Introduction

Health information on medical and health-related topics that individuals need for their own use or the well-being of other people is of high significance [1, 2]. Furthermore, it encompasses information about symptoms, diagnosis, and treatment of illnesses and serves as a reservoir of knowledge for improving health, preventing diseases, and accessing healthcare systems [3]. Access to health information has been recognized as a public health concern [4]. Studies show that information-seeking for proper nutrition, health status, disease prevention, proper nutrition, child-rearing practices, and guidance is rising [5]. Typically, health information comes from various sources such as healthcare professionals, print and electronic media, the internet, friends, and family, making it readily available [6].

Due to the limited time health professionals spend on examinations, many patients lack knowledge about their treatment, and with the proliferation of online health information, there is always a sense of uncertainty in understanding the details of health information [7]. However, many users lack the skills to find credible health information and do not have an accurate assessment of the quality of the information they obtain. Sometimes, misconceptions may arise from the information acquired [8, 9].

Knowledge and information in the field of health were traditionally reserved exclusively for medical professionals before the emergence of the Internet. Today, with the help of high-speed broadband, social media, and wireless networks, a large portion of the population relies on the Internet for a wide range of health information sources [6]. Many users study specific medical conditions and engage in real-time communication with healthcare providers through chat rooms, Q&A forums, and social media platforms. Most individuals who conduct online searches for health information aim to gather information on health recommendations to receive better guidance from their consulting physicians or simply seek assurance about their health status. While a significant amount of health information on the Internet is provided by reputable sources such as government agencies, research institutions, product vendors, healthcare centers, and individual professionals [10], there is a vast spectrum of information that, unintentionally, can mislead users, leading to mistrust and issues regarding the credibility of the sources or the accuracy of the provided services [11]. Such individuals are highly vulnerable to misleading information.

Diverse statistics about the application of health information worry each stakeholder’s mind, such as doctors, patients, health care workers, managers, policymakers, economists, and researchers. However, the advancements in accessibility to information,  information credibility, and its negative impact on users and patients are serious concerns among researchers searching and evaluating health information resource domains. Health information has some specific features; hence, its users have their particular characteristics [12]. Health information should be considered in terms of its terminology [13], specialty [14], short half-life and influence on health behavior [15], sensitivity to the extent of life and death, being on first demand and excessively dependent on the time and type of request, high availability for patients, preventing attendance in physician’s office, high influence on teens and youth [7] and features of site design [13]. Particularly, the users’ desire for anonymity and freedom of search is a highly considered issue [4, 5].

Importantly, there are some concerns in this area, such as unclear motivation of content providers and, in many cases, their lack of expertise, trust of lower age groups, youth, and special patients, variety of sites except traditional and governmental sites [12], lack of familiarity of searchers with search and evaluation techniques, exaggeration of some sites about some diseases and not being based on medical evidence [16]. Physical-mental harm capacity and the special condition of health information, on the one hand, and the lack of mechanisms for controlling and evaluating it, on the other hand, have brought many concerns. Some reports show that searchers often trust the health information [14]. According to Eysenbach (2020) [7], the ability rate of users to evaluate health information is lower than other available information such as news, business, and sciences. But in new information environments, the users are responsible for credibility judgments about the information they receive [17, 18]. As such, credibility assessment becomes a task for those who receive the information rather than for those who provide it.

The proliferation of online health information seekers has led to the growth of non-professional websites offering counseling in this domain [19]. A study [4] showed that health-conscious individuals often do not attach significant importance to the credibility of shared information in online health communities. Instead, searching for the information is reassuring and comforting in the face of fears of illness. These health concerns and often exaggerated perceptions of their illnesses can be potentially detrimental. Another study on the use of e-health services found that two-thirds of users never trust the privacy of the visited websites, and 23% of them cannot even recall the service providers [20]. What is more concerning is that most authors of such information are not healthcare professionals, and some have not even undergone relevant health training [21]. Consequently, several studies have proposed different models and frameworks for evaluating the quality of online health information, with significant criteria being accuracy, power, prevalence, responsibility, design, and security among others [22, 23].

In recent decades, researchers have paid considerable attention to health information seeking. They have conducted both quantitative and qualitative research on various aspects, such as channels for acquiring health information [24], attitudes toward health information seeking [25], motivations for seeking health information [26], and the influence of different demographic and non-demographic factors on health information seeking [27]. However, research focusing on the challenges and barriers to evaluating health information and trust issues in this context is limited, leaving a research gap. Given the crucial importance of access to high-quality health information for promoting self-care and preventive behaviors, diagnosing and treating diseases, and its relevance to healthcare practitioners and health policy-makers, research that addresses the challenges of evaluating health information, identifies them, and provides solutions is urgently needed, which is especially crucial in the current era with the widespread impact of COVID-19 and the potential for the recurrence of similar global health crises in the near future.

This study aimed to investigate the challenges in evaluating and trusting health information and explore the influence of personality traits in this context. Given the diversity in the quality of available health information and the presence of different personality types, research that bridges these two aspects will be highly valuable. This study is among the pioneering research efforts that delve into the relationship between barriers to evaluating health information and personality traits. Among the most important users of health information on the internet are medical faculty members and students and health fields who use information continuously. Such continuity is created due to class work projects and Internet dependency for searching health information. On the other hand, faculty members of medical fields also use the health information on the web for teaching-research activities and their treatments, especially due to its evidence-based nature. The selection criteria for the research population were the expertise and experience of participants who allocate a large amount of their time to search and evaluate health information on the web.

Literature review

Research on health information in the web environment is a fascinating research area that numerous researchers have conducted. A quality volume concerning health information credibility edited by Miriam J. Metzger and Andrew J. Flanagin (2007) reveals research efforts related to the subject area [28]. There is also much research in literature from which the following could be put forth.

In their study exploring the relationship between manipulated expertise and trustworthiness in predicting health information credibility and searching for potential moderators of the relationship, Yang and Beatty [5] searched mainstream databases related to online health information. The results of identifying 20 relevant studies indicated that manipulated expertise correlated with health information credibility at a higher level than did trustworthiness in the online but not offline context and that sample characteristic (student vs. nonstudent populations; age of participants), as well as the year of publication of the study, were significant moderators of the relationship. Cader (2013) has studied nurses for information quality of health and nursing on the internet using grounded theory in a two-stage evaluation [14]. Semi-structured interviews and focus groups were stated as methodologies of this research. The evaluation process was presented as a form of recognition. The evaluation methods depended on factors such as the evaluation skills of nurses, available time, and information level of the sites. The six stages of evaluating nurses were: assessing the user-friendliness, appearance, and authors, in relation to nurses’ work, investigating the evidence, and cross-checking strategies.

Liew (2011) evaluated thirty public free health information sources for studying the help options from content and visual aspects [13]. The results indicated that 63% of the sources contained the option “about the site,” 73% had contact information, 20% were accessible to professionals and the general public, 23% included medical residency terms, 83% linked to related resources, 31% in a language other than English, 13% had exceptional help for disabling and elderly people, 23% had advanced search feature and 47% had clear support options. Childs (2005) evaluated English health websites with qualitative methods, such as interviews and focus groups, from March 2002 to February 2003 [16]. Findings indicated the necessity of user guidance in two fields: individual user guidelines and support group guidelines. Individual user guidelines included strategies for searching and evaluating the information on a website, and supporting health professionals. The support group guidelines focused on designing a quality website and providing credible information, marketing a site,  and designing guidance to users about using health information.

Kalichman et al. (2006) revealed that 32% of respondents believed the information from an unreliable site was accurate, and 29% perceived the website as reliable and credible [29]. The results are evidence of patients’ vulnerability to incorrect information due to the inability to critically evaluate information from unreliable sites. Accessing reliable health information was identified as a global concern in the Health on the Net Foundation research. Respondents believed that improving credibility, reliability, and accuracy can greatly help users. Gerrish et al. (2011) indicated that 42% of nurses take medical evidence from the Internet, while only 48% call themselves efficient in health information evaluation [30].

However, Spink and Jansen (2004) found fewer searches were allocated to health information than other topics. Their research revealed that five major subjects had been searched more than others, including public health, weight, puberty, pregnancy, and human relations [31]. Searches for health information have been reduced from 1997 to 2003 due to increasing specialized tools. The meta-analysis of Wantland et al. (2004) has revealed promising results comparing web-based and medical interventions without the web [15]. Some advantages of web health information for patients are increasing nutrition and therapeutic knowledge, more participation in healthcare, and weight retention. The results of this research have considered medical web-based intervention appropriate for doctors in diagnostic and therapeutic activities and patients in changing behavior. In Table 1, we categorized the most studied predictors of online health information.

Table 1. Predictors of trust to online health information.

Methods

The present study is an applied study conducted using the survey-descriptive method. Since experts carry out health-related searches more frequently, our statistical population is the experts, including medical students and faculty members. Due to the high dispersion of medical specialties, we selected medicine and nursing as a statistical population, which conducts more Internet searches. Thus, the Faculty of Medicine and School of Nursing and Midwifery of Tehran University of Medical Sciences were selected as the research location. Two questionnaires were distributed among a random sample consisting of 148 respondents. Statistical data were collected and entered into SPSS software 24.0 for analyzing purposes.

Data collection tools included two questionnaires. The first questionnaire, derived from an extensive literature review, was related to users’ behavior in search and credibility evaluation of medical and health information with 22 questions. The second questionnaire included 12 questions about the personality trait of conscientiousness in users’ search and evaluation methods. Given that one of the research aims was to investigate the effect of the personality trait of conscientiousness in credibility evaluation, the sixty-question questionnaire of Costa and McCrae (1992), which is applied in many types of research, was chosen as the base [32]. Among the five aspects of personality, conscientiousness was detected to have the most relation with evaluation of information resources, and related questions were selected from the main questionnaire and were provided to the statistical population. The questionnaire was distributed to faculty members and experts in the Information Science field. The initial questionnaire was modified based on their opinions and distributed to participants, including 30 medical students from diverse specialties for reliability. In this study, Cronbach's alpha coefficient was 0.93.

Research questions

This study aimed to address the following research questions:

1. What challenges do the participants face when using online health information?
2. What are the participants’ perceptions regarding the credibility of online health information?
3. Do the participants trust the health information available online?
4. To what extent do the participants exhibit conscientiousness, and is there any difference based on demographic characteristics?
5. Is there a relationship between the conscientiousness of the participants and their credibility assessment of online health information?
6. Is there a relationship between the conscientiousness of the participants and their trust in online health information sources?

Results

Initially, the demographic characteristics of the study population are described in Table 2 as follows:

Table 2. Demographic characteristics of research participants.

 The frequency of options selected by the participants in the relevant question was examined using descriptive analysis to address the first research question. The results of this analysis are presented in Table 3.

Table 3. Challenges of using online health information.

Examining the participants’ opinions on using online health information reveals that the majority of them (37.7%) perceive "difficulty in determining the quality of information" as a challenge in their search and use the information they find, followed by “incredibility of information found on the internet (30%)," and “inappropriate information (21%)” Challenges related to "difficulty in finding information," "difficulty in quickly retrieving information," and "time-consuming internet use" accounted for smaller portion with 11% of participants pointed them out. As seen in the fourth row of Table 3, many participants search health information online encountered various challenges. The reason for the increased percentages in the fifth row of the table is also derived from this point.

To examine the existing differences among different demographic groups (gender, position, and academic degree) in facing these challenges, a comparison between the cells of the contingency table should be considered, which is presented in Table 4.

Table 4. Challenges in using online health information by demographic groups (f= frequency; t= Total; p= Percent).

As seen in Table 4, the highest frequency is related to difficulty in determining the quality of internet information corresponds with the gender variable of males. It should be noted that the situation is due to the larger number of male participants compared to females in the present study. As observed in the last column-row, over 52% of participating women in the research faced the same problem, indicating that a higher percentage of female participants encountered the challenge compared to males. In terms of student and faculty positions, over half of students (53 individuals) and faculty members (63%) faced the challenge. Among different educational degree groups, associate professors had the highest percentage of facing this problem.

To address the second research question—the examination of the credibility of sources from the perspective of the participants, their opinions about the credibility of information provided on the internet, the source of credibility, and their accuracy regarding information providers were analyzed and presented in the form of tripartite tables (5 and 6).

The investigation of the opinions of participants regarding the source of credibility of internet information (Table 5) shows that objectivity is the most essential criterion in determining the credibility of internet sources, with more than 31% of them mentioned, followed by currency (20%) and authority (17%). Accuracy in content presentation and coverage is less important.

Table 5. Source of credibility evaluation of online health information (f= frequency; p= Percent)

It is worth mentioning that the level of accuracy of people in credibility sources differs from each other. In the following, the amount of attention paid by the participants in the research to the source of providing information, as the most important source of information credibility, was analyzed (Table 6).

Table 6. Attention to the accuracy of information providers (f= frequency; p=percent; a= actual; d= density)

Most participants (27%) sometimes pay attention to the information providers when using online sources. Interestingly, 11.5% of the participants never pay attention to the information providers when using internet information. Despite the importance of the source, only 19.6% of participants "always" pay attention to online information providers.

To investigate why the participants do not find the information presented on websites and databases usable and pass over it, we analyzed their opinions in response to the question, "Which of the following reasons causes you to reject health information provided by a website?" The results of their opinions are presented in Table 7.

Table 7. Reasons for rejecting online health information (f= frequency; p= percent; a= actual; d= density).

References are the most important criterion for medical participants in accepting or rejecting health information provided on the Internet (Table 7). More than 33% of the participants reject health information presented on a website when references are absent.

The trust of the participants in health information provided on internet websites was analyzed to answer the third research question at two levels: their overall trust in the information and their trust in the information for patient care. The results related to the data analysis for these two levels are presented in Tables 8 and 9.

Table 8. Overall trust in online health information (f= frequency; p= percent; a= actual; d= density)

As observed in Table 8, the majority of the participants (more than 35%) trust health information provided on internet websites only in the range of 10% to 19%. Notably, only 4.1% of the participants have trust levels between 80%-100% in online health information. The percentage and frequency of individuals' trust levels in internet information in other percentage ranges are presented in Table 9.

Table 9. Participants' trust in online health information for patient care (f= frequency; p= percent; a= actual; d= density)

The examination of trust in Internet-based health information for patient care among the participants indicates that most (more than 34%) rarely trust Internet information for patient care. Additionally, 17.4% of the participants frequently and consistently trust the Internet for patient care, while 19% never trust Internet information.

Another variable examined in this research is conscientiousness, a vital personality trait [32]. The results of studies by Costa and McCrae [32], based on various factor analyses, have shown that personality consists of five fundamental and underlying factors. These five factors, namely Neuroticism (N), Extraversion (E), Openness to Experience (O), Agreeableness (A), and Conscientiousness (C), have been confirmed through various measurement methods, including self-report questionnaires and correlations with many personality questionnaires. Others perceive individuals who score high in conscientiousness as forward-thinking, intelligent, and trustworthy. They avoid trouble and achieve high levels of success through purposeful planning and persistence. On the negative side, they may exhibit perfectionism and workaholic tendencies. Conversely, overly conscientious individuals may be excessively task-oriented, dry, and exhausting. In general, this trait relates to motivation, organization, and stability in goal-directed behaviors, with its components including competence, orderliness, dutifulness, striving for achievement, self-discipline, and caution, which makes it closely related to information evaluation behavior [33].

Descriptive statistics regarding the conscientiousness of participants are presented in Table 10 to address the fourth research question, broken down by demographic characteristics. Data analysis indicates that the overall average conscientiousness of participants in the study is 2.1 out of 4. This score is above the average for this personality trait.

Table 10. Mean and SD related to conscientiousness.

Comparative analysis of different demographic groups reveals that the average conscientiousness of men (with a score of 2.12 out of 4) is higher than that of women, and students (with a score of 2.11) have higher conscientiousness than professors. Among students at various academic levels, Ph.D. students have the highest conscientiousness (with an average of 2.13) compared to students in other academic levels. Among different academic ranks, associate professors have higher conscientiousness compared to others.

To investigate differences between various demographic groups, independent t-tests and analysis of variance (ANOVA) were conducted, with the results presented in Table 11.

Table 11. ANOVA results for testing conscientiousness based on demographic groups.

Since Levene's test indicated homogeneity among the scores of the two groups, this study utilized a parametric independent t-test to identify the differences between the groups. As shown in Table 11, although the mean scores of conscientiousness for men were higher than those for women, the observed difference in means between the two groups (.02710) was not significant enough to conclude a meaningful difference between these two groups, which also holds true for the difference between the participants, as indicated by the obtained t-value (.172), suggesting that there is no significant difference between the two groups in the conscientiousness variable, and the observed difference is likely due to random factors. Furthermore, the results of Levene's test indicated homogeneity among the scores of different academic levels. Therefore, the use of a parametric analysis of variance was appropriate.

The difference between different groups regarding academic degrees in the conscientiousness factor was insignificant, meaning that students at different levels and professors with different academic degrees have similar levels of conscientiousness and do not differ significantly from each other (Table 12).

Table 12. ANOVA results for testing differences in conscientiousness based on academic ranks (Levene's test (Sig. = .390)).

Data on conscientiousness were transformed into rank data to answer the fifth question, and the Spearman correlation test was used to investigate the relationship between conscientiousness and dimensions of source credibility belief, a non-parametric test used to examine the concordance/homogeneity of changes in the values of two variables and when conditions such as normality of score distributions, the interval scale of measurement, and homogeneity of variances (i.e., similarity of variability in scores between different situations) are not met. The results of this test are presented in Table 13.

Table 13. Correlation between the level of conscientiousness and source credibility.

The results of the correlation test show a significant correlation (0.363) between the conscientiousness of the participants and the level of credibility evaluation they attribute to online information sources. Additionally, there is a relationship (0.443) between the conscientiousness of participants and their reasons for rejecting internet information, which is significant at the 1% level. It indicates that with changes in the levels of conscientiousness of the participants, their reasons for rejecting health information also change, and individuals with different levels of conscientiousness attribute different reasons for rejecting information, including the presence of advertisements, inappropriate appearance, unknown authorship, lack of references or links, lack of contact information, and outdated information.

Examining the relationship between conscientiousness and the accuracy of information providers also shows that the two variables are correlated at approximately 0.075, which is not statistically significant at the 1% and 5% levels. In other words, changes in the conscientiousness levels of the participants do not result in significant changes in their accuracy in evaluating information providers.

A similar approach to the previous question was used to answer the sixth research question, which is the examination of the relationship between the conscientiousness of participants and their trust in internet sources. The results of this analysis are presented in Table 14.

Table 14. The correlation coefficient between conscientiousness level and trust.

The results of the correlation analysis using the Spearman correlation coefficient indicate a relationship of 0.307 between the conscientiousness of students and medical faculty members and their overall trust in internet resources, which is statistically significant at the 1% level. The results acknowledged a change in the level of conscientiousness of individuals also leads to a change in their trust in Internet resources. Additionally, no significant relationship between the conscientiousness of individuals and their trust in Internet resources for medical treatment (refer to the second column of Table 14).

Discussion

The research findings indicated that medical professionals face various challenges when accessing online healthcare information, such as difficulties in finding or quickly retrieving information, determining the quality of information, and information inaccuracies. Most participants (37.7%) expressed "difficulty in assessing the quality of information" as their primary concern when searching for and using internet information. Furthermore, over 30% mentioned the incredibility of internet information as a major issue. More than 52% of female participants in the research faced the challenge of "determining the quality of internet information," suggesting that a higher percentage of women encountered this issue compared to men. Additionally, in terms of academic position, even though a higher number of students (53 individuals) faced this problem, a higher percentage of faculty members (63%) also experienced it. The findings are consistent with previous research, such as Eyenbach et al. (2020) and Cader (2013) have noted that quality and credibility are pressing concerns [7, 14].

Based on the research findings, it is clear that medical professionals face significant challenges when accessing online healthcare information. The difficulties in finding or quickly retrieving information, determining its quality, and dealing with information inaccuracies are common concerns. The fact that a large percentage of participants expressed difficulty in assessing the quality of information highlights the need for critical evaluation skills among medical professionals. With the abundance of information available online, it becomes crucial for healthcare professionals to have the ability to discern reliable sources from unreliable ones.

The finding that over 30% of participants mentioned the incredibility of internet information as a major issue further emphasizes the importance of trustworthiness in online health information. This indicates that medical professionals are aware of the potential inaccuracies and biases that can exist in online sources.

The observation that a higher percentage of female participants faced challenges in determining the quality of internet information compared to men suggests that there may be gender differences in how healthcare professionals approach online information. This finding could be explored further to better understand the reasons behind this difference and to develop strategies to address it. The fact that both students and faculty members faced challenges in determining the quality of internet information highlights that this is an issue across different levels of expertise. It is important for educational institutions and professional organizations to provide guidance and training on evaluating online health information to equip healthcare professionals with the necessary skills. Overall, the research findings highlight the need for healthcare professionals to be conscientious and critical when evaluating online health information. It is essential to have strategies in place to address the challenges mentioned, such as promoting information literacy, providing access to trustworthy sources, and encouraging collaboration and consensus among professionals.

Findings also showed that objectivity is the most important criterion for assessing the credibility of online resources, with over 31% of respondents emphasizing this aspect. Currency and author credibility are also significant factors in their evaluation. Notably, a significant number of the participants (27%) sometimes consider information providers when using internet sources. Interestingly, 11.5% of participants never pay attention to information providers when using internet information. Credible references and links are the most crucial criteria when accepting or rejecting information provided on the Internet. More than 33% of participants reject health information presented on a website in the absence of references and links. Similarly, more than 20% of research participants considered the lack of information about the author as one of the main reasons for rejecting health information. Notably, most participants (over 64%) have less than 40% trust in health information presented on internet sites (Table 8), indicating low levels of credibility in such information among them. Furthermore, over 82% of participants have little or occasional trust in health information, showing shallow trust. Such findings should be more studied because accuracy and subject coverage are also essential criteria in information evaluation, which are less considered by the studied sample. Confirming the research such as Childs (2005) and Kalichman et al., (2006), the findings remind us of the necessity of education and updating evaluation skills among the users affected by such reliance [16, 29].

The findings related to the conscientiousness indicators among different participant groups in this study (Tables 10, 11, and 12) demonstrate that their conscientiousness levels are above average, and there is no significant difference between them in terms of demographic indicators. Furthermore, one of the important findings of this study is the correlation between the conscientiousness of the participants with their trust levels in online health information (0.363) and their reasons for rejecting internet information (0.443). This finding is consistent with previous studies [12, 29]. This correlation was also observed in information rejection. By changing the levels of conscientiousness among the participants, their reasons for rejecting health information would change simultaneously. In conscientiousness, different people have different reasons for rejecting information, including advertisements, inappropriate appearance, unknown author, lack of references or links, and lack of contact and current information. There is also a high correlation in the accuracy rate of information providers. To be more precise, by changing the participants’ conscientiousness levels,, no change occurs in their accuracy rate in information providers. Considering the significant relation between the conscientiousness of the participants and their total trust in the internet resources, by changes in people’s conscientiousness level, people’s trust level in the internet resources will also be changed. This study indicates that changes in the levels of conscientiousness would lead to changes in their reasons for rejecting health information, with individuals with different levels of conscientiousness citing various reasons, including the presence of advertisements, inappropriate appearance, unclear authorship, lack of references or links, and outdated information. However, this correlation does not appear to accurately assess the participants' accuracy in evaluating information providers' trustworthiness. Another important finding of this research is that changes in individuals' conscientiousness levels also lead to changes in their trust levels in internet resources. Also, the lack of a significant relationship between people’s conscientiousness and their trust level in the online health resources in patients’ treatment suggests that individuals with different levels of conscientiousness may approach the assessment of health information differently and have varying levels of trust. Given the multiple challenges in evaluating health information and its low levels of trust, it is necessary to consider the personality traits of conscientiousness more carefully, as individuals with lower levels of this trait may be at risk of serious harm due to the use of incorrect health information.

The findings of this study suggest that individuals with different levels of conscientiousness may have varying reasons for rejecting health information, such as the presence of advertisements, inappropriate appearances, unclear authorship, lack of references or links, and outdated information. This indicates that conscientiousness plays a role in how individuals evaluate and trust online health information. However, it is important to note that this correlation may not accurately reflect the participants' accuracy in evaluating the trustworthiness of information providers. While conscientiousness may influence the reasons for rejecting information, it does not necessarily guarantee an accurate assessment of trustworthiness. The study also highlights that changes in individuals' conscientiousness levels can lead to changes in their trust levels in internet resources.

This suggests that conscientiousness may impact how individuals approach the assessment of health information and their overall trust in online resources. It is noteworthy that there was no significant relationship between conscientiousness and trust levels in online health resources for patients' treatment. This finding indicates that individuals with different levels of conscientiousness may have different approaches to evaluating health information and varying levels of trust. Given the challenges in evaluating health information and the low levels of trust associated with it, the study suggests that considering the personality trait of conscientiousness is important. Individuals with lower levels of conscientiousness may be at risk of harm due to the use of incorrect health information. This highlights the need for targeted interventions and education to improve critical evaluation skills and promote trust in reliable sources.

Overall, the study provides valuable insights into the relationship between conscientiousness, evaluation of health information, and trust levels. It underscores the importance of considering personality traits when addressing the challenges of accessing and trusting online health information.

Implications and limitations

The present study’s findings indicate that participants face various challenges in evaluating the credibility of health information and trusting information sources, which prevent them from fully relying on the information they find for disease prevention or helping patients. Such findings suggest the existence of a crisis in the way health information is presented online, undermining information credibility and seriously affecting user trust. Another important point in this research is the significant impact of conscientiousness mechanisms on how online health information is evaluated and the level of trust in it. That is, individuals with high levels of conscientiousness tend to have a weak assessment of the credibility of health information and lack sufficient trust in it.

Since the target population in this study consisted of academicians and experts in the field of health and medicine, future research should consider incorporating data from other social groups to increase the effectiveness and generalizability of the research findings. Future research could explore medical professional’s perspectives on different sources, such as websites or social media platforms, comparatively. Healthcare professionals and policymakers can use the research findings to develop strategies for increasing media literacy among the general public, raising awareness about the challenges, and addressing them. Given that the present study is descriptive and implemented in a limited community of users, it is recommended to use mixed and qualitative methodologies such as interviews, thinking aloud, video typing, or very standard checklists and conduct more extensive research to achieve broader and more generalizable results.

Conclusion

The present research provides valuable insights into the challenges of evaluating the quality of health information and its impact on user trust and utilization. The study participants identified objectivity as the most critical criterion for evaluating health information, but they overlooked other important factors such as authorship, topic coverage, and accuracy. However, the presence of references and links to credible sources played a significant role in rejecting health information, highlighting the need to include these elements in health information sources. Furthermore, the study examined conscientiousness as a personality trait and found that individuals with this trait tend to scrutinize health information more carefully. They expressed lower trust due to the perceived lower quality of information, leading to decreased trust and utilization. These findings highlight the importance of considering personality traits when studying health information evaluation and utilization. These research findings have implications for conducting more comprehensive studies in healthcare and informing policymaking in the context of online health information delivery, including social media platforms. By understanding the factors influencing trust and utilization of health information, healthcare providers and policymakers can develop strategies to improve the quality and credibility of online health information sources.

Availability of data and materials

Please contact the corresponding author if you would like access to the datasets used or analyzed during this study.

Funding

Not applicable. 

Authors’ Contribution

H.K. conceived and designed the study, with overall supervision by H.K. HR.S. was responsible for questionnaire distribution and collection, with oversight from H.K. E.V. and T.W. reevaluated the data, revised the manuscript, and conducted the statistical analysis. HR.S. and T.W. performed a reanalysis of the statistical data. All authors critically reviewed and approved the final manuscript.

Acknowledgment

Not applicable.

Ethics approval and consent to participate

Informed consent was obtained from participants who completed the questionnaires. We assured participants that their information would be treated confidentially throughout the study and that their privacy would be respected. The ethics committee at Shahid Beheshti University, Tehran, Iran, granted an exemption for this study protocol as it does not involve any patients. All methods were conducted in accordance with the relevant guidelines and regulations, including adherence to the Declaration of Helsinki.

Consent for publication

Not applicable.

Competing interests

The author declares no competing interests.

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