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Health literacy is an individual's or a community's capacity to comprehend, receive, read, and use relevant healthcare information and services. The World Health Organization (WHO, 2018) defines health literacy as the cognitive and social skills that determine the ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health. As a result, the WHO helps individuals manage long-term health concerns, participate in preventative...
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Related Experiment Video

Updated: May 21, 2025

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Exploring Laypersons' Experiences With a Mobile Symptom Checker App as an Interface Between eHealth Literacy, Health

Roland Koch1, Marie-Theres Steffen1, Anna-Jasmin Wetzel1

  • 1Institute for General Practice and Interprofessional Care, Tübingen University Hospital, Tübingen, Germany.

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Summary

Symptom checker use is a complex, cyclic process influenced by personal, social, and contextual factors. Health literacy is crucial for users to validate app information and integrate it into their health behaviors.

Keywords:
AIartificial intelligenceeHealth literacyhealth literacyinterview studyqualitative researchsymptom checker apps

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Area of Science:

  • Digital Health
  • Health Informatics
  • Human-Computer Interaction

Background:

  • Symptom checkers offer symptom recognition and action recommendations but lack reliability for self-triage or diagnostics.
  • The role of health literacy in symptom checker use and the path to healthcare consultation are not fully understood.

Purpose of the Study:

  • To qualitatively explore laypersons' use of symptom checkers, focusing on usage processes, entry points, outcomes, and the influence of health literacy.
  • To address how users describe the process of using symptom checkers, their entry points and outcomes, and the expression of health and eHealth literacy.

Main Methods:

  • A qualitative observatory study involving 15 laypersons interviewed about their experiences with the symptom checker Ada.
  • Analysis employed an integrative approach combining social positioning, agency, and the Rubicon model.

Main Results:

  • Symptom checker use follows a cyclic process: motivation, intention formation, implementation, and evaluation, influenced by biographical, social, and contextual factors.
  • Users utilize symptom checkers for understanding conditions, seeking action recommendations, and documenting health information, requiring integration into behaviors using personal, social, and technological resources.
  • Evaluation of app outputs is context-dependent and influenced by user expectations, condition severity, and prior experiences, with health literacy critically impacting validation.

Conclusions:

  • Symptom checker use is a complex, cyclic process influenced by context, biography, and health literacy, with trust and attitudes affecting engagement.
  • App outputs inform decisions, but users may not act on them, especially in ambiguous situations, relying on personal and social resources.
  • Symptom checkers can interface with healthcare, but development must address usage complexity to realize their full potential.