VOL. 21 NO. 4, DECEMBER, 2016
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Credibility and usefulness of health information on Facebook:
a survey study with U.S. college students
Sung Un Kim and Sue Yeon Syn.
Abstract
Introduction. This study examines ways in which college students
perceive the credibility and usefulness of health information on
Facebook, depending on topic sensitivity, information source and
demographic factors.
Method. With self-selection sampling, data were collected from
two universities through an online survey; 351 responses were used
for analysis.
Analysis. The data were analysed using analysis of variance and
t-tests.
Results. Overall, college students tend to consider health
information with low sensitivity levels as significantly more
credible and useful than health information with high sensitivity
levels on Facebook. Regardless of topic sensitivity, college students
tend to consider professional information sources as more credible
and useful than non-professional information sources on Facebook.
However, among non-professional information sources, they prefer
an experienced person over family when it comes to serious health
issues. Female students tend to trust highly sensitive health
information more than male students. Students living in campus
residence halls are less likely to consider health information on
Facebook as credible or useful. The more students are educated, the
more credible or useful they consider professional information
sources.
Conclusions. This study demonstrates critical factors influencing
students' perceptions of health information on a social networking
site and provides implications for healthcare marketers and health
educators.
Introduction
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The Internet is becoming an increasingly popular source of
health information. The Pew Internet and American Life
Project (Fox and Duggan, 2013
) reported that 81 per cent of
U.S. adults use the Internet and 72 per cent of them had used
the Internet to search for health information during the
previous year. Young adults tend to more actively use the
Internet and social networking sites than older adults.
Approximately 93 per cent of young adults (aged 18-29) go
online and 72 per cent of online young adults use social
networking sites (Lenhart, Purcell, Smith and Zikhur, 2010
).
College students' active engagement in social networking sites
increases the possibility that they will come across health
information on such sites (Liu, 2010
). Studies reveal that
college students actively use the Internet and social networking
sites for health information (Escoffery
et al., 2005; Horgan and
Sweeney, 2012). Although college students appear to
understand that information on the Web may not be highly
credible, they rarely verify its accuracy (Metzger, Flanagan and
Zwarun, 2003).
There have been continuous scholarly efforts to examine
people's perceptions on the credibility (e.g., Bliemel and
Hassanein, 2007; Dutta-Bergman, 2003; Freeman and
Spyridakis, 2004; Luo and Najdawi, 2004) and usefulness
(e.g., Magnezi, Bergman, Grosberg and Eysenbach 2014
; Sin
and Kim, 2013; Yoon and Kim, 2014; Zhang, 2013) of online
health information. And, healthcare marketers and health
educators have begun to explore social networking sites in
order to understand their potential as health communication
venues for different age groups and for different health topics.
In spite of this, few studies have been performed about
people's perceptions of health information on social
networking sites and the various factors that influence
perceptions. Thus, this study aims to understand how college
students perceive the credibility and usefulness of health
information differently in a social networking site setting,
particularly on Facebook, by topic sensitivity, information
source and demographic factors.
We chose college students as a target group because they
heavily rely on online health information due to their
sensitivity about confidentiality among peers and lack of easy
access to health care providers (Chou, Hunt, Beckjord, Moser
and Hesse, 2009; Gray, Klein, Noyce, Sesselberg and Cantrill,
2005; Okoniewski, Lee, Rodriguez, Schnall and Low, 2014;
Zhang, 2013
). Also, compared with other age groups, college
students use social networking sites the most (Duggan, Ellison,
Lampe, Lenhart and Madden, 2015). Among various social
networking site platforms, we chose Facebook because it is the
most popularly used social networking site at present (Duggan
et al., 2015) and is used widely by college students for everyday
life information, including health information (Kim, Park and
Bozeman, 2011; Park, Kee and Valenzuela, 2009).
Literature review
College students' use of the Internet and
social networking sites for health
information
College students actively use the Internet and social
networking sites to obtain health information (Escoffery
et al.,
2005; Horgan and Sweeney, 2012). Undergraduate students
use search engines, predominantly Google, for most online
searches for health information (Senkowski and Branscum,
2015). Popular health topics for college students' online
searches include the following: 'a particular illness or
condition', 'nutrition, exercise, or weight-control issues', 'a
mental health issue', 'a particular doctor or hospital', and 'a
particular prescription drug' (Banas, 2008
, p. 231); sexual
health, nutrition, fitness, weight loss, and sports-related
injuries (Horgan and Sweeney, 2012
); diet/nutrition
information, and fitness and exercise information (Hanauer,
Col, Dibble and Fortin, 2004). Kim et al. (2011) found that
undergraduate students evaluate online health information
mostly by aesthetics and peripheral cues of source credibility
and message credibility. They tend to overly trust search
engine results, thus there is a need for undergraduate students
to learn about credible health-related Websites and obtain
skills with which to properly evaluate the quality of online
health information (Kim
et al., 2011). Similarly, Prybutok and
Ryan (2015
) found that college students (aged 18-30) decide to
use health information by its aesthetic appeal and site utility.
They are substantially engaged with health information
sources on the Internet and value opportunities to interact
with people online. Head and Eisenberg (2011
) found that
college students evaluate online information for their everyday
life searches, including health issues, by Website design,
familiarity from previous use, currency, URL, and authors'
credentials.
Research has found demographic differences in college
students' information seeking about health topics. For
instance, Fogel, Fajiram and Morgan (2010
) found that African
Americans are more likely to search on the Internet for birth
control information than Whites, and female students tend to
search for birth control information on the Internet more than
males. In their study with community college students,
Hanauer et al. (2004) revealed that Black and Hispanic
students tend to search for health information online more
often than Asian and White students, but no sex difference was
found. Female students and those with Internet experience are
more likely to search for health information online than their
counterparts (Escoffery
et al., 2005). Yoon and Kim (2014)
examined the health information behaviour of Korean
graduate students living in the U.S. and found that these
international graduate students are motivated to search for
health information online due to fast and easy searches,
followed by a great deal of information, availability of diverse
opinions, and information in Korean.
When it comes to college students with certain medical
conditions, Gowen, Deschaine, Gruttadara and Markey (2012
)
revealed that young adults (aged 18-24) with a mental illness
tend to engage more in various social networking activities,
than those with no mental illness, in order to build networks
and make online friends. They believe social networking sites
help to prevent them from being isolated and to live more
independently (Gowen
et al., 2012). Smith (2011) examined
how Black and White college students search for HIV/AIDS
information on the Internet and reported that 80 per cent of
the participants did not possess the skills necessary to properly
search online health information, regardless of race.
Credibility of online health information
Hovland, Janis and Kelley (1953) found that people perceive
credibility in two main dimensions: trustworthiness and
expertise. Trustworthiness means 'the goodness or morality of
the sources and can be described with terms such as well
intentioned, truthful, or unbiased' (Fogg
et al., 2002, p. 9), and
expertise refers to 'perceived knowledge of the source and can
be described with terms such as knowledgeable, reputable, or
competent' (Fogg
et al., 2002, p. 9). People trust the accuracy
of online health information when they deem the authors of
the information and the intentions of the Website as credible
(Bliemel and Hassanein, 2007
). Also, people's trust in online
health information is closely related to the quality of
information (Luo and Najdawi, 2004
). Based on the
elaboration likelihood model (Petty and Cacioppo, 1986
),
Freeman and Spyridakis (2004
) discussed the idea that the
perception of credibility of online health information is
affected by source characteristics and reader characteristics.
Source characteristics include publishers, authors, advertising,
sponsorships, links, contact information, communication
channel or technology, and privacy and security policies, while
reader characteristics include an individual's age, sex,
education, income, health status, experience with illness, and
experience with technology (Freeman and Spyridakis, 2004).
There have been numerous studies about factors that influence
people's credibility judgments of health information. With
respect to source credibility, Johnson and Meischke (1991a
;
1991b
) examined women's source and content preferences
regarding cancer information and revealed that regardless of
whether they had a mammography or not, women prefer
certain types of sources according to content. More specifically,
women prefer doctors to friends and family, organizations, and
media for general information, specific information, diagnosis
information, treatment information, and information for
coping, while they equally prefer doctors and organizations for
prevention information. Another study discovered that people
are more likely to trust online health information provided by
personal doctors, medical universities and federal governments
than that provided by local hospitals, insurance companies,
and community health organizations (Dutta-Bergman, 2003
).
Medical universities and federal resources are trusted by those
who are more educated and health information oriented,
whereas local hospitals and health insurance companies are
trusted by those who have lower incomes and are less health
information oriented (Dutta-Bergman, 2003
). The
completeness of health information on the Internet increases
consumer assessment of source and website credibility (Dutta-
Bergman, 2004). Research has found that people tend to trust
health information on Websites with domain name extensions
.edu, .gov or .org (Health on the Net, 2006
; Senkowski and
Branscum, 2015; Walther, Wang and Loh, 2004).
Also, the visual design of a Website is known to impact
perceived credibility (Fogg, 2003
; Pariera, 2012; Robins,
Holmes and Stansbury, 2010). According to Freeman and
Spyridakis's (2009
) study, most participants in the study
consider source credibility as critical in evaluating online
health information. However, although people deemed articles
and authors of articles with 'Contact Us' links significantly
more expert and credible than those without such as link, they
used contact information as a cue only for peripheral
processing rather than for central processing of information
evaluation. Prybutok and Ryan (2015
) found that college
students (aged 18 to 30) use both site and message credibility
to evaluate health-related Websites. Their study recommends
that for site credibility, the site should look professional and
contain current and updated information, and for message
credibility, reviews and comments should be maintained to be
accurate and positive (Prybytok and Ryan, 2015
). In addition,
textual clues and high quality of design increase perceived