Table 2 Heuristics of decision-making related to Internet searching

Prior clinical or symptom related experience

previous interactions with a health care provider, prior experiences with symptoms (self or familiar other)

“I would—this would probably be where I would reflect on what my personal experience would have caused me to feel this way, and I would—if I started feeling really terrible”

“Then I’ll search for symptoms of the flu, because I didn’t get my flu shot, so I have to look into that.”

“I want to check silent migraines, sometimes I get those, and see what happens and why it triggers it.”

Credibility of information source

recognition of information status or contributors to the website, organization or format of the website, and resonance with participant

“We're going to go to CDC for seasonal influenza because I feel like that would be a beneficial type of information.”

“I’m going to use Wikipedia, even though it’s frowned upon.”

“I’d probably click on flu and oh, the first one says flu.gov. So, a government site might have some accurate information.”

Internet story coherence

consistency in information presented with own biases, vignette symptom definition, prior history with symptoms, or information obtained during search

“This is sounding a little bit closer to what I’m experiencing.”

“And this is pretty much where I would probably stop because it says right here the common cold, bronchitis or a viral syndrome.”

“There’s a lot of the same or the similarities between the flu and my symptoms, so I’m going to keep that on the table and think that maybe I have the flu, but go look at some other diseases.”