Cultural influences on seeking quality health information: An exploratory study of the Korean community
Highlights
► Cultural differences limit the use of health information by Korean consumers. ► Accuracy and reliability were the most frequently used quality criteria. ► Consumers relied heavily on informal social networks for health information. ► Perceptions of health information quality should be seen in a cultural context. ► Librarians and health professionals should educate consumers about quality criteria.
Introduction
Consumer health information accessed through both the Internet and libraries is becoming important for public health care (Cline and Haynes, 2001, Kouame et al., 2005, Marshall and Williams, 2006, Shepperd et al., 1999, Smith et al., 2005). “Healthy People 2010” (U.S. Department of Health & Human Services, 2001) and the Pew Internet and American Life Project (Fox, 2006, Fox, 2008) found that the use of consumer health information by lay people, particularly through the Internet, was a widespread trend. Koreans living in the U.S. commonly seek consumer health information through the Internet (Oh and Kreps, 2011, Pourat et al., 2000). Previous studies (Asian Pacific Islander American Health Forum, 2006, August, Pourat et al., 2000) found that the high use of online consumer health information by ethnic minority consumers, especially Korean Americans, could be caused by several factors: low income, low language proficiency, vast cultural differences, and low rates of insurance coverage, since those not born in the U.S. or holding official residency status, are not eligible for public health insurance such as Medicaid or Medicare.
Korean immigrants are the fifth largest Asian American community in the U.S., as well as one of the fastest-growing minority groups, constituting 1,609,980 people (U.S. Census Bureau, 2008). Their education levels are relatively high, compared to other ethnicities in the U.S., but many immigrants, particularly Asians, have difficulty in speaking English (U.S. Census Bureau, 2008). Among Korean immigrants in the U.S., 47% were reported to have limited English proficiency, and 75% spoke only Korean at home (Asian Pacific Islander American Health Forum, 2006). Levels of English proficiency are closely associated with access to health information and health care services. People who have low English proficiency are more likely to be uninsured, and thereby less likely to seek health care services (Asian Pacific Islander American Health Forum, 2006). According to the UCLA Center for Health Policy Research (Brown, Lavarreda, Rice, Kincheloe, & Gatchee, 2005), 34% of Korean immigrants were uninsured, which was one of the highest rates among all ethnic groups. Many Korean immigrants preferred to use Korean-speaking doctors or home remedies incorporating consumer health information (Asian Pacific Islander American Health Forum, 2006), so key barriers such as the difficulties of communication and cultural understanding and lack of health insurance may affect the health information-seeking practices of Koreans living in the U.S.
Section snippets
Problem statement
Previous research has focused mostly on assessment of consumer health information, or quality criteria, from the perspective of quality evaluation experts or information providers, rather than consumers, the actual users of health information. Furthermore, there is a lack of research on the interaction between consumers' cultural characteristics and their understanding of health information quality, and health information-seeking behavior in general. Despite the size and growth of ethnic
Consumer health information-seeking
Consumer health information is defined as information on health care choices and medical topics provided to lay people, who are referred to as health information consumers (Medical Library Association and the Consumer & Patient Health Information Section, 2003). Consumer health information includes preventive medicine, health promotion, wellness, and access to the health care systems, as well as disease-related issues such as symptoms and treatments (Medical Library Association and the Consumer
Procedures
This study was conducted as a follow-up to a quantitative study employing self-administered surveys (Stvilia et al., 2009). Researchers used semi-structured interviews, since interviews are well-proven qualitative methods for an exploratory study (Babbie, 2004). They selected 20 participants who had each provided in-depth responses on previous surveys. A stratified sampling procedure was used to compare health information-seeking behaviors between age groups. The study divided the sample into
Overview
Most of the interviewees reported that they most frequently visited Google or Naver (a popular search portal in South Korea) first when searching for health information. Other Web sites consumers mentioned using were Yahoo! and Wikipedia. Study participants reported that they rarely used online databases to search for health information because they were unfamiliar with them. In general, they selected health Web sites linked within the first one to two pages of search engine results when a
Discussion
Findings indicated that interviewees relied on cognitive authority when discerning the quality of health information. Among the quality indicators frequently mentioned were duplication, authority, expertise, and experience. The quality indicators duplication, authority, and experience illustrated that the interviewees assigned weight to the reputations of other people. The more duplicated a source, the greater the agreement among others that the source was reputable. Health information provided
Conclusion
Korean members of the community reported diverse consumer health information needs. Their consumer health information needs were mainly about self-health care such as diseases, nutrition and diet, and self-treatment. The research found ethnic-specific health information-seeking behaviors, as well as general behaviors. Korean members of the community reported quality indicators that could be classified into two main categories: accuracy and reliability. In general, culture-related quality
Acknowledgments
The authors would like to acknowledge the assistance of Christopher T. Jones for his proofreading of this article.
Yong Jeong Yi is a Ph.D. candidate at School of Library and Information Studies, College of Communication & Information, Florida State University. She studies consumer health information and health informatics. In particular, she focuses on consumer health information services in libraries, health literacy and health information resources. She has been working on her dissertation investigating the association between health literacy and consumer health information behaviors in public libraries.
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Cited by (0)
Yong Jeong Yi is a Ph.D. candidate at School of Library and Information Studies, College of Communication & Information, Florida State University. She studies consumer health information and health informatics. In particular, she focuses on consumer health information services in libraries, health literacy and health information resources. She has been working on her dissertation investigating the association between health literacy and consumer health information behaviors in public libraries.
Besiki Stvilia is an assistant professor at the School of Library and Information Studies, College of Communication & Information, Florida State University. He studies and teaches in the areas of metadata and ontology design, information quality assurance, image retrieval, and social informatics. In particular, he studies the evolving patterns of collaborative work organization and technology use in large community-based open information systems, and develops models for information and metadata quality measurement, dynamics and effective intervention. His work has appeared in many conference proceedings and journals, including First Monday, Journal of the American Society for Information Science and Technology, and Library & Information Science Research.
Lorri Mon is an assistant professor at the School of Library and Information Studies, College of Communication & Information, Florida State University. She is interested in intermediated information seeking in computer supported collaborations and virtual environments. In particular she studies the changing nature of online interactions in collaborative efforts of asking questions and seeking answers as these exchanges move from face-to-face settings to digital and remote virtual environments. She also studies the websites, resources, and other information artifacts used, selected and created in conjunction with question-answering and information-exchanging interactions.