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T-Space at The University of Toronto Libraries >
Journal of Medical Internet Research >
Volume 6 (2004) >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/4708

Title: Internet Usage by Low-Literacy Adults Seeking Health Information: An Observational Analysis
Authors: Birru, Mehret S
Monaco, Valerie M
Charles, Lonelyss
Drew, Hadiya
Njie, Valerie
Bierria, Timothy
Detlefsen, Ellen
Steinman, Richard A
Keywords: Original Paper
health education
health promotion
socioeconomic factors
Issue Date: 3-Sep-2004
Publisher: Gunther Eysenbach; Centre for Global eHealth Innovation, Toronto, Canada
Citation: Mehret S Birru, Valerie M Monaco, Lonelyss Charles, Hadiya Drew, Valerie Njie, Timothy Bierria, Ellen Detlefsen, Richard A Steinman. Internet Usage by Low-Literacy Adults Seeking Health Information: An Observational Analysis. J Med Internet Res 2004;6(3):e25 <URL: http://www.jmir.org/2004/3/e25>
Abstract: [This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2004/3/e25 ] Background: Adults with low literacy may encounter informational obstacles on the Internet when searching for health information, in part because most health Web sites require at least a high-school reading proficiency for optimal access. Objective: The purpose of this study was to 1) determine how low-literacy adults independently access and evaluate health information on the Internet, 2) identify challenges and areas of proficiency in the Internet-searching skills of low-literacy adults. Methods: Subjects (n=8) were enrolled in a reading assistance program at Bidwell Training Center in Pittsburgh, PA, and read at a 3rd to 8th grade level. Subjects conducted self-directed Internet searches for designated health topics while utilizing a think-aloud protocol. Subjects' keystrokes and comments were recorded using Camtasia Studio screen-capture software. The search terms used to find health information, the amount of time spent on each Web site, the number of Web sites accessed, the reading level of Web sites accessed, and the responses of subjects to questionnaires were assessed. Results: Subjects collectively answered 8 out of 24 questions correctly. Seven out of 8 subjects selected "sponsored sites"-paid Web advertisements-over search engine-generated links when answering health questions. On average, subjects accessed health Web sites written at or above a 10th grade reading level. Standard methodologies used for measuring health literacy and for promoting subjects to verbalize responses to Web-site form and content had limited utility in this population. Conclusion: This study demonstrates that Web health information requires a reading level that prohibits optimal access by some low-literacy adults. These results highlight the low-literacy adult population as a potential audience for Web health information, and indicate some areas of difficulty that these individuals face when using the Internet and health Web sites to find information on specific health topics.
Description: Reviewer: Hansen, Derek
Reviewer: Zarcadoolas, C
URI: http://hdl.handle.net/1807/4708
ISSN: 1438-8871
Other Identifiers: doi:10.2196/jmir.6.3.e25
Rights: Copyright (cc) Retained by author(s) under a Creative Commons License: http://creativecommons.org/licenses/by/2.0/
Appears in Collections:Volume 6 (2004)

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