Health information for hard-to-reach target groups: A qualitative needs assessment.

INTRODUCTION: Reaching socially disadvantaged families and older people with health information can be challenging. A needs assessment was conducted to learn more about their health-related needs and preferences and derive recommendations for health information. METHODS: Focus groups were conducted with socially disadvantaged families, older people and suitable disseminators, like counsellors from various types of counselling centres or welfare facilities (81 participants), and analysed using content analysis. RESULTS: Socially disadvantaged and hard-to-reach people want to understand health problems, become active in dealing with them themselves, and be involved in medical decision-making. Health information should consider the challenging everyday lives, the limited time available and the short attention span of socially disadvantaged families. There is a preference for short texts and videos. Older people may favour more comprehensive print products for complex topics. Matching photos and illustrations are vital to attract attention. Health information is preferably received via personal contact. Furthermore, online services and social media channels are popular. DISCUSSION: Some recommendations can be helpful for all target groups of health information, like more illustrations. Others are more specific to the groups investigated and require conceptual groundwork and greater resources, for example, a specific service for disseminators. CONCLUSION: Hard-to-reach target groups want to understand their health issues, and be proactive and involved in decision-making. Personal contact is of utmost importance. Disseminators play a crucial role and need information they can customize for their clients.

[Health information on the Internet: Who is searching for what, when and how?]. / Gesundheitsinformationen im Internet: Wer sucht was, wann und wie?

INTRODUCTION: The Institute for Quality and Efficiency in Health Care (IQWiG, Germany) has a statutory mandate to provide patients and their family members as well as the wider public with evidence-based health information (www.informedhealthonline.org). Since 2006 IQWiG has maintained the publicly available website gesundheitsinformation.de. Currently, about 80 million people live in Germany, and the majority of them have internet access. The goal of this project was to evaluate published studies examining health information seeking behaviour (who, when and how) on the internet. METHODS: A systematic search was conducted in several databases (PubMed, MEDLINE [Ovid)], PsycInfo [Ovid] und CINAHL [Ebsco]) for studies on internet searches for health information. No study type restrictions were imposed. Data were extracted from the relevant studies, and then discussed in the project group and summarised qualitatively. RESULTS: Of the 1,150 abstracts identified, 169 publications were analysed in full. 74 studies were included, most of which were surveys (n=59). The data were extracted from these studies and then summarised qualitatively to obtain an overview of the current state of research in this field. The results suggest that the group most often searching for health-related information on the internet - either on their own behalf or on behalf of others - consists of middle-aged women with a higher level of education and income. The most common reason for initiating a search for health information is a visit to the doctor, and the most common starting point is a search engine. Page layout and user-friendliness are the main criteria for assessing the credibility of websites and the information they provide. Users are more likely to trust information that is consistent with their own experiences and opinions. DISCUSSION: There is a growing trend of using the internet as a source for health information. It seems that trust in the credibility of a given website or information mostly depends on factors that are hardly related to the quality of content. This may pose a particular challenge for the creation and dissemination of evidence-based health information. Further research is required to examine the needs of the individual groups using internet-based health information.

Integrating patients' views into health technology assessment: Analytic hierarchy process (AHP) as a method to elicit patient preferences.

BACKGROUND: Patient involvement is widely acknowledged to be a valuable component in health technology assessment (HTA) and healthcare decision making. However, quantitative approaches to ascertain patients' preferences for treatment endpoints are not yet established. The objective of this study is to introduce the analytic hierarchy process (AHP) as a preference elicitation method in HTA. Based on a systematic literature review on the use of AHP in health care in 2009, the German Institute for Quality and Efficiency in Health Care (IQWiG) initiated an AHP study related to its HTA work in 2010. METHODS: The AHP study included two AHP workshops, one with twelve patients and one with seven healthcare professionals. In these workshops, both patients and professionals rated their preferences with respect to the importance of different endpoints of antidepressant treatment by a pairwise comparison of individual endpoints. These comparisons were performed and evaluated by the AHP method and relative weights were generated for each endpoint. RESULTS: The AHP study indicates that AHP is a well-structured technique whose cognitive demands were well handled by patients and professionals. The two groups rated some of the included endpoints of antidepressant treatment differently. For both groups, however, the same six of the eleven endpoints analyzed accounted for more than 80 percent of the total weight. CONCLUSIONS: AHP can be used in HTA to give a quantitative dimension to patients' preferences for treatment endpoints. Preference elicitation could provide important information at various stages of HTA and challenge opinions on the importance of endpoints.