Traditionally health advice has been anchored in face-to-face settings but increasingly patients are using the Internet for their health advice needs. This means that patients are now offered inconsistent advice from a range of sources and must determine which sites to trust and which to reject. To understand how consumers make these choices, 13 participants diagnosed with hypertension took part in a longitudinal study in which they searched for information and advice relevant to their condition. A content analysis of the group discussions revealed support for a staged model of trust in which mistrust or rejection of Websites is based on design factors and trust or selection of Websites is based on content factors such as source credibility and personalization. Based on this model, a set of guidelines for developing trust in health Websites is proposed and key differences between face-to-face communication and web-based systems are discussed.

In recent years the number of health related websites has increased dramatically and so have concerns regarding the quality of online information. The sheer volume of sites and the variety of information available have left health consumers potentially with greater choice but it is not clear whether these online changes are reflected in user behaviour. This study addresses whether users are becoming more proficient in searching for credible, high quality information and whether they are more demanding of the type of information being sought and less ready to trust online health advice. This paper describes changes in the use of the Internet for health advice over a five-year period. It compares findings from two large-scale online questionnaire studies undertaken in 2000 and 2005. Key changes and similarities in usage and trust practices are noted. The rise in unregulated sites is discussed in terms of patients “acting as scientists” using websites to test out theories regarding their health. The increasing importance of design issues is also highlighted and implications for website designers and content providers are presented.

Do different design and information content factors \ninfluence trust and mistrust of online health sites? Fifteen women faced with a risky health decision were observed while searching the Internet for information and advice over four consecutive weeks. In some sessions their searches were unstructured, whilst in other sessions they were directed to review specific sites, chosen for their trust design elements. Content analysis of concurrent \nverbalisations and group discussion protocols provided \nsupport for a staged model wherein design appeal predicted \nrejection (mistrust) and credibility of information and \npersonalisation of content predicted selection (trust) of \nadvice sites.