This study was aimed to examine the correlation of online health information seeking behavior with the health-related quality of life in a sample of Iranian female students. Findings showed that online health information seeking experience have no statistical correlations with health-related quality of life components including physical component summary (P = .46) and mental component summary (P = .53).
Adolescence is a vital and effective period of life regarding health especially the health promoting behaviors. Statistics show that one fifth of the world's population is between the ages 10–19 with 85 percent living in developing countries. Promoting the adolescents’ health is one of the national development goals and satisfying the health needs of this population are among the top priorities of health systems around the world. Changing adolescents’ health-related behaviors and their lifestyle requires providing appropriate and complete health information for them [27]. Health information includes a range of information that can be used in personal and community health decisions [28]. Making health information accessible and considering the health information seeking behavior of adolescents can improve their health through the improvement of health literacy [29]. Girls play an important role in the health of today's and future society, and investing in improving their health is one of the most important strategies to achieve the global health goals [30].
Health information is obtained from various sources. The Internet is an attractive and common source of health information today [16,28,31]. The use of the internet to access health information has increased in recent years due to the reasons such as accessibility, high volume of information disseminated trough that, confidentiality, low cost, multi-media capabilities and the ability to interact and to gain support [24,27,32]. Reports indicate that adolescents are increasingly spending their time for using internet. Using internet is part of young people's daily activities and they acquire and enhance many life skills, including health management, through online information [32].
A US national survey has found that 75 percent of online teens search health information [33]. A study in US also has reported that 98 percent of 12 years and older youth use online resources to search health information [34]. Another survey at two US educational institutes [35]; a study at three Ghanaian universities [32]; a study involving international students in East Asia [36] and a study at 6 colleges in Oman also have reported the similar results [37]. Therefore, although, Internet access is still limited in some countries [38,39] but it seems that internet is increasingly become a main information source in the majority of countries.
According to the Iran 2016 census, adolescents make up 8% of the country population that equals to 12 million people, half of whom are girls [30]. Iran has one of the highest rates of internet access in its region [24]. In Iran, as other countries, using the internet for health-related purposes has increased in recent years. A survey of adolescents in Shiraz, Iran, has showed that Internet is among the top sources of respondents' health information, with 88% using the internet to find a kind of health information [28]. Two other studies in Tehran high schools have reported the similar rates [40,41]. Another study on the students aged 15–18 years from different schools in Isfahan [27], a study involving 430 students from Gonabad University [42], two other studies at Gorgan and Kermanshah universities [29,43], Two other studies at Tabriz University and Tehran University of Medical Sciences have also have reported the similar results [24,44].
Overall, it seems that using internet as a source of health information is expanding; although, existing literature shows that searching online health information is correlated with some variables such as age, gender, education level, skills and experience of Internet use, health status and availability and reliability of sources [1,35,45].
Adolescents often seek health information with different objectives and motives [28,29,44] and they, typically seek information relating to the variety of health subjects such as healthy eating, physical activity, exercise, weight control, risks and complications of diseases treatments, sexual and reproductive health, sexual and physical abuse, alcohol consumption and other substances, tobacco use, mental health, accidents and injuries, health care providers and support groups [27,33,35,38,44].
Due to the increasing use of the Internet for health purposes, many studies have been conducted on the online health information seeking behavior in different demographic groups including students. Most of these studies have examined the sources of health information used by different groups, attitudes towards health information seeking, the aims and motivations, types of information sought and the factors related to health information seeking behavior [28]. But few studies have examined the actual effect of accessing online health information on the health status. In fact, the question that whether online health information seeking behavior significantly affects health status or no has largely remained unanswered,. Therefore, this study was aimed to explore the online health experience of Iranian girl students and its correlation with their health related quality of life.
The findings showed that majority of participants have good or to somehow good general health status. Numerous studies have been conducted on the general health status of adolescents in Iran; most of them have reported approximately similar findings [30].
Also, the descriptive findings of study regarding online health information seeking behavior showed that the participants have moderate scores regarding all sub-scales of eHIQ.
Regarding the attitudes to online health information and sharing them, a similar study aimed at explaining health information behavior of adolescents in Shiraz, has reported that participants' general attitude toward health information retrieved from the Internet is positive. The majority of participants also had a good trust to the quality of information and was interested in retrieving health information from Internet twice [28]. Another study at Tabriz University has reported that Internet is one of the trusted sources of health information for participants [44]. At the same time; a study in Isfahan schools has shown that more than 47 percent of those who did not use the Internet to search health information reported the lack of trust in Internet information as the main cause of their decision to don’t be online health information seeker [27]. Regarding sharing health information, a study in US has found that although 98% of participants were online health information seekers, only 51.5% of them shared their health information and only 25% of them thought that social media could provide usable health information. This study also, has reported that women have shared their health information more than men and adolescents between the ages 12–14 years more than other age groups. People with poor self-reported health and those who thought online sources could help them in accessing health information were also more likely to share their health information [34]. In summary, based on the available literature, it seems that trust in online health information and interest in sharing it are different across different socio-economic contexts. The participants of our study, also thought that information provided by health websites are moderately understandable. In this regard, many studies have reported the poor understandability of internet information as a main challenge of online users.
Statistical tests also showed that different dimensions of online health information seeking behavior have no significant correlations with health related quality of life. In this regard, in a survey of 400 school-age adolescents in Shiraz, respondents stated that they believe the retrieved online health information affects health status positively [28]. In another study at Tabriz University, participants approved the effects of their online health information seeking on the some health-related behaviors [45]. A study among the Nigerian students has found that only 50% of participants consulted with a physician about their health after searching online health information [38]. A study at 3 Ghanaian universities also reported that 72.4 percent of respondents used retrieved online information as a basis for lifestyles modifications and more than 73 percent of students stated that access to online health information improved or partially improved their health status, while 1.2 percent said that using Internet has no effect on their overall health [32].
Overall it seems that although Internet technology has provided a good opportunity to access health information, its practical impact on health status is still being controversial. This can have many explanations. Challenges such as the lack of appropriate information and inadequate quality, poor health literacy of internet users, insufficient skills in searching information, lack of trust in online health information sources and concerns about the security and confidentiality reduce the potential of internet in serving the health of population [27,33,44]. The production and dissemination of health misinformation is also a serious concern. Today, a large amount of health misinformation is also produced and published online, which is potentially a threat to public health [23]. Low internet access is also an infrastructure challenge in some parts of the world [38]. Therefore, it is necessary to formulate and apply improvement strategies to maximize the health benefits of internet. These strategies can be formulated in two levels: