Ahmed Allam*, Università della Svizzera italiana (Institute of Communication and Health), Lugano, Switzerland Peter Johannes Schulz*, Università della Svizzera italiana (Institute of Communication and Health), Lugano, Switzerland Kent Nakamoto, Virginia Tech university (Marketing Department), Virginia, United States Track: Research Presentation Topic: Search, Collaborative Filtering and Recommender Technologies Presentation Type: Rapid-Fire Presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: A-Pechet Room Date: 2012-09-16 11:00 AM – 11:45 AM Last modified: 2012-09-10

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Background: Since the Internet has begun to boom, people depend on the World Wide Web for searching and exchanging information all over the world. Despite the power of search engines in retrieving and ranking results in reply to user queries, the process of finding or choosing relevant and credible websites is still a big challenge. Thus when it comes in finding information on the Internet, people are affected and tend to believe the results offered by search engines are the most helpful or the most trustworthy, especially if they were retrieved by widely used and reputable search engines (Google, Bing, etc...).
Objective: We test the effect of different manipulations of the Google custom search engine on the user’s trust, knowledge and attitudes toward vaccination.
Method: An experiment was conducted comparing three customized search engines. The customization of each search engine was done by determining the different set of websites the search engine covers written as xml file. Additionally we manipulated the ranking procedure by applying suitable weights for websites to be promoted or demoted. The first one is the normal Google (Group1), and its search coverage is the whole web. Group2 used Google configured to find a set of websites that are evaluated by the Health on the Net (HON) code, which aims at providing health information of better quality and trustworthiness on the net. The set of HON sites that focused on Vaccination topics and provided credible information was retrieved by a script written in Python. Group 3 used an engine configured to search for websites, blogs and forums that discourage vaccination and were run by anti-vaccination activists or movements. Marketing students from Virginia (USA) enrolled in a study-abroad program in Lugano (Switzerland) were asked to participate in the experiment. A Pre-Post-Test design was employed. Students were allocated randomly to one of the three search engines. After having compiled a pre-test questionnaire, they had to search for information about vaccination for 12 minutes. The post-test questionnaire asked knowledge questions and opinion/attitude Likert scales; we also measured credibility, relevance, and trustworthiness of the sites and the information participants had found.
Results: The sample of students was N=39 (Group1:n=12,Group2:n=14,Group3:n=13). 20.5% were males and 79.5% females. We used an alpha level of .05 for all statistical tests. Using one-way ANOVA and Kruskal Wallis test showed no difference between the three groups in terms of trust in information(F(2,36)=1.83,p=.175)(Chi²=2.549,p=0.28),satisfaction with information(F(2,36)=1.841,p =.173)(Chi²=1.218,p=0.544),level of being convinced (F(2,36)=.989,p=.382) (Chi²=0.763,p=0.683), information relevance (F(2,36)=2.973,p =.064) (Chi²=5.443,p=0.066) and trust in Google (F(2,36)=3.077,p =.058)(Chi²=4.205,p=0.122). Knowledge questions were calculated as scores and then ranked to apply the Wilcoxon signed-ranks test for checking any significance within each group before/after experiment. A significant increase in knowledge was observed in Group2(Z=-2.088,p=.037).When it comes to attitudes/opinions such as the importance of vaccination of adults against influenza (Z=-2.326,p=.020) and the effectiveness of vaccination against swine flu (Z=-2.230,p=.026) showed a significant change within Group 2. For Group 1 and Group 3 there was no significant change. Lastly Group 3 showed an increase in the concern for side-effects of vaccination of adults (Z=-2.582,p=.010) and for believing that vaccination was causing more harm than good (Z=-2.200,p=.028).
Conclusion: The study suggests that reading the websites offered by the quality- and credibility-conscious search engine may make Internet users of health information more knowledgeable than other sites, and strengthens appropriate and well-founded opinions and behavioral intentions in them. Opinionated sites generated by biased search engines create some opinion change in users. Both effects, however, are apparently independent of users’ manifest site credibility and evaluation judgments. Users are affected, be it beneficially or detrimentally, but the basis of this effect escapes them. This suggests they are not consciously perceptive of indicators that steer them towards the promising sources or away from the dangerous ones. In this sense the health information seeker on the Internet is flying blind.