In Primary Health Care, What Are the Outcomes of Using Online Consumer Health Information?

Introduction: The use of online consumer health information (OCHI) usually improves knowledge, participation in healthcare, and health outcomes. However, little is known about these outcomes in a primary care setting. Our objectives are to revise an initial framework on OCHI outcomes and identify strategies to prevent negative OCHI outcomes. Methods: A systematic mixed studies review informed an interpretive qualitative study. Review: Six bibliographic databases were searched using a strategy developed by four librarians. Two independent reviewers selected and critically appraised included studies. Using thematic analysis, harmonization of themes, and a framework synthesis, we produced a revised framework of OCHI conditions and outcomes. Configurational Comparative Method (CCM) was used to investigate the association between three conditions (health literacy, health status, confidence in OCHI) and positive/negative outcomes. Qualitative study: Interviews with 19 OCHI users and 10 health care practitioners and health librarians explored negative outcomes in-depth. Three qualitative researchers performed a thematic analysis and identified potential preventive strategies. Results: In 65 included studies, we identified 31 outcomes and 21 conditions, which were then defined and included in the revised framework. Preliminary CCM results linked high literacy or high confidence with a positive outcome. In the qualitative study, we found three dimensions of OCHI 'tensions' (internal, interpersonal, service-related) and three main preventive strategies (providing reliable OCHI sources, teaching consumers how to evaluate OCHI sources, encouraging consumers to discuss OCHI). Conclusion: The results help us understand the outcomes of OCHI use and support the key role of health librarians in preventing negative OCHI outcomes.