Internet-Based Health Information–Seeking Behavior of Students Aged 12 to 14 Years: Mixed Methods Study

Abstract

Background Many children and adolescents are surrounded by smartphones, tablets, and computers and know how to search the internet for almost any information. However, very few of them know how to select proper information from reliable sources. This can become a problem when health issues are concerned, where it is vital to identify incorrect or misleading information. The competence to critically evaluate digital information on health issues is of increasing importance for adolescents. Objective The aim of this study was to assess how children and adolescents rate their internet-based health literacy and how their actual literacy differs from their ratings. In addition, there was a question on how their search performance is related to their self-efficacy. To evaluate these questions, a criteria-based analysis of the quality of the websites they visited was performed. Finally, the possibility to increase their internet-based health literacy in a 3-day workshop was explored. Methods A workshop with a focus on health literacy was attended by 14 children and adolescents in an Austrian secondary school. After prior assessments (Culture Fair Intelligence Test, revised German version; Reading Speed and Reading Comprehension Test for Grades 6 to 12, German; electronic health literacy scale [eHEALS]; and General Self-Efficacy Scale, Reversed Version, German), the students were asked to perform an internet-based search on a health-related issue. Browser histories and screenshots of all internet searches were gathered, clustered, and analyzed. After the workshop, the health literacy of the students was assessed again by using the eHEALS. Results The 14 students opened a total of 85 homepages, but only eight of these homepages were rated as good or fair by two experts (independent rating) based on specific criteria. The analysis showed that the students judged their own internet-based health literacy much higher than the actual value, and students who had rated themselves better did not visit websites of high quality. Internet-based health literacy correlated significantly with the self-efficacy of the students (rs=0.794, P=.002). Conclusions Our study showed that it is possible to draw the attention of students to critical aspects of internet search and to slightly improve their search competence in a workshop. Targeted improvement of health literacy is urgently required, and students need special instruction for this purpose. Further investigations in this area with larger sets of data, which could be feasible with the help of a computer program, are urgently needed.

Adolescents’ self-efficacy and digital health literacy: a cross-sectional mixed methods study

“…eHEALS responses were quantitatively analysed to calculate an average score for each participant and an average score for the cohort. We followed other studies with similar target populations [ 30 ] and considered eHEALS scores above 3.5 out of 5 to represent high digital health literacy. Video recordings were analysed using an observational checklist based on previous research [ 34 ] (Additional file 2 ).…”

“…Self-efficacy explains that health behaviours are sustained when a person believes they are capable of executing a desired behaviour, for example via performance attainment when past success informs current behaviour [ 28 ]. Self-efficacy is useful for understanding adolescents’ digital health literacy capabilities [ 29 , 30 ]. It explains adolescents’ information-seeking motivation, behaviour and awareness of appraisal and application skills.…”

Assessment of information literacy skills and information-seeking behavior of medical students in the age of technology: a study of Pakistan

“…Internet and health literacy are fundamental facilities to improve medical student ISB (Gedefaw, 2020). Most of the students improve their health literacy search skill in workshop (Maitz et al , 2020). Health literacy is a basic skill to make success health-related decisions (Yamashita et al , 2020).…”

Differential impact of web habits and active navigation on adolescents' online learning

“…However, several studies suggested that they often do not take into account or are not able to evaluate the reliability and credibility of the sources of the information they are presented with online (Hautala et al, 2018). For ADOLESCENTS ONLINE ACTIVE LEARNING 5 instance, Maitz et al (2020) found that more than 90% of the web pages visited by 14-year-olds during a health search task (i.e., suggest whether to get rid of a hairy mole) were judged poor or unreliable by independent raters. In particular, adolescents seem to fail to consider those aspects of the websites that would be relevant to appraise their reliability, such as the presence of advertisements (Gossen et al, 2011;McGrew et al, 2018), and do not take into account the website's sponsors or political and industry affiliations (McGrew et al, 2018).…”

“…In particular, adolescents seem to fail to consider those aspects of the websites that would be relevant to appraise their reliability, such as the presence of advertisements (Gossen et al, 2011;McGrew et al, 2018), and do not take into account the website's sponsors or political and industry affiliations (McGrew et al, 2018). Instead, they often focus on more superficial cues, such as the vaunted expertise of the person providing information (e.g., the source of health-related information claiming to be a doctor, Maitz et al, 2020), or the website appearance (Freeman et al, 2018). In this respect, a meta-analysis by Dresang (2005) indicated that young people tend to discard the information coming from text-only websites, preferring more interactive pages, rich with video and visual content.…”