Health information on the Internet: a qualitative study of NHS Direct Online users Peter Williams Paul Huntington and David Nicholas Introduction Health information has permeated the Internet. Electronic health information is becoming ubiquitous. Quite apart from the Government’s NHS Direct presence on the Internet there exist thousands of health Web sites of commercial, voluntary and individual origin. Medical support/discussion newsgroups have also flourished. For those without Web access touch-screen kiosks can be found in health centres, supermarkets and libraries, and the Internet itself is now accessible on touch-screen systems and digital television. Despite the huge economic and political investment in digital health information-provision there has been little evaluation of the investment in terms of its impact on the health consumer. The CIBER group at City University are working on a major Department of Health (DoH)-funded research project, ‘‘Digital Health’’ (Nicholas et al., n.d.), on the use and impact of the remote health information initiatives mentioned above. This paper reports on one study within this research programme: a qualitative examination of use of the Internet by the general public, using the somewhat novel method of an online survey that attempted to capture qualitative data from a small number of open questions. Much attention is afforded to the methodology, given its comparatively unusual nature. Aims and objectives The main aim of the research was to enrich data accrued from both computer transaction log analysis (see, for example, Nicholas et al., 2002a) and questionnaire surveys employing principally closed questions (Nicholas et al., 2001a, b, 2002a, b) measuring the use and impact of the Internet on the general public. The study was interested principally in the extent to which, and in what ways, the Internet was being employed with regard to people’s health. The objectives of the study were to examine: reasons behind people’s decisions both to look for health information and to consult the Internet for this purpose, and what drew people to the NHS Direct site in particular; how they use the Internet with regard to health (i.e. the number and type of The authors Peter Williams and Paul Huntington are Research Fellows and David Nicholas is Head of Department, all at the Centre for Information Behaviour and the Evaluation of Research (CIBER), Department of Information Science, City University, London, UK. E-mail: www.soi.city.ac.uk/organisation/is/research/ciber/ Keywords Internet, Health education, National Health Service, Quality, Surveys Abstract Examines the way the general public exploits the Internet for health information, the motives behind usage, attitudes towards issues such as quality concerns, and the extent to which Internet interventions affect the doctor-patient relationship. Although a questionnaire survey was used (posted on the NHS Direct Web site), the questions asked were open, and invited free-text ``qualitative’’ answers. This method was a success in terms of the amount and richness of the data accrued. Results suggested that the Internet is exploited in a wide variety of ways, by users acting in a number of roles ± patient, intermediary or professional. Some health professionals are now so comfortable with the Internet that they encourage Internet usage by their patients. Lay users demonstrated a high level of understanding of issues raised, and showed a (healthy?) scepticism regarding the information provided. Many users felt that their consultations with doctors had been enriched by Internet-acquired information. Electronic access The Emerald Research Register for this journal is available at http://www.emeraldinsight.com/researchregister The current issue and full text archive of this journal is available at http://www.emeraldinsight.com/0001-253X.htm 304 Aslib Proceedings Volume 55 . Number 5/6 . 2003 . pp. 304-312 # MCB UP Limited . ISSN 0001-253X DOI 10.1108/00012530310498879