Talk presented at the 2009 Usability Professionals Association Conference. For a copy of the slides, please email kath@usability.org

1. Talk
What Triggers Trust?
How Health Consumer Behavior is Evolving with the Web
Arabella Crawford
Kath Straub, PhD
Usability Professionals’ Associa9on 2009 InternaEonal Conference

2. Then

3. Website credibility circa 2000
Credibility Killers
Quick response to ques9ons Slow download
Physical address Has ads
Contact informa9on Typos
Recently updated Broken links
Professionally designed .
Arrangement makes sense .
. Hard to navigate
. Has popup ads
. No updates
Has ads that match the topic .
Requires you to register Hard to tell ads from content
Credibility Enhancers
Fogg, et. al., 2000

4. Website credibility circa 2000
Credibility Killers
Technology Focus
Credibility Enhancers

5. Early evolution of information consumers
Quick response to ques9ons Design look
Physical address Informa9on structure
Contact informa9on .
Recently updated .
Professionally designed Usefullness of informa9on
Arrangement makes sense .
. Func9onality
. Customer Service
. Iden9ty of sponsor
Has ads that match the topic .
Requires you to register Readability
Afillia9ons
2002 2004
Fogg, et. al., 2003
Credibility Enhancers

6. Early evolution of information consumers
Quick response to ques9ons Design look
Physical address Informa9on structure
Contact informa9on .
Recently updated .
Usability Focus
Professionally designed
Arrangement makes sense
Usefullness of informa9on
.
. Func9onality
. Customer Service
. Iden9ty of sponsor
Has ads that match the topic .
Requires you to register Readability
Afillia9ons
2002 2004
Credibility Enhancers

7. Consumers use different cues than professionals (2003)
Name/Affilia9on Design look
Informa9on source Informa9on focus
Business mo9ve Informa9on design
Informa9on focus Adver9sing
Adver9sing 3 Company mo9ve
Design look 1 Reputa9on/Affilia9on
Informa9on bias Informa9on bias
Informa9on design Informa9on accuracy
Wri9ng tone Wri9ng tone
Informa9on Accuracy 2 Informa9on source
Health
Professionals Non‐professionals
Fogg, et. al., 2003 Credibility Enhancers

8. Then Now (ish)

9. People look to the web for health information (2008)
Jones, et. al., 2008

10. How does then compare to late 2007?
• Online survey
• QuesEons built from on Sillence (2004)
• 518 parEcipants
Crawford, et. al., 2008a

11. Why do they go online?
of note...
Websites contain more informa9on than doctors can know, or
paEents can reasonably expect them to know.
They use the web both before and aWer going to the doctor

13. How they they get there?
of note...
• 70% of health info seekers start at a known site, not
search

14. When you type sites in, its easy to mix up the URL ...
Cancer
Consumers’ Error Rates: PredicEng URLs
.gov
.org
.com
Crawford, et. al., 2008b

15. What inspires trust?
•of note...
• Health informaEon consumers start by confirming that the
site says something that they already know.
• Trust is indexed against Reputa9on, content characteris9cs,
and content quality.
• Consumers cross check facts

16. Why do consumers do?
of note...
• Health informaEon seekers read content most.
• Content from other users is more engaging than interacEons
like symptom checkers.

17. Why go back?
of note...
InformaEon seekers go back because content was useful and
other sources confirmed it was validity.

18. Takeaways
Trust markers
• Health informaEon consumer today use the trust/credibility markers
that health experts used in 2002.
• SItes are more credible if the first confirm something that the
informaEon seeker already knows.
• Content quality and characterisEcs are increasingly important for inEal
trust and driving repeat visits.
Self‐reported behaviors
• Health informaEon consumers are looking for convenient,
comprehensive that can be perused privately.
• They read more than they interact.

19. Takeaways
Trust markers
• Health informaEon consumer today use the trust/credibility markers
that health experts used in 2002.
• SItes are more credible if the first confirm something that the
informaEon seeker already knows.
• Content quality and characterisEcs are increasingly important for inEal
Content
trust and driving repeat visits.
Self‐reported behaviors
• Health informaEon consumers are looking for convenient,
comprehensive that can be perused privately.
• They read more than they interact.
Credibility & Trust

20. Credibility & trust for consumer health seekers
2000 Technology
2002 Usability
2008 Content
Social networking &
technology-driven collaboration
Content level usability
Computer-mediated empathy

21. Ideal physician behaviors
Confident, Positive
Empathetic
Attentive (Humane)
Comprehensive
Plain English (Forthright)
Collaborative (Respectful)
Conscientious (Thorough)
Bendapudi,, et al, 2006

22. Credibility & trust for consumer health seekers
2000 Technology
2002 Usability
Questions?
2008 Content
Social networking &
technology-driven collaboration
Content level usability
Computer-mediated empathy

23. References
Bendapudi, N, Berry, L., Frey, K., Parish, J., Rayburn, W. (2006) Patients' Perspectives on Ideal Physician Behaviors. Mayo
Clinic Proceedings, 81(3):338-344.
Crawford, Broch, J., and Straub, K. (2008b) What’s In a Name?; Best PracEces for SelecEng Usable URLs. Proceedings of
UPA08, 2008. BalEmore, Maryland.
Crawford, A., & Straub, K. (2008q) Convenience, Content and Credibility: What consumers are looking for on health
informaEon sites. Proceedings of UPA08, 2008. BalEmore, Maryland.
Fogg, B.J., Soohoo, C., Danielson, D.R., Marable, L., Stanford, J., & Tauber, E.R. (2003). How do users evaluate the
credibility of Web sites? A study with over 2,500 parEcipants. Proceedings of DUX2003, Designing for User Experiences
Conference.
Jones, S. and Fox, S. (2008) GeneraCons on‐line 2009. PEW Internet and America Life Report. Downloaded from hYp://
www.pewinternet.org/Reports/2009/GeneraCons‐Online‐in‐2009.aspx
Fogg, B.J., Swani, P., Treinen, M., Marshall, J., Osipovich, A., Varma, C., Laraki, O., Fang, N., Paul, J., Rangnekar, A., &
Shon, J. (2000). Elements that affect Web credibility: Early results from a self‐report study. Proceedings of CHI'00,
Extended Abstracts on Human Factors in CompuDng Systems, 287‐288.
Sillence, E., Briggs P., Fishwick L, Harris, P., Trust and Mistrust of Online Health Sites. Proceedings of CHI 2004, April 24–
29, 2004, Vienna, Austria.
Rains, S., & Karmikel, C. D., (2009) Health informaEon‐seeking and percepEons of website credibility: Examining.
Computers in Human Behavior 25 (2009) 544–553

24. For information & reprints, etc.
Arabella Crawford
Consumer Researcher
arabella@usability.org
Kath Straub
Principal
kath@usability.org
www.usability.org