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Health System Change: Collaborative Researchers
Tuesday, August 26, 2008 | 
Pew Internet Posts
Ha Tu and Genna Cohen of the Center for Studying Health System Change released their latest report on how Americans gather health information (HTML report; news release).
I met with them in June and learned a bit more about how they approached this massive data set (N=18,000+).
First, a bit of background. I became acquainted with Ha Tu in 2003 when, unbeknownst to each other, we came out with what appeared to be different estimates of the e-patient population. After talking with her to better understand HSC's data, I wrote:
Recent reports, one by the Center for Studying Health System Change and another by a team of Stanford researchers, have estimated a lower population of health seekers by limiting the scope of their survey questions. We deliberately keep the timeframe open, asking if respondents had "ever" searched for a health topic, because it has been our observation that once an Internet user has been successful in an online endeavor, she will return to it the next time she has a similar problem or question, no matter how much time has lapsed between the searches. We also do not limit respondents to thinking exclusively about their own health concerns since our past research shows that more than half of Internet health searches are conducted on behalf of someone else. Indeed, for most Americans, health is a family affair, not a solitary activity. Finally, for the first time, we asked questions of respondents about 16 specific health topics, rather than just asking them about general health searches, and this drove up the number of Internet users who say they have searched for health-related topics online.
(See p. 1 of Internet Health Resources for more data from this era.)
This time around, Ha and Genna invited me to preview their data so we could understand the differences and similarities of our findings before releasing them to the world. As I wrote to them afterwards, meeting with them was better than a cup of coffee to get me awake and excited about work that day. It was a wonderful collaborative moment and I very much appreciate their reaching out to me.
Their report finds that 56% of American adults sought information about a personal health concern:
Use of all information sources rose substantially, with the Internet leading the way: Internet information seeking doubled to 32 percent during the six-year period. Consumers across all categories of age, education, income, race/ethnicity and health status increased their information seeking significantly, but education level remained the key factor in explaining how likely people are to seek health information.
It turns out that my report E-patients With a Disability or Chronic Disease probably tracks most closely with HSC's data on "personal health concerns" since that population is more likely than the general population to search on their own behalf instead of for other people and to talk with a medical professional about what they find. For example: "Fully 49% of e-patients with chronic conditions talked with a health professional about what they found online during their most recent search, compared with 30% of e-patients with no chronic conditions."
Another report that I thought tracked their work is Information Searches That Solve Problems, which I wrote about here.
Yet there was still a difference between our findings since Pew Internet combines all searches (the respondent's own as well as her searches for others) whereas HSC chooses to keep them separate. Ha and Genna account for the "whole picture" of the e-patient/e-caregiver population in the following footnote: "In total, 65 percent of adults sought information either for themselves or other adults in 2007; 40 percent did so using the Internet." It is an excellent solution, answering some observers' questions before they are raised, yet forwarding what they believe is an important measure of health behavior.
I very much appreciate the work of the Center for Studying Health System Change and am thankful for the time the researchers took to explain their data. Research grows stronger through collaboration and good research is an element of participatory medicine.
Posted by Susannah Fox at 7:36 AM | Link to This Entry
Changing news audience behavior
Saturday, August 23, 2008 | Pew Internet Posts
Our colleagues at the Pew Research Center For The People & The Press have issued their latest findings from a survey they have conducted every two years about Americans' news consumption habits.
One headline is that 23% of American adults fit into a news-audience category they call "Integrators." They get the news from both traditional sources and the internet, and they comprise a more engaged, sophisticated and demographically sought-after audience segment than those who mostly rely on traditional news sources.
The People-Press analysts led by Andrew Kohut also identify three other groups in a typology of news consumers:
Posted by Lee Rainie at 7:19 AM | Link to This Entry
Video viewing on an Olympic scale
Thursday, August 14, 2008 | Pew Internet Posts
According to the Torrent tracking site, TorrentFreak, the opening ceremony for the Beijing Olympics was the most-downloaded television show for the week of August 3-10th. With well over one million downloads, demand for the opening ceremony far surpassed the interest in other popular shows like "Mad Men" and "So You Think You Can Dance." As various blogs have reported, Olympics fans can find P2P streams or Torrent files that are made available before the official broadcasts, as well as HD or iPod-ready versions of the events.
Americans' interest in sports-related video online is not new, but it's likely getting a big boost from Olympics content driving users to the Web. In our 2007 "Online Video" report, we found that 14% of adult internet users had specifically downloaded or watched sports-related video. Among younger users ages 18-29, the number watching sports video was much higher at 24%. However, that data was gathered before the 2008 Super Bowl and well before the heavily-promoted Beijing games. With NBC and the official Beijing Olympics page providing official online video coverage through their sites, YouTube users uploading "unofficial" content, and Torrent files floating everywhere in between, consuming all of this Olympic video may need to become an event of its own.
Posted by Mary Madden at 15:36 PM | Link to This Entry
No Longer in the News, Earthquake Survivors Face a Painful Recovery
Tuesday, August 5, 2008 | Pew Internet Posts
Senior Research Fellow Deborah Fallows has posted a new essay about the aftermath of the devastating May 12 earthquake in China:
Media focus in China turned away weeks ago from the May 12 earthquake to the Beijing Olympics, which begin in just a few days...
But devastated Sichuan is still looking out at the rest of China. The first order of recovery was to resurrect television and mobile phone networks, rural China's sources for information and communication.
(Read Deb's full report on the current scene as well as her previous dispatches from China.)
Posted by Deborah Fallows at 12:45 PM | Link to This Entry
New Health Data
Wednesday, July 30, 2008 | Pew Internet Posts
The Pew Internet Project recently updated our top three Latest Trends charts: Who's Online, Internet Activities, and Daily Internet Activities.
Two of the new data points relate to health and health care. The October-December 2007 national phone survey included 2,054 adults age 18 and older, including 500 cell phone users. Of those, 75% say they have looked for health or medical information online. 10% of internet users say they searched for health information "yesterday," which in a tracking survey like this one yields a picture of the "typical day" online. Health has moved up in the "typical day" list (from 7% in 2006 to the current 10% of internet users), but for most people the average day includes lots of emails (60% of internet users), general searches (49%), and news reading (39%) if they are online at all (30% of internet users are offline on a typical day).
With this survey, we returned to the health question wording we had used in 2000 and 2002: "Do you ever use the internet to look for health or medical information" (at that time yielding an estimate of 66% of internet users). In 2003-7, respondents were prompted with questions about specific health topics, such as diet, drugs, or alternative treatments, yielding a consistently higher estimate (80%) for the percentage of internet users who seek health information online in 2003, 2004, and 2006. It is nice to see that when we returned to asking the more basic one-line question, it returns a similar result: 75% of internet users have looked for health or medical information online.
The Oct-Dec 2007 survey is also distinguished by the fact that we included a group of cell phone users in our sample. We believe this is an important part of capturing an accurate picture of the U.S. population since 14.5% of all American adults live in households with only wireless phones (see "Polling in the age of cell phones").
We will update our 17 health topic trend data in a survey to be fielded this fall and, if you are interested in more frequent updates, I am writing about my observations of the internet's impact on health care on the e-patients.net blog.
Posted by Susannah Fox at 9:48 AM | Link to This Entry
OneWebDay is less than two months away
Monday, July 28, 2008 | Pew Internet Posts
I am honored to be today's ambassador for OneWebDay which will be celebrated on September 22, 2008. The idea behind OneWebDay is simple: let's set aside one day a year to reflect with others about how the internet has affected our lives. The brainchild of Susan Crawford, 2006 was the first year for OneWebDay. This year, the theme is the internet and participatory democracy.
My reflections on this theme start with data, unquestionably an occupational hazard for me. At the Pew Internet Project, we have tracked the growing number of people who use the internet to follow political campaigns. Check out our latest on the topic: The Internet and the 2008 Election. A striking figure from in that report is this:
Posted by John Horrigan at 8:43 AM | Link to This Entry
New numbers for blogging and blog readership
Tuesday, July 22, 2008 | Pew Internet Posts
Because blogs have been in the news lately with the Netroots Nation and BlogHer conferences recently wrapping up, it seemed like an opportune time to post our latest figures for blogging and blog readership.
Blog reading
In our spring tracking survey we took two new measurements of blog reading, each of which captures a slightly different set of behaviors. Our first measure of blog readership uses the present-tense question, "Do you ever read someone else's online journal or blog?". In total, 33% of internet users (the equivalent of 24% of all adults) say they read blogs, with 11% of internet users doing so on a typical day.
Our second blog readership question is based on a slightly different question construction: the past-tense "Have you ever read someone else's online journal or blog?" This figure is consistently higher than the one discussed above; this is because its wording captures people who once read blogs but now do not for whatever reason. 42% of internet users (representing 32% of all adults) answer this question affirmatively.
In addition to serving as example of the power of question wording, there are also some interesting demographic differences in our two blog readership questions. For example, male and female internet users are equally likely to say that they do read other people's blogs (35% for men, 32% for women). However, among internet users men are more likely to say that they have read other people's blogs (48% vs. 38%). We suspect that this is due to the male-heavy nature of the initial blog readership population--men are generally heavily represented among the early adopters for most technologies, but women catch up over time. Due to the way the second question is worded, it captures some of those (largely male) early adopters who are not captured in the first question.
Blog creation
We only asked one question about blog creation, making these figures fairly straightforward. 12% of internet users (representing 9% of all adults) say they ever create or work on their own online journal or blog. For a majority of bloggers, working on their blog is not an every-day activity: 5% of internet users blog on a typical day. This question uses the same present-tense construction as the first blog readership question above.
Posted by Aaron Smith at 11:15 AM | Link to This Entry
Internet Access Among Older Adults
Monday, July 21, 2008 | Pew Internet Posts
Pew Internet Project data is quoted in an AP story about how John McCain is not a frequent internet user, so I thought I'd highlight some sources for people who want to explore the numbers for themselves:
Home Broadband 2008 (report based on April-May 2008 survey data, which is quoted in the AP story)
Who's Online (our fall 2007 survey data)
Internet Activities (our fall 2007 survey data)
Generations Online (report based on 2005 data, not to be confused with Generations on Line, which provides internet training and tips for older adults)
And, of course, we have data about The Internet and the 2008 Election
Posted by Susannah Fox at 8:45 AM | Link to This Entry
Doctors' Digital Footprints
Friday, July 18, 2008 | Pew Internet Posts
The Journal of the American Medical Association recently published an article about how doctors should be aware of how they are portrayed online and consider taking steps to manage their digital identities.
It is an article that, for the most part, could have been written about any profession with its warnings about "slanderous information published about someone with the same name" or "by a vengeful…colleague or ex-lover." And the advice given is also familiar: create your own web page to be sure correct information is available about you and use appropriate privacy settings on social network sites.
One piece of advice is different from other articles on this topic: "Talk to patients about how they are using the internet." Danny Sands, MD, gives fellow doctors the same advice, but more because he believes that someone's level of internet savvy is a key piece of information, particularly since many patients report that online information affects their health care decision-making.
In this case, however, the authors advise physicians, especially those treating young adults or adolescents "who commonly use the internet," to stay alert to the possibility that their patients may know "revealing information about favorite sports teams, social causes, musical tastes, sexual orientation, and political leanings" about them. Indeed, the authors set the tone for the article by warning that "those seeking information…are potentially clinging, possibly personality disordered, or perhaps even threatening," citing a 1978 New England Journal of Medicine article entitled, "Taking Care of the Hateful Patient."
Since our study, Digital Footprints, found that most people do not feel compelled to limit the amount of information found about them online and few closely monitor their digital identities, I can see why the authors want to raise the alarm with their peers. In addition, it is a fairly common practice to search for information about someone else -- half of internet users have done so, including 11% who searched for someone they are thinking about hiring. However, if that is "disordered" behavior, we have an epidemic on our hands thanks to the power of search engines.
Posted by Susannah Fox at 11:07 AM | Link to This Entry
Do we have a right to online privacy?
Friday, July 11, 2008 | Pew Internet Posts
The Senate Commerce Committee held a hearing on Wednesday about the privacy implications of online advertising. Present for Congress's first real consideration of the issue were representatives from big-name internet companies such as Google, Microsoft and Facebook. In addition were privacy experts from the Center for Democracy & Technology and the Competitive Enterprise Institute, who followed up the hearing with a heated discussion on the PBS News Hour.
Google argued that advertisements, their main source of revenue, are what allow them to keep the bulk of their services free for customers. Targeted ads, they suggested, are also beneficial to customers because they don't bog us down with largely useless information. Online shoppers or web surfers are exposed only to ads deemed relevant to them – or to what their data say about them.
So, what information do internet companies collect for advertising? On a typical search Google will collect your IP address, operating system, browser type, requested search query and cookies. Although generally none of the information collected is personally identifiable, internet users are still largely unaware of internet companies' – and third-party advertisers' – collection methods and use of their information.
But, while the ads that often bombard the tops, bottoms and sides of our computer screens sometimes seem a bit eerie to the average user, privacy experts have even greater concerns. Is any of the information personally identifiable? Even if it isn't, could enough small pieces of that information be combined to paint a big enough picture that could be used to identify us personally? Could it then fall into the wrong hands or become public?
Congress is exploring new federal privacy protections that would make data collection more transparent and secure. They are looking to set a baseline for how information can be gathered and used; for example, limiting the use of information to the purpose for which it was originally collected.
The Pew Internet Project has explored consumers' awareness of their digital audit trails in two recent reports, "Privacy Implications of Fast, Mobile Internet Access" and "Digital Footprints."
Posted by Sydney Jones at 13:35 PM | Link to This Entry
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