Feufel Markus A, Stahl S Frederica
Harding Center for Risk Literacy, Center for Adaptive Behavior and Cognition, Max Planck Institute for Human Development, Berlin, Germany.
J Med Internet Res. 2012 Jun 13;14(3):e87. doi: 10.2196/jmir.2051.
Online health information is of variable and often low scientific quality. In particular, elderly less-educated populations are said to struggle in accessing quality online information (digital divide). Little is known about (1) how their online behavior differs from that of younger, more-educated, and more-frequent Web users, and (2) how the older population may be supported in accessing good-quality online health information.
To specify the digital divide between skilled and less-skilled Web users, we assessed qualitative differences in technical skills, cognitive strategies, and attitudes toward online health information. Based on these findings, we identified educational and technological interventions to help Web users find and access good-quality online health information.
We asked 22 native German-speaking adults to search for health information online. The skilled cohort consisted of 10 participants who were younger than 30 years of age, had a higher level of education, and were more experienced using the Web than 12 participants in the less-skilled cohort, who were at least 50 years of age. We observed online health information searches to specify differences in technical skills and analyzed concurrent verbal protocols to identify health information seekers' cognitive strategies and attitudes.
Our main findings relate to (1) attitudes: health information seekers in both cohorts doubted the quality of information retrieved online; among poorly skilled seekers, this was mainly because they doubted their skills to navigate vast amounts of information; once a website was accessed, quality concerns disappeared in both cohorts, (2) technical skills: skilled Web users effectively filtered information according to search intentions and data sources; less-skilled users were easily distracted by unrelated information, and (3) cognitive strategies: skilled Web users searched to inform themselves; less-skilled users searched to confirm their health-related opinions such as "vaccinations are harmful." Independent of Web-use skills, most participants stopped a search once they had found the first piece of evidence satisfying search intentions, rather than according to quality criteria.
Findings related to Web-use skills differences suggest two classes of interventions to facilitate access to good-quality online health information. Challenges related to findings (1) and (2) should be remedied by improving people's basic Web-use skills. In particular, Web users should be taught how to avoid information overload by generating specific search terms and to avoid low-quality information by requesting results from trusted websites only. Problems related to finding (3) may be remedied by visually labeling search engine results according to quality criteria.
在线健康信息质量参差不齐，且往往科学质量较低。特别是，受教育程度较低的老年人群体据说在获取高质量在线信息方面存在困难（数字鸿沟）。关于（1）他们的在线行为与年轻、受教育程度更高且更频繁使用网络的用户有何不同，以及（2）如何支持老年人群体获取高质量在线健康信息，我们所知甚少。
为了明确技术熟练和技术不熟练的网络用户之间的数字鸿沟，我们评估了技术技能、认知策略以及对在线健康信息态度方面的质性差异。基于这些发现，我们确定了教育和技术干预措施，以帮助网络用户查找和获取高质量的在线健康信息。
我们让22名以德语为母语的成年人在网上搜索健康信息。技术熟练的一组由10名参与者组成，他们年龄小于30岁，受教育程度较高，且比技术不熟练的一组中的12名参与者更有网络使用经验，后者年龄至少50岁。我们观察在线健康信息搜索过程以明确技术技能方面的差异，并分析同步的口头记录以识别健康信息搜索者的认知策略和态度。
我们的主要发现涉及（1）态度：两组中的健康信息搜索者都对在线检索到的信息质量表示怀疑；在技术不熟练的搜索者中，这主要是因为他们怀疑自己处理大量信息的能力；一旦访问了一个网站，两组对质量的担忧都消失了，（2）技术技能：技术熟练的网络用户根据搜索意图和数据源有效地筛选信息；技术不熟练的用户容易被无关信息分散注意力，以及（3）认知策略：技术熟练的网络用户搜索是为了自我了解；技术不熟练的用户搜索是为了证实他们与健康相关的观点，如“疫苗有害”。无论网络使用技能如何，大多数参与者一旦找到满足搜索意图的第一条证据就会停止搜索，而不是根据质量标准。
与网络使用技能差异相关的发现表明了两类干预措施，以促进获取高质量的在线健康信息。与发现（1）和（2）相关的挑战应通过提高人们的基本网络使用技能来解决。特别是，应该教导网络用户如何通过生成特定的搜索词来避免信息过载，以及如何仅从可信网站请求结果来避免低质量信息。与发现（3）相关的问题可以通过根据质量标准对搜索引擎结果进行可视化标注来解决。
