How Users' gaze behavior is related to their quality evaluation of a health website based on HONcode principles?

While the health website is an easily accessible source for patients to use when seeking health information, the quality of online health information has been a critical issue that concerns all stakeholders in healthcare. The aim of this research was to examine the relationship between users' evaluation of the health website quality and their gaze behavior on the web pages. Eye tracking and a self-report questionnaire based on the HONcode principles were used to address the objective. We found that (1) the evaluations of authority, privacy, financial disclosure, and advertising policy are positively correlated with the fixation count and total fixation duration toward corresponding page components, while the evaluations of complementarity and attribution are negatively correlated with the fixation count and total fixation duration to corresponding page components; and (2) the fixation count and total fixation duration toward health information sources are negatively related to the evaluation of health website quality, while the fixation count and total fixation duration to site owner are positively related to the quality evaluation. Users' attention to page components is closely related to the evaluation of principles, and also has a certain impact on the overall quality evaluation of a health website. Based on the findings, our research may serve to improve the health website design and be a foundation to develop an automatic evaluation approach of the health website quality.