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Use of traditional health intervention tactics to engage with groups identified as hard to reach via the Internet can remain effective. For example, an Australian telephone-based nutrition intervention has successfully recruited participants from more disadvantaged and regional areas [ 59 , 60 ]. The intervention recently incorporated an interactive website to assist with recruiting new participants and engaging existing participants [ 61 ].

There are strengths and limitations to the current study. The results can be generalized to Western Australia due to the high response rate and representative sample selection.


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Due to the recent rapid uptake of the Internet and other developments, including Web 2. Use of the Internet to source nutrition and dietary information has been reported for the Western Australian adult population, not of Western Australian Internet users. In future, collecting data on use of the Internet, device used, and other relevant technology may help to provide context to use of the Internet to source health and nutrition information.

Frequency of use of the Internet to source nutrition and dietary information, the websites that were used, and quality of information sourced were not measured and more information is urgently needed in this area. The study does not specifically investigate the information sources used depending on the information required; for example, information sources for how to feed a toddler a healthy diet may differ to seeking advice on losing weight or healthy recipe ideas for family eating. The cross-sectional survey results are self-reported and are not validated against objective measures; however, it provides useful evidence to measure public attitudes.

Height and weight measures are self-reported; however, the use of a correction formula attempted to account for possible underestimation of weight status. Further research is needed to explore population use of the Internet for nutrition and dietary information and how to deliver public health interventions effectively.

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This study found that there had been dramatic growth in using the Internet as a source of nutrition and dietary information since ; however, the majority of the adult population still obtain their information from other sources. Relatively fewer Western Australians used the Internet for this purpose when compared with other Western countries, but their demographic characteristics were broadly consistent. This study found that increased weight was not associated with use of the Internet as a source, which was surprising because the Internet has been identified as an important resource for individuals with stigmatized health conditions, including obesity.

Given the rapid increase in use of the Internet in recent years, it is likely that prevalence of using the Internet to source nutrition and dietary information will continue to change. Changes in the prevalence and characteristics of users over time are important areas to continue to monitor to inform future development of nutrition interventions. The Internet provides a cost-effective platform to reach the identified users with nutrition and dietary interventions, but should be integrated with traditional health promotion tactics to reach the broader population.

Policy makers and practitioners delivering Internet-based nutrition interventions should ensure they identify and understand the target population, and customize and tailor communications to meet their needs. Use of non—text-based social media, including images, illustrations, video, and sound, should be included to meet the needs of those with limited literacy. Provision of credible, reliable, and practical information is recommended, including quicker ways to prepare healthy foods and how to choose healthy foods.

It is also important for policy makers to improve provision of quality nutrition and dietary information on the Internet generally, which could include certification of websites that provide trustworthy information. National Center for Biotechnology Information , U. J Med Internet Res. Published online Aug Christina Mary Pollard ua. Originally published in the Journal of Medical Internet Research http: This is an open-access article distributed under the terms of the Creative Commons Attribution License http: The complete bibliographic information, a link to the original publication on http: This article has been cited by other articles in PMC.

Abstract Background The Internet contains a plethora of nutrition information. Objective The aim was to assess the change in prevalence and demographic characteristics of Western Australian adults accessing the Internet as a source of nutrition information and identify specific information needs. Conclusions Use of the Internet as a main source of nutrition information has grown rapidly since ; one-third of Western Australian adults reported using the Internet for this purpose in Introduction Use of technology for communication has increased and traditional sources of information have changed in importance over time.

Outcome Measurements The main purpose of this study was to assess change in prevalence and demographic characteristics of Western Australian adults using the Internet as a source of nutrition and dietary information. Statistical Analysis The data were collected to be representative of the Western Australian population. Open in a separate window. Table 2 Prevalence of using the Internet as a source to obtain nutrition and dietary information, the Nutrition Monitoring Survey Series, Western Australia, Table 3 Factors associated with using the Internet as a source of obtaining nutrition and dietary information, the Nutrition Monitoring Survey Series, Western Australia, Table 4 Association between using the Internet as a source to obtain nutrition and dietary information and perception of whether it would be easier for respondents to eat healthy diet.

Table 5 Prevalence of using Internet as a source obtaining nutrition and dietary information, the Nutrition Monitoring Survey Series, Western Australia, and Internet-Based Information That Would Make it Easier to Eat Healthily Western Australians who used the Internet as a source of nutrition and dietary information were more likely than nonusers to agree that quicker ways of preparing healthy foods and help deciding if foods are healthy would help them to eat more healthily.

Recent Survey Results Data from the and surveys were examined to explore recent changes in prevalence and the demographic profile of Internet users to guide current nutrition program development. Quality of Information The NMSS is a government survey that contributes evidence of prevalence of use and demographic information to Western Australian policy and programs. Use of the Internet for Population-Wide Nutrition Interventions Use of the Internet as a source of nutrition and dietary information has shown recent rapid uptake by Western Australian adults making it appealing for dissemination of public health interventions.

Limitations There are strengths and limitations to the current study. Conclusions This study found that there had been dramatic growth in using the Internet as a source of nutrition and dietary information since ; however, the majority of the adult population still obtain their information from other sources.

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Using the Internet to help with diet, weight, and physical activity: The internet and nutrition education: Eur J Clin Nutr. Australian National Preventive Health Agency. Health promotion success in Australia and a note of warning. Health Promot J Austr. Australian Institute of Health and Welfare. Links between sites help in locating specific information.

Useful links match the original site's audience or context, reflect an architecture that permits free movement forward and backward, and contain content meeting the criteria described here Rippen, Aesthetic and format characteristics. Websites combining text, audio and visual formats afford adaptability to consumer preferences and learning styles. Aesthetic qualities should contribute to comfort and use.

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Color coordination, lack of clutter, unobtrusive backgrounds and legibility of text contribute to quality Post, Technical materials may be simplified by translation into pictorial format Essex, However, too many graphics may slow access McGrath, Access to peer-reviewed resources, user surveys and codes of conduct may facilitate consumers' task of evaluating online health information.

Unlike medical literature, much online health information lacks peer review Ambre et al. However, informed consumers increasingly can access peer-reviewed health information via sites that provide abstracts and full-text journal articles, often with extensive archives , e. Beyond scientific research articles, consumers can access websites developed specifically to assure high quality evidenced-based information e.

Healthfinder, MedlinePlus to search for information or verify that found elsewhere Wootton, Few websites feature user-rating systems Ambre et al. Some post unofficial reviews, ratings and standards for evaluating sites Essex, Jadad and Gagliari, As Berland et al. Numerous organizations offer criteria for assessing websites [e. Eng and Gustafson, ], but such assessments are for personal use rather than formal site evaluation. At present, the most widespread attempt to apply a code of conduct to online health information was developed by HON.

HON is a self-governing body promoting eight ethical standards for online health information online: As of January , HON registered connections to its code from more than external servers and more than 20 external web pages Health on the Net Foundation, However, HON encourages use of their verification system to determine if sites are bona fide HON subscribers versus simply displaying the logo Health on the Net Foundation, In summary, increasing quality concerns mandate evaluation standards. Despite relative consensus on evaluation criteria, they have not been widely disseminated to the public nor are they a fail-safe method for assuring quality.

Articles educate readers about Internet use, speculate on the impact of online health information and report or project innovations. Little literature reports research regarding Internet use or its effects. Just 5 years ago, journal articles commonly explained what the Internet is to health professionals [e.

Guay, ; Dow et al. Much early writing — simply defined key terms, explained use and projected impact on a profession [e. McKinney and Bunton, ; Frisse et al.

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Even more recently, numerous articles explain the Internet and summarize basic use [e. Gagel, ; Littleton, ; Lunik, ; Machles, a , b ]. Many articles address best sites, in general [e. Judkins, ], or based on profession, specialization or disease or disorder [e. Korn, ; Bell, ; Mann, ], including articles for consumers [e. Stemmer-Frumento, ; Tomlin, ]. Second-generation health-related Internet uses go beyond disseminating information. Numerous authors project what the Internet will offer consumers in the future; often reality is not far behind. The rate of Internet development quickly renders projections out of date, blurring a sense of present and future.

This review of literature regarding consumer online health-information seeking mirrors health information on the Internet; the literature often has little evidence base for its claims. Challenges to consumers, public health professionals and researchers alike include the rapidity of change of content, structure and technology embedded in the Internet.

Sometimes analysts are challenged to research and publish findings before they are obsolete! The challenge of future research is to devise methods and conceptual frameworks appropriate for investigating the richness of the Internet's dynamics relative to health issues.

Abelhard and Obst, in grappling with research challenges, indicate that new methods may be required with regard to sampling as users may vary with amount of use, expertise, nature of use Abelhard and Obst, Researchers will be challenged to discriminate effects due to the Internet versus other highly accessible health-information sources e.

Controlled studies may include longitudinal investigations as use and influence may vary over time , retrospective cohort studies and case control studies, as alternatives to traditional studies using control groups Adelhard and Obst, Research needs to address the demographic characteristics of participants, to more precisely identify the underserved, as well as the kinds of information consumers are seeking, what they locate, how they judge the quality of information found, what they learn Wyatt, and how they are influenced behaviorally.

Researchers need to compare the processes, outcomes and cost-effectiveness of traditional versus online health-information seeking, as well as various types of online information seeking e. Despite abundant speculation regarding the consequences of consumer participation in interactive health communication, little research has investigated these issues; a lack of compelling evidence exists regarding relative effectiveness ; perhaps more importantly, little evidence exists regarding effects.

Critics bemoan absence of research regarding the Internet's effectiveness [e.

Eng and Gustafson, ]. However, assessing effectiveness presumes a consensus regarding websites' goals and objectives. Public health professionals' goals involve enhancing health knowledge, beliefs and behavior.

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Thus, from the perspective of their creators, some websites may be deemed effective if they are commercially successful, personally confirming, or succeed in disseminating information and gathering support for riskpromoting or unhealthy functions. Despite observers' contentions, little research has assessed the impact of interactive health communication on the health care system Wyatt, ; Abelhard and Obst, , although health care Sonnenberg, , health care interaction, and health and medical outcomes Adelhard and Obst, likely are affected.

That terminology, and this review, suggest a conceptual framework for future research and practice: Much of the literature reviewed here focuses on the Internet as a high-tech conveyor in the rapid diffusion of information or health lessons. However, to do so is to ignore the very nature of the Internet.

Compared to traditional planned information dissemination phenomena, the Internet reflects a paradigm shift by offering interactivity and reciprocal influence, pointing toward transactional rather than one-way processes, and blending interpersonal and mass communication processes. Framing Internet use as health communication invites social systems and social influence theoretical frameworks. These frameworks suggest additional avenues for research. The present review clarifies the interdependence of the Internet with other components of health communication systems, including health care, health promotion, risk-inducing communication, and the roles of everyday interpersonal communication and mass media in health.

Understanding the opportunities and influences posed by the Internet as one component of the larger health communication system offers directions for research as well as practice. For example, research needs to address 1 the impact of interactive health communication on the physician—patient relationship, as well as how health care providers might influence consumers' use of the Internet, 2 the implications of the Internet for the larger health care system, including medical outcomes and health care costs, and 3 how the Internet influences and is influenced by a managed care environment.

To view Internet use as a communication process activating social influence suggests shifting focus from information to messages and meanings. Although the issue of quality of health information is significant, understanding the Internet's impact both positively and negatively defies simply considering information and its accuracy. To protect your information when using wireless hotspots, send information only to sites that are fully encrypted, and avoid using mobile apps that require personal or financial information.

Encryption is the key to keeping your personal information secure online. An encrypted website protects only the information you send to and from that site. A secure wireless network encrypts all the information you send using that network. The information you share is stored on a server — a powerful computer that collects and delivers content. Many websites, like banking sites, use encryption to protect your information as it travels from your computer to their server.

Look for https on every page you visit, not just when you sign in.

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If you use an unsecured network to log in to an unencrypted site — or a site that uses encryption only on the sign-in page — other users on the network can see what you see and what you send. They could hijack your session and log in as you. New hacking tools — available for free online — make this easy, even for users with limited technical know-how.

Your personal information, private documents, contacts, family photos, and even your login credentials could be up for grabs.