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.

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.

Purpose – The aim of this paper is to investigate whether/how youths’ pre-existing beliefs regarding health-related topics influence their online searching behaviors, such as their selection of keywords and search results, their credibility assessments and the conclusions they draw and the uses they make (or do not make) of the information they find. More specifically, we sought to determine whether positive hypothesis testing occurs when youth search for health information online and to ascertain the potential impacts this phenomenon can have on their search behaviors, their ability to accurately answer health-related questions and their confidence in their answers. Design/methodology/approach – An exploratory field experiment was conducted with participants in an after-school program (“HackHealth”), which aims to improve the health literacy skills and health-related self-efficacy of middle-school students from socio-economically disadvantaged backgrounds. Findings – Evidence of positive hypothesis testing among the participants was found and important impacts on their search outcomes were observed. Practical implications – The paper was concluded with suggestions for improving digital literacy instruction for youth so as to counteract the potentially negative influences of positive hypothesis testing. Originality/value – This study extends existing research about positive hypothesis testing to investigate the existence and impact of this phenomenon within the context of tweens (ages 11-14) searching for health information online.

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