Transforming digital health literacy
In an era of exceedingly fast digital transformation, the spread of health misinformation poses a profound risk to public safety. Online spaces, where algorithms prioritise relevance over accuracy, offer fertile ground for the formation of ‘epistemic communities’, groups united by shared beliefs, often based on misinformation. Within these communities, alternative ways of evaluating information can influence individuals’ choices and doctor-patient communication.
Understanding behaviour regarding online health content
Undertaken with the support of the Marie Skłodowska-Curie Actions (MSCA) programme, the SOS TIPS project aimed to build tools and frameworks to increase digital health literacy, specifically to improve how people search for and evaluate health information online. “By empowering individuals with the skills to critically evaluate online health information, we aim to reduce the risks associated with health misinformation, and enhance patient safety,” explains MSCA research fellow Szilvia Zörgő. The SOS-TIPS team pioneered a new approach to understanding how people assess online health content. They developed a multi-method research framework that integrates eye-movement tracking, human-computer interaction analysis, and qualitative feedback. This innovative approach, known as the qualitative/unified exploration of state transitions (QUEST), captures online information-seeking behaviours in real time and offers researchers deeper insights into cognitive processes involved in evaluating health information. Using QUEST, researchers studied the behaviour of two groups with divergent health beliefs: anti-vaccination proponents and alternative medicine users. Results indicated the ways users navigate, interpret, and determine the reliability of health information. Participants often judged health information based on indicators like publication dates, author affiliations, and the presence of advertisements. These insights, especially in the context of digital health literacy, can help design ‘smart searching’ guidelines for various user groups, including vulnerable individuals with lower digital health skills.
Methodological innovations
QUEST was developed as part of the reproducible open coding kit ROCK, an open-source R package enabling the systematic analysis of qualitative and quantitative data. Additionally, the team created SQAFFOLD, a file organisation and licensing framework supporting open science. SQAFFOLD helps researchers document and justify their methodological decisions, making the entire research process transparent and sustainable. The ROCK toolkit and SQAFFOLD are publicly available and designed to be user-friendly, even for those unfamiliar with the R programming language. The toolkit includes an interface iROCK, which makes it easier for researchers without coding expertise to use these resources effectively.
Impact and future directions
SOS TIPS laid the groundwork for future research in online health information-seeking behaviour and better health decision-making. Acknowledging its commitment to open science, the project was awarded an Open Science award by the young European research universities network (YERUN). With new funding from the Dutch government, the project team will continue to enhance the functionality and expand the usability of iROCK. In addition, a follow-up study will delve further into ‘smart searching’ guidelines, tailored by users’ digital health literacy skills, which could eventually support health literacy interventions. This future work continues to support the SOS TIPS mission of advancing open science and fostering transparency in qualitative research.
Keywords
SOS TIPS, health information, digital health literacy, QUEST, SQAFFOLD, iROCK, R programming
