Google It!: Urban Community College Students' Use of the Internet to Obtain Self-Care and Personal Health Information.

Abstract Background: As electronic resources increasingly play a major role in consumer health, eHealth literacy has emerged as a valuable tool to improve and enhance health knowledge and behavior. Yet for some populations, access to health information alone does not lead to better health practices or outcomes. Low income populations increasingly rely on ehealth information but may lack the knowledge and skills to interpret and evaluate the information. Results: Students are active users of the Internet and search the web for a variety of personal health needs. In fact, the Internet was the students' most often consulted health information source. Students reported searching the Internet to identify self-care strategies, alternative therapies, and information related to nutrition and fitness. Students felt the Internet empowered their health care decision making. However, students also reported skepticism related to the validity of health related information and failed to identify reliable strategies for evaluating the credibility of Internet health resources. Conclusion: Although digital media offers new opportunities to address health disparities and increase health literacy among urban community college students, they should be given the opportunity to process eHealth information at a deeper level and taught how to effectively evaluate health information found on the Web. Key Words eHealth, health education, health literacy, community college students Introduction The Institute of Medicine (IOM) defines health literacy as, "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions" (National Research Council, 2004). Furthermore, eHealth literacy has been defined as the ability of individuals to seek, find, understand and appraise information from electronic sources and apply such knowledge to addressing or solving health problems (Skinner, 2006). According to both definitions, health literacy encompasses much more than just the ability to read and write. Whether it is in paper or digital format, health literacy includes the competence and motivation to use health information and services in ways that enhance health. In contrast, lower levels of literacy have been associated with increased rates of hospital admission, increased healthcare expenditures, and poor health outcomes, particularly among racial and ethnic minorities (Vernon, Trujillo, Rosenbaum, & DeBuono, 2007). Health illiteracy has been recognized as a major healthcare problem in the United States of America. Of significant importance is the link between low health literacy and health disparities in the USA. Despite technology and scientific advances, our nation's leading causes of death are primarily related to disparities in socioeconomic status, literacy rates, knowledge and access (Pampel, Krueger, & Denney, 2010). The National Healthcare Quality Report (2012) states that disparities in health are not getting smaller (U.S. Department of Health and Human Services Agency for Healthcare Research and Quality, 2012). In fact, for Hispanics, African Americans and the poor, most access measures have remained unchanged or worsened within the past decade (U.S. Department of Health and Human Services Agency for Healthcare Research and Quality, 2013) Research shows that these groups are disproportionately affected by low health literacy rates (Paasch-Orlow et al., 2005) and public health experts see these problems as interrelated determinants of health (Paasche-Orlow & Wolf, 2010). Although not often recognized as such, college students are a vulnerable population, particularly minority college students. Many college students do not meet sleep, dietary or physical activity guidelines (Huang, Harris, Lee, Nazir, Born, & Kaur, 2003) (Wald, Muennig, O'Connell, & Garber, 2014). …