Background: Previous studies have revealed that most pregnant women rarely discuss informal information found on the
internet with health professionals and have frequently expressed concerns for medical experts’ reactions to the online information
they shared, as well as the lack of time to consult the medical experts in general. To date, little information is available on the
effect of individual differences in utilizing medical help-seeking strategies on their medical decisions during the perinatal period.
Objective: The objectives of this study were (1) to determine associations among perinatal women’s medical help-seeking
strategies, changes in medical decision making, and online health information utilization with a focus on the mediating effect of
self-efficacy in perinatal health literacy on the intent to consult health professionals, and (2) to clarify these associations in perinatal
women with two different medical problems: obstetric and mental health.
Methods: A total of 164 perinatal women aged 24 to 47 years (mean 34.64, SD 3.80) repeatedly completed the Problem Solving
in Medicine and Online Health Information Utilization questionnaires to examine the moderating effect of two types of medical
problems on their decision-making processes. To validate the hypothesized relationships in the proposed conceptual model
encompassing obstetric and mental health problem-solving models, path analyses were performed.
Results: This study found that some perinatal women, who use an online informal medical help-seeking (OIMH) strategy,
would be more likely to change their medical decisions based only on internet-based information without consulting health
professionals (P<.001), compared to other women using different medical help-seeking strategies. Particularly, this concern is
significantly prevalent when encountering obstetric problems during the perinatal period (obstetric problem-solving: P<.001;
mental health problem-solving: P=.02). Furthermore, perinatal women with mental health issues using the OIMH strategy showed
a significant difference in intent to consult health professionals based on online health information when the medical problem
they had to solve was different (obstetric problem-solving: P=.94; mental health problem-solving: P=.003).
Conclusions: Despite the positive mediating effects of perinatal women’s enhanced health literacy on the intent to discuss
personal medical issues with health professionals based on online health information, the strategy used is of fundamental importance