Abstract
BACKGROUND: The internet is a key source of health information, but the quality of content from popular search engines varies, posing challenges for users-especially those with low health or digital health literacy. To address this, the "tala-med" search engine was developed in 2020 to provide access to high-quality, evidence-based content. It prioritizes German health websites based on trustworthiness, recency, user-friendliness, and comprehensibility, offering category-based filters while ensuring privacy by avoiding data collection and advertisements. OBJECTIVE: This study aims to evaluate the acceptance and usability of this independent, noncommercial search engine from the users' perspectives and their actual use of the search engine. METHODS: For the questionnaire study, a cross-sectional study design was used. In total, 802 participants were recruited through a web-based panel and were asked to interact with the new search engine before completing a web-based questionnaire. Descriptive statistics and multiple regression analyses were used to assess participants' acceptance and usability ratings, as well as predictors of acceptance. Furthermore, from October 2020 to June 2021, we used the open-source web analytics platform Matomo to collect behavior-tracking data from consenting users of the search engine. RESULTS: The study indicated positive findings on the acceptance and usability of the search engine, with more than half of the participants willing to reuse (465/802, 58%) and recommend it (507/802, 63.2%). Of the 802 users, 747 (93.1%) valued the absence of advertising. Furthermore, 92.3% (518/561), 93.9% (553/589), 94.7% (567/599), and 96.5% (600/622) of those users who used the filters agreed at least partially that the filter functions were helpful in finding trustworthy, recent, user-friendly, or comprehensible results. Participants criticized some of the search results regarding the selection of domains and shared ideas for potential improvements (eg, for a clearer design). Regression analyses showed that the search engine was especially well accepted among older users, frequent internet users, and those with lower educational levels, indicating an effective targeting of segments of the population with lower health literacy and digital health literacy. Tracking data analysis revealed 1631 sessions, comprising 3090 searches across 1984 unique terms. Users performed 1.64 (SD 1.31) searches per visit on average. They prioritized the search terms "corona," "back pain," and "cough." Filter changes were common, especially for recency and trustworthiness, reflecting the importance that users placed on these criteria. CONCLUSIONS: User questionnaires and behavior tracking showed the platform was well received, particularly by older and less educated users, especially for its advertisement-free design and filtering system. While feedback highlighted areas for improvement in design and filter functionality, the search engine's focus on transparency, evidence-based content, and user privacy shows promise in addressing health literacy and navigational needs. Future updates and research will further refine its effectiveness and impact on promoting access to quality health information.