Publication Date


Document Type


Committee Members

Kevin Bennett (Committee Member), Tamera Schneider (Committee Chair), Wayne Shebilske (Committee Member), Clark Shingledecker (Committee Member)

Degree Name

Doctor of Philosophy (PhD)


The Internet has become a platform that many users, governments, corporations, and other organizations hope to leverage in order to support a dynamic and effective physician-patient partnership. However, many researchers have identified significant shortcomings with the current online health information domain. This research examined the use of online health information technology (HIT) by individuals with and without visual disabilities. Two studies were conducted to understand online health information searching behaviors of individuals with and without disabilities. The impact of providing relevant search keywords to participants, and the impact of stress appraisals upon health information search behavior and HIT website usage were the primary constructs evaluated. The first study examined the impact of the provision of focused keywords on participant health-related search performance. It was hypothesized that in trials where keywords were provided, there would be improved search accuracy, efficiency, and quality of responses. In addition, it was hypothesized that when people appraised the task as a challenge compared to threat, they would have improved search accuracy, efficiency, and quality of responses. The first study utilized a repeated measure design with randomization of treatment conditions for keyword provision (provided or not) for four distinct health-information related search tasks. The findings revealed that the provision of keywords and stressor appraisals influence participant performance of health-related, online search tasks. Challenged individuals who receive keywords, and threatened individuals who do not receive keywords demonstrate what is typically considered to be more effective online search performance. The second study examined the unique health-related search behaviors employed by individuals with visual disabilities using screen reader software. The findings revealed that there are substantial improvements in web design and online health information architecture that can be implemented to improve the user experience, accessibility, and comprehensibility of this critical data source for individuals that use screen readers. The results of both studies show that users typically demonstrate fairly shallow searches (selecting information from the first page of search results), lean toward a single search engine (, and are able to find reasonably accurate health information. However, for participants with visual disabilities, there remain several obstacles to effective health information website selection and navigation due to poor labeling of images, hyperlinks, and page arrangement, and conflicts between embedded code and screen reader software.

Page Count


Department or Program

Department of Psychology

Year Degree Awarded


Creative Commons License

Creative Commons Attribution-Noncommercial-Share Alike 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License.