Women who effectively use health information on the Internet appear to make ongoing use of varied resources there, according to University of Wisconsin-Madison researchers. The scientists” findings are based on their evaluation of an experimental Internet site they created for women with breast cancer.

The researchers have found that urban Caucasian women who benefited the most from the Internet site combined frequent on-line conversations with other breast cancer patients along with ongoing use of information resources and tools to help them make decisions. Many of those who only posted and read discussion group messages didn”t benefit.

However, this pattern is most clear for urban Caucasian women, according to communication scientist Suzanne Pingree. Although rural and African-American women benefited the most overall from access to the site, only some of them fit the usage patterns of urban Caucasian women.

The issue of reaching traditionally underserved groups, such as rural and African-American women, is important because people frequently turn to the Internet when they need health information, Pingree says. However, a so-called “digital divide” exists, where underserved groups have less access to the Internet and the health information it contains.

Pingree, along with a group of researchers at the Center for Health Systems Research and Analysis, are trying to bridge this gap by examining how women use health information on the Web, and what patterns of use give the best results. They hope that what they find can be applied to design better health information sites, Pingree said.

The Wisconsin researchers developed the site as part of the Comprehensive Health Enhancement Support System. They design and study Internet-based support and information programs for patients and their families. The breast cancer site provides information about the disease, resources to help patients make decisions and assess their progress, the option of asking a health expert questions, and a discussion group. When the women used the site, a computer program monitored their activity so that the researchers could analyze it later.

Researchers have known for several years that having access to CHESS helps breast cancer patients have greater emotional support and well being, know more about breast cancer and have fewer concerns than women who did not have access to the site. In addition, African-American and rural women benefited even more than Caucasian women. Given those results, the scientists then tried to understand how women who benefited the most from access to CHESS differed from benefited the least.

The contrast between the two groups of women generally indicates that only using the computer to maintain contact with other breast cancer patients is not enough, even if these contacts occur almost daily. The contacts need to be mixed with information and decision-making tools. The urban Caucasian women in this study who benefited the most and those who benefited the least fit this pattern. But the results were less clear for African-American and rural women. In both groups, the women who benefited the least didn”t spend a lot of time in discussion groups, the way some of the Caucasian women did. Instead, African-American and rural women who didn”t benefit hardly used CHESS at all.

Pingree thinks this presents two challenges for designers of web-based health systems. “First, we need to find ways to keep all discussion group users connecting to the rest of the system,” she says. “When the most-successful users participate in discussions, it seems to stimulate them to explore our information and tools.” The second challenge is to attract African-American and rural women more consistently into the system. Pingree thinks that “the interpersonal connection our discussion groups offer isn”t as big a lure for them, either because they have good support networks already, or the groups are mostly urban Caucasian women whose concerns don”t resonate, making the discussions a less-interesting way to get involved in CHESS.”

The breast cancer site is different from other health information Web sites, according to Pingree. “There are isolated pockets of information out there, but it”s not all together and no one is evaluating whether it works,” she says. “One day, we hope that this site will be available to the public.”

This study was funded by a grant from the National Institute of Child Health and Human Development. The other researchers with the Center for Health Systems Research and Analysis were Robert Hawkins, Fiona McTavish and David Gustafson.