Healthcare access in rural China has seen a significant transformation with the advent of internet technologies. The shift to digital platforms for health information acquisition could overcome regional barriers and enhance patient knowledge and engagement. Yet, the prevalence, trust, and influence of online health information in these areas remain understood. A study published in BMJ Open investigated these factors among adults in rural Zhejiang Province, China, uncovering essential insights into internet-based health information utilization (DOI: 10.1136/bmjopen-2018-026202).

The research, carried out from May to June 2015, adopted a cross-sectional population-based approach using a self-designed questionnaire. The response rate among 652 adults aged 18 and above stood at an impressive 82.8%, rendering the findings highly representative of the region. The primary outcome was assessing the prevalence, trust, and usefulness of online health information. Concomitantly, the study sought to identify factors associated with these outcomes through inferential analysis.

The results painted a mixed picture. Only 34.8% of participants expressed trust in online health information. In contrast, the majority still placed their faith in traditional doctor-patient consultations as the primary source for health-related knowledge. Internet usage for health information was relatively rare, with merely 36.7% of participants, dubbed ‘Internet users,’ indicating they had accessed the internet in the past year for any purpose. This cohort saw a slightly higher frequency, with 40.6% reporting to have sought health information online. Nevertheless, of the 239 internet users, just 103 regarded the information obtained as beneficial.

Demographic analysis bore fruit to interesting associations. Younger adults, those with higher education levels, individuals employed in service-based tertiary sectors, and those reporting excellent health status emerged as frequent users of online health information. They also exhibited a greater inclination to trust this modality (p<0.001). These insights facilitate tailoring future public health interventions to enhance digital health literacy where it is most needed and receptive.

The study builds on a corpus of literature emphasizing the significance of digital literacy and accessibility in health information-seeking behavior. Fox and Duggan, in their report for the Pew Research Center, presented an early comprehensive analysis of online health information-seeking behaviors ( Ghweeba et al. highlighted similar patterns in Egypt, indicating a universal emergence of digital health engagement (J Med Internet Res 2017;19:e216 DOI: 10.2196/jmir.6855). Furthermore, Baumann, Czerwinski, and Reifegerste identified gender-specific determinants for online health information-seeking behaviors, underscoring the importance of individualized communication strategies (J Med Internet Res 2017;19:e92 DOI: 10.2196/jmir.6668).

Importantly, the study reflects a time when China’s internet penetration was blossoming. Reports from the China Internet Network Information Center indicate a gradual increase in internet users, which underpins the potential for a steeper rise in online health information utilization in the future (

This research holds implications for the development of internet hospitals and health platforms in China. The concept of internet hospitals, as elucidated in works by Xie et al., embodies the promise of telemedicine in enhancing healthcare delivery (J Med Internet Res 2017;19:e239 DOI: 10.2196/jmir.7854). Jing’s commentary in China Daily further illumined the prospect of ‘healthcare just a click away,’ articulating the transformative effect of online health resources on patient autonomy and the broader healthcare landscape (

The current study emphasizes the need for concerted efforts to bridge the digital divide in rural communities. Education, tailored outreach programs, and improving internet infrastructure could be instrumental in promoting online health literacy and making digital health a reality for rural residents. Nonetheless, as patient-provider interactions remain foundational, integrating online resources with traditional care models is crucial. It entails recognizing the role of doctors as trusted information disseminators who can guide patients in navigating and making the most of digital health information.


1. Online Health Information China
2. Health Information-Seeking Behavior
3. Digital Health Literacy
4. Rural Internet Health Access
5. Telemedicine in China


1. Qiu, Y., Ren, W., Liu, Y., Yin, P., & Ren, J. (2019). Online health information in a rural residential population in Zhejiang Province, China: a cross-sectional study. BMJ Open, 9(5), e026202. doi:10.1136/bmjopen-2018-026202
2. Fox, S., & Duggan, M. (2013). Health Online. Pew Research Center. Retrieved from
3. Ghweeba, M., Lindenmeyer, A., Shishi, S., et al. (2017). What predicts online health information-seeking behavior among Egyptian adults? J Med Internet Res, 19(7), e216. doi:10.2196/jmir.6855
4. Baumann, E., Czerwinski, F., & Reifegerste, D. (2017). Gender-Specific Determinants and Patterns of Online Health Information Seeking. J Med Internet Res, 19(4), e92. doi:10.2196/jmir.6668
5. Xie, X., Zhou, W., Lin, L., et al. (2017). Internet hospitals in China: Cross-sectional survey. J Med Internet Res, 19(7), e239. doi:10.2196/jmir.7854