Mme Sally WYATTMme Sally WYATTROYAL NETHERLANDS ACADEMY &

MAASTRICHT UNIVERSITY

Santé, internet, informationSanté, internet, information

• Intermediary – transports meaning without transformation – a black box counting for one

• Mediators – input never a good predictor of output – they transform, translate, distort & modify – however simple it may look, it can lead in multiple directions

• Bruno Latour (2005:39) Reassembling the Social, OUP.

The clean pipeline: idealised view of The clean pipeline: idealised view of information intermediariesinformation intermediaries

The messy reality of finding health The messy reality of finding health informationinformation

How does the information match my previous knowledge?

How badly do I need the information?

What do I need it for? (e.g., making a specific decision; emotional support; corroboration of a diagnosis; etc.).

Is the information consistent with my beliefs and values?

How urgent is the situation?

How familiar am I with the topic?

How easy is it to apply the information to my situation?

Am I ready to believe what I find? Am I ready to act on it?

Do I the need information for myself or another person?

Sources of Health Information Health Information Seekers’ NeedsHealth Info(r)mediators

Alternative health care informationCommercial product informationCommonly -held beliefs (‘folk remedies’, etc.)ConjectureEpidemiologic dataExperience of othersGovernment policyMedical informationOpinionsOwn embodied experiencePharmaceutical product informationResearch/scientific evidenceSuperstitionBeauty and& fitness industryHealth food industry

Legal regimes, policiesWestern medical care providers, including pharmacistsAllied health care (& social service) providersComplementary & alternative health care providersTraditional healersPeer / para-professional support workersLibraries, librarians & other information professionalsNewspapers, magazines & other print mediaTelevision, radio & other broadcast mediaHealth information websites & portalsOnline social support sitesFriends & familyMedical images, electronic health records & other health informatics applicationsFilters, search engines & other software applications

Internet Search Engines

INVISIBLEVISIBLE

Health Care Providers

Community Health Workers

Legal Regimes

Diagnostic Images

Websites

Friends, family, etc. Libraries

Librarians

Internet Content Filters

Info(r)mediators – visibility continuumInfo(r)mediators – visibility continuum

• Types of health information seeker– Band-aid internet use– Looking up/checking out– Doing research

• Constraints experienced by patients– Patients reluctant to take on role– Lack of skills and competences for information literacy– Health care professionals reluctant to let patients take on

role

• What does this mean for policy agenda about ‘information for choice’?

Emergence of the informed patient?Emergence of the informed patient?

• New patient responsibilities– Sharing health information– Sharing health experiences– Sharing experiences of health care provision

• Who benefits? Evidence for what and for whom?

• Legal and ethical constraints

Web 2.0Web 2.0

• Using the internet to find and share health information is not a linear process. Different ways of using the internet need to be understood in terms of different types of users and also in relation to different temporal and social trajectories. Health, well-being, ageing, changing jobs, moving house all affect how people, individually and collectively, use the internet.

Vive la différence!Vive la différence!