Prepared by Sarah Rudd, Knowledge Specialist, North Bristol NHS Trust sarah.rudd@nbt.nhs.uk
The paper for discussion: Article: Demirci, Ş., Uğurluoğlu, Ö., Konca, M. and Çakmak, C. (2021), Socio-demographic characteristics affect health information seeking on the Internet in Turkey. Health Info Libr J, 38: 304-312. https://doi.org/10.1111/hir.12358 (Free access provided by Wiley for three months from mid October 2022).
Online health literacy in Turkey
Health literacy forms a key part of the recent update to the Knowledge for Healthcare strategy (Health Education England, 2021). The strategy notes that in England 43% of adults aged 16-65 struggle to “understand word based health information sufficiently well to make health decisions”, with this number creeping up to 61% when numbers are also added in.
This article explores how the socio-demographic characteristics of people in Turkey affect health information seeking behaviour on the internet, essentially the health literacy of those people.
Given the explosion of information of all types on the internet over the last 20+ years, the number of people looking for health information has also exploded. The authors considered potential background reasons from other studies on the ability of people to find health information, and the factors which draw people to looking for information about their health online.
The aim of the study is to find out what socio-demographic characteristics of people in Turkey influence searching the internet for health information. To do this the authors used data from the annual “Household Information Technology Use” (HITU) survey conducted in 2018 by the Turkey Statistical Institute (TSI), which collects data on the use of digital technology by people aged 16-74 years in Turkey, rather than conducting additional research on the topic. This seems to have been a shrewd move as the survey collects socio-demographic information and has a question about searching for health information on it. Of the almost 29,000 respondents to the survey, approximately 9500 were excluded as they had answered “no” to the question posed. This resulted in 19,389 participants being included in the final analysis.
As part of the results, the authors provide a table showing the demographic breakdown of the survey participants, with a roughly equal spread of male to female respondents. They found:
- Women were more likely to search the internet for health information than men (statistically significant result)
- Participants aged 45 years or younger search for health information online more frequently than participant aged >46
- Participants who had completed no schooling were less likely to search the internet for health information than participants who had any level of school completion. As the level of completed education grew, so did the increase in likelihood of searching for health information.
- Dependent of the area of Turkey lived in, there were differences in the seeking of health related information.
- People who used the internet most sought out more health information than those who used it every few weeks.
In the discussion comparisons were drawn to similar studies and found that many of the conclusions that could be drawn from this study had been found in research conducted in other countries.
- Gender was the most statistically significant factor which influenced online health information seeking, with the suggestion (based on the work of other researchers) that this is due to women searching for information about those they care for (eg children).
- Training on use of the internet for health information should focus on a number of different groups:
- women who may be carers
- people aged >46 as they may have less experience with digital technology and searching online
- those with lower levels of education, as their experience of “online health information seeking” is directly related to their education level (ie, the lower the education level the greater need for support in seeking information)
- region of residence is related to the amount of experience seeking information on the internet and therefore people in certain regions may need additional training
- Employment status affects the amount of online information seeking, but employment status was felt not to be statistically significant as the internet is inexpensive in Turkey and therefore available to most people.
The authors drew the conclusion that socio-demographic characteristics did influence the searching behaviour for online health information by those completing the survey.
Points to consider:
- Why didn’t the authors examine the socio-demographics of the respondents to the survey question who answered “No”?
- How do the results and conclusions of the research in Turkey relate to health literacy in the UK?
- What can we take from the article and apply to our own population?
HILJ Club 
An interesting analysis and article. I agree that more in depth exploration would also need to address those who answered ‘no’, but I suppose as the questions were in the context of a wider population survey the findings might be limited- still it would have been good to look especially as the additional demographic information.
While I think there are certainly lessons that could be taken from this into other countries, it would also be good to have someone with more geographical and local knowledge to explore comparisons when looking at comparing it to other populations and groups – for example the higher number of responses in Istanbul might suggest also a higher digital literacy/digital accessibility there to begin with, offer a different picture of how healthcare is delivered in different regions (I admit, I am in total ignorance of this)- or even just engagement with government surveys!
That said there are parallels to be drawn more broadly, which the authors’ acknowledge including the likelihood for more women to be not just looking for themselves but looking things up for people they care for, and strategies both to support this with ensuring accessible reputable information is important and can begin by being targeted at these groups who already know they have that information need; equally the article says that the internet is relatively inexpensive but the older population group may lack the digital literacy – or prefer other sources they trust more- is also worth exploring, but more broader examinations of engagement with less-engaged groups I think would be needed.
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