Patients with lower literacy levels in search for health
information may gravitate toward websites advertising services and products, a
small study by researchers at Loyola University suggests.
The study, published in the upcoming issue of the ARC
Journal of Urology, tracked 27 participants as they conducted web searches for
information related to their recent urological cancer diagnosis. It's titled "The Influence of Literacy and Education on Online Health Information Seeking Behavior in Cancer Patients."
The patients were first given surveys that included
questions about their education attainment levels. They then took the Wide
Range Achievement Test: Fourth Edition, considered a standard tool to assess
literacy levels.
Finally, the patients were asked to conduct a five-minute,
self-directed web search about their cancer, which the researchers tracked with
software.
The authors broke a total of 206 unique website hits into
seven categories one of which was “advertisements.” These were defined as sites
“that promoted the sale of a product, service, or therapy.”
Of the 17 patients who visited advertisements during their
session, 71 percent had below-average literacy scores. Of the 10 who didn't
visit advertisements, 80 percent had above-average literacy scores.
The authors found a similar correlation between website
visits and education, with more than half of the visits to advertisements
accounted for by the third of patients whose highest attainment level was high
school.
There were numerous limitations to the study, the most
important of which was the small sample size. This, for instance, led to a
strange circumstance in which those with the highest literacy rates ended up going
to fewer websites geared toward their specific type of cancer – an outcome the
authors could do only speculate about.
The researchers acknowledged the sampling limitation. They
also noted that the group was heavily male-biased and that the tracked searches
were contrived and lasted for a short time.
Though the sample size of the study was too small to draw
broad conclusions, the results do underscore a possibility that lower education
and literacy levels could skew someone's search behavior. The researchers
suggested their study be used toward developing a methodology that can assess
both larger groups and different search topics.
Previous research has suggested that advertisement websites
tend to have poorer-quality information (though information quality wasn’t
assessed in this paper). The authors pointed out that these types of websites also
tend to be easier to read.
Functional illiteracy is not uncommon in adults, according
to the National Center for Education Statistics. The last time it conducted a
survey in 2003, the center estimated up to 93 million Americans had “below
basic” or “basic” literacy, making it difficult for many of them to deal with some
everyday reading tasks.
While this study points to a need for further research into
the relationships between different demographic groups and the quality of the
health information they may seek on the Internet, the authors stress that
medical professionals should help patients navigate the online morass.
"Clinicians need to be mindful of the variability in
literacy and education of their patients," the researchers wrote, "in order to guide their patients
towards balanced and reputable online health information sources."
