Navigating Online Health Information and Misinformation in Chronic Disease: Patterns of Seeking, Verification, and Perceived Risk (Preprint)

BACKGROUND People living with chronic diseases increasingly rely on online sources to support ongoing self-management. While digital environments expand access to health information, they also expose patients to misinformation of varying credibility. Prior studies have largely described information-seeking behaviours or misinformation exposure separately, with limited integration of verification processes. OBJECTIVE This study examined the interrelationships between online health information seeking (HIS), verification behaviour (VER), and misinformation-related perceptions (MIS) among individuals with chronic diseases using a behaviourally integrated framework. METHODS A cross-sectional online survey was conducted among adults with self-reported chronic diseases. The questionnaire assessed health information seeking, verification practices, and perceptions of health misinformation using Likert-scale measures. Data were analysed using descriptive statistics, visual analytics, and structural equation modelling (SEM) to evaluate direct and indirect associations between constructs. RESULTS Participants reported frequent engagement with online health information and widespread use of verification strategies. SEM analysis revealed a strong positive association between HIS and VER (β = 0.81), indicating that active information seeking was closely linked to credibility assessment behaviours. HIS was positively associated with MIS (β = 0.41), suggesting that greater engagement increased awareness of misleading content. VER demonstrated a modest negative association with MIS (β = −0.29), consistent with a buffering effect whereby verification practices partially attenuated misinformation-related perceptions. CONCLUSIONS Findings support a mechanistic interpretation in which online health information seeking promotes verification behaviour, and verification practices may mitigate the perceived impact of misinformation. These results extend beyond descriptive accounts by demonstrating how information-seeking and evaluative behaviours interact within misinformation-rich digital environments. Interventions that reinforce verification strategies and embed credibility cues within commonly used platforms may strengthen safe digital health engagement among chronic disease populations