Background: Despite the widespread growth of medical content on the World Wide Web (WWW), very little is known about identity, interests and motivation of users accessing pediatric information.

Objective: To better characterize the users and the utilization patterns of the pediatric WWW.

Methods: We conducted an observational study during a 5 week period from 1/24-2/28/97 focusing on the Pediatric Points of Interest (POI), a collection of more than 3200 links to pediatric WWW resources(http://www.med.jhu.edu/peds/neonatology/). Data were derived from a log of users visiting the site, the date of the visit, and the links they requested, as well as self-administered electronic surveys.

Results: A total of 5216 individual users visited the POI with an average of 149 new users per day and 3209 (62%) identified themselves as health care providers (HCPs) or laypersons (LPs). Of the 1998 HCPs, 45% were physicians and 23% were nurses. Most visitors (HCPs 59%, LPs 54%) had less than one year of Internet experience. HCPs were more likely to visit the POI repeatedly during the study period (HCPs 20%, LPs 15%, p<0.001). Users from North America accounted for 83% of visitors. HCPs were interested (multiple choices allowed) in “medical education” (56%),“research” (41%), “resource identification” (38%), and“disease specific information” (37%). Laypersons expressed the greatest interest in “disease specific information” (38%),“research” (32%), “medical education” (28%),“resource identification” (28%) and “patient education” (19%). The average user had 6.9 interactions with the POI server for a total of 36187 requests. Of those, 45% represented browsing within the POI while 55% were requests for links to pediatric WWW resources. The ratio of these pediatric resources to POI browsing was 1.2 (HCPs 1.1, LPs 1.3). On a scale from 1 (worst) to 5 (best) users evaluated the POI better than 3.9 in content, layout, ease of use and organization. LPs were more likely to visit sites intended for a non-medical audience such as“Patient Education” (LPs 42% - HCPs 25%, p<0.01) while HCPs visited “Professional Education & Resources” (LPs 12% - HCPs 29%, p<0.01).

Conclusions: Using the POI, LPs and HCPs were able to locate resources corresponding to their interest and level of medical knowledge with a minimum of navigation. High marks by users and a large number of repeat visitors suggest that users perceive this medium as effective in the identification of resources and actively seek out link collections such as the POI.