Purpose -The purpose of this paper is to focus on disadvantaged tweens' (ages 11 through 13) strategies for making predictive and evaluative judgments of the credibility of health information online. More specifically, this paper identifies the features of Google search results pages and web sites that signal credibility (or lack thereof) to this population and the reasons behind their perceptions. Design/methodology/approach -The authors employed an ethnographic approach (using various types of data collection methods) targeted to generate in-depth descriptions of tweens making predictive and evaluative judgments of credibility, focussing on the ways in which these tweens naturally assess the credibility of online information. Findings -The research has yielded novel findings concerning the types of factors that influence disadvantaged tweens' credibility assessment strategies, such as limited English-language vocabularies, lack of familiarity with perhaps otherwise well-known sources, and forced reliance on (and/or general preference for) non-textual modalities, such as audio and video. Practical implications -The findings indicate a need for implementing digital literacy programs in a naturalized setting, building on tweens' existing heuristics and thereby resulting in strategies that are simultaneously compatible with their natural inclinations within the online environment and likely to consistently lead them to accurate credibility-related judgments. Originality/value -This study provides novel insights into how disadvantaged tweens interact with online health information in a natural context, and offers invaluable information regarding the ways in which credibility assessment processes should be facilitated within formal or informal digital literacy programs.
BackgroundTechnology offers opportunities to improve healthcare, but little is known about Internet use by COPD patients. We tested two hypotheses: Internet access is associated with socio-demographic disparities and frequency of use is related to perceived needs.MethodsWe analyzed data from a 2007–2008 national convenience sample survey of COPD patients to determine the relationship between Internet access and frequency of use with demographics, socio-economic status, COPD severity, and satisfaction with healthcare.ResultsAmong survey respondents (response rate 7.2%; n = 914, 59.1% women, mean age 71.2 years), 34.2% reported lack of Internet access, and an additional 49% had access but used the Internet less than weekly. Multivariate models showed association between lack of access and older age (OR 1.10, 95% CI 1.07, 1.13), lower income (income below $30,000 OR 2.47, 95% CI 1.63, 3.73), less education (high school highest attainment OR 2.30, 95% CI 1.54, 3.45), comorbid arthritis or mobility-related disease (OR 1.56, 95% CI 1.05, 2.34). More frequent use (at least weekly) was associated with younger age (OR 0.95, 95% CI 0.93, 0.98), absence of cardiovascular disease (OR 0.48, 95% CI 0.29, 0.78), but with perception of needs insufficiently met by the healthcare system, including diagnostic delay (OR 1.72, 95% CI 1.06, 2.78), feeling treated poorly (OR 2.46, 95% CI 1.15, 5.24), insufficient physician time (OR 2.29, 95% CI 1.02, 5.13), and feeling their physician did not listen (OR 3.14, 95% CI 1.42, 6.95).ConclusionsAn analysis of the characteristics associated with Internet access and use among COPD patients identified two different patient populations. Lack of Internet access was a marker of socioeconomic disparity and mobility-associated diseases, while frequent Internet use was associated with less somatic disease but dissatisfaction with care.
Although youth are increasingly going online to fulfill their needs for information, many youth struggle with information and digital literacy skills, such as the abilities to conduct a search and assess the credibility of online information. Ideally, these skills encompass an accurate and comprehensive understanding of the ways in which a system, such as a Web search engine, functions. In order to investigate youths' conceptions of the Google search engine, a drawing activity was conducted with 26 HackHealth afterschool program participants to elicit their mental models of Google. The findings revealed that many participants personified Google and emphasized anthropomorphic elements, computing equipment, and/or connections (such as cables, satellites and antennas) in their drawings. Far fewer participants focused their drawings on the actual Google interface or on computer code. Overall, their drawings suggest a limited understanding of Google and the ways in which it actually works. However, an understanding of youths' conceptions of Google can enable educators to better tailor their digital literacy instruction efforts and can inform search engine developers and search engine interface designers in making the inner workings of the engine more transparent and their output more trustworthy to young users. With a better understanding of how Google works, young users will be better able to construct effective queries, assess search results, and ultimately find relevant and trustworthy information that will be of use to them.
Background Although a low health literacy level has been found to be among the most powerful predictors of poor health outcomes, there is very little research focused on assessing and improving the health literacy skills of adolescents, particularly those from socioeconomically disadvantaged backgrounds. The vast majority of existing research focuses solely on reading comprehension, despite the fact that health literacy is actually a multifaceted concept, which entails many different types of skills. Objective The aim of this paper is to first mine existing literature to identify the many different skills that have been posited to constitute health literacy, and then, using this collection of skills as an overarching structure, to highlight the challenges that disadvantaged youth participating in our HackHealth after-school program encounter as they identify and articulate their health-related information needs, search for health-related information online, assess the relevance and credibility of this information, and manage and make use of it. Methods We utilized the design-based research method to design, implement, and revise our HackHealth program. To collect data regarding HackHealth participants’ health literacy skills and associated challenges, we used a variety of methods, including participant observation, surveys, interviews, focus groups, and logging of Web browser activities. We also collected data through specialized instructional activities and data collection forms that we developed for this purpose. Quantitative and qualitative techniques were used to analyze this data, as well as all of the artifacts that each student produced, including their final projects. Results We identified the various challenges that the 30 HackHealth participants faced in completing various health-related information activities during the course of the program. Based on these findings, we describe important implications for working with youth from socioeconomically disadvantaged backgrounds, how to assess and improve their health literacy skills, and offer specific recommendations for health literacy instruction aimed at this population. Conclusions With an increased societal focus on health and a shift from viewing patients as passive recipients of medical care to viewing them as active arbiters of their own health, today’s youth need to possess an array of health literacy skills to ensure that they can live long and healthy lives. Working with adolescents to help them develop and practice these skills will also help to break the cycle between poor health literacy and poor health outcomes, thereby reducing health disparities and improving the long-term outlook for the health of our nation.
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