A path analysis of Internet health information seeking behaviors among older adults

Abstract

The Internet has emerged as an innovative tool that older adults can use to obtain health-related information. However, the relationships among predictors of Internet health information seeking behaviors (IHISB) in this population are not well understood. To fill this gap, this study examined the direct and indirect pathways of potential predictors of IHISB among older South Korean adults, using the modified Technology Acceptance Model 3. Participants were 300 older South Korean adults who had used the Internet to obtain health information within the past month. Data were collected via a self-report questionnaire and were analyzed through structural equation modeling. Two variables—prior experience and behavioral intention to use—had positive direct effects on IHISB. These findings imply that health care providers promoting IHISB among older adults should consider these individuals' prior experience with the Internet and their willingness to use the Internet as a source of health information.

Introduction

The Internet has emerged as a new and innovative channel for obtaining health information.¹ This information could be particularly useful in helping older adults maintain good physical, psychological, and social well-being, as such information can enhance self-education on issues such as personal care and illness prevention.2, 3, 4 Another advantage of the Internet is that it is easily accessible to physically frail older adults who have limited access to community health services.¹

In South Korea, the Internet has great potential as an effective source of health information for older adults, given the country's high ratio of Internet usage and rapidly aging population. Over 77.8% of South Koreans use the Internet.⁵ Furthermore, approximately 82% of Korean households have a computer at home, and 81.6% have Internet access.⁵

Approximately 11% of the total South Korean population consists of adults aged 65 years or older, and most of this population has at least one chronic disease. For such patients, appropriate information is necessary for proper care.⁶ These older adults generally have a positive attitude toward health information obtained over the Internet and are willing to learn how to use the Internet to obtain this information.⁷ However, actual Internet use to obtain health information is comparatively low among South Korean older adults: only 1.8–28% of them search for health information on the Internet, whereas 65.5% of South Koreans between 20 and 40 years old do so.7, 8, 9 Thus, it is necessary to encourage South Korean older adults to make use of the abundant health information available on the Internet, and to do so, the factors associated with Internet health information seeking behaviors (IHISB) in this age group need to be identified.

Possible predictors of IHISB among older adults have already been identified, such as sociodemographic characteristics, attitudes toward health information from the Internet, and perceived ease of use.7, 10 However, the complex relationships among these predictors are not well understood in Korean elderly population. To fill this gap, the present study explored the direct and indirect pathways of potential predictors of older adults' IHISB in Korean elderly population. The predictors were selected based on the modified Technology Acceptance Model 3 (TAM 3) and a literature review.

The theoretical basis of this study is the TAM 3.¹¹ The TAM was developed to predict individual adoption and use of new information technology (IT).¹² It is currently the most widely applied model of IT user acceptance and usage; the TAM 3 identifies three factors predictive of the use of new IT: behavioral intention to use, perceived usefulness, and perceived ease of use. Behavioral intention affects individual user behavior; it is determined by both perceived usefulness and perceived ease of use. Perceived usefulness is determined by several factors, including subjective norms, the image of the technology, job relevance, output quality, result demonstrability, and perceived ease of use. Perceived ease of use is influenced by computer self-efficacy, perception of external control, computer anxiety, computer playfulness, perceived enjoyment, and objective usability.

In the present study, searching for health information on the Internet can be considered a novel form of IT in the TAM 3 because seeking health information on the Internet is new to many older adults, the target population. In addition, previous studies found that determinants of various TAM factors, such as computer anxiety and computer self-efficacy, were associated with Internet use in this population.13, 14 Therefore, the TAM 3 was selected for this study. The direct and indirect pathways to IHISB in the study were explored using five multidimensional variables selected on the basis of both the TAM 3 and a literature review: perceived usefulness and associated determinants, perceived ease of use and associated determinants, behavioral intention to use, sociodemographic factors, and attitudes toward Internet health information.