Health literacy and the Internet: a study on the readability of Australian online health information

BACKGROUND The increasing amount of health information available on the internet makes it more important than ever to ensure that people can judge the accuracy of this information to prevent them from harm. It may be possible for platforms to set up protective mechanisms depending on the level of digital health literacy and thereby to decrease the possibility of harm by the misuse of health information. OBJECTIVE This study aimed to create an instrument for digital health literacy assessment (DHLA) based on the eHealth Literacy Scale (eHEALS) to categorize participants by level of risk of misinterpreting health information into high-, medium-, and low-risk groups. METHODS This study developed a DHLA and constructed an online health information bank with correct and incorrect answers. Receiver operating characteristic curve analysis was used to detect the cutoff value of DHLA, using 5 items randomly selected from the online health information bank, to classify users as being at low, medium, or high risk of misjudging health information. This provided information about the relationship between risk group for digital health literacy and accurate judgement of online health information. The study participants were Taiwanese residents aged 20 years and older. Snowball sampling was used, and internet questionnaires were anonymously completed by the participants. The reliability and validity of DHLA were examined. Logistic regression was used to analyze factors associated with risk groups from the DHLA. RESULTS This study collected 1588 valid questionnaires. The online health information bank included 310 items of health information, which were classified as easy (147 items), moderate (122 items), or difficult (41 items) based on the difficulty of judging their accuracy. The internal consistency of DHLA was satisfactory (α=.87), and factor analysis of construct validity found three factors, accounting for 76.6% of the variance. The receiver operating characteristic curve analysis found 106 people at high risk, 1368 at medium risk, and 114 at low risk of misinterpreting health information. Of the original grouped cases, 89.6% were correctly classified after discriminate analysis. Logistic regression analysis showed that participants with a high risk of misjudging health information had a lower education level, lower income, and poorer health. They also rarely or never browsed the internet. These differences were statistically significant. CONCLUSIONS The DHLA score could distinguish those at low, medium, and high risk of misjudging health information on the internet. Health information platforms on the internet could consider incorporating DHLA to set up a mechanism to protect users from misusing health information and avoid harming their health.

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Low-Level Evidence Suggests that Perceived Ability to Evaluate and Trust Online Health Information is Associated with Low Health Literacy

Evidence Based Library and Information Practice ◽

10.18438/b88g9g ◽

2016 ◽

Vol 11 (2) ◽

pp. 183

Author(s):

Lindsay Alcock

Keyword(s):

Health Literacy ◽

Health Information ◽

Evaluation Criteria ◽

Positive Association ◽

The Internet ◽

Online Health Information ◽

Low Level ◽

Evaluative Criteria ◽

Low Health Literacy ◽

The Impact

Objective – To review, based on research evidence, the correlation between low health literacy and four outcomes of interest: (1) the ability to evaluate online health information based on (2) perceived reliability and accuracy, (3) trust in the Internet as an information source, and (4) the application of established evaluation criteria. Design – Systematic review and narrative synthesis. Setting –MEDLINE, PsycInfo, Web of Science, CINAHL, and Communication and Mass-media Complete as well as articles discovered through the snowball method. Subjects – 38 studies identified through a systematic literature search. Methods – An exhaustive list of potential articles was gathered through searching five online databases and Google Scholar, and hand searching of references. Inclusion and exclusion criteria were applied in a two-phase screening process in which two researchers participated to address reliability. Data, including study characteristics and metadata, predictors, assessment methods, and outcomes, were extracted from relevant studies, and then synthesized narratively. Main Results – Following duplication removal 13,632 records were retrieved, 254 of which were identified for full-text assessment. Thirty-eight studies met the eligibility criteria. All studies were non-experimental and therefore graded as a low level of evidence; 35 were cross-sectional designs, 1 a focus group, and 2 were observational studies. Studies varied widely in population definition and sample size and were published between 2001 and 2013, primarily in North America. Overall, a positive association was identified between health literacy and outcomes related to the ability to evaluate or trust Internet health information, while findings were inconsistent related to perceived quality of information and the application of evaluative criteria. Four studies examined the impact of health literacy levels on one or more of the outcomes of interest. The most prevalent outcome measure studied was trust in online health information, and the least prevalent was the use of evaluative criteria. The ability to trust online health information was assessed primarily through self-reporting, half of which utilized the eHealth Literacy scale, the majority of which indicated a positive correlation between education level or low health literacy and the perceived or actual ability to evaluate online health information. No studies on perceived information quality were found to utilize health literacy as an indicator. A positive association between educational level and trust in health information on the Internet was reported in ten studies, while two articles noted a similar correlation based on proxies for health literacy, including English language proficiency and comprehension comfort. In terms of the use of evaluation criteria, only one study focused on health literacy, indicating that those with low health literacy evaluate online health information based on search result placement, celebrity endorsement, image quality, and site authorship, and that they trust university researchers more than government or religious authorities to provide health information. No association was shown between readability or physician-provided online information and evaluation criteria while one study demonstrated that study participants with higher education tended to check author credentials more often when evaluating a website. Conclusion – Effective and informed evaluation of online health information is impacted by low health literacy.

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Age and Neurocognition Are Associated With Credibility Evaluations of Health Websites

10.31234/osf.io/zh63x ◽

2021 ◽

Author(s):

Michelle A. Babicz ◽

Samina Rahman ◽

Victoria Kordovski ◽

Savanna Tierney ◽

Steven Paul Woods

Keyword(s):

Older Adults ◽

Health Literacy ◽

Health Information ◽

Age Groups ◽

The Internet ◽

Online Health Information ◽

Younger Adults ◽

Neurocognitive Functions ◽

Credibility Rating ◽

Future Work

The internet has become a common means by which many older adults seek out health information. The prevalence of misinformation on the internet makes the search for accurate online health information a more complex and evaluative process. This study examined the role of age and neurocognition in credibility evaluations of credible and non-credible health websites. Forty-one older adults and fifty younger adults completed a structured credibility rating task in which they evaluated a series of webpages displaying health information about migraine treatments. Participants also completed measures of neurocognition, internet use, and health literacy. Results suggested that older adults rated non-credible health websites as more credible than younger adults, but the age groups did not differ in their ratings of credible sites. Within the full sample, neurocognition was positively associated with credibility ratings for non-credible health websites, whereas health literacy was related to the ratings of credible sites. Findings indicate that older adults may be more likely to trust non-credible health websites than younger adults, which may relate to differences in higher-order neurocognitive functions. Future work might examine whether cognitive-based supports for credibility training in older adults can be used to improve the accuracy with which they evaluate online health information.

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Relationship Between Levels of Digital Health Literacy Based on the Taiwan Digital Health Literacy Assessment and Accurate Assessment of Online Health Information: Cross-Sectional Questionnaire Study

Journal of Medical Internet Research ◽

10.2196/19767 ◽

2020 ◽

Vol 22 (12) ◽

pp. e19767

Author(s):

Peggy Liu ◽

Ling-Ling Yeh ◽

Jiun-Yi Wang ◽

Shao-Ti Lee

Keyword(s):

Health Literacy ◽

High Risk ◽

Health Information ◽

Digital Health ◽

Characteristic Curve ◽

Risk Groups ◽

The Internet ◽

Online Health Information ◽

Literacy Assessment ◽

Information Bank

Background The increasing amount of health information available on the internet makes it more important than ever to ensure that people can judge the accuracy of this information to prevent them from harm. It may be possible for platforms to set up protective mechanisms depending on the level of digital health literacy and thereby to decrease the possibility of harm by the misuse of health information. Objective This study aimed to create an instrument for digital health literacy assessment (DHLA) based on the eHealth Literacy Scale (eHEALS) to categorize participants by level of risk of misinterpreting health information into high-, medium-, and low-risk groups. Methods This study developed a DHLA and constructed an online health information bank with correct and incorrect answers. Receiver operating characteristic curve analysis was used to detect the cutoff value of DHLA, using 5 items randomly selected from the online health information bank, to classify users as being at low, medium, or high risk of misjudging health information. This provided information about the relationship between risk group for digital health literacy and accurate judgement of online health information. The study participants were Taiwanese residents aged 20 years and older. Snowball sampling was used, and internet questionnaires were anonymously completed by the participants. The reliability and validity of DHLA were examined. Logistic regression was used to analyze factors associated with risk groups from the DHLA. Results This study collected 1588 valid questionnaires. The online health information bank included 310 items of health information, which were classified as easy (147 items), moderate (122 items), or difficult (41 items) based on the difficulty of judging their accuracy. The internal consistency of DHLA was satisfactory (α=.87), and factor analysis of construct validity found three factors, accounting for 76.6% of the variance. The receiver operating characteristic curve analysis found 106 people at high risk, 1368 at medium risk, and 114 at low risk of misinterpreting health information. Of the original grouped cases, 89.6% were correctly classified after discriminate analysis. Logistic regression analysis showed that participants with a high risk of misjudging health information had a lower education level, lower income, and poorer health. They also rarely or never browsed the internet. These differences were statistically significant. Conclusions The DHLA score could distinguish those at low, medium, and high risk of misjudging health information on the internet. Health information platforms on the internet could consider incorporating DHLA to set up a mechanism to protect users from misusing health information and avoid harming their health.

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Does Online Searching Cause or Enforce Health Information Disparity?

Journal of Information & Knowledge Management ◽

10.1142/s0219649213500329 ◽

2013 ◽

Vol 12 (04) ◽

pp. 1350032 ◽

Cited By ~ 2

Author(s):

Yong-Mi Kim

Keyword(s):

Social Media ◽

Health Literacy ◽

Health Information ◽

Self Efficacy ◽

Healthcare Providers ◽

Health Benefits ◽

The Internet ◽

Online Health Information ◽

Online Searching ◽

Health Related

A growing number of people are seeking health information on the Internet. To meet demands, healthcare providers are increasingly disseminating information online. While online health information has enhanced the dissemination of health information and improved people's health-related knowledge, critics posit that such dissemination has widened knowledge disparities in health information and health benefits as a result. Drawing on existing studies, this study identified the main causes of such disparity, namely education, health literacy, computer self-efficacy (CSE) and usage of health-related social media. The finding showed that education resided at the centre of the disparity and impacted other elements. An interesting finding is although individuals possess high levels of CSE, the efficacy does not highly impact their health benefits, meaning that computer does not directly cause health information disparity but is the tool to promote health-related knowledge disparity.

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Community desires for an online health information strategy

Australian Health Review ◽

10.1071/ah08719 ◽

2010 ◽

Vol 34 (4) ◽

pp. 467 ◽

Cited By ~ 8

Author(s):

Jared M. Dart ◽

Cindy Gallois

Keyword(s):

Health Care ◽

Socioeconomic Status ◽

Health Literacy ◽

Health Information ◽

Clinical Pathways ◽

The Internet ◽

Online Health Information ◽

Local Health ◽

Information Strategy ◽

Low Socioeconomic

Objective. To determine whether the community’s attitudes to components of a community eHealth strategy differ across three different socioeconomic groups. Design. A survey questionnaire was designed and implemented across three different communities. Participants and setting. Paper-based surveys were left in community organisations and local health practices in a low socioeconomic community on the outskirts of Ipswich, Queensland (n = 262), a mid-high socioeconomic community in the western suburbs of Brisbane (n = 256) and at a local university (n = 200). Main outcome measures. Ascribed importance and comfort with proposed components of a community eHealth strategy. Results. A community-oriented health website was perceived as useful in getting access to relevant health information. Those who were most comfortable with accessing online health information were those who were: experienced, had home internet access and were frequent internet users. The most important types of health information for the website were: information about the treatment of conditions, how to manage a chronic illness, how to stay healthy and patient clinical pathways. The low socioeconomic community had different information priorities – all categories were considered more important, particularly information about how the public system operates, local health support groups, and the roles of health professionals. Conclusions. Different communities have different information demands but there is a strong demand for information which empowers community members to take control of their own health and become active participants in their health care. Tools such as a community health portal and patient clinical pathways should become more available. What is known about the topic? There is existing literature discussing the impact of the internet and other eHealth strategies, in terms of the perceptions and preferences of different parts of the community. Many previous researchers have pointed to deficiencies in health literacy as a function of socioeconomic status and their negative consequences for health outcomes and participation in health care. The internet has been recommended as a useful way to increase health literacy, if users’ knowledge and skills and preferences are adequately assessed and catered for. What does this paper add? This paper adds detail to what is known about the preferences of various parts of the community in terms of eHealth and online health information. It adds Australian data to our understanding of the role of the internet, and of community-based approaches to eHealth. Our results underscore the importance of understanding differences as a function of socioeconomic status, as well as knowledge of basic internet skills, health literacy, and online experience in determining patients’ preferences for and use of these means of accessing health information. What are the implications for practitioners? In the context of the growing burden of chronic disease and the importance of lifestyle factors and risk factor modification, this research suggests that a concerted online health information approach is valuable and timely. In particular, the paper provides data as to different communities’ opinions of potential components of an online health information strategy.

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Protocol paper for the ‘Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI)’ study: a mixed qualitative methods study

BMJ Open ◽

10.1136/bmjopen-2018-024188 ◽

2018 ◽

Vol 8 (8) ◽

pp. e024188

Author(s):

Maureen Seguin ◽

Laura Hall ◽

Helen Atherton ◽

Rebecca Barnes ◽

Geraldine Leydon ◽

...

Keyword(s):

Health Information ◽

Current Evidence ◽

The Internet ◽

Online Health Information ◽

Online Information ◽

Wide Range ◽

Patient Questionnaires ◽

Ethical Approval ◽

Use Of The Internet ◽

Questionnaire Studies

IntroductionMany patients now turn to the internet as a resource for healthcare information and advice. However, patients’ use of the internet to manage their health has been positioned as a potential source of strain on the doctor–patient relationship in primary care. The current evidence about what happens when internet-derived health information is introduced during consultations has relied on qualitative data derived from interview or questionnaire studies. The ‘Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI)’ study combines questionnaire, interview and video-recorded consultation data to address this issue more fully.Methods and analysisThree data collection methods are employed: preconsultation patient questionnaires, video-recorded consultations between general practitioners (GP) and patients, and semistructured interviews with GPs and patients. We seek to recruit 10 GPs practising in Southeast England. We aim to collect up to 30 patient questionnaires and video-recorded consultations per GP, yielding up to 300. Up to 30 patients (approximately three per participating GP) will be selected for interviews sampled for a wide range of sociodemographic characteristics, and a variety of ways the use of, or information from, the internet was present or absent during their consultation. We will interview all 10 participating GPs about their views of online health information, reflecting on their own usage of online information during consultations and their patients’ references to online health information. Descriptive, conversation and thematic analysis will be used respectively for the patient questionnaires, video-recorded consultations and interviews.Ethics and disseminationEthical approval has been granted by the London–Camden & Kings Cross Research Ethics Committee. Alongside journal publications, dissemination activities include the creation of a toolkit to be shared with patients and doctors, to guide discussions of material from the internet in consultations.

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Lifestyle Segmentation to Explain the Online Health Information–Seeking Behavior of Older Adults: Representative Telephone Survey

Journal of Medical Internet Research ◽

10.2196/15099 ◽

2020 ◽

Vol 22 (6) ◽

pp. e15099 ◽

Cited By ~ 2

Author(s):

Winja Weber ◽

Anne Reinhardt ◽

Constanze Rossmann

Keyword(s):

Older Adults ◽

Health Information ◽

Information Seeking ◽

Internet Use ◽

Information Seeking Behavior ◽

The Internet ◽

Online Health Information ◽

Sociodemographic Variables ◽

Seeking Behavior ◽

Health Related

Background As a result of demographic changes, the number of people aged 60 years and older has been increasing steadily. Therefore, older adults have become more important as a target group for health communication efforts. Various studies show that online health information sources have gained importance among younger adults, but we know little about the health-related internet use of senior citizens in general and in particular about the variables explaining their online health-related information–seeking behavior. Media use studies indicate that in addition to sociodemographic variables, lifestyle factors might play a role in this context. Objective The aim of this study was to examine older people’s health-related internet use. Our study focused on the explanatory potential of lifestyle types over and above sociodemographic variables to predict older adults’ internet use for health information. Methods A telephone survey was conducted with a random sample of German adults aged 60 years and older (n=701) that was quota-allocated by gender, age, educational status, and degree of urbanity of their place of residence. Results The results revealed that participants used the internet infrequently (mean 1.82 [SD 1.07]), and medical personnel (mean 2.89 [SD 1.11]), family and friends (mean 2.86 [SD 1.21]), and health brochures (mean 2.85 [SD 1.21]) were their main sources of health information. A hierarchical cluster analysis based on values, interests, and leisure time activities revealed three different lifestyle types for adults aged over 60 years: the Sociable Adventurer, the Average Family Person, and the Uninterested Inactive. After adding these types as second-step predictors in a hierarchical regression model with sociodemographic variables (step 1), the explained variance increased significantly (R2=.02, P=.001), indicating that the Average Family Person and the Sociable Adventurer use the internet more often for health information than the Uninterested Inactive, over and above their sociodemographic attributes. Conclusions Our findings indicate that the internet still plays only a minor role in the health information–seeking behavior of older German adults. Nevertheless, there are subgroups including younger, more active, down-to-earth and family-oriented males that may be reached with online health information. Our findings suggest that lifestyle types should be taken into account when predicting health-related internet use behavior.

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Anxiety, Knowledge and Help: A Model for How Black and White College Students Search for HIV/AIDS Information on the Internet

The Qualitative Report ◽

10.46743/2160-3715/2011.1041 ◽

2014 ◽

Author(s):

Kim Smith

Keyword(s):

College Students ◽

Black Students ◽

Health Information ◽

Information Literacy ◽

The Internet ◽

Online Health Information ◽

Literacy Training ◽

Aids Information ◽

White College ◽

Hiv Aids

Using the "think aloud" protocol, which allows for the collection of data in real time, the researcher audio taped comments from 13 white college students from a predominately white university in the Southeastern United States and 15 black students from a predominately black university, as they explained how they searched for HIV/AIDS information on the Internet. A grounded theory analysis of the tapes revealed a three-stage model that students progressed through as they searched for HIV/AIDS information on the Internet. That model also revealed that all of the white students searched for general information about HIV/AIDS on the Internet, while all black students searched for general and specific information about how the disease affected the African-American community. Eighty percent of students regardless of race did not know how to properly search for online health information. The researcher discusses the need for online health information literacy training, the theories that might explain why black students searched the way that they did, and the challenges to providing culturally-sensitive online health information literacy training for African-Americans who have been historically suspicious of the United State's health care system.

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An examination of the quality of late-life depression websites on the Internet (Preprint)

10.2196/preprints.36177 ◽

2022 ◽

Author(s):

Teaghan Pryor ◽

Kristin Reynolds ◽

Paige Kirby ◽

Matthew Bernstein

Keyword(s):

Mental Health ◽

Older Adults ◽

Health Literacy ◽

Health Information ◽

Mental Health Literacy ◽

Late Life ◽

The Internet ◽

Late Life Depression ◽

Mental Health Information

BACKGROUND The Internet can increase the accessibility of mental health information and improve the mental health literacy of older adults. The quality of mental health information on the Internet can be inaccurate or biased, leading to misinformation OBJECTIVE This study’s objectives were to evaluate the quality, usability, and readability of websites providing information concerning depression in later life. METHODS Websites were identified through a Google search, and evaluated by assessing quality (DISCERN), usability (Patient Education Materials Assessment Tool; PEMAT) and readability (Simple Measure of Gobbledygook; SMOG). RESULTS The overall quality of late-life depression websites (N = 19) was moderate, usability was low, and readability was poor. No significant relationship was found between quality and readability of websites. CONCLUSIONS Websites can be improved by enhancing information quality, usability, and readability related to late-life depression. The use of high-quality websites may improve mental health literacy and shared treatment decision-making for older adults.

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