 7/21 (13NA) |
St Jean 2016 [35] | Questionnaire, interviews, card-sorting techniques | University websites, flyers at clinics and support group meetings | n = 34 | 32-81 | f, m | T2D | USA, (Michigan) | Information behaviour of people with DM, associated factors, that facilitate or hinder their diabetes-related information seeking and use | This study showed several types of factors (physical, social, affective, and cognitive) that may facilitate, hinder, or impede the health-related information seeking | + | 6/21 (12NA) |
Weymann et al. 2016 [43] | Semi-structured interviews, questionnaire | University Hospital, self-help groups, self-help associations | n = 10 (interviews) n = 178 (questionnaire) | 36-86 | f, m | T2D | Germany | Internet use, knowledge and information and support needs of people with T2D | Majority uses internet, no correlation between age and internet use, diabetes knowledge low, desire for shared decision-making | + | 6/21 (8NA, 3NR) |
Information-seeking behaviour: type, sources and content
Main category | Subcategory | Examples | Study designs | ||
---|---|---|---|---|---|
Qualitative studies | Quantitative studies | Mixed-methods studies | |||
Passive attention | Picking up information in the newspaper or TV shows [9] | [44] | – | ||
Passive search | Searching without a specific purpose; passively received information [29] | – | – | ||
Active search | Active seeking in the beginning [29] | ||||
Ongoing search | Looking for credible sources to ‘weave their ongoing web of information’ [9] | – | |||
Combined types | Start with general information and continue with more specific ones [12] | – | |||
Healthcare professional | Physicians, nurses, dietitians, diabetes educator, pharmacists [12] | ||||
Diabetes groups | Groups as one of the major information sources [31] | [31] | [42] | ||
Relatives/friends | Family with DM history as an information source [29] | ||||
Other patients | Other T1DM patients or patient society [26] | – | [26] | ||
Internet | Superficial and particular websites [33] | ||||
Brochures/magazines | Printed media is still a mentioned source [9] | ||||
Books | Books as a helpful source, especially obtain information after diagnosis [33] | – | |||
Broadcast media | Radio and television [5] | [29] | |||
Social networks | Facebook or twitter [9] | – | |||
Diet | [32] | ||||
Complications | Symptoms of DM kidney failure [32] | [32] | |||
Exercise | Effect of exercise on blood sugar level [12] | ||||
Medication and pharmacological interactions | Insulin treatment [34] | [32] | |||
Pregnancy | Breastfeeding and DM [34] | – | [34] |
Associated variables
Category of associated variable | Category of information-seeking behaviour | Specific associated variables | Study |
---|---|---|---|
Quantitative studies | |||
Demographic | Types of information-seeking behaviour | Older and female participants show reduced information seeking | [5] |
Information sources | Younger participants often use Internet to find health information | ||
Male participants prefer ophthalmologists | [5] | ||
Male and younger participants prefer broadcast media as a source | [5] | ||
Female uses Internet more often for health information | [38] | ||
Older participants prefer Internet as a source | [42] | ||
Participants born outside Australia prefer Internet as a source | [42] | ||
Immigrants (Canadian) prefer family and friends as a source of information | [10] | ||
Immigrants (Canadian) use physicians less than Canadian-born | [10] | ||
Content of information | A younger age is related to searching for information about exercise | [5] | |
A younger age is related to searching for complications | [5] | ||
A younger age is related to searching for information about hypoglycaemia | [5] | ||
A younger age is related to searching for dietary issues | [5] | ||
Role-related/interpersonal | Types of information-seeking behaviour | People with DM with a family history of DM have significantly higher average information-seeking behaviour scores of active information receipt and interpersonal relationships | [44] |
Information sources | Receiving information from people and from novel media, and the effect of information according to the patient, was significantly higher for people with diabetes during pregnancy compared with prediabetes and diabetes. | [44] | |
Source characteristics | Information sources | Unorganised information appears to act as a barrier for younger people with diabetes | [5] |
Socioeconomic | Types of information-seeking behaviour | Lower education level is related to reduced seeking behaviour | [5] |
Participants with a lower income show reduced information seeking | [5] | ||
Information sources | Higher education level is related to a preference for a combination of verbal and written information | [24] | |
Higher education level is related to Internet use | |||
Particularly, patients with lower education level prefer physicians as their main source of information | [5] | ||
Lower education level is related to a preference for verbal communication | [24] | ||
A higher income is related to Internet use | |||
A lower income is related to a preference for physicians as the main source of information | [5] | ||
Content of information | Higher education level is related to information needs about complications | [5] | |
Higher education level is related to information needs about hypoglycaemia | [5] | ||
Higher education level is related to information needs about exercise | [5] | ||
A higher income is related to information needs about complications | [5] | ||
A higher income is related to information needs about exercise | [5] | ||
Duration of DM | Types of information-seeking behaviour | Longer duration of DM is related to reduced seeking | |
Information sources | Longer duration of DM is related to preference for ophthalmologists | [5] | |
Shorter duration of DM is related to Internet use | |||
Content of information | Shorter duration of DM is related to information needs about exercise | [5] | |
Shorter duration of DM is related to information needs about hypoglycaemia | [5] | ||
Longer duration of DM is related to information needs about foot complications | [5] | ||
Lifestyle | Information sources | Human information behaviour is related to BMI and fitness level: lower self-reported fitness level and higher BMI are related to higher desire for tailored information | [22] |
Higher BMI is related to Internet use | [41] | ||
Content of information | Higher BMI is related to information seeking about nutrition | [22] | |
Qualitative studies | |||
Demographic | Information sources | Different demographic factors, e.g. gender | [28] |
In an older population, the minority use the Internet for health information seeking | [27] | ||
Role-related/interpersonal | Information sources | Family as a motivator for using the Internet for health information seeking | [27] |
Environmental | Information sources | Cultural aspects like a preference for herbal medicine or religious and spiritual beliefs could lead to an avoidance of healthcare professionals | [28] |
Source characteristics | Types of information-seeking behaviour | Lower quality could maybe lead to less active seeking | [30] |
Socioeconomic | Types of information-seeking behaviour | Higher education level is related to active seeking and a complex style of information-seeking behaviour | |
A higher income is related to a use of a more complex style of information-seeking behaviour | [31] | ||
A lower income is related to a use of simple styles of information-seeking behaviour | [31] | ||
Information sources | Higher education level is related to Internet use | [29] | |
Duration of DM | Types of information-seeking behaviour | Shorter duration of DM is related to passive seeking | [29] |
Short duration of DM is related to active seeking; longer duration leads to less active seeking | [30] | ||
Short duration of DM shows a search for baseline information and after a longer duration of DM more complex information seeking starts | [31] | ||
Information sources | Health professionals consulted in all phases of disease | ||
Mixed-methods studies | |||
Demographic | Information sources | Black participants mainly obtain baseline information from a physician | [33] |
Role-related/interpersonal | Content of information | For childbearing women, information about pregnancy and DM are most important | [34] |
Source characteristics | Types of information seeking | Doctor motivates active seeking of information | [35] |
Trust as a factor influencing the use of Internet as a source | [33] | ||
Socioeconomic | Types of information-seeking behaviour | Lower education level is related to reduced seeking behaviour and the perception of importance to learn more about DM | [12] |
Information sources | Higher education level is related to Internet use | [34] | |
Lower education level is related to the use of special websites | [33] | ||
Duration of DM | Types of information-seeking behaviour | Short duration of DM is related to active seeking; longer duration leads to less active seeking | [12] |