The world wide web is filled with health advice. Unfortunately, recommendations may not be all that reliable. That's why many public health professionals look down on this type of consultation.
That being said, this trend has risen over the years and shows no signs of slowing. This means authorities and officials need to realize they must follow the old adage, "If you can't beat 'em, join 'em." Yet, the means to perform this effectively has been rather enigmatic.
One direction followed by many trusted health sources provides key information in an objective, one-size-fits-all manner. This populist method focuses on sharing evidence and advice applicable to the masses. Yet, this method may inadvertently lead to the concept of health brokering in which one person ends up being the trusted source for advice. While this may not be entirely troublesome, the entitlement may be given to a person with extensive online acumen but limited health knowledge.
This conundrum reveals a significant hurdle in providing appropriate advice using the internet. While information may be readily available, the need for a personalized touch is left unfulfilled. Yet finding a suitable health broker for every single person visiting a website is simply not possible. A middle ground needs to be found whereby information is both useful and to some extent personal.
That balance may have been found thanks to a large-scale initiative known as the Food4Me study. Conducted by an international group of researchers, this attempt to determine how best to personalize medicine has revealed what the public needs in addition to information to make healthy decisions. As the study has found, the requirements are far less than what one might expect.
The study was an attempt to mimic an online personal nutrition service. The actual nutritional information based on evidence was the same for everyone. Yet, how it was used to coach individuals varied based on one of four levels of personalization.
- Those in Level 0 received general information geared for the European population;
- Level 1 individuals gained advice based solely on dietary intake;
- Level 2 included body measurements and blood tests;
- Level 3 also involved genetic analysis of the individual.
The first level was essentially the Dr. Google control. Level 1 was the type of personalization expected from an online service. Levels 2 and 3 were far more extensive in nature as they required the individual to visit the home base to allow for the measurements and blood analysis.
The study ran for six months with over 1,200 people equally divided among the four levels. As the study began, participants in Levels 1-3 received personalized feedback reports developed by dietitians. The information was based on the collection of data they received.
At the half way point and also at the end of the study, the participants were asked to fill out a questionnaire regarding their dietary intake. Based on replies, messages were sent out to remind the individuals of any gaps in their recommended diets. To emphasize the personal nature of the coaching, the advisories also referred to specific data acquired at the onset of the study.
After the study was completed, the team examined the questionnaires and other information collected from the participants in order to determine if any changes had been made in their dietary habits. In all cases, the answer was yes although those in the Level 0 control appeared to make the least amount of change. This came as no surprise as the objective method was expected to have the poorest results.
The real surprise came when the team examined the other levels. Based on the amount of information collected, a difference between the levels would have been expected with Level 3 showing the highest amount of change. Yet, there were no such gaps. The information collected appeared to have no value in terms of the actions of the individuals.
The lack of a link between more information and improved results was revealing. The impetus for change was not based on the amount of personalized data collected. Instead, the force behind change happened to be something far less scientific: personalized motivation. By having someone there to guide you -- even irregularly as in this study -- people may be given the encouragement necessary to make beneficial changes in their lives.
This study offers good insight into how health advice may be best provided on the internet. Having readily available information is a key component. But having a personal touch may lead to increased trust and eventually acceptance and adoption of the recommendations.
For doctors, dietitians, and other qualified professionals, this study may open the door to improving health through online consultation. Keeping track of and giving feedback to patients virtually may effectively improve behaviour and outcomes. Moreover, this could help to solidify the relationship between an individual and the health profession such that one day a person may consult a known and trusted professional instead of relying on a broker or whatever comes up during a web search.
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