Pilot Study of Online Information Seeking Behaviors of Low Literacy Latina Breast Cancer Survivors (Preprint)
Authors: Iacobelli Francisco , Dragon Ginger , Mazur Giselle , Guitelman Judy 
Published: March 2020

BACKGROUND

Internet searching has become an increasingly useful tool for seeking health information. However, it is largely textual in nature and written for high literacy populations. Therefore, low literacy and low health literacy Latinas are at a disadvantage in terms of searching online as well as processing online resources. Internet searching presents a problem, as low literacy populations tend to make mistakes while typing, ending up with misleading results lists. In addition, even if an appropriate result list is displayed, Low literacy Latinas may be challenged in their ability to process the information contained in any individual article from that list.

OBJECTIVE

The objective of this study is to explore and describe the search behaviors of Latina breast cancer survivors and their caregivers. We explore their preferences in the modality of the query (voice/text), as well as other factors that present difficulties when searching for, and processing health information online.

METHODS

We recruited 7 Latina breast cancer survivors, of which 3 brought their caregivers, totaling 10 women. We administered the HLiTT health literacy test, a demographic survey, and a breast cancer knowledge assessment to each participant. Next, we trained the participants on searching online with either a keyboard or voice. Then, we asked participants to find information about (a) maintaining good spirits after breast cancer; (b) affordability of breast cancer treatment; (c) general information about breast cancer and treatment options; and (d) any lingering issues they had around survivorship. Participants were allowed to search in English and/or Spanish. We video and audio recorded the computer activity of each participant/patient-caregiver (dyad) and coded it for search behaviors.

RESULTS

We found that there was a significant positive correlation between participants’ HLiTT scores, and the time spent on articles (R=0.78, P=0.04). We also found a strong, but non-significant correlation between highest educational level and reading aloud (R=-0.75, P=0.089). We also found a similar correlation between HLiTT scores and the ratio of time spent perusing results vs. reading individual articles (R=-0.64, P=0.12), indicating that higher HLiTT scorers spent more of their time with individual articles, while lower HLiTT scorers spent more time perusing result lists. We also found that on average, participants attempted 6 spoken searches (SD: 4.32) and only 2.8 written searches (SD: 3.48). However, in debriefing interviews they stated a preference for voice searches.

CONCLUSIONS

Health literacy, more so than educational level attained, may be highly correlated with an individual’s ability to consume health information. Low health literacy individuals were more inclined to browse result lists instead of selecting or reading an individual article. We found a preference for voice searching, which may indicate a need to compensate for potential written misspellings and grammatical errors that could appear in written queries. We also found that many low literacy patients read aloud to better understand content. Understanding search behaviors and information evaluation strategies of low literacy Latina breast cancer survivors is fundamental for designing useful interfaces for them to find relevant and reliable information online.

CLINICALTRIAL

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