Next Article in Journal
Therapeutic Alliance: A Comparison Study between Adolescent Patients and Their Therapists
Previous Article in Journal
New Media Literacy, Health Status, Anxiety, and Preventative Behaviors Related to COVID-19: A Cross-Sectional Study in Taiwan
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Profile of the Users and the Most Visited Topics of a Pediatric eHealth Website

by
Bruno José Nievas-Soriano
1,
Gracia María Castro-Luna
1,*,
Sonia García-Duarte
2,
María del Carmen González-López
3 and
Tesifón Parrón-Carreño
1
1
Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain
2
Obstetrics and Gynecology Unit, Hospital Torrecárdenas, 04009 Almería, Spain
3
Primary Health Care District of Almería, Andalusian Health Service, 04006 Almería, Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2021, 18(21), 11248; https://doi.org/10.3390/ijerph182111248
Submission received: 3 October 2021 / Revised: 23 October 2021 / Accepted: 25 October 2021 / Published: 26 October 2021

Abstract

:
Parents need information about their children’s health, and the Internet has become an essential repository for this information. However, there is almost no information about which topics are the most searched, consulted, or shared, or about the main characteristics of pediatric website users. The main aim of this research was to describe the profile of the users of a pediatric website, which topics they searched for, which topics were the most consulted, and which were the most shared. Users’ demographic data were analyzed regarding their use of the Internet to search for information about health. A pediatric website for parents was analyzed. A 26-item questionnaire collected demographical features of the users of the website. Descriptive and analytical analyses were performed. Most participants used general search engines for their health searches, and the most searched keywords were prurigo, barking cough, and laryngitis. The most visited topics were unexplained fever, snots, and laryngitis. The most shared were snots, lipotomy, and dizziness. The users were mainly women (67.8%), with an average age of 38.8 years, and one or two children (89%) with a mean age of 4.6 years. The users who mainly used the Internet for health purposes were women of younger age, and with a higher educational level.

1. Introduction

The interest of users in the Internet as a tool for seeking health-related information is growing [1]. Parents need information about their children’s health, and the Internet is a growing resource from which to obtain this information [2]. For this reason, parents are increasingly accessing the web in search of information on health [3,4]. However, there are no references about the main characteristics of these users and how they may affect the use of health portals [5].
According to the literature, women use the Internet more than men in regard to health [3,6,7,8,9,10], and they also participate more in studies on eHealth interventions [11]. Young adults seem to perform more health searches on the Internet [3,7,8,9,12,13] due to their higher digital skills [14]. More educated users use the Internet more in regard to health [7,9,12,13,15,16], as do people with higher incomes [13,17,18]. Geographically, according to some authors, users who live in urban areas perform more health searches on the Internet [11], while others point out that this would be the case for those who live further away from medical services [15].
In the pediatric setting, the likelihood of performing health searches on the Internet could be related to the number of visits to a pediatrician [3,15]. These health searches occur even before a visit to a doctor [4]. Although little is known about how they are performed [19,20], there does seem to be a consensus in the literature that most parents use general search engines, such as Google, to perform searches on their children’s health [3,18,21,22,23,24,25,26]. Only 1% of the users use social media such as Facebook [3], although their use is increasing [14,23,27]. Parents of children with serious diseases are more active searchers [4,6], as are those of children with chronic diseases [6,16,28,29], although some authors have found no differences in the latter group [30]. However, there is no scientific literature on what parents are searching for when they arrive at a pediatric website, the topics they consult most on these websites, and how they share them.
Therefore, the main objective of this study was to describe the profile of the users of a pediatric website, written in an easy language and with a simple interface, and to find out what topics they searched for to access the website, what topics they consulted within the website, and what topics they shared with other users. In addition, the users’ demographic data were analyzed in regard to their use of the Internet to search for health topics.

2. Materials and Methods

For the study, we used a pediatric website for parents, written in Spanish, open access and free, where 338 pediatric topics with information based on scientific evidence about symptoms, diseases, and care of a healthy child, written in simple language by a pediatrician, could be located and consulted. The website was available at https://notodoespediatria.com (accessed on 2 October 2021), and it was developed using the free web hosting service WordPress.com (Automattic Inc., San Francisco, CA, USA). The main objective of the website was to allow parents to access evidence-based pediatric information, and it was certified by the Health on the Net Foundation. The interface of the website was designed to be easily usable by any kind of user. The background was white, the text black, and the images used were simple drawings with soft colors. The different sections of the website were accessible from a menu located at the head of the home page. On the right, a search engine allowed users to find any term within the website. When this research was performed, the website had been working for five years and six months.
Data on visits, visitors, most visited topics, search keywords, most shared topics, and shared topics were obtained from the WordPress servers. The two units of measurement for website traffic were visits and unique visitors: visits were counted when a visitor loaded a page, and unique visitors were counted when a user was detected for the first time in a specific period.
A 26-item questionnaire was designed to obtain a demographic profile of the website users (Table 1). No personal data were collected that would allow for the identification of participants. The questionnaire was developed using Google Forms (Google L.L.C., Mountain View, CA, USA) and remained active for website visitors for eight weeks. An informed consent form was displayed on the first page of the questionnaire, informing participants about the conditions of the study, its objectives, that the questionnaire was anonymous and therefore did not collect personal data, and that participants could leave the questionnaire at any time. No economic incentives were offered.
To perform univariate analysis, central tendencies and dispersion measurements were calculated for quantitative variables; absolute and relative frequencies were used for qualitative variables. The Kolmogorov–Smirnoff test was applied to establish the goodness of fit to normality for the variables studied, to determine the use of parametric or non-parametric tests. For means and proportions, 95% confidence intervals (CIs) were calculated. To perform bivariate analysis, the non-parametric Mann–Whitney U test was used for the contrast of the hypothesis of the equality of quantitative variables; for qualitative ones, the Pearson chi-squared test was used; and for the correlation of quantitative variables, Spearman’s rho was used. The statistical analyses were performed using S.P.S.S. version 26 (I.B.M. Inc., Armonk, NY, USA).
All the procedures described in this study were approved by the Human Research and Bioethics Committee of the University of Almería (Spain), reference number UALBIO2020/023.

3. Results

This section may be divided by subheadings. It should provide a concise and precise description of the experimental results, their interpretation, as well as the experimental conclusions that can be drawn.

3.1. Most Visited Topics, Most Used Keywords, and Most Shared Topics

At the time of data collection for this study, the website had been working over five years and six months, and it had received 2,909,785 visits, made by 2,432,167 unique visitors. The 25 most visited topics during are shown in Table 2. These 25 topics constituted 70.5% of the total number of visits (n = 2,052,102). The most visited topics were unexplained fever, snots, and laryngitis. The least visited topics, of the 338 posted on the website, were: alcohol intake in adolescents (n = 22), compulsive intake in children (n = 16), and suicide attempts in children and adolescents (n = 15).
WordPress detected 43,559 terms, words, and phrases users used in general search engines, such as Google, to access entries and pages of the website. The 25 most used keywords are shown in Table 3 and constituted 37.2% (n = 16,215) of the keywords used to access the website. The most frequently used were prurigo (used 3735 times), kennel cough (1848 times), and laryngitis (1296 times). Some search engines did not disclose search terms for privacy reasons, so they were shown as unknown search terms when search terms were not known. The total number of unknown search terms was 1,774,427.
Some of the topics of the website were shared, via the links available on the WordPress platform itself, a total of 2949 times. The most used social media were Facebook (1688 topics shared) and Twitter (1259 topics shared). The most shared topics are shown in Table 4. These include snots in children (shared 124 times), syncope, lipotomy and dizziness (shared 97 times), and laryngitis (shared 86 times).

3.2. Demographical Aspects of the Survey Participants

During the eight weeks that the questionnaire was available, the website received 117,032 visits from 98,577 unique visitors, of which 0.52% (n = 516) participated in the study by completing 516 valid questionnaires. Their main demographical features are shown in Table 5. The mean age of the participants of the study was 38.8 years, with a standard deviation (S.D.) of 6.1 years; 67.8% (n = 350) were women; 73.8% (n = 381) had university or higher education; 65.6% (n = 339) reported a household income of over 26,000 euros per year; 92.2% (n = 476) resided in Spain; and 78.1% (n = 403) lived in urban areas.

3.3. Demographic Aspects of Participants’ Children

The demographical features of their children are shown in Table 6. A total of 89% of the study participants (n = 459) had one or two children; 14.5% (n = 75) had children with chronic diseases; and 3.9% (n = 20) had children with serious diseases. Regarding the frequency with which they visited a pediatrician, 52.5% of the participants (n = 271) reported visiting a pediatrician three or fewer times a year; 47.4% of participants (n = 154) reported visiting a pediatrician between four and seven times a year; and 17.6% of participants (n = 91) reported visiting a pediatrician more than eight times a year.

3.4. Use of the Internet for Health Aspects

Regarding the use of the Internet for health aspects (Table 7), a total of 98.4% of the participants (n = 508) had access to the Internet on their smartphones, and 53.3% (n = 275) regularly accessed the Internet using that device. A total of 95.3% of the participants (n = 492) accessed the Internet several times a day, and 94.2% of the participants (n = 486) used the Internet for health searches. A total of 81.8% of the participants (n = 422) used general search engines for these searches; 72% of the participants (n = 371) relied on the Internet for health issues related to them; 65% (n = 335) relied on the Internet for health searches related to their children; and 86.1% of the participants (n = 444) reported that they could find information about children’s health on the Internet. A total of 50.4% of the participants (n = 260) reported that the information found on the Internet had never influenced their decision to visit a doctor, and 41.5% (n = 214) reported that it had influenced their decision to visit a pediatrician.

3.5. Use of the Analyzed Website

Regarding the data related to the specific use of the website (Table 8), a total of 45.5% of the participants (n = 235) knew about the website through social networks, and 54.7% of the participants (n = 282) accessed it using their smartphone. A total of 51.6% of the participants (n = 266) had known about it for more than a year, and 80.4% (n = 415) had accessed it between one and ten times. A total of 25.8% of the participants (n = 133) stated that they were searching for information, before visiting a pediatrician, when they accessed the website for the first time.

3.6. Bivariate Analysis

Bivariate analysis of the data stated these following aspects: A total of 96.6% of the women in our study (n = 338) reported using the Internet for health searches, compared to 89.2% (n = 148) of the men (chi-square = 11.30; p < 0.001). The mean age of participants who reported using the Internet for health searches (38.6 years) was significantly lower than the mean age of those who did not (41.8 years) (Mann–Whitney U; p = 0.003). A total of 95.5% of participants (n = 364) with an undergraduate or graduate degree reported using the Internet for health searches, compared to 88.4% of participants (n = 99) with a primary or secondary school education (chi-square = 7.73; p = 0.005). Among the study participants, no association was found between household income level and greater use of the Internet for health searches (chi-square value, likelihood ratio = 8.6; p = 0.070). No differences were found between the use of the Internet for health searches and whether the participants lived in urban or rural areas (chi-square value, likelihood ratio = 0.038; p = 0.084).
There was a positive correlation between participants’ trust in the Internet for consulting about their own health and for consulting about their children’s health (Spearman’s rho correlation = 0.844; p < 0.001). There was no difference between using the Internet for health searches and having a child with a chronic illness (chi-square value = 0.321; p = 0.570) or with a severe illness (chi-square value, continuity correction = 0.750; p = 0.380). There were no differences in the frequency with which they visited a pediatrician and income level (Spearman’s rho correlation −0.064; p = 0.144). No statistically significant differences were found between using the Internet to perform health searches and the number of times they visited a pediatrician (Mann–Whitney U; p = 0.111).
There was a positive and significant correlation between the degree to which the participants in the study considered themselves capable of finding information about children’s health on the Internet and their confidence to consult health issues about their children on the Internet (Spearman’s rho correlation = 0.309; p < 0.001). There was also a positive and significant correlation between the degree to which they considered themselves able to find information about children’s health on the Internet and how confident they felt when using websites similar to the one analyzed (chi-square value, likelihood ratio = 19.196; p = 0.014). Women with a higher education level reported feeling more able to find information about children’s health on the Internet than those with primary or secondary education (chi-square value, likelihood ratio = 9.11; p < 0.001).

4. Discussion

Users, and specifically parents, increasingly demand more reliable health resources on the Internet [1,2,3,4]. Nevertheless, it is not easy to develop these resources without clearly knowing the profile of the users that are going to use them. As there are few studies about this specific aspect, we decided to perform research to acknowledge the main features of users of such websites. This could help actual and future developers of eHealth websites, especially if they are focused in pediatrics. Therefore, the main objective of this study was to describe the profile of the users of a pediatric website and to find out what topics they searched for to access the website, what topics they consulted within the website, and what topics they shared with other users. The demographic users’ data were analyzed concerning their use of the Internet to search about health topics.
According to numerous authors, most parents who use the Internet as a source of health information are women [6,7,16,27,31], who also tend to participate more in studies related to the use of the Internet for health [11], findings that we have confirmed in our results. Highly educated women tend to have higher eHealth competencies [31,32], which we also found in our study. In terms of age, young users tend to be more likely to use the Internet for issues about health [7,10,12,13,18], as we have also found. However, according to other studies, most parents would be younger than 35 years old [6,9], but in our study the mean age of the participants was higher (38.8 years).
Users with a higher educational level use the Internet more to search for health information [7,9,12,13,15,16,18], especially in the pediatric field [16], and the results of our study are concordant with this fact. On the other hand, there seems to be a positive association between having health competencies and trusting the Internet as a source of information [33]. The results of our study also seem to go in this direction.
For some authors, people with higher incomes use the Internet more concerning health aspects [13,17,18], while others have found no differences in this regard [15,30]. The results of our study are more in agreement with these latter studies. On the other hand, users who live in cities make more health searches on the Internet [11], while others point out that this would happen in those who live further away from medical services [15]. However, there are no differences in this regard [3,34], as was the case in our study.
Some authors report that users search for health information as often for themselves as for their relatives [15], while other studies describe that users tend to use the Internet more for information about others [35]. Our results agree with the first statement, as our users used and relied on the Internet for their own health and for that of their children. The likelihood of performing health searches could be related to the number of visits to a pediatrician [3,15], although there are authors that have not found such an association [28], as is the case with our results. Users with lower income levels could also consult a pediatrician more often [28]. However, we found no differences in this regard among the participants in our study.
There are no references in regard to how parents search for information [19,20]. These searches occur even before going to the doctor [4], and most users use general search engines, especially Google [3,21,22,23,24,25,26], something with which our results agree. Our study found that the terms most frequently used in general search engines to reach the analyzed website were prurigo, barking cough, and laryngitis. However, the most consulted topics on the same website were those related to fever without cause, snots, and laryngitis. Only 1% of users seem to use networks such as Facebook [3] to search about health, a figure similar to our findings. The importance of social networks is increasing however [14,23,27], which is consistent with the fact that most of the participants in the study reported having found out about the analyzed website through this medium. Indeed, Facebook was the social media most frequently used to share topics published on the website. Therefore, social media could be a good starting point to attract more users to websites such as the one analyzed. An important aspect to consider here is the use of friendly interfaces.
Parents of children with serious illnesses are more active searchers [4,6]. The same is true of parents of children with chronic diseases [6,16,26,28,29], although some authors have found no differences in the latter group [30]. In our study, we found no differences between using the Internet to perform health searches and having a child with a chronic or severe disease, although this could be related to the generalist nature of the Web. Thus, and differently to other studies on this topic, our research collected some aspects that could be important for developers when researching future pediatric eHealth resources: we found no differences among users regarding incomes, or if they lived near or far from medical services. Our users relied on the Internet for their health and the health of their children, and we found no differences, among users, regarding the number of visits to a pediatrician.
These results highlight the importance of increasing the people involved with health searches and the use of reliable pediatric eHealth resources. In our opinion, more studies are necessary to evaluate different aspects of eHealth websites from the point of view of the users. This way, we could analyze aspects such as their usability or perceived utility, among others. This research could help developers to make attractive interfaces for all kind of users. For this research, we selected come variables that could be interesting from the point of view of researchers. Our analysis allowed us to define the profile of the users of a pediatric website, highlighting features that allow us to conclude that perhaps we need to develop more usable interfaces. This way, we could attract more general users, who are less involved with technology, to access reliable scientific eHealth websites. Future research could study the potential correlation among the variables selected in this research.
The main limitation of this work is that, although the participants participated randomly, they did it voluntarily, thus generating a selection bias, which is unavoidable in open, online surveys [36]. There are also some limitations in the statistics provided by WordPress: in regard to the terms that users used in general search engines, such as Google, to access the website analyzed, the number of unknown terms was considerable, which may lead to a bias when interpreting these data. Concerning the most shared topics, WordPress shows the number of those shared from their platform, but it is not possible to know the topics that were shared by direct copying of links. Finally, it is essential to consider that the data obtained in this study come from the analysis of a specific website. Albeit it had been functioning for more than five years, the external validity of the results and the conclusions should be considered with caution. The greatest strength of this study lies in the fact that the website had been functioning over five years and six months, and it had received 2,909,785 visits, made by 2,432,167 unique visitors, when this research was performed. Regarding the data collected through the questionnaire, the sample was 516 participants, a figure higher than that recommended by other authors for studies of this type [37,38]. Finally, it is important that the sample and the data obtained came from real users of a pediatric website, which provides considerable value to this study for potential considerations about future eHealth developments in pediatrics.

5. Conclusions

The main characteristics of the users of the analyzed website, about pediatrics for parents, were the following: users were predominantly female, with an average age of 38.8 years, most of them lived in urban areas, and had one or two children with a mean age of 4.6 years. Most accessed the Internet several times a day, mainly from their smartphones, conducted online health searches, considered themselves capable to find information about children’s health online, and relied on the Internet for health information about their children. The most visited topics were fever without cause, snots, and laryngitis. The most shared topics were snots, syncope, and laryngitis. Facebook was the social network where the topics of the analyzed website were shared the most.
The users who most frequently used the Internet to search about health were young women with a high level of education. No differences were found regarding income level, area of residence, whether they had children with chronic or severe diseases, or the frequency with which they visited a pediatrician. Although most of the participants in our study reported using general search engines to perform online health searches, prurigo, barking cough, and laryngitis being the most searched terms, most of them reported having found our website through social networks. Our results also highlight the importance of increasing the people involved with health searches and the use of reliable pediatric eHealth resources. This way, we could analyze aspects such as their usability or perceived utility, among others. These aspects could be helpful when designing an eHealth pediatric website for parents.

Author Contributions

Conceptualization, B.J.N.-S., G.M.C.-L., S.G.-D., M.d.C.G.-L. and T.P.-C.; methodology, B.J.N.-S., G.M.C.-L., S.G.-D., M.d.C.G.-L. and T.P.-C.; formal analysis, B.J.N.-S., G.M.C.-L., S.G.-D., M.d.C.G.-L. and T.P.-C.; investigation, B.J.N.-S., G.M.C.-L., S.G.-D., M.d.C.G.-L. and T.P.-C.; data curation, B.J.N.-S., G.M.C.-L., S.G.-D., M.d.C.G.-L. and T.P.-C.; writing—original draft preparation, B.J.N.-S., G.M.C.-L., S.G.-D., M.d.C.G.-L. and T.P.-C.; writing—review and editing, B.J.N.-S., G.M.C.-L., S.G.-D., M.d.C.G.-L. and T.P.-C.; supervision, B.J.N.-S. and T.P.-C. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

All the procedures described in this study were approved by the Human Research and Bioethics Committee of the University of Almería (Spain), reference number UALBIO2020/023.

Informed Consent Statement

An informed consent form was displayed on the first page of the questionnaire, informing participants about the conditions of the study, its objectives, that the questionnaire was anonymous and therefore did not collect personal data, and that participants could leave the questionnaire at any time.

Data Availability Statement

All data are contained within the article.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Li, F.; Li, M.; Guan, P.; Ma, S.; Cui, L. Mapping Publication Trends and Identifying Hot Spots of Research on Internet Health Information Seeking Behavior: A Quantitative and Co-Word Biclustering Analysis. J. Med. Internet Res. 2015, 17, e81. [Google Scholar] [CrossRef] [PubMed]
  2. van der Gugten, A.C.; de Leeuw, R.J.R.J.; Verheij, T.J.M.; van der Ent, C.K.; Kars, M.C. E-health and health care behaviour of parents of young children: A qualitative study. Scand. J. Prim. Health Care 2016, 34, 135–142. [Google Scholar] [CrossRef] [Green Version]
  3. Bujnowska-Fedak, M.M. Trends in the use of the Internet for health purposes in Poland. BMC Public Health 2015, 15, 194. [Google Scholar] [CrossRef] [Green Version]
  4. Vogel, T.K.; Kleib, M.; Davidson, S.J.; Scott, S.D. Parental Evaluation of a Nurse Practitioner-Developed Pediatric Neurosurgery Website. JMIR Res. Protoc. 2016, 5, e55. [Google Scholar] [CrossRef] [PubMed]
  5. Stinson, J.; Gupta, A.; Dupuis, F.; Dick, B.; Laverdière, C.; LeMay, S.; Sung, L.; Dettmer, E.; Gomer, S.; Lober, J.; et al. Usability Testing of an Online Self-Management Program for Adolescents with Cancer. J. Pediatr. Oncol. Nurs. 2015, 32, 70–82. [Google Scholar] [CrossRef] [PubMed]
  6. Esmaeilzadeh, P. Healthcare consumers’ opt-in intentions to Health Information Exchanges (HIEs): An empirical study. Comput. Hum. Behav. 2018, 84, 114–129. [Google Scholar] [CrossRef]
  7. Kubb, C.; Foran, H.M. Online Health Information Seeking by Parents for Their Children: Systematic Review and Agenda for Further Research. J. Med. Internet Res. 2020, 22, e19985. [Google Scholar] [CrossRef]
  8. Beck, F.; Richard, J.-B.; Nguyen-Thanh, V.; Montagni, I.; Parizot, I.; Renahy, E. Use of the Internet as a Health Information Resource among French Young Adults: Results from a Nationally Representative Survey. J. Med. Internet Res. 2014, 16, e128. [Google Scholar] [CrossRef]
  9. Spoelman, W.A.; Bonten, T.N.; de Waal, M.W.M.; Drenthen, T.; Smeele, I.J.M.; Nielen, M.M.J.; Chavannes, N.H. Effect of an evidence-based website on healthcare usage: An interrupted time-series study. BMJ Open 2016, 6, e013166. [Google Scholar] [CrossRef] [Green Version]
  10. Zhang, H.; Zhang, H.; Wang, X.; Yang, Z.; Zhao, Y. Analysis of Requirements for Developing an mHealth-Based Health Management Platform. JMIR mHealth uHealth 2017, 5, e117. [Google Scholar] [CrossRef] [Green Version]
  11. Juvalta, S.; Kerry, M.J.; Jaks, R.; Baumann, I.; Dratva, J. Electronic Health Literacy in Swiss-German Parents: Cross-Sectional Study of eHealth Literacy Scale Unidimensionality. J. Med. Internet Res. 2020, 22, e14492. [Google Scholar] [CrossRef]
  12. Ćwiklicki, M.; Schiavone, F.; Klich, J.; Pilch, K. Antecedents of use of e-health services in Central Eastern Europe: A qualitative comparative analysis. BMC Health Serv. Res. 2020, 20, 171. [Google Scholar] [CrossRef] [Green Version]
  13. Takahashi, Y.; Ohura, T.; Ishizaki, T.; Okamoto, S.; Miki, K.; Naito, M.; Akamatsu, R.; Sugimori, H.; Yoshiike, N.; Miyaki, K.; et al. Internet Use for Health-Related Information via Personal Computers and Cell Phones in Japan: A Cross-Sectional Population-Based Survey. J. Med. Internet Res. 2011, 13, e110. [Google Scholar] [CrossRef] [PubMed]
  14. Shaw, T.; McGregor, D.; Brunner, M.; Keep, M.; Janssen, A.; Barnet, S. What is eHealth (6)? Development of a Conceptual Model for eHealth: Qualitative Study with Key Informants. J. Med. Internet Res. 2017, 19, e324. [Google Scholar] [CrossRef] [PubMed]
  15. Baumann, E.; Czerwinski, F.; Reifegerste, D. Gender-Specific Determinants and Patterns of Online Health Information Seeking: Results from a Representative German Health Survey. J. Med. Internet Res. 2017, 19, e92. [Google Scholar] [CrossRef] [Green Version]
  16. Park, E.; Kim, H.; Steinhoff, A. Health-Related Internet Use by Informal Caregivers of Children and Adolescents: An Integrative Literature Review. J. Med. Internet Res. 2016, 18, e57. [Google Scholar] [CrossRef]
  17. Shroff, P.L.; Hayes, R.W.; Padmanabhan, P.; Stevenson, M.D. Internet Usage by Parents Prior to Seeking Care at a Pediatric Emergency Department: Observational Study. Interact. J. Med. Res. 2017, 6, e17. [Google Scholar] [CrossRef]
  18. Goldman, R.D. Online resources in pediatrics. Can. Fam. Physician 2014, 60, 443–444. [Google Scholar]
  19. Neill, S.; Roland, D.; Jones, C.H.; Thompson, M.; Lakhanpaul, M. Information resources to aid parental decision-making on when to seek medical care for their acutely sick child: A narrative systematic review. BMJ Open 2015, 5, e008280. [Google Scholar] [CrossRef] [Green Version]
  20. Manganello, J.A.; Falisi, A.L.; Roberts, K.J.; Smith, K.C.; McKenzie, L.B. Pediatric injury information seeking for mothers with young children: The role of health literacy and ehealth literacy. J. Commun. Healthc. 2016, 9, 223–231. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  21. Park, E.; Kwon, M. Health-Related Internet Use by Children and Adolescents: Systematic Review. J. Med. Internet Res. 2018, 20, e120. [Google Scholar] [CrossRef] [Green Version]
  22. Mackert, M.; Kahlor, L.; Tyler, D.; Gustafson, J. Designing e-Health Interventions for Low-Health-Literate Culturally Diverse Parents: Addressing the Obesity Epidemic. Telemed. eHealth 2009, 15, 672–677. [Google Scholar] [CrossRef] [Green Version]
  23. Chung, M.; Oden, R.P.; Joyner, B.L.; Sims, A.; Moon, R.Y. Safe Infant Sleep Recommendations on the Internet: Let’s Google It. J. Pediatr. 2012, 161, 1080–1084.e1. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  24. Iftikhar, R.; Abaalkhail, B. Health-Seeking Influence Reflected by Online Health-Related Messages Received on Social Media: Cross-Sectional Survey. J. Med. Internet Res. 2017, 19, e382. [Google Scholar] [CrossRef]
  25. Smith, D.A. Situating Wikipedia as a health information resource in various contexts: A scoping review. PLoS ONE 2020, 15, e0228786. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  26. Fox, S. After Dr Google: Peer-to-Peer Health Care. Pediatrics 2013, 131, S224–S225. [Google Scholar] [CrossRef] [Green Version]
  27. Nicholl, H.; Tracey, C.; Begley, T.; King, C.; Lynch, A.M. Internet Use by Parents of Children with Rare Conditions: Findings from a Study on Parents’ Web Information Needs. J. Med. Internet Res. 2017, 19, e51. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  28. Harvey, S.; Memon, A.; Khan, R.; Yasin, F. Parent’s use of the Internet in the search for healthcare information and subsequent impact on the doctor–patient relationship. J. Med. Sci. 2017, 186, 821–826. [Google Scholar] [CrossRef]
  29. Boogerd, E.A.; Noordam, C.; Verhaak, C.M. The Sugarsquare study: Protocol of a multicenter randomized controlled trial concerning a web-based patient portal for parents of a child with type 1 diabetes. BMC Pediatr. 2014, 14, 24. [Google Scholar] [CrossRef] [Green Version]
  30. Mitchell, S.J.; Godoy, L.; Shabazz, K.; Horn, I.B. Internet and Mobile Technology Use Among Urban African American Parents: Survey Study of a Clinical Population. J. Med. Internet Res. 2014, 16, e9. [Google Scholar] [CrossRef]
  31. de Graaf, M.; Totte, J.; Breugem, C.; van Os-Medendorp, H.; Pasmans, S. Evaluation of the Compliance, Acceptance, and Usability of a Web-Based eHealth Intervention for Parents of Children with Infantile Hemangiomas: Usability Study. JMIR Res. Protoc. 2013, 2, e54. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  32. Sebelefsky, C.; Voitl, J.; Karner, D.; Klein, F.; Voitl, P.; Böck, A. Internet use of parents before attending a general pediatric outpatient clinic: Does it change their information level and assessment of acute diseases? BMC Pediatr. 2016, 16, 129. [Google Scholar] [CrossRef] [Green Version]
  33. Diviani, N.; van den Putte, B.; Giani, S.; van Weert, J.C. Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature. J. Med. Internet Res. 2015, 17, e112. [Google Scholar] [CrossRef] [Green Version]
  34. Serafica, R.; Inouye, J.; Lukkahatai, N.; Braginsky, N.; Pacheco, M.; Daub, K.F. The Use of Mobile Health to Assist Self-management and Access to Services in a Rural Community. CIN Comput Inform UN 2019, 37, 62–72. [Google Scholar] [CrossRef]
  35. Hossain, N.; Yokota, F.; Sultana, N.; Ahmed, A. Factors Influencing Rural End-Users’ Acceptance of e-Health in Developing Countries: A Study on Portable Health Clinic in Bangladesh. Telemed eHealth. 2019, 25, 221–229. [Google Scholar] [CrossRef] [PubMed]
  36. Eysenbach, G. Improving the Quality of Web Surveys: The Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J. Med. Internet Res. 2004, 6, e34. [Google Scholar] [CrossRef] [PubMed]
  37. Kline, R.B. Principles and Practices of Structural Equation Modelling, 4th ed.; The Guilford Press: New York, NY, USA, 2016; ISBN 9781609182304. [Google Scholar]
  38. Paiva, P.C.P.; de Paiva, H.N.; de Oliveira Filho, P.M.; Lamounier, J.A.; de Ferreira, E.F.; Ferreira, R.C.; Kawachi, I.; Zarzar, P.M. Development and Validation of a Social Capital Questionnaire for Adolescent Students (SCQ-AS). PLoS ONE 2014, 9, e103785. [Google Scholar] [CrossRef] [Green Version]
Table 1. Demographical data collected.
Table 1. Demographical data collected.
About User’s Profile
Gender
Age
Level of study
Income level
Country of residence
Urban or rural world
About Their Children
Number of children
Age of their youngest child
Children with chronic illnesses
Children with severe illnesses
Number of pediatrician appointments within the last year
Internet Use about Health
The device usually used to access the Internet
If they had access to the Internet via their mobile phone
How often they accessed the Internet
If the Internet was used to perform searches about health
If the Internet had influenced a decision to go to the doctor
If the Internet had influenced a decision to go to a pediatrician
Frequency of health-related searches on the Internet
How much they relied on the Internet for their health
How much they relied on the Internet for their children’s health
If they felt capable of finding information about children’s health on the Internet
About Access to the Pediatric Website
How they knew about the website
How they accessed the website
How long they had known about the website
How many times they had consulted the website
What they were searching for the first time they accessed the website
Table 2. Twenty-five most visited topics of the website.
Table 2. Twenty-five most visited topics of the website.
Twenty-Five Most Visited Topics of the Websiten%
Fever for no apparent reason330,46610.4
Snots in children283,5909.8
Laryngitis (barking cough)252,5208.7
Presence of blood in stool (rectorrhagia)181,3196.2
Syncope, lightheadedness, dizziness, or fainting146,9125.1
Children who poop without meaning to (encopresis)111,3383.8
Swollen lymph nodes or lymph nodes94,1103.2
Prurigo (skin lesions or papules)89,0043.1
Cephalohematoma and caput succedaneum48,2701.7
Umbilical cord infection (omphalitis)47,7691.6
Dizziness and vertigo in children42,3211.5
Dental caries41,6131.4
Bleach or caustic poisoning40,6751.4
Parasitic infections in children40,6531.4
Infant colic37,3581.3
Facial paralysis in children30,3541.0
Large head (macrocephaly)30,2351.0
Fever28,8750.9
Constipation27,6640.9
Diarrhea or acute gastroenteritis27,0610.9
Aphthous ulcers (stomatitis, mouth sores, or ulcers)25,9130.8
Anemia of infancy (or physiological anemia of lactation)24,3330.8
Enlargement of the spleen (splenomegaly) in children24,3070.8
Normal psychomotor development in 6 to 11 years old children22,9620.8
Ibuprofen poisoning in children22,4800.7
Total2,052,10270.5
Table 3. Most used keywords in general search engines.
Table 3. Most used keywords in general search engines.
Most Used Keywords in General Search Enginesn%
Prurigo37358.6
Barking cough18484.2
Laryngitis in children12962.9
Fever in children with no apparent cause10922.5
Macrocephaly8832.0
Cephalohematoma8491.9
Kennel cough in children6871.6
Fever without symptoms6631.5
Childhood laryngitis4631.1
Thelarche4381.0
Fever in children without symptoms4341.0
Laryngitis4210.9
Omphalitis3520.8
Fever without symptoms in children3280.7
Kennel cough in children3200.7
Fainting in children3050.7
Laryngitis in infants2620.6
Fever with no apparent cause2520.6
Bloody stools in children2400.6
Fever without apparent cause in children2390.6
Gibbering2280.5
Dizziness in children2260.5
Snotty throat, baby2240.5
Lipotomy in children2200.5
Pediatrics2100.5
Total16,21537.2
Table 4. Most shared topics from the website.
Table 4. Most shared topics from the website.
Most Shared Topics from the Websiten%
Snots in children1244.2
Syncope, lightheadedness, dizziness, or fainting in children973.3
Laryngitis (barking or hoarse cough)862.9
Fever for no apparent reason692.3
Infant colic451.5
Limping in infancy421.4
Children who poop without meaning to (encopresis)411.4
Pharyngitis, tonsillitis, and pharyngotonsillitis391.3
Prurigo (skin lesions or papules)351.2
All about Bexsero, the vaccine against meningitis321.1
Hallucinations in children (phobic hallucinations)321.1
Swollen lymph nodes or lymph nodes321.1
Food allergies in children311.1
Inflammation of the gums (gingivitis)301.0
Homepage301.0
Large head (macrocephaly)270.9
Presence of blood in stool (rectorrhagia)250.8
Constipation240.8
Aphthous ulcers (stomatitis or mouth ulcers)230.8
Umbilical cord infection (omphalitis)230.8
Sleep in children220.8
Coffee-with-milk spots on the skin in children200.7
Premature thelarche (breast development)200.7
Children who do not eat properly200,7
Bleach (caustic) poisoning190.6
Total294933.5
Table 5. Demographic data of participants.
Table 5. Demographic data of participants.
Distribution by AgeMeanS.D.
38.86.1
Distribution by Sexn%
Female35067.8
Male16632.2
Distribution by the Level of Studyn%
Masters or postgraduate degree12824.8
University studies25349.0
Secondary school or baccalaureate9217.8
Primary or school graduate203.9
Others234.5
Distribution by Income Leveln%
More than EUR 75.000/year5711.0
Between EUR 51.000 and 75.000/year9217.8
Between EUR 26.000 and 50.000/year19036.8
Between EUR 11.000 and 25.000/year13325.8
Less than EUR 10.000/year448.5
Distribution by Place of Residencen%
Spain47692.2
Central/South America244.7
North America122.3
Another European country30.6
Africa10.2
Distribution by Geographical Arean%
Urban40378.1
Rural11321.9
Total Number of Participants516100
Table 6. Demographic data of participants’ children.
Table 6. Demographic data of participants’ children.
Distribution by AgeMeanS.D.
4.64.0
Distribution by the Number of Childrenn%
One18235.3
Two27753.7
Three or more397.6
None183.5
Children with Chronic Illnessesn%
Yes7514.5
No40979.3
It is under study326.2
Children with Serious Illnessesn%
Yes203.9
No49095.0
It is under study61.2
Frequency of Pediatric Visitsn%
Between 0 and 1 time a year12524.2
Between 2 and 3 times a year14628.3
Between 4 and 7 times a year15429.8
Between 8 and 10 times a year6212.0
More than 10 times a year295.6
Total Number of Participants516100
Table 7. Use of the Internet for health aspects.
Table 7. Use of the Internet for health aspects.
Device Usually Used to Access the InternetN%
Smartphone27553.3
Computer5210.1
Tablet203.9
Indistinct16932.8
You Have Access to the Internet on Your Mobile PhoneN%
Yes50898.4
No81.6
The Frequency You Usually Access the InternetN%
Several times a day49295.3
Once a day, or less244.7
Use of the Internet to Perform Health SearchesN%
Yes48694.2
No305.8
How Health Information Is Searched on the InternetN%
Use of general search engines, such as Google42281.8
I access directly the websites I want to consult8416.3
Other ways (Facebook pages, online forums, etc.)101.9
Confidence on the Internet to Consult about Their HealthN%
A lot71.4
Quite a lot9919.2
Something26551.4
Little13325.8
Nothing122.3
Confidence on the Internet to Consult about Their Children’s HealthN%
A lot71.4
Quite a lot8015.5
Something24848.1
Little15029.1
Nothing316.0
The Extent to Which the Users Considered Themselves Capable to Find Information about Children’s Health on the InternetN%
Highly skilled6312.2
Quite capable19938.6
Somewhat capable18235.3
Poorly trained6612.8
Not trained at all61.2
The Health Searches Have Influenced Whether to See a DoctorN%
Yes26050.4
No23044.6
I do not know265.0
The Health Searches Have Influenced Whether to See a PediatricianN%
Yes21441.5
No26050.4
I do not know428.1
Total Number of Participants516100
Table 8. Data related to the use of the analyzed website.
Table 8. Data related to the use of the analyzed website.
How the Website Was Foundn%
Through search engines6111.8
Through social networks23545.5
Recommendation through a message6011.6
By verbal recommendation in a non-health environment5610.9
Verbal recommendation from a health professional479.1
By two or more of these ways458.7
None of these ways122.3
Which Device Was Used to Access the Websiten%
A smartphone28254.7
Computer8316.1
Tablet214.1
Indistinct13025.2
How Long the Website Was Knownn%
More than one year26651.6
Between 1 and 12 months6813.2
Less than a month18235.3
How Many Times the Website Had Been Visitedn%
Between 1 and 5 times28855.8
Between 5 and 10 times12724.6
Between 10 and 20 times6111.8
More than 20 times407.8
What the User Was Searching for the First Time the Website Was Accessedn%
Information before a pediatrician appointment13325.8
Expand on information given by a physician or pediatrician10921.1
Healthy child information7013.6
Information before going to the emergency room5310.3
Clarify something not understood in the consultation or the emergency room448.5
Others10720.7
Total Number of Participants516100
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Share and Cite

MDPI and ACS Style

Nievas-Soriano, B.J.; Castro-Luna, G.M.; García-Duarte, S.; González-López, M.d.C.; Parrón-Carreño, T. Profile of the Users and the Most Visited Topics of a Pediatric eHealth Website. Int. J. Environ. Res. Public Health 2021, 18, 11248. https://doi.org/10.3390/ijerph182111248

AMA Style

Nievas-Soriano BJ, Castro-Luna GM, García-Duarte S, González-López MdC, Parrón-Carreño T. Profile of the Users and the Most Visited Topics of a Pediatric eHealth Website. International Journal of Environmental Research and Public Health. 2021; 18(21):11248. https://doi.org/10.3390/ijerph182111248

Chicago/Turabian Style

Nievas-Soriano, Bruno José, Gracia María Castro-Luna, Sonia García-Duarte, María del Carmen González-López, and Tesifón Parrón-Carreño. 2021. "Profile of the Users and the Most Visited Topics of a Pediatric eHealth Website" International Journal of Environmental Research and Public Health 18, no. 21: 11248. https://doi.org/10.3390/ijerph182111248

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop