Background: Web-based patient education is increasingly offered to improve patients’ ability to learn, remember, and apply health information. Efficient organization, display, and structural design, that is, information architecture (IA), can support patients’ ability to independently use web-based patient education. However, the role of IA in the context of web-based patient education has not been examined systematically. Objective: To support intervention designers in making informed choices that enhance patients’ learning, this paper describes a randomized experiment on the effects of IA on the effectiveness, use, and user experience of a patient education website and examines the theoretical mechanisms that explain these effects. Methods: Middle-aged and older adults with self-reported hip or knee joint complaints were recruited to use and evaluate 1 of 3 patient education websites containing information on total joint replacement surgery. Each website contained the same textual content based on an existing leaflet but differed in the employed IA design (tunnel, hierarchical, or matrix design). Participants rated the websites on satisfaction, engagement, control, relevance, trust, and novelty and completed an objective knowledge test. Analyses of variance and structural equation modeling were used to examine the effects of IA and construct a theoretical model. Results: We included 215 participants in our analysis. IA did not affect knowledge gain (P=.36) or overall satisfaction (P=.07) directly. However, tunnel (mean 3.22, SD 0.67) and matrix (mean 3.17, SD 0.69) architectures were found to provide more emotional support compared with hierarchical architectures (mean 2.86, SD 0.60; P=.002). Furthermore, increased perceptions of personal relevance in the tunnel IA (β=.18) were found to improve satisfaction (β=.17) indirectly. Increased perceptions of active control in the matrix IA (β=.11) also improved satisfaction (β=.27) indirectly. The final model of the IA effects explained 74.3% of the variance in satisfaction and 6.8% of the variance in knowledge and achieved excellent fit (χ217,215=14.7; P=.62; root mean square error of approximation=0.000; 95% CI [0.000-0.053]; comparative fit index=1.00; standardized root mean square residual=0.044). Conclusions: IA has small but notable effects on users’ experiences with web-based health education interventions. Web-based patient education designers can employ tunnel IA designs to guide users through sequentially ordered content or matrix IA to offer users more control over navigation. Both improve user satisfaction by increasing user perceptions of relevance (tunnel) and active control (matrix). Although additional research is needed, hierarchical IA designs are currently not recommended, as hierarchical content is perceived as less supportive, engaging, and relevant, which may diminish the use and, in turn, the effect of the educational intervention.

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中文翻译：

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信息架构对基于网络的中老年人患者教育的有效性和用户体验的影响：在线随机实验

背景：越来越多地提供基于网络的患者教育，以提高患者学习、记忆和应用健康信息的能力。高效的组织、展示和结构设计，即信息架构（IA），可以支持患者独立使用基于网络的患者教育的能力。然而，IA 在基于网络的患者教育背景下的作用尚未得到系统的检验。目的：为了支持干预设计者做出有利于患者学习的知情选择，本文描述了一项关于 IA 对患者教育网站的有效性、使用和用户体验影响的随机实验，并检验了解释这些影响的理论机制. 方法：招募了自我报告髋关节或膝关节不适的中年和老年人，以使用和评估 3 个包含全关节置换手术信息的患者教育网站中的 1 个。每个网站都包含基于现有传单的相同文本内容，但采用的 IA 设计（隧道、分层或矩阵设计）不同。参与者对网站的满意度、参与度、控制力、相关性、信任度和新颖性进行评分，并完成了客观的知识测试。方差分析和结构方程模型用于检验 IA 的影响并构建理论模型。结果：我们的分析包括 215 名参与者。IA 不直接影响知识增益 (P=.36) 或总体满意度 (P=.07)。然而，隧道（平均 3.22，标准差 0.67）和矩阵（平均 3.17，标准差 0. 69) 与分层架构相比，架构提供了更多的情感支持（平均 2.86，SD 0.60；P=.002）。此外，发现在隧道 IA (β=.18) 中增加个人相关性的感知可以间接提高满意度 (β=.17)。在矩阵 IA (β=.11) 中增加对主动控制的感知也间接提高了满意度 (β=.27)。IA 效应的最终模型解释了 74.3% 的满意度方差和 6.8% 的知识方差，并实现了极好的拟合（χ217,215=14.7；P=.62；近似的均方根误差=0.000；95% CI [0.000-0.053]；比较拟合指数=1.00；标准化均方根残差=0.044）。结论：IA 对用户使用基于网络的健康教育干预的体验具有微小但显着的影响。基于 Web 的患者教育设计人员可以采用隧道 IA 设计来引导用户通过按顺序排列的内容或矩阵 IA，从而为用户提供对导航的更多控制。两者都通过增加用户对相关性（隧道）和主动控制（矩阵）的感知来提高用户满意度。尽管需要进行额外的研究，但目前不推荐分层 IA 设计，因为分层内容被认为不太支持、参与和相关，这可能会减少教育干预的使用，进而降低教育干预的效果。

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