Uloga zdravstvene informacijske pismenosti u vrednovanju mrežnih zdravstvenih informacija

Objective – To review, based on research evidence, the correlation between low health literacy and four outcomes of interest: (1) the ability to evaluate online health information based on (2) perceived reliability and accuracy, (3) trust in the Internet as an information source, and (4) the application of established evaluation criteria. 
 
 Design – Systematic review and narrative synthesis.
 
 Setting –MEDLINE, PsycInfo, Web of Science, CINAHL, and Communication and Mass-media Complete as well as articles discovered through the snowball method.
 
 Subjects – 38 studies identified through a systematic literature search.
 
 Methods – An exhaustive list of potential articles was gathered through searching five online databases and Google Scholar, and hand searching of references. Inclusion and exclusion criteria were applied in a two-phase screening process in which two researchers participated to address reliability. Data, including study characteristics and metadata, predictors, assessment methods, and outcomes, were extracted from relevant studies, and then synthesized narratively. 
 
 Main Results – Following duplication removal 13,632 records were retrieved, 254 of which were identified for full-text assessment. Thirty-eight studies met the eligibility criteria. All studies were non-experimental and therefore graded as a low level of evidence; 35 were cross-sectional designs, 1 a focus group, and 2 were observational studies. Studies varied widely in population definition and sample size and were published between 2001 and 2013, primarily in North America. 
 
 Overall, a positive association was identified between health literacy and outcomes related to the ability to evaluate or trust Internet health information, while findings were inconsistent related to perceived quality of information and the application of evaluative criteria. Four studies examined the impact of health literacy levels on one or more of the outcomes of interest. 
 
 The most prevalent outcome measure studied was trust in online health information, and the least prevalent was the use of evaluative criteria. The ability to trust online health information was assessed primarily through self-reporting, half of which utilized the eHealth Literacy scale, the majority of which indicated a positive correlation between education level or low health literacy and the perceived or actual ability to evaluate online health information. 
 
 No studies on perceived information quality were found to utilize health literacy as an indicator. A positive association between educational level and trust in health information on the Internet was reported in ten studies, while two articles noted a similar correlation based on proxies for health literacy, including English language proficiency and comprehension comfort. In terms of the use of evaluation criteria, only one study focused on health literacy, indicating that those with low health literacy evaluate online health information based on search result placement, celebrity endorsement, image quality, and site authorship, and that they trust university researchers more than government or religious authorities to provide health information. 
 
 No association was shown between readability or physician-provided online information and evaluation criteria while one study demonstrated that study participants with higher education tended to check author credentials more often when evaluating a website.
 
 Conclusion – Effective and informed evaluation of online health information is impacted by low health literacy.

BackgroundHealth beliefs may mediate the relationship between trust and vaccination decisions, as confidence in online health information has expanded quickly. However, little is known about how health attitudes and trust in health information affect COVID-19 vaccine intention. This study aimed to assess the effect of health beliefs and trust in information sources on the willingness to receive a COVID-19 vaccine among the general public in Saudi Arabia.MethodsThis study was designed and carried out at the Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. Selected items were extracted from the Saudi Residents’ Intention to Get Vaccinated Against COVID-19 (SRIGVAC) survey. They were categorized and validated into constructs of a health belief model (the perceived threat of COVID-19, vaccine-related benefits, barriers, and safety concerns) and trust in health information (from online platforms and health authorities/providers). Regression analysis and parallel mediation were used to assess the predictors of vaccination intentions.ResultsBased on the responses of 3,091 participants, vaccine-related barriers and safety concerns negatively influenced vaccination intention, whereas vaccine benefits and the perceived threat of COVID-19 were positively correlated with vaccination intention. Trust in online health information had a direct relationship with intentions (β = 0.09, p < 0.0001) as well as indirect relationships through the perceived benefits (β = 0.095), the perceived barriers (β = −0.029), and the perceived safety concerns toward the vaccine (β = −0.010). The relationship between the willingness to vaccinate and trust in authentic information was fully mediated by all domains of health beliefs, with indirect coefficients of 0.004, 0.310, −0.134, and −0.031 for the perceived threat, vaccine benefits, barriers, and safety concerns, respectively.ConclusionThe relationship between the willingness to vaccinate and trust in authentic information was fully mediated by all domains of health beliefs. Vaccine coverage in Saudi Arabia can be optimized by targeting the health beliefs of the general public.

This article make an addition to the growing body of research that explores the significance of demographic factors (Age, Education level and Income) on perceived trust in health information , specifically in the context of knowledge gap hypothesis. A questionnaire-based survey collected data from female students studying at different levels and belonging to different age and income groups. The level of perceived trust in online health information was measured on the bases of these socio demographic differences. Findings revealed that eHealth literacy is a determinant of the perceived trust in online health information (OHI). However, result demonstrate no significant impact of independent variable i-e socio-demographics (age, education level and income) on the perceived trust of users in online sources which shows that digital media technologies are bridging the knowledge gap between haves and haven’t.

BackgroundDistrust in the Internet as a source of health information remains common among older adults. The influence of this distrust on Internet use for health-related purposes, however, is unclear.ObjectiveThe objective of our study was to explore how older adults’ trust in the Internet influences their online health-related activities, and to identify potential targets for improving health-related Internet resources for older adults.MethodsData were obtained from a nationally representative, random digit-dial telephone survey of 1450 adults 50 years of age and older in the United States. A model was developed to conceptualize the hypothesized relationships among individual characteristics, distrust, and avoidance of the Internet as a health resource. Multivariate logistic regression analyses were conducted to examine the association between trust in online health information and use of the Internet for health-related purposes. Additional multivariate logistic regression analyses were conducted to identify the key characteristics associated with trust in online health information, adding sequentially the variables hypothesized to account for distrust among older adults: sociodemographic and health characteristics, inexperience and technical difficulties with the Internet, negative feelings toward the Internet, and lack of awareness about the sources providing the health information found online.ResultsThe mean (SD) age of the study population was 63.7 (10.6) years. Of the 823 (56.8%) Internet users, 628 (76.3%) reported using the Internet as a health resource. Trust in the Internet as a source of health information was associated with using the Internet for a number of health activities, including searching for information about a specific health condition (adjusted OR 4.43, P < .001), purchasing prescription drugs (adjusted OR 2.61, P = .03), and talking with a health care provider about information found online (adjusted OR 2.54, P = .002). Older adults (age ≥65 years) were less likely to trust the Internet as a source of health information (OR 0.63, P = .04), even after adjusting for other sociodemographic characteristics and health and function. This age effect was only slightly attenuated (adjusted OR 0.69, P = .13) after adjusting for inexperience and technical difficulties with the Internet, but it disappeared entirely (adjusted OR 0.96, P = .91) after adjusting for other hypothesized contributors to distrust (including finding the Internet confusing because it provides “too much information,” and lacking awareness about the source providing health information found online).ConclusionsWebsite design features that clearly identify the source and credibility of information and minimize confusion may build trust among older adults and offer an opportunity to increase the utility of the Internet as a health resource for this population.

BackgroundThe recent surge in online health information and consumer use of such information has led to expert speculations and prescriptions about the credibility of health information on the World Wide Web. In spite of the growing concern over online health information sources, existing research reveals a lacuna in the realm of consumer evaluations of trustworthiness of different health information sources on the Internet.ObjectiveThis study examines consumer evaluation of sources of health information on the World Wide Web, comparing the demographic, attitudinal, and cognitive differences between individuals that most trust a particular source of information and individuals that do not trust the specific source of health information. Comparisons are made across a variety of sources.MethodsThe Porter Novelli HealthStyles database, collected annually since 1995, is based on the results of nationally-representative postal-mail surveys. In 1999, 2636 respondents provided usable data for the HealthStyles database. Independent sample t tests were conducted to compare the respondents in the realm of demographic, attitudinal, and cognitive variables.ResultsThe most trusted sources of online health information included the personal doctor, medical university, and federal government. The results demonstrated significant differences in demographic and health-oriented variables when respondents who trusted a particular online source were compared with respondents that did not trust the source, suggesting the need for a segmented approach to research and application. Individuals trusting the local doctor were younger ( t 2634= 4.02, P< .001) and held stronger health beliefs (F 1= 5.65, P= .018); individuals trusting the local hospital were less educated ( t 2634= 3.83, P< .001), low health information oriented (F 1= 6.41, P= .011), and held weaker health beliefs (F 1= 5.56, P= .018). Respondents with greater trust in health insurance companies as online health information sources were less educated ( t 2634= 1.90, P= .05) and less health information oriented (F 1= 4.30, P= .04). Trust in medical universities was positively associated with education ( t 2634= 11.83, P< .001), income ( t 2634= 10.19, P< .001), and health information orientation (F 1= 10.32, P<.001). Similar results were observed in the realm of federal information credibility, with individuals with greater trust in federal sources being more educated ( t 2634= 7.45, P< .001) and health information oriented (F 1= 4.45, P= .04) than their counterparts.ConclusionsThe results suggest systematic differences in the consumer segment based on the different sources of health information trusted by the consumer. While certain sources such as the local hospital and the health insurance company might serve as credible sources of health information for the lower socioeconomic and less health-oriented consumer segment, sources such as medical universities and federal Web sites might serve as trustworthy sources for the higher socioeconomic and more health-oriented groups.

This study explores why people participate in health-related Internet activities and what the potential impacts of such activities are. Specifically, this study examines how trust in health information (i.e., from a physician and from the Internet) determines individuals’ health-related Internet activities and whether this use subsequently improves outcomes such as discussion with doctors about online health information and satisfaction with health care. Findings from a Web-based survey in South Korea indicated that trust in health information from doctors decreased communication activities, whereas trust in online health information increased both communication and information activities. Both communication and information activities increased discussions with doctors about online health information, which subsequently led to satisfaction with health care.

The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N = 7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.

BackgroundThe internet has become a major mean for acquiring health information; however, Web-based health information is of mixed quality and may markedly affect patients’ health-related behavior and decisions. According to the social information processing theory, patients’ trust in their physicians may potentially change due to patients’ health-information-seeking behavior. Therefore, it is important to identify the relationship between internet health information and patient compliance from the perspective of trust.ObjectiveThe objective of our study was to investigate the effects of the quality and source of internet health information on patient compliance using an empirical study based on the social information processing theory and social exchange theory.MethodsA Web-based survey involving 336 valid participants was conducted in China. The study included independent variables (internet health information quality and source of information), 2 mediators (cognition-based trust [CBT] and affect-based trust [ABT]), 1 dependent variable (patient compliance), and 3 control variables (gender, age, and job). All variables were measured using multiple-item scales from previously validated instruments, and confirmative factor analysis as well as structural equation modeling was used to test hypotheses.ResultsThe questionnaire response rate was 77.16% (375/486), validity rate was 89.6% (336/375), and reliability and validity were acceptable. We found that the quality and source of internet health information affect patient compliance through the mediation of CBT and ABT. In addition, internet health information quality has a stronger influence on patient compliance than the source of information. However, CBT does not have any direct effect on patient compliance, but it directly affects ABT and then indirectly impacts patient compliance. Therefore, the effect of ABT seems stronger than that of CBT. We found an unexpected, nonsignificant relationship between the source of internet health information and ABT.ConclusionsFrom patients’ perspective, internet health information quality plays a stronger role than its source in impacting their trust in physicians and the consequent compliance with physicians. Therefore, patient compliance can be improved by strengthening the management of internet health information quality. The study findings also suggest that physicians should focus on obtaining health information from health websites, thereby expanding their understanding of patients’ Web-based health-information-seeking preferences, and enriching their knowledge structure to show their specialization and reliability in the communication with patients. In addition, the mutual demonstration of care and respect in the communication between physicians and patients is important in promoting patients’ ABT in their physicians.

BackgroundRecent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information.ObjectiveThe main aim of this study was to review existing evidence on the association between low health literacy and (1) people’s ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information.MethodsFive academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels.ResultsAfter abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive.ConclusionsThe findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review, future research in this field should (1) specifically focus on health literacy, (2) devote more attention to the identification of the different criteria people use to evaluate online health information, (3) develop shared definitions and measures for the most commonly used outcomes in the field of evaluation of online health information, and (4) assess the relationship between the different evaluative dimensions and the role played by health literacy in shaping their interplay.

The effects of information source and eHealth literacy on consumer health information credibility evaluation behavior

Adolescents' disease- and fitness-related online health information seeking behaviors: The roles of perceived trust in online health information, eHealth literacy, and parental factors

Wikipedia has been increasingly used as a health education tool, and is widely used by medical students and health professionals as a source of health information, which influences clinical practices and the health of users, highlighting the importance of the quality of available health information. Through the “WikiProject Medicine” Project, initiatives are developed to evaluate and improve the quality of Wikipedia health information, including Parkinson's disease (Matheson and Matheson-Monnet 2017; Joorabch Doherty and Dawson , 2020; Wikipedia, 2025; Herbert et al., 2015; Smith, 2020). However, there is still a lack of adequate methodology to evaluate the quality of health information available online, including Wikipedia articles (Dominguesand Lopes, 2019; Smith, 2020; da Silva Couto, 2021). Therefore, this protocol aims to present evaluation guidelines to compare the quality of online health information, specifically related to Parkinson's disease, available on Wikipedia in multiple languages, in order to ensure the quality of information about Parkinson's disease.

Helicobacter pylori (H. pylori) has drawn considerable attention because of its high infection rate. Although WeChat Official accounts (WOAs) have become a prevalent source of public health information, the reliability and scientific validity of H. pylori-related content on the platform remain uncertain. Therefore, this study aimed to systematically evaluate the reliability and quality of health information on H. pylori disseminated through WOAs and propose evidence-based strategies for enhancing the standard of online health information. Articles containing the keywords "" or "" (Chinese for H. pylori) were retrieved from the WeChat platform. After selection, a total of 115 articles were included in this study. Subsequently, raters collectively evaluated the articles using the Journal of American Medical Association (JAMA) benchmark criteria, the modified DISCERN (mDISCERN) tool, and the Global Quality Scale (GQS). Statistical analyses were then conducted. All continuous data were described as median (interquartile range). The median scores for JAMA, mDISCERN, and GQS across all articles were 2.00 (1.00), 3.00 (2.00), and 3.00 (2.00), respectively. Spearman correlation analysis revealed significant positive correlations between each pair of assessment tools (JAMA, mDISCERN, and GQS; P<0.001). The Kruskal-Wallis test indicated that JAMA, mDISCERN, and GQS scores were all significantly associated with article sources (p<0.001). Enterprise accounts contributed to the majority of articles (58.51%). Articles sourced from non-profit organizations demonstrated higher reliability and quality, whereas those from individual sources exhibited lower scores. The issues identified in the articles primarily concerned the treatment of H. pylori. Generally, the reliability and quality of H. pylori information found on WOAs was unsatisfactory. Users face a significant risk of exposure to misinformation. Content originating from non-profit organizations or large tertiary hospitals demonstrated strong correlations with higher reliability and quality scores. To address these challenges and enhance the credibility of online health information, concerted efforts are required.

Increased needs for information about health have been observed among elderly people, who constitute a growing group. This paper will present a small-scale study on elderly people and health-related information, and take a closer look at the role of libraries as a source. The study was conducted in order to test a questionnaire. The respondents are 65 years or older and belong to the small Swedish-speaking minority in Finland. The health information behaviour of the respondents is approached through the concept of health information literacy (HIL), meaning the abilities to recognize a need for health information, to identify and use likely information sources, and to evaluate, understand, and use the information in order to make good health decisions. Fifty-five self-administered questionnaires were distributed through a snowball-sampling method. Forty-six questionnaires were returned by mail. Descriptive statistics and a One-way ANOVA were used for the analysis. The results show that libraries and library staff were fairly little used, and even less as sources for health information. When the respondents needed health information, they usually turned to medical expertise. The HIL of the respondents seemed sufficient in some respects, but weaker in others. Needs were identified and sources chosen seemingly easily, but some problems were found in understanding. Also quality assessment seemed to be difficult for many respondents. There might, thus, be room for a broadening of the information environment of the respondents, as well as of other elderly seekers of health information. Enhancing people's (health) information literacy is often suggested to be the information profession's responsibility. As long as there is only little or no interaction between elderly people and libraries, this task is difficult, and more research is needed to find out how libraries could reach out to the growing group of elderly people.

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