Evaluating Health Advice in a Web 2.0 Environment: The Impact of Multiple User-Generated Factors on HIV Advice Perceptions.

Unlike traditional media, social media systems often present information of different types from different kinds of contributors within a single message pane, a juxtaposition of potential influences that challenges traditional health communication processing. One type of social media system, question-and-answer advice systems, provides peers' answers to health-related questions, which yet other peers read and rate. Responses may appear good or bad, responders may claim expertise, and others' aggregated evaluations of an answer's usefulness may affect readers' judgments. An experiment explored how answer feasibility, expertise claims, and user-generated ratings affected readers' assessments of advice about anonymous HIV testing. Results extend the heuristic-systematic model of persuasion (Chaiken, 1980) and warranting theory (Walther & Parks, 2002). Information that is generally associated with both systematic and heuristic processes influenced readers' evaluations. Moreover, content-level cues affected judgments about message sources unexpectedly. When conflicting cues were present, cues with greater warranting value (consensus user-generated ratings) had greater influence on outcomes than less warranted cues (self-promoted expertise). Findings present a challenge to health professionals' concerns about the reliability of online health information systems.

Media Effects: Theory and Research.

This review analyzes trends and commonalities among prominent theories of media effects. On the basis of exemplary meta-analyses of media effects and bibliometric studies of well-cited theories, we identify and discuss five features of media effects theories as well as their empirical support. Each of these features specifies the conditions under which media may produce effects on certain types of individuals. Our review ends with a discussion of media effects in newer media environments. This includes theories of computer-mediated communication, the development of which appears to share a similar pattern of reformulation from unidirectional, receiver-oriented views, to theories that recognize the transactional nature of communication. We conclude by outlining challenges and promising avenues for future research.

Social media and online hate.

Social media host alarming degrees of hate messages directed at individuals and groups, threatening victims' psychological and physical well-being. Traditional approaches to online hate often focus on perpetrators' traits and their attitudes toward their targets. Such approaches neglect the social and interpersonal dynamics that social media afford by which individuals glean social approval from like-minded friends. A theory of online hate based on social approval suggests that individuals and collaborators generate hate messages to garner reward, for their antagonism toward mutually hated targets, by providing friendship and social support that enhances perpetrators' well-being as it simultaneously deepens their prejudices. Recent research on a variety of related processes supports this view, including notions of moral grandstanding, political derision as fun, and peer support for interpersonal violence.

Supporting tobacco control: stimulating local newspaper coverage with a technical assistance website for local coalitions.

A large and growing literature confirms that well-designed web-based programs can be effective in preventing or treating several chronic diseases. This study examined how the Internet can deliver information and train community activists and specifically tested the effects of web-based technical assistance on local tobacco control coalitions' efforts to use media advocacy to advance their agendas. The authors compared a highly interactive, Enhanced website (intervention) to a noninteractive, Basic text-based website (comparison) in Colorado communities. A total of 24 tobacco control coalitions led by local county health departments and nursing services were enrolled in the project and randomly assigned to use either the intervention or comparison website. A total of 73 local daily and weekly newspapers were identified in the service areas of 23 of the 24 coalitions. A posttest assessment of newspaper coverage was conducted to locate all newspaper articles with tobacco control information published between January 1 and April 9, 2004, the last 3 months of the intervention. Although there was no evidence of a treatment effect on the frequency of newspaper articles on tobacco-related issues, there was, however, evidence that newspapers in counties where the coalition had access to the Enhanced website printed more stories focused on local/regional issues and more anti-tobacco local/regional stories than in the counties where coalitions had access to the Basic website. Coalitions can improve their influence on local media for community tobacco control when high-quality online technical assistance, training, and resources are available to them.

Continued benefits of a technical assistance web site to local tobacco control coalitions during a state budget shortfall.

CONTEXT: A state budget shortfall defunded 10 local tobacco coalitions during a randomized trial but defunded coalitions continued to have access to 2 technical assistance Web sites. OBJECTIVE: To test the ability of Web-based technology to provide technical assistance to local tobacco control coalitions. DESIGN: Randomized 2-group trial with local tobacco control coalitions as the unit of randomization. SETTING: Local communities (ie, counties) within the State of Colorado. PARTICIPANTS: Leaders and members in 34 local tobacco control coalitions funded by the state health department in Colorado. INTERVENTION: Two technical assistance Web sites: A Basic Web site with text-based information and a multimedia Enhanced Web site containing learning modules, resources, and communication features. MAIN OUTCOME MEASURE(S): Use of the Web sites in minutes, pages, and session and evaluations of coalition functioning on coalition development, conflict resolution, leadership satisfaction, decision-making satisfaction, shared mission, personal involvement, and organization involvement in survey of leaders and members. RESULTS: Coalitions that were defunded but had access to the multimedia Enhanced Web site during the Fully Funded period and after defunding continued to use it (treatment group × funding status × period, F(3,714) = 3.18, P = .0234). Coalitions with access to the Basic Web site had low Web site use throughout and use by defunded coalitions was nearly zero when funding ceased. Members in defunded Basic Web site coalitions reported that their coalitions functioned worse than defunded Enhanced Web site coalitions (coalition development: group × status, F(1,360) = 4.81, P = .029; conflict resolution: group × status, F(1,306) = 5.69, P = .018; leadership satisfaction: group × status, F(1,342) = 5.69, P = .023). CONCLUSIONS: The Enhanced Web site may have had a protective effect on defunded coalitions. Defunded coalitions may have increased their capacity by using the Enhanced Web site when fully funded or by continuing to use the available online resources after defunding. Web-based technical assistance with online training and resources may be a good investment when future funding is not ensured.

Health information, credibility, homophily, and influence via the Internet: Web sites versus discussion groups.

Despite concerns about online health information and efforts to improve its credibility, how users evaluate and utilize such information presented in Web sites and online discussion groups may involve different evaluative mechanisms. This study examined credibility and homophily as two underlying mechanisms for social influence with regard to online health information. An original experiment detected that homophily grounded credibility perceptions and drove the persuasive process in both Web sites and online discussion groups. The more homophilous an online health information stimulus was perceived as being, the more likely people were to adopt the advice offered in that particular piece of information.

Attributes of interactive online health information systems.

The development of online communication systems related to prevention, decision making, and coping with cancer has outpaced theoretical attention to the attributes that appeal to system users and that create effective interactions. This essay reviews a number of sociotechnical attributes related to online discussion systems and tutorials, including interactivity, presence, homophily, social distance, anonymity/privacy, and interaction management. These attributes are derived from different theoretical perspectives which have led to clinical trials and other empirical studies demonstrating effectiveness or attraction to end users. The effects of a subset of these attributes are connected to learning, social influence, and coping, as illustrated in evaluations of an interactive smoking prevention site and a cancer advice/support discussion system.

The effect of top-level domains and advertisements on health web-site credibility.

BACKGROUND: Concerns over health information on the Internet have generated efforts to enhance credibility markers; yet how users actually assess the credibility of online health information is largely unknown. OBJECTIVE: This study set out to (1) establish a parsimonious and valid questionnaire instrument to measure credibility of Internet health information by drawing on various previous measures of source, news, and other credibility scales; and (2) to identify the effects of Web-site domains and advertising on credibility perceptions. METHODS: Respondents (N = 156) examined one of 12 Web-site mock-ups and completed credibility scales in a 3 x 2 x 2 between-subjects experimental design. Factor analysis and validity checks were used for item reduction, and analysis of variance was employed for hypothesis testing of Web-site features' effects. RESULTS: In an attempt to construct a credibility instrument, three dimensions of credibility (safety, trustworthiness, and dynamism) were retained, reflecting traditional credibility sub-themes, but composed of items from disparate sources. When testing the effect of the presence or absence of advertising on a Web site on credibility, we found that this depends on the site's domain, with a trend for advertisements having deleterious effects on the credibility of sites with .org domain, but positive effects on sites with .com or .edu domains. CONCLUSIONS: Health-information Web-site providers should select domains purposefully when they can, especially if they must accept on-site advertising. Credibility perceptions may not be invariant or stable, but rather are sensitive to topic and context. Future research may employ these findings in order to compare other forms of health-information delivery to optimal Web-site features.

Research ethics in Internet-enabled research: human subjects issues and methodological myopia.

As Internet resources are used more frequently for research on social and psychological behavior, concerns grow about whether characteristics of such research affect human subjects protections. Early efforts to address such concerns have done more to identify potential problems than to evaluate them or to seek solutions, leaving bodies charged with human subjects oversight in a quagmire. This article critiques some of these issues in light of the US Code of Federal Regulations' policies for the Protection of Human Subjects, and argues that some of the issues have no pertinence when examined in the context of common methodological approaches that previous commentators failed to consider. By separating applicable contexts from those that are not, and by identifying cases where subjects' characteristics are irrelevant and/or impossible to provide, oversight committees may be able to consider research applications more appropriately, and investigators may be less ethically bound to ascertain and demonstrate those characteristics.