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Trust is a key factor in consumer decisions about website engagement. Consumers will engage with sites they deem trustworthy and turn away from those they mistrust. In this paper, we present a framework for understanding trust factors in web-based health advice. The framework is derived from a staged model of trust and allows predictions to be made concerning user engagement with different health websites. The framework is then validated via a series of qualitative, longitudinal studies. In each study, genuine consumers searched online for information and advice concerning their specific health issue. They engaged in free searching and were directed towards sites previously reviewed using the framework. Thematic analysis of the group discussions provided support for the framework and for the staged model of trust wherein design appeal predicted rejection (mistrust) and credibility of information and …