Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Division of Ergonomics, Department of Psychology and Ergonomics, Technische Universität Berlin, Berlin, Germany.
J Med Internet Res. 2023 Jun 20;25:e46231. doi: 10.2196/46231.
Previous studies have revealed that users of symptom checkers (SCs, apps that support self-diagnosis and self-triage) are predominantly female, are younger than average, and have higher levels of formal education. Little data are available for Germany, and no study has so far compared usage patterns with people's awareness of SCs and the perception of usefulness.
We explored the sociodemographic and individual characteristics that are associated with the awareness, usage, and perceived usefulness of SCs in the German population.
We conducted a cross-sectional online survey among 1084 German residents in July 2022 regarding personal characteristics and people's awareness and usage of SCs. Using random sampling from a commercial panel, we collected participant responses stratified by gender, state of residence, income, and age to reflect the German population. We analyzed the collected data exploratively.
Of all respondents, 16.3% (177/1084) were aware of SCs and 6.5% (71/1084) had used them before. Those aware of SCs were younger (mean 38.8, SD 14.6 years, vs mean 48.3, SD 15.7 years), were more often female (107/177, 60.5%, vs 453/907, 49.9%), and had higher formal education levels (eg, 72/177, 40.7%, vs 238/907, 26.2%, with a university/college degree) than those unaware. The same observation applied to users compared to nonusers. It disappeared, however, when comparing users to nonusers who were aware of SCs. Among users, 40.8% (29/71) considered these tools useful. Those considering them useful reported higher self-efficacy (mean 4.21, SD 0.66, vs mean 3.63, SD 0.81, on a scale of 1-5) and a higher net household income (mean EUR 2591.63, SD EUR 1103.96 [mean US $2798.96, SD US $1192.28], vs mean EUR 1626.60, SD EUR 649.05 [mean US $1756.73, SD US $700.97]) than those who considered them not useful. More women considered SCs unhelpful (13/44, 29.5%) compared to men (4/26, 15.4%).
Concurring with studies from other countries, our findings show associations between sociodemographic characteristics and SC usage in a German sample: users were on average younger, of higher socioeconomic status, and more commonly female compared to nonusers. However, usage cannot be explained by sociodemographic differences alone. It rather seems that sociodemographics explain who is or is not aware of the technology, but those who are aware of SCs are equally likely to use them, independently of sociodemographic differences. Although in some groups (eg, people with anxiety disorder), more participants reported to know and use SCs, they tended to perceive them as less useful. In other groups (eg, male participants), fewer respondents were aware of SCs, but those who used them perceived them to be more useful. Thus, SCs should be designed to fit specific user needs, and strategies should be developed to help reach individuals who could benefit but are not aware of SCs yet.
先前的研究表明，症状检查器（SC，支持自我诊断和自我分诊的应用程序）的用户主要是女性，年龄小于平均水平，且具有较高的正规教育水平。德国的数据很少，迄今为止，还没有研究将使用模式与人们对 SC 的认识和对其有用性的看法进行比较。
我们探讨了与德国人口对 SC 的认识、使用和感知有用性相关的社会人口学和个体特征。
我们在 2022 年 7 月对 1084 名德国居民进行了一项关于个人特征以及他们对 SC 的认识和使用的横断面在线调查。通过商业小组的随机抽样，我们根据性别、居住州、收入和年龄对参与者的回答进行分层，以反映德国人口。我们对收集到的数据进行了探索性分析。
在所有受访者中，16.3%（177/1084）知道 SC，6.5%（71/1084）之前曾使用过 SC。知道 SC 的人更年轻（平均 38.8，SD 14.6 岁，vs 平均 48.3，SD 15.7 岁），更常为女性（107/177，60.5%，vs 453/907，49.9%），且具有更高的正规教育水平（例如，大学/学院学位，72/177，40.7%，vs 238/907，26.2%），与不知道 SC 的人相比。对于用户与非用户，也观察到了同样的情况。然而，当将用户与知道但未使用 SC 的非用户进行比较时，这种情况就消失了。在用户中，40.8%（29/71）认为这些工具有用。那些认为这些工具有用的人报告了更高的自我效能感（平均 4.21，SD 0.66，vs 平均 3.63，SD 0.81，在 1-5 的量表上）和更高的净家庭收入（平均 EUR 2591.63，SD EUR 1103.96 [mean US $2798.96，SD US $1192.28]，vs 平均 EUR 1626.60，SD EUR 649.05 [mean US $1756.73，SD US $700.97]）。与认为 SC 没有帮助的人相比，更多的女性（13/44，29.5%）认为 SC 没有帮助，而男性则较少（4/26，15.4%）。
与其他国家的研究一致，我们的研究结果表明，在德国样本中，社会人口统计学特征与 SC 使用之间存在关联：与非使用者相比，使用者平均年龄更小，社会经济地位更高，且更常见为女性。然而，使用情况不能仅用社会人口统计学差异来解释。它似乎表明，社会人口统计学解释了谁知道或不知道这项技术，但那些知道 SC 的人同样有可能使用它，而与社会人口统计学差异无关。尽管在一些群体（例如，患有焦虑症的人）中，更多的参与者报告知道和使用 SC，但他们倾向于认为它们的用处较小。在其他群体（例如，男性参与者）中，较少的受访者知道 SC，但那些使用它们的人认为它们更有用。因此，SC 应该根据特定用户的需求进行设计，应该制定策略来帮助那些可能受益但尚未意识到 SC 的人。
