american college health association 2011 annual meeting “i heard on the internet that…”...

American College Health Association 2011 Annual Meeting “I Heard on the Internet That…” Helping Students Find Reliable Health Information Online

David Arnold & Colleen Lesher, University of North Texas June 2, 2011

“I Heard On The Internet That…”

Helping Students Find Reliable Healthcare Information Online

David M. ArnoldColleen Lesher

University of North Texas



Objectives

1. Identify the problems with searching for health information online.

2. Discuss current students’ needs to find health information online.

3. List effective methodology to educate students to recognize reliable health information.



How Do People Find Health Information?

• “Traditional” news media– Newspapers, Journals– Radio– Television

• From a medical provider in a treatment relationship

• Family members• Research materials

(textbooks, journal articles)

• The Internet



The Internet

• Change from Restricted Content to Open Content (Web 2.0)

• Reference Libraries• Social Media– Facebook– YouTube



Study of Health Information Online

• Search 6 Health Related Questions:– “How is HIV

transmitted?”– “What does skin cancer

look like?”– “How do I know if I’m

depressed?”– “How many calories

should I eat in a day?”– “Should I get a flu

shot?”– “How do I treat a

urinary tract infection?”

• Analyze the top 50 results:– Accuracy (subjectively

scored with rubric, score 0 to 100)

– Complexity (run through Flesch Reading Ease (score 0 to 120)

– Placement of results (score 0 to 50)

• Separated by website type

• Plotted by accuracy/complexity and weighted by search placement



Health Information OnlineReadability and Accuracy by Website

Type Restricted Registration (.edu, .gov) Unrestricted Registration (.com, .org, .net)



Problems with Finding Health Information on the Internet

1. Information may be unreliable, inaccurate, or even dangerous to student health.

2. Accurate information may be difficult to access or understand.

3. Higher quality information (accurate and accessible) may not be within the first 10 results generated in a search engine.



The Bigger Problem

This study is already out of

date.



Millennials and the Internet Generation

• Born in 1980s, early 1990s (Millennials)

• Born in 1990s (Net Generation)

• Extreme connectivity

• Digital natives• Acquired ADD



How Millennials and Net Gen Access Information

• Internet (over 86%) • Paper Media• Reference Books• Peers (and other)



How Can We Educate Students About Finding Health Information

Online?• During a treatment visit– Structured education with materials– Passive education with materials

• During outreach events– Specifically focused programming– Passive education with materials



Educational Methodology

1. Teach critical thinking (10 questions from Harvard Insight Consumer Guide to Health)

2. Teach Searching Proficiency

3. Recommend Restricted Domains



Questions to Consider in Evaluating Health Information

1. What is the message?

2. Is the source reliable?

3. How strong is the evidence overall?

4. Does this information matter?

5. What do the numbers mean?

6. How does this risk compare to others?

7. What actions can be taken to reduce risk?

8. What are the trade-offs?

9. What else do I need to know?

10.Where can I get more information?



Evaluating Health

Information:What is the Message?

• Presentation vs. Facts• Individual Perception

(half-full, half-empty)• Purpose of the

Message– Is the goal to educate

you?– If the goal to sell you a

product?



Evaluating Health Information:Is the Source Reliable?

Less ReliableOne or a few observationsAnecdote or case reportUnpublishedNot repeatedNonhuman subjectsResults not related to

hypothesisNo limitations mentionedNot compared to previous

results

More ReliableMany observations

Scientific studyPublished and peer-reviewed

Reproduced resultsHuman subjects

Results about tested hypothesis

Limitations discussedRelationship to previous

results



Evaluating Health Information:How Strong is Evidence Overall?

• Extensive coverage is not strong evidence

• How does this information fit in with other information?

• How recent is the study?



Evaluating Health Information:Does this Information Matter?

• Personal area of effect

• Information for personal improvement or idle knowledge?



Evaluating Health Information:What do the Numbers Mean?

• Restate numbers in applicable terms (i.e. 1% is 1 in 100, or 360 of 36,000 students)

• Statistics without confidence

• Numbers and personal bias



Evaluating Health Information:How Does this Risk Compare to

Others?• Risk in context:

– Number of people who die from heart disease

– Number of people who die from lightning strikes

• “Lower” risks are sensationalized

• Control over risk scenarios



Evaluating Health Information:What Actions Can be Taken to Reduce

Risk?• Identify means to improve health• Immediate reactions to new (or new-

found) risks may increase risk• Actions to mitigate risk vary by

individual



Evaluating Health Information:What are the Trade-Offs?

• Reducing risks may require trade-offs:– Side effects– Behavior change– Resource management

• Is trade-off worth risk mitigation?



Evaluating Health Information:What Else Do I Need to Know?• Identify the information that would

help you make a better decision• What information is missing for you

to go forward?• Avoid the sensational, and rely on

the well-established



Evaluating Health Information:Where Can I Get More Information?

• Confirm findings across methodologies

• Research dissenting data –Manage information uncertainty– Determine reliability of findings



Teaching Students About Online Health Information in the

Treatment Visit• When prompted, go

over a worksheet• Go over worksheet

before assigning student to look online

• Have worksheet available in room, at nurses’ station, front desk, checkout, etc.



Teaching Students About Online Health Information in Outreach

• Specific? Develop an experiential activity

• Include in existing education

• Leave each participant with a worksheet

• For passive programs: place information in student union, recreation centers, etc.

• Webpage



Institutional Implications

• Institutional Accreditation– Student Learning Outcomes

“As a result of participating in a Health Services educational program, students will be able to consider critical thinking issues involving health information found on the Internet.”

– Evaluate pre- post-test

• AAAHC Accreditation (Health Promotion)



“I Heard On The Internet That…”

Helping Students Find Reliable Healthcare Information Online

David M. Arnold [email protected]

Colleen [email protected]

University of North Texas

american college health association 2011 annual meeting “i heard on the internet that…”...

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