Journal of Community Health (2018) 43:1094–1099

https://doi.org/10.1007/s10900-018-0526-9

ORIGINAL PAPER

Health Information Seeking Behavior Among College Students

Corey H. Basch1 · Sarah A. MacLean2 · Rachelle‑Ann Romero1 · Danna Ethan3

Published online: 19 May 2018

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Abstract
Individuals have a wide range of resources when searching for health topics. The aim of this research was twofold: (1) to
identify and assess the resources college students use when exercising health information seeking behavior (HISB); and (2)
to examine perceptions and behaviors regarding adoption of online tools. A questionnaire was developed to assess HISB
in a sample of college students. Items pertaining to HISB were adapted from a Health Information National Trends Survey
with permission from the National Cancer Institute at the National Institutes of Health. During Spring 2018, 258 students
in 9 sections of a personal health class at a public university in NJ completed the questionnaire. Students were most likely
to often or always use the Internet for health information (n = 74%) over other sources. Females were more likely to use the
Internet for health information (p = .030), to consult a health or medical professional (p = .042) and to confirm the health
information they find with a health or medical professional (p = .028). Females also reported spending significantly more
time on social media (mean 4.96 h/day) compared to males (4.00 h/day, p = .041). Non-white students were significantly more
likely to often use the Internet to find health information (p = .039), while white students reported spending significantly less
time on the Internet (p < .001) and on social media (p < .001). Future research is needed to understand motivating factors
for HISB, and to tailor interventions accordingly to assure that college students who exhibit HISB have appropriate levels
of e-health literacy.

Keywords Health information · Information seeking behavior · Internet · College students

Introduction an individual finds health information [1, 3]. Today, with

the help of rapid technological advances, individuals have a
Health information seeking behavior (HISB) is commonly wide range of resources when searching for health topics [4].
known as a process of gathering information about health In the past, sources of health information were limited, but
[1]. Various factors influence the need to seek information, research suggests that use of the Internet influences HISBs
some including a concern for a particular health condition [5]. Over 3.9 billion people worldwide use the Internet [6].
or disease, a health-related risk or benefit, or an interest in a Likewise, the rise of social media mimics the advances of
discovery covered by the media [2]. HISB generally occurs the Internet, with nearly 2.5 billion users worldwide in 2017
when an individual reacts to a health-related need. Effective [7]. Therefore, it does not come as a surprise that these are
practice of HISB can inform health-enhancing actions and channels whereby consumers search for information regard-
serves as an important mechanism for understanding how ing health.
When individuals engage in HISB, they have a variety of
information at their disposal that is easily accessible, avail-
* Corey H. Basch able, and free of cost. With the availability of a myriad of
[email protected] health resources, individuals are now managing health issues
1
Department of Public Health, William Paterson University,
more independently, seeking information frequently for
Wayne, NJ 07470, USA themselves and for others, especially when access to care is
2
Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy
limited [4, 8]. HISB has become an integral aspect of a per-
Place, New York, NY 10029, USA son’s accountability for and cognizance of personal health
3
Health Education and Promotion, Department of Health
[9]. Despite the emergence of this new tool, there remains a
Sciences, Lehman College, The City University of New paucity of research regarding the HISB of college students,
York, New York 10468, USA

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Journal of Community Health (2018) 43:1094–1099 1095

an important subset of the population, as they are generally the following,” Consider the quality of information from one
faced with making health decisions on their own for the first web source as accurate; Gather information using several
time during this time period of recently established inde- web sources to evaluate and approve its accuracy; Share the
pendence. The aim of this research, therefore, was twofold: information you find with family or friends without checking
(1) to identify and assess the resources college students use its accurateness; Confirm the information you find with a
when exercising HISB; and (2) to examine perceptions and health or medical professional. Furthermore, respondents
behaviors regarding adoption of online tools. were asked to rate on a Likert scale (with 1 as very inac-
curate and 5 as very accurate) the accuracy of information
on the Internet and social media when searching for health
Methods or medical information. Finally, respondents were asked to
indicate their level of agreement on if the number of fol-
A questionnaire was developed to assess HISB in a sample lowers and/or who is within the same network influences
of college students. Select items pertaining to HISB were the accuracy of information presented, and if the Inter-
adapted from a Health Information National Trends Survey net and social media provide helpful resources for health
(HINTS) with permission from the National Cancer Institute information.
at the National Institutes of Health (NIH) [10]. The first sec- During Spring 2018, instructors of 9 face-to-face and
tion addressed demographics, which included gender, race, hybrid sections of a personal health course at a public
age, college major, as well as grade level. university in Northern New Jersey were sent an e-mail of
The second section addressed ways in which students invitation to participate in the questionnaire. All instruc-
go about finding health information. Questions included: tors accepted the invitation. Questionnaires were given to
“Where do you go first to find information about health?” each instructor in each course section and disseminated to
with the options Family and/or friends; Health or medical all students who were present at the time the survey was
professional; Internet; Newspaper and/or books; Social distributed. Students were reminded that their participation
media; Television and Other. Subjects were also presented in the study was voluntary and no identifying information
a blank line so that they may indicate an unspecified primary would be collected. A total of 329 students present in each
source they utilize when seeking health information. class were invited to participate. A total of 258 question-
A follow-up question was asked focusing in general, the naires were returned with a resultant response rate of 78.4%.
frequency of engagement (with response options of Never; IBM SPSS Statistics for Windows (version 23, Armonk,
Rarely; Sometimes; Often; and Always) using each of the NY) was used to calculate descriptive statistics and perform
aforementioned sources. Inclusion of this question helped statistical tests. For survey questions that used a 5-point
determine where college students mainly acquire health Likert scale, responses were grouped into three categories
information. (Table 1). Students were compared based on gender, race,
The third section addressed Internet and social media age, class year, and major using Chi square tests of associa-
usage patterns. Respondents were asked to recall, in the tion for categorical variables and independent sample t-tests
past 12 months if they have used any source on the Internet for continuous variables. When an expected cell count was
for information about their health or the health of some- < 5, Fisher’s exact test was used in place of a Chi square test.
one else. In another question, they were asked where on the We considered results to be significant if p < 0.05, which is
Internet would they typically go first for health information. indicated in bold in Table 1. This study was approved by the
Popular health-based websites were presented as response Institutional Review Board at William Paterson University
options. Additionally, they were given a two-part question (Protocol # 2018-340).
that inquired if they self-diagnosed a medical problem in the
past 12 months, and if they had seen a medical professional
to assess and confirm their self-diagnosis. Inclusion of this Results
question was used to establish the number of participants
that had self-diagnosed but did not see medical professional, A total of 258 students completed the survey. Students
and to guide the research by postulating the influence of were most likely to often or always use the Internet for
seeking health information on the Internet and social media health information (n = 190), followed by a health or medi-
when evaluating one’s own health. cal professional (n = 138) and friends or family (n = 135)
The fourth section largely pertained to accuracy of infor- (Table 1). Though the majority indicated that they often or
mation, including one question appraising the likelihood always use the Internet, most students (n = 178) said they
of engaging certain behaviors when seeking health topics rarely or never use social media. Nearly three-quarters of
online. Respondents were asked, “When searching health students (71%) reported that they were likely or very likely
or medical issues on the Internet, how likely are you to do to gather information using several web sources to evaluate

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1096 Journal of Community Health (2018) 43:1094–1099

Table 1  Survey responses grouped by gender and race with Chi square tests of association
Total Gender Race
Female Male p White Non-white p
258 164 92 75 183

In general, how often do you use each of the following sources to get health information?
Family and/or friends Never/rarely 51 31 20 .673 13 38 .139
Sometimes 70 42 26 15 55
Often/always 135 90 45 46 89
Health or medical professional Never/rarely 31 21 10 .042 11 20 .647
Sometimes 86 46 40 23 63
Often/always 138 95 41 39 99
Internet Never/rarely 19 12 7 .030 3 16 .039
Sometimes 46 22 24 20 26
Often/always 190 129 59 52 138
Newspaper or books Never/rarely 173 110 61 .976 53 120 .589
Sometimes 58 37 21 14 44
Often/always 21 13 8 7 14
Social media Never/rarely 178 111 65 .265 53 125 .385
Sometimes 51 30 21 12 39
Often/always 23 18 5 9 14
Television Never/rarely 184 112 70 .530 60 124 .128*
Sometimes 54 37 17 10 44
Often/always 14 10 4 4 10
When searching health or medical issues on the Internet, how likely are you to…
Consider the quality of information from (Very) unlikely 62 43 18 .141 17 45 .975
one web source as accurate Neutral 82 46 36 23 59
(Very) likely 100 67 32 29 71
Gather information using several web (Very) unlikely 19 11 8 .100 7 12 .576
sources to evaluate and approve its Neutral 53 28 25 13 40
accuracy
(Very) likely 183 123 58 54 129
Share the information you find with family (Very) unlikely 95 61 33 .827 25 70 .544
or friends without checking its accuracy Neutral 73 44 28 20 53
(Very) likely 87 57 30 29 58
Confirm the information you find with a (Very) unlikely 41 22 19 .028 10 31 .601
health or medical professional Neutral 71 39 31 19 52
(Very) likely 143 101 41 45 98
When searching for health or medical (Very) inaccurate 20 14 6 .702 6 14 .757
issues, how accurate do you think the Somewhat accurate 161 104 56 44 117
information on the Internet is?
(Very) accurate 75 45 29 24 51
When encountering health or medical top- (Very) inaccurate 131 88 43 .315 38 93 .919
ics on social media, how accurate do you Somewhat accurate 105 65 38 31 74
think the information is?
(Very) accurate 20 10 10 5 15
The number of followers and/or who is (Strongly) disagree 91 65 26 .127 24 67 .477
within the same network influences the Somewhat agree 113 70 42 37 76
accuracy of the information presented
(Strongly) agree 52 28 23 13 39
The Internet provides helpful resources for (Strongly) disagree 11 8 3 .580* 2 9 .767*
health information Somewhat agree 108 65 42 31 77
(Strongly) agree 136 90 45 41 95
Social media provides helpful resources for (Strongly) disagree 108 72 36 .342 30 78 .896
health information Somewhat agree 108 71 36 32 76
(Strongly) agree 38 20 17 12 26

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Journal of Community Health (2018) 43:1094–1099 1097

Table 1  (continued)
Total Gender Race
Female Male p White Non-white p
258 164 92 75 183

Used any source on the Internet for information about your 221 141 78 .616 64 157 .766
health in the past 12 months
Used any source on the Internet for information about another’s 162 109 51 .060 46 116 .813
health in the past 12 months
Self-diagnosed a medical problem in the past 12 months 81 58 23 .106 21 60 .481
Hours a day spent searching the internet** 3.75 (3.04) 3.75 (3.25) 3.77 (2.70) .959 2.50 (1.54) 4.24 (3.34) < .001
Hours a day spent using social media** 4.61 (3.58) 4.96 (3.90) 4.00 (2.89) .041 3.15 (2.31) 5.19 (3.82) < .001

*Fisher exact
**Independent t-test [mean (standard deviation)]

and approve the accuracy of information but fewer students Table 2  Description of those who self-diagnosed a medical problem
(55%) reported they were likely or very likely to confirm the in the past 12 months (N = 82)
information with a health or medical professional. Total Saw a medical professional p*
The majority of students (62%) believed that the health to assess and confirm the
information found on the Internet was somewhat accurate. condition
However, students were more skeptical of information found Yes No
on social media. Only 20 students (7%) reported that they (N = 60) (N = 22)
believe the health information they find on social media is Gender
accurate or very accurate. While 53% of students agreed or Female 58 40 18 .182
strongly agreed that the Internet provides helpful resources Male 24 20 4
for health information, only 14% agreed or strongly agreed Race
that social media provides helpful resources for health White 22 19 3 .103
information. Non-white 60 41 19
Student responses were compared based on gender, race, Age
age, class year, and whether they were a health major. There 18–19 46 33 13 .741
were no significant differences by age, health major, or class ≥ 20 36 27 9
year. Males and females differed significantly in the sources Health major
used to get health information. Females were more likely to Yes 43 32 11 .734
use the Internet (p = .030) and to consult a health or medical No 38 27 11
professional (p = .042). Females were also significantly more Class
likely to confirm the information they find with a health First-year 47 34 13 .844
or medical professional (p = .028). Females also reported ≥ Sophomore 35 26 9
spending significantly more time on social media (mean
4.96 h/day) compared to males (4.00 h/day, p = .041).Non- *Chi square
white students were significantly more likely to often use the
Internet to find health information (p = .039). White students Conclusions
reported spending significantly less time on the Internet
(p < .001) and on social media (p < .001). The findings of this study are novel for several reasons.
When asked about searching the Internet for health infor- The results show that college students were more likely
mation in the past year, most students reported using it for to visit the Internet for health information than they were
information about their own health (85%) or someone else’s a health or medical professional. This is in concert with
health (63%). Among those who self-diagnosed a medical research from a large national survey which demonstrates
problem in the past 12 months (n = 82, 31%), 60 students that younger individuals are using the Internet for infor-
(73%) saw a medical professional to assess and confirm mation [8]. In addition, those with limited access, busy
the condition. The percent of people who sought confirma- schedules, and financial issues were more likely to search
tion did not differ significantly based on any demographics for information on the Internet [8]. These are all issues that
(Table 2).

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1098 Journal of Community Health (2018) 43:1094–1099

college students likely face. Further research is needed to The limitations of this study include the cross-sectional
determine the motivating factors for HISB on the Internet design which confines the ability to generalize these find-
prior to a medical professional or other sources, however, ings. In addition, respondents are subject to recall bias when
the aforementioned factors are possibly influential. asked to recall prior practices. Nevertheless, it offers insight
The results of this study also demonstrated that a high into the HISB of college students, and the need for further
proportion of respondents reported using the Internet to seek research on this important topic.
information on their own health as well as the health of oth-
ers. Research indicates that young adults based their search Compliance with Ethical Standards
on individual health needs, their familiarity of the content
providers, their preference for facts or personal experiences, Conflict of interest The authors declare no conflicts of interest.
and their level of interest in the content design [9, 11]. How-
ever, future research is needed on the level at which college
students possess electronic-health (e-health) literacy. References
E-health literacy is not only the ability to locate health
1. Mukherjee, A., & Bawden, D. (2012). Health informa-
information, but to assess its content and the level to which
tion seeking in the information society. Health Information
is can be used for resolving an issue related to health, a tool and Library Journal, 29(3), 242–246. https​://doi.org/10.111
has been developed to measure e-health literacy via knowl- 1/j.1471-1842.2012.00997​.x.
edge comfort, and perceived skills [12]. As e-health literacy 2. Pesälä, S., Virtanen, M. J., Sane, J., Mustonen, P., Kaila, M., &
Helve, O. (2017). Health information-seeking patterns of the gen-
increases, then HISB becomes more effective. Research eral public and indications for disease surveillance: Register-based
reveals that e-health literacy levels of college students was study using lyme disease. JMIR Public Health and Surveillance,
correlated with general health [13]. The population aged 3(4), e86. https​://doi.org/10.2196/publi​cheal​th.8306.
18–29, make up approximately 93% of all online users [14], 3. Chaudhuri, S., Le, T., White, C., Thompson, H., & Demiris, G.
(2013). Examining health information–seeking behaviors of older
thus increasing the need for health communication inter- adults. Computers, Informatics, Nursing: CIN, 31(11), 547–553.
ventions in this population. The Internet and social media https​://doi.org/10.1097/01.NCN.00004​32131​.92020​.42.
are used for a variety of HISB reasons as creating personal 4. Bratucu, R., Gheorghe, I., Purcarea, R., Gheorghe, C., Popa Velea,
content, sharing experiences or links to health topics, and O., & Purcarea, V. (2014). Cause and effect: The linkage between
the health information seeking behavior and the online environ-
more commonly today accessing online health accounts and ment-—A review. Journal of Medicine and Life, 7(3), 310–316.
connecting with healthcare professionals [9, 11, 15, 16], all 5. Chen, Y., Li, C., Liang, J., & Tsai, C. (2018). Health informa-
of these could be areas further study regarding HISB. tion obtained from the internet and changes in medical decision
Another noteworthy finding from this study was that col- making: Questionnaire Development and Cross-Sectional Sur-
vey. Journal of Medical Internet Research, 20(2), e47. https​://
lege students found information on the Internet to be helpful, doi.org/10.2196/jmir.9370.
and reportedly use Internet is being used to self-diagnose 6. Internet World Stats. (2017). Internet users in the world by
medical issues. This is aligned with other studies which have regions. Retrieved from http://www.inter​netwo​rldst​ats.com/stats​
reported the popularity of the Internet for HISB [17–19]. .htm.
7. Social network users worldwide from 2010 to 2021 (in billions).
College students exhibit great interest in health topics. With Retrieved from https:​ //www.statis​ ta.com/statis​ tics/​ 278414​ /numbe​
that in mind, they are likely to engage in and repeat HISB. r-of-world​wide-socia​l-netwo​rk-users​/.
However, there is a possibility that the information that they 8. Bhandari, N., Shi, Y., & Jung, K. (2014). Seeking health informa-
access may not always be accurate, which may be a potential tion online: Does limited healthcare access matter? Journal of
the American Medical Informatics Association: JAMIA, 21(6),
risk to their health and well-being [20]. 1113–1117. https​://doi.org/10.1136/amiaj​nl-2013-00235​0.
This study further revealed that questions related to accu- 9. Fergie, G., Hilton, S., & Hunt, K. (2016). Young adults’ expe-
racy of information were mixed, with some subgroups more riences of seeking online information about diabetes and men-
likely than others to take measures to confirm accuracy of tal health in the age of social media. Health Expectations: An
International Journal of Public Participation in Health Care
the information they gathered. Evaluating the accurateness and Health Policy, 19(6), 1324–1335. https​://doi.org/10.1111/
of health information may be difficult if e-health literacy hex.12430​.
is underdeveloped. Previous research found that people 10. Health Information National Trends Survey (HINTS). (2017).
with high e-health literacy had better consciousness of their HINTS 5, cycle 1 survey. Retrieved from https​://hints​.cance​r.gov/
docs/Instr​ument​s/HINTS​5_Cycle​1_Annot​ated_Instr​ument​_Engli​
health and the information they sought in that they were able sh.pdf.
to search, assess, and apply appropriate materials to their 11. Fergie, G., Hunt, K., & Hilton, S. (2013). What young people want
self-care [20]. College students who exercise HISB and have from health-related online resources: A focus group study. Journal
low e-health literacy may be unaware of acquiring materi- of Youth Studies, 16(5), 579–596. https​://doi.org/10.1080/13676​
261.2012.74481​1.
als that may be inaccurate. By addressing this issue, new 12. Norman, C. D., & Skinner, H. A. (2006). eHEALS: The eHealth
methods may be developed to support the better practice of Literacy Scale. Journal of Medical Internet Research, 8(4), e27.
HISB among college students. https​://doi.org/10.2196/jmir.8.4.e27.

13

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

Journal of Community Health (2018) 43:1094–1099 1099

13. Britt, R. K., Collins, W. B., Wilson, K., Linnemeier, G., & Engle- 17. Hogue, M.-C. B., Doran, E., & Henry, D. A. (2012). A prompt
bert, A. M. (2017). eHealth literacy and health behaviors affecting to the web: The media and health information seeking behav-
modern college students: A pilot study of issues identified by the iour. PLoS ONE, 7(4), e34314. https​://doi.org/10.1371/journ​
American College Health Association. Journal of Medical Inter- al.pone.00343​14.
net Research, 19(12), e392. https​://doi.org/10.2196/jmir.3100. 18. Leung, L. (2008). Internet embeddedness: Links with online
14. Pew Research Center. (n.d.). Teen and Young Adult Internet Use. health information seeking, expectancy value/quality of health
Retrieved from http://www.pewres​ earch​ .org/millen​ nials​ /teen-inter​ information websites, and internet usage patterns. Cyber Psychol-
net-use-graph​ic/. ogy & Behaviour, 11(5), 565–569.
15. Jackson, D. N., Chou, W.-Y. S., Coa, K. I., Oh, A., & Hesse, 19. Lewis, T. (2006). Seeking health information on the internet: Life-
B. (2016). Implications of social media use on health infor- style choice or bad attack of cyberchondria? Media Culture and
mation technology engagement: Data from HINTS 4 cycle 3. Society, 28(4), 521.
Translational Behavioral Medicine, 6(4), 566–576. https​://doi. 20. Tennant, B., Stellefson, M., Dodd, V., Chaney, B., Chaney, D.,
org/10.1007/s1314​2-016-0437-1. Paige, S., et al. (2015). eHealth literacy and web 2.0 health infor-
16. Iftikhar, R., & Abaalkhail, B. (2017). Health-seeking influence mation seeking behaviors among baby boomers and older adults.
reflected by online health-related messages received on social Journal of Medical Internet Research, 17(3), e70. https​://doi.
media: Cross-sectional survey. Journal of Medical Internet org/10.2196/jmir.3992.
Research, 19(11), e382. https​://doi.org/10.2196/jmir.5989.

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