|Abstract or Summary
- Use of the Internet for health information has been gaining popularity, and some studies suggest an increase in the use of online interactive peer-to-peer forums for seeking health information. Internet health information-seeking is especially popular among those with stigmatized conditions such as obesity, and negative healthcare experiences have been linked to Internet information-seeking in general. Little is known about the relationships between healthcare experiences and the use of the Internet for weight loss-specific information, including when this information is sought from interactive online forums. The purpose of this dissertation was to identify and understand healthcare processes, including characteristics of patient-provider interactions, that may influence individuals to seek weight loss information from online peer-to-peer forums. To achieve this purpose, a two-phase project was conducted. First, associations between patient-centered communication and two behaviors were examined quantitatively using a large nationally-representative dataset: (1) use of the Internet for assistance with diet, weight, and physical activity, and (2) participation in online support groups for those with similar health or medical conditions. Results indicated no significant associations between those healthcare experiences and either behavior. The second, qualitative phase of this dissertation involved analyzing forum posts related to personal healthcare experiences from three high-traffic weight loss-related forums. These data were explored to examine aspects of patient-centered communication, as well as additional healthcare experiences, that influenced forum users' weight loss information-seeking behaviors. Five major themes were identified: (1) access and time available for healthcare providers to answer questions; (2) healthcare providers’ management of affect, including shame and embarrassment related to weight; (3) clarity of health-related information given by healthcare providers; (4) trust of health information received from healthcare providers; and (5) forum users' general impressions of rapport with their providers. For some, Internet-based interactive forums serve as an alternative to provider-based information; for others, these forums are an environment in which weight loss information from providers may be verified, explained, or clarified. Our study provides evidence that interacting with peers in online communities may influence future health behaviors and future healthcare-seeking behaviors. Understanding how healthcare experiences influence Internet weight loss information-seeking from online peers, as well as how participating in these forums may influence subsequent health-related behaviors, is an important topic that warrants further exploration.