Acceptance and usability of an independent, non-commercial search engine for medical information: a cross-sectional questionnaire study and user-behavior tracking (Preprint)

Abstract

The internet has become a common source of health-related information, highlighting the growing reliance on digital platforms for healthcare knowledge. The quality of health information obtained from popular search engines may vary, posing challenges to users in evaluating the quality and reliability of these websites, especially to individuals with low health literacy and low digital health literacy. Therefore, a new search engine was developed in 2020, with the goal of providing access to high-quality, evidence-based content and addressing the navigational needs of individuals seeking health information online. The search engine prioritizes high-quality German health websites, assessed based on the categories trustworthiness, recency, user-friendliness, and comprehensibility. Category ratings influence the order of the results and can be used as filters, while the engine upholds user privacy through no data collection and advertising.

This study aims to evaluate the acceptance and usability of this independent, non-commercial search engine from the users’ perspectives and actual use of the search engine.

For the questionnaire study, a cross-sectional study design was employed. 802 participants were recruited through an online panel and were asked to interact with the new search engine before completing an online questionnaire. Descriptive statistics and multiple regression analyses were used to assess participants’ acceptance and usability ratings, as well as predictors of acceptance. Further, from October 2020 to June 2021, we used an open-source web analytics platform, to collect behavior tracking data from consenting users of the search engine.

The study indicates positive findings on the acceptance and usability of the search engine, with over half of the participants willing to reuse (58.0%) and recommend it (63.2%). 93.1% of users valued the absence of advertising and 92-97% found the adjustable filters helpful. They criticized some of the search results regarding the selection of domains and shared ideas for potential improvements, e.g. for a clearer design. Regression analyses showed that the search engine was especially well-accepted among older users, frequent internet users, and those with lower educational levels, indicating an effective targeting of segments of the population with lower health and digital health literacy. The analysis of the tracking data revealed 1,631 sessions with 3,090 searches across 1,984 terms. Users performed 1.64 searches per visit on average. They prioritized the search terms "corona," "back pain", and "cough". Filter changes were common, especially for "recency" and "trustworthiness", reflecting the importance users placed on these criteria.

Our non-commercial search engine prioritizes high-quality health websites based on trustworthiness, recency, user-friendliness, and comprehensibility and shows proper user acceptance, usability and actual use and meets the navigational needs of persons with lower health and digital health literacy.