Institut für Wirtschaftsinformatik Humboldt-Universität zu Berlin Kralisch & Berendt 2005 Access...

Institut für Wirtschaftsinformatik Humboldt-Universität zu Berlin Kralisch & Berendt 2005

Access to medical information in a multilingual and cross-

cultural context

Anett Kralisch & Bettina Berendt

Institute of Information SystemsHumboldt-University Berlin, Germany

http://www.wiwi.hu-berlin.de/{~kralisch, ~berendt}

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Motivation

• use of Internet as information source

• ease of finding information

• personal and situational variables1.

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Motivation

• Use of Internet as information source

• Ease of finding informations

• Personal and situational variables1. 2.

• International eHealth-website

•Visitors of different• CULTURAL BACKGROUNDS• LINGUISTIC BACKGROUNDS• MEDICAL KNOWLEDGE LEVELS

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Motivation

• Use of the Internet as an information source

• Ease of finding information

• Personal and situational variables

1. 2.• International eHealth-website

• Visitors of different• CULTURAL BACKGROUNDS• LINGUISTIC BACKGROUNDS• MEDICAL KNOWLEDGE

How does the user‘s background affect information seeking behaviour?

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Agenda

1. The potential impact of the 3 variables

2. Method & Data

4. Discussion and Outlook

3. Results

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Agenda


2. Method & Data


3. Results

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2. The impact of the 3 variables

Medical knowledge

Language

Culture

Information Seeking Behaviour

?

?

?

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The impact of culture(a simplified view)

• Culture as mental concepts affecting one‘s behaviour and thinking patterns (e.g. Hofstede 1991, Hall 1989, Trompenaars 1995)

• Cultures can be described through a number of dimensions (e.g. Hofstede, Hall)

e.g. people‘s preferences w.r.t: INFORMATION

TIME

SPACE

Different search options correspond to different degrees of preference, e.g.

H1: short-term oriented cultures prefer (fast access through) search engines more than long-term oriented cultures.

*For further hypotheses see: Kralisch & Berendt IWIPS 2004

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The impact of language(a simplified view)

Native speakers (L1)

lower cognitive effort

higher preference of

ACTIVE LANGUAGE use

(compared to L2 users)

Non-native speakers (L2)

higher cognitive effort

higher preference of

PASSIVE LANGUAGE use

(compared to L1 users)

Different search options correspond, to varying degrees, to these preferences, e.g.

H2: Native speakers prefer search engines more than non-native speakers.

* For further hypotheses see Kralisch & Berendt CATAC‘04

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The impact of medical knowledge(a simplified view)

Different search options correspond, to varying degrees, to a patient´s or physician´s knowledge and search goals, e.g.

Physicians and Patients differ in:

• in their knowledge of medical terms

• in their perceptions/differentiation of disease symptoms

• in other aspects of knowledge about diseases (e.g. Where does the disease occur?)

• in their search goals

H3: Physicians prefer search engines more than patients.

* For further hypotheses see Kralisch & Berendt 2005

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Agenda


2. Method & Data


3. Results

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Method & Data

• LOGFILE ANALYSIS + QUESTIONNAIRE– eHealth website– data recorded Sept/Oct 2004

• The website: – public health– multilingual: German, English, French, Spanish, Portuguese– search options: search engine, alphabetical links, content links

• The users: – about 160 answered questionnaires + corresponding user sessions– 34 countries– 15 native tongues– patients and physicians

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Questionnaire

• Embedded in the disease information part of the website

• Forced choice questions asking for– Native Tongue– Proficiency level of language in which website is read– Country of origin– Country of residence

• 7-point-Likert-Scale items asking for– (further questions) regarding proficiency level– 5 cultural items

• Battery of questions asking for – demographic data, including – Internet use– medical knowledge

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Operationalisation1. Operationalisation of search preference• Which search option was (not) used.• In combination with which other search options was the search option used?• In which order where the search option used.• Number of page requests prior to access of search option.• Frequency of use of search option.• Frequency of use of search option per page request.

Factor analysis applied for item reduction.

2. Operationalisation of culture• Cultural index scores by Hofstede• Control through 5 questions regarding cultural items

3. Operationalisation of language• Native speaker vs. Non-native speakers according to answers in questionnaire• Control of proficiency level in non-native language

4. Operationalisation of medical knowledge• Physicians vs. Patients according to answers in questionnaire

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Agenda


2. Method & Data


3. Results

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Results

Medical knowledge

Language

Culture


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Results

Medical knowledge

Language

Culture


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Results: Information Seeking Behaviour

1. Use of

• Alphabetical search

&

• Search engine

2. Use of• Search by body parts

Characteristics 2 main types of information seeking behaviour (Factor Analysis)

• active vocabulary use

• name of disease required (predominantly goal oriented)

• fast information access

• little context information

• passive vocabulary use

• predominantly exploratory search behaviour

• more time-consuming

• highest amount of context information

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Results: Culture

Medical knowledge

Language

Culture


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Results: Culture

Classical approach:

CULTURAL DIMENSIONS INFORMATION SEEKING BEHAVIOUR

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Results: Culture

Classical approach:

CULTURAL DIMENSIONS INFORMATION SEEKING BEHAVIOURno significant correlation hereno significant correlation here

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Results: Culture

Classical approach:

CULTURAL DIMENSIONS INFORMATION SEEKING BEHAVIOURhere: no significant correlationshere: no significant correlations

Our new (explorative) approach:

Analyses based on GEOGRAPHICAL REGIONS

Europe:

Austria, Belgium, France, Germany, Hungary, Netherlands, Portugal, Slovenia, Ukraine, United Kingdom

N-America:

Canada, United States

S-& C-America:

Brazil, Chile, Colombia, Mexico

Asia:

Hong Kong, India, Malaysia,

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Results: ANOVA

Medical knowledge

Language

Culture in terms of regions


p = .026

p = .016

p = .134

significant interactions

P = .004

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Results: Language

Medical knowledge

Language

Culture


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Results: Language

Search Behaviour 1

• Significant correlations r=.248*

• alphabetical search & search engine are more used by

NON-NATIVE SPEAKERS

• confirms results in previous studies

• contradicts “intuitive“ thinking

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Results: Medical Knowledge

Medical knowledge

Language

Culture


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Results: Medical Knowledge

Search Behaviour 1

• Significant correlations r=.231*

• alphabetical search & search engine are more used by PHYSICIANS

• corresponds to “intuitive“ thinking

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Results: Interactions

Medical knowledge

Language

Culture in terms of regions


significant interactions

P = .004

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Results: Interactions

Patients

Non-Native speakers (among patients)

Native speakers (among patients)

92.7% 7.3%

Physicians

Non-Native speakers (among physicians)

Native speakers (among physicians)

50.0% 50.0%

r= .409**

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Conclusion: impact on Info Seeking Behaviour

1. Language and Medical Knowledge • Language & Medical Knowledge affect Information Seeking Behaviour

• medical knowledge appears to have a more important impact

• strong interactions between Language & Medical Knowledge

Does domain knowledge mediate language effects?

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Conclusion: impact on Info Seeking Behaviour

2. Culture

• no impact of Culture in terms of cultural dimensions

• only minor impact of Culture in terms of countries

• however significant differences with regard to some aspects exist:

e.g. the number of native speakers among patients

(much more in Europe & N-America, p =.001)

Does willingness to accept foreign language information depend on - the distribution of the Internet within the country?

- the information offered in a certain languages?- other socio-economic variables ?

Does objective (impact of L2 proficiency level) and subjective language information processing effort (impact of other variables) exist?

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Agenda


2. Method & Data


3. Results

4. Discussion & Outlook

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Recommendations for website design

• Patients and Physicians have different preferences in their information seeking behaviour

• Native speakers and non-native speakers have different preferences in their information seeking behaviour

• Native language information is more important for patients than for physicians

• In some regions, offering information in their native language is more important than in others

Realisation in website design through:

e.g. separate website areas for patients and physicians

e.g. highlighting of more appropriate search options

e.g. terminological support for non-native speakers, especially patients

e.g. adapted versions for groups of countries

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Future Research

• Does the use of the preferred search option also enhance the user‘s navigational performance?

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Future Research

• Does the use of the preferred search option also enhand the user‘s navigational performance?

• To which extent do culturally adapted search tools increase the user‘s satisfaction?

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Future Research



• How appropriate are culture index scores in the field of HCI? Is a new notion of culture needed that integrates socio-economic variables?

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Future Research




• To which extent is the user´s willingness to accept non-native language information affected by the languages offered on the Internet?

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Future Research




• To which extent is the users willingness to accept non-native language information affected by the language offer on the Internet?

• To which extent can domain knowledge mediate language effects?

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Future Research




• To which extent is the users willingness to accept non-native language information affected by the language offer on the Internet?

• To which extent can domain knowledge mediate language effects?

• Limited validity of this study: larger data set required.


Vielen Dank für Ihre Aufmerksamkeit! (L1 )

Thank you for your attention! (L2 )

Institut für Wirtschaftsinformatik Humboldt-Universität zu Berlin Kralisch & Berendt 2005 Access...

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