Ebeveynler ve Online Sağlık Bilgisi Arama Davranışı: Sağlık Okuryazarlığı Kapsamında Bir İnceleme

Year 2023, Volume: 08 Issue: 19 - Dijital Ebeveynlik, 904 - 933, 30.09.2023

Ezgi Eyüboğlu

https://doi.org/10.37679/trta.1328286

Abstract

Dijitalleşme, hayatın her alanını kuşattığı gibi, toplumun sağlıkla ilgili tüm pratiklerini de etkisi altına almaktadır. Bu bağlamda, ebeveynler tarafından çocukları ile ilgili sağlık bilgisine ulaşmada sıklıkla tercih edilen bir kaynak konumunda olan dijital medyadaki içerikler, önem taşımaktadır. Sağlığın geliştirilmesine yönelik üretilen ve tasarlanan içeriklerde kaynağın uzmanlığı, bilginin güncelliği, mesajın etkinliği ve medya ortamının dinamikleri kadar toplumun sağlık okuryazarlık düzeyine uygun bilginin paylaşılması da kritik bir rol oynamaktadır. Sağlık bilgisinin kolay anlaşılır ve bireylerin bilgi gereksinimini karşılayacak bir dil ve nitelikte olması, sağlık okuryazarlığının yaygınlaşmasını ve uzun dönemde bireylerin sağlıklarını koruma ve sürdürme noktasında doğru davranışlar sergilemelerini sağlayabilmektedir. Bu çalışmada, ebeveynlerin çocuklarının sağlığıyla ilgili kullandığı dijital içeriklerin işlevsel sağlık okuryazarlık düzeyi açısından incelenmesi hedeflenmektedir. Bu doğrultuda, amaçsal örnekleme yolu ile belirlenen 34 WEB sitesi içerik analizi tekniği ile işlevsel sağlık okuryazarlığı düzeyine karşılık gelen okunabilirlik ve sağlık bilgisinin içeriği ve kalitesi açısından değerlendirilmiştir. Analiz sonucunda online sağlık bilgisi kaynaklarının ‘orta güçlükte’ okunabilir olduğu, içeriğin güvenilirlik ve kalite düzeyinin yetersiz olduğu saptanmıştır

Keywords

Dijitalleşme, Sağlık Okuryazarlığı, Dijital Ebeveynlik, Online Sağlık Bilgisi Arama Davranışı, Sağlık İletişimi

Parents and Online Health Information Search Behavior: An Examination Within the Scope of Health Literacy

Abstract

Digitalization, as it encompasses every aspect of life, also affects all practices related to public health. Content in digital media, a source frequently preferred by parents in obtaining health information about their children, is essential in this context. In the content produced and designed for health promotion, sharing the information appropriate to the health literacy level of the society plays an important role, as well as the expertise of the source, the up-to-dateness of the information, the effectiveness of the message, and the dynamics of the media environment. Having health information in a language and quality that is easy to understand and meets the information needs of individuals can ensure that health literacy becomes widespread and that individuals exhibit correct behavior in terms of protecting and maintaining their health in the long term. From this point of view, this study aims to examine health-related content parents use in digital media regarding health literacy level. Thirty-four WEBsites determined by purposeful sampling were evaluated regarding readability and content and quality of health information corresponding to functional health literacy level by content analysis technique. The research results showed that the online health information resources were 'moderately difficult' to read, and the reliability and quality level of the content was insufficient.

Keywords

Dijitalleşme, Sağlık Okuryazarlığı, Dijital Ebeveynlik, Online Sağlık Bilgisi Arama Davranışı, Sağlık İletişimi

References

• Abel, T. (2007). Cultural capital in health promotion. health and modernity: the role of theory in health promotion (D.V. McQueen ve I. Kickbusch). New York: Springer. 1-170.
• Agency for Healthcare Research and Quality. (2007). About the CAHPS item set for addressing health literacy. https://cahps. ahrq.gov/surveys-guidance/itemsets/ literacy/2311_About_Health.pdf Erişim Tarihi: 11.08.2023.
• Aldoory, L. (2017). The status of health literacy research in health communication and opportunities for future scholarship. health communication, 32(2), 211-218. http://dx.doi.org/10.1080/10410236.2015.1114065
• Ateşman, E. (1997). Türkçe’de okunabilirliğin ölçülmesi. Dil Dergisi, 58, 71-74.
• Austvoll-Dahlgren, A., Bjorndal, A., Odgaard-Jensen, J. ve Helseth, S. (2012) Evaluation of a WEB portal for improving public access to evidence-based health information and health literacy skills: a pragmatic trial. Plos One,7 (5), 1-11.
• Basavakumar D., Flegg, M., Eccles, J., ve Ghezzi P. (2019). Accuracy, completeness and accessibility of online information on fibromyalgia. Rheumatol International, 39, 735-742
• Berens, E. M., Vogt, D., Messer, M., Hurrelmann, K., ve Schaeffer, D. (2016). Health literacy among different age groups in Germany: results of a cross-sectional survey. BMC Public Health, 16(1), 1-8. https://doi.org/10.1186/s12889-016- 3810-6
• Berkman, N.D., Davis, T.C., ve McCormack, L. (2010). Health Literacy: what is it? Journal of Health Communication, 15(9), 9-19.
• Bittlingmayer, U.H., Harsch, S., ve Islertas, Z. (2021). Health Literacy in the Context of Health Inequality – A Framing and a Research Overview. Luis A. Saboga-Nunes, Uwe H. Bittlingmayer, Orkan Okan, Diana Sahrai (Der.), New Approaches to Health Literacy: Linking Different Perspectives içinde (11-43). New York, NY: Springer.
• Bitzer, E.M., Schwendemann, H.E. (2021). The significance of health literacy for public health and health promotion. Saboga-Nunes, L.A., Bittlingmayer, U.H., Okan, O., Sahrai, D. (Der). New Approaches to Health Literacy. Gesundheit und Gesellschaft. Springer VS, Wiesbaden. https://doi.org/10.1007/978- 3-658-30909-1_5.
• Caiata-Zufferey, M., Abraham, A., Sommerhalder, K., & Schulz, P. J. (2010). Online health information seeking in the context of the medical consultation in Switzerland. Qualitative Health Research, Vol 20(8), 1050– 1061.
• Can, A.B., Sönmez, E., Özer, F., Ayva, G., ve Bacı, H. (2014). “Sağlık Arama Davranışı Olarak İnternet Kullanımını İnceleyen Bir Araştırma”. Cumhuriyet Tıp Dergisi. 36(4), 486-494.
• Camerini, L., Schulz, P.J., ve Nakamoto, K. (2012). Differential effects of health knowledge and health empowerment over patients’ self-management and health outcomes: a cross-sectional evaluation. Patient Education Counselling. 89, 337– 344.
• Cavanaugh, D. L., Riebschleger, J., ve Tanis, J. M. (2021). Mental health literacy WEB sites for children of parents with a mental illness. Clinical child psychology and psychiatry, 26(3), 720–733. https://doi.org/10.1177/13591045211005514.
• Charnock, D., Shepperd, S., Needham, G., ve Gann, R. (1999). Discern: An instrument for judging the quality of written consumer health information on treatment choices. Journal of Epidemiology and Community Health,53 ,105–111.
• Chen, D., Zhang, R., Feng, J., ve Liu, K. (2020). Fulfilling information needs of patients in online health communities. Health information and libraries journal, 37(1), 48–59. https://doi.org/10.1111/hir.12253
• Cheneguin, A. A., Salvat, I.S., Barrero, H.R.,ve Lacomba, T.M. (2020). How good is online information on fibromyalgia? An analysis of quality and readability of WEB sites on fibromyalgia in Spanish. BMJ Open, e037065. https://doi. org/10.1136/bmjopen-2020-037065
• Chinn, D. (2011). Critical health literacy: A review and critical analysis. Social Science & Medicine, 73(1), 60–67. doi:10.1016/j.socscimed.2011.04.004 10.1016/j. socscimed.2011.04.004
• Choi, J., ve Bakken, S. (2010). WEB-based education for low-literate parents in Neonatal Intensive Care Unit: development of a WEB site and heuristic evaluation and usability testing. International journal of medical informatics, Vol(79):8, ss. 565–575. https://doi.org/10.1016/j.ijmedinf.2010.05.001
• Cline, R. J., & Haynes, K. M. (2001). Consumer health information seeking on the Internet: The state of the art. Health Education Research, Vol(16), ss. 671–692.
• DataReportal (2022). Digital 2022: Global Overview Report. Erişim Tarihi: 30.06.2023 https:// datareportal.com/reports/digital-2022-global-overview-report
• Demir, F., Özsaker, E., ve Özcan, İ.A. (2020). The quality and suitability of written educational materials for patients. Journal of Clinical Nursing, Vol(17), ss. 259–265.
• Deniz, Ç.D., Kozanhan, B., Ttar, M.S., ve Özler, S. (2020). Üçlü test ile ilgili internet bilgilendirme metinlerinin okunabilirlik ve içeriklerinin değerlendirilmesi. Mersin Üniversitesi Sağlık Bilimleri Dergisi, Vol (13):1, ss. 35-44. doi: 10.26559/ mersinsbd.569617
• DISCERN (1999). Quality criteria for consumer health online. http://www.discern.org.uk/ Erişim tarihi:14.06.2023
• Diviani, N., Van den Putte, B., Giani, S., ve Van Weert, J. C. (2015). Low health literacy and evaluation of online health information: a systematic review of the literature. Journal of medical Internet research, 17(5), e112. https://doi. org/10.2196/jmir.4018.
• Doğan, F. (2018). Pediatri kliniğinde çocuğu tedavi gören ebeveynlerin çocuklarının hastalıkları ile ilgili internet kullanım durumlarının belirlenmesi. Hasan Kalyoncu Üniversitesi Sağlık Bilimleri Enstitüsü, Yayımlanmamış Yüksek Lisans Tezi.
• Elliot, J.O., Charyton, C. ve Long, L. (2007). A health literacy assessment of the National Epilepsy Foundation WEB site. Epilepsy & Behavior, 11, ss. 525–553
• European Union (2014). European citizens' digital health literacy. Flash Eurobarometer 404- TNS Political & Social. https://op.europa.eu/en/publication-detail/-/ publication/fd42f9e7-937c-41f3-bf03-4221b2db712b Erişim tarihi: 01.07.2023
• Eurostat (2022). Digital economy and society statistics- households and individuals. https:// ec.europa.eu/eurostat/statisticsexplained/index.php?title=Digital_ economy_and_society_statistics_-_households_and_individuals Erişim tarihi: 01.07.2023
• Eysenbach G, Powell J, Kuss O, Sa E.R (2002). Empirical studies assessing the quality of health information for consumers on the world wide WEB: a systematic review. The Journal of the American Medical Association (JAMA), 287:20, 2691-2700.
• Eyüboğlu, E., & Schulz, P. J. (2016). Do health literacy and patient em¬powerment affect self-care behaviour? A survey study among Turk¬ish patients with diabetes. BMJ Open, 6:3 https://doi. org/10.1136/bmjopen-2015-010186 PMID:26975936.
• Fleisher, J.E., Shah, K., Fitts, W., ve Dahodwala, N.A. (2015). Associations and Implications of low Health Literacy in parkinson’s disease. MOVEMENT Disorders Clinical Practice, 3:3, 250-256.
• Flesch, R. (1948). A new readability yardstick. Journal of Applied Psychology, 32, 221-233.
• Fox S., ve Jones, S. (2009). The social life of ınternet users. pew internet and american life project, Washington DC. Erişim Tarihi:03.07.2023. https://www.pewresearch. org/internet/2009/06/11/the-social-life-of-health-information/
• Ghaddar S. F., Valerio M.A., Garcia C.M., ve Hansen L. (2012). Adolescent health literacy: The importance of credible sources for online health information. Journal of School Health, 82:1, 28-36.
• Gökdoğan F, Kır, E., Özcan, A., Cerit, B., Yıldırım, Y., Akbal, S. (2003). Eğitim kitapçıkları güvenilir mi? 2. Uluslararası & IX. Ulusal Hemşirelik Kongresi Kongre Kitabı, 517-521.
• Haas, K., Brillante, C., Sharp, L., Elzokaky, A. K., Pasquinelli, M., Feldman, L., Kovitz, K. L., & Joo, M. (2018). Lung cancer screening: assessment of health literacy and readability of online educational resources. BMC Public Health,18:1, 1-7.Doi: https://doi.org/10.1186/s12889-018-6278-8.
• Harris, P.R., Sillence, E., ve Briggs P (2011). Perceived threat and corroboration: key factors that improve a predictive model of trust in internet-based health information and advice. Journal of Medical Internet Research, 27:13 doi:10.2196/jmir.1821
• HealthyPeople.gov. (2019a). Healthy People 2030 Framework. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. https://www.healthypeople.gov/ 2020/About-Healthy-People/Development- Healthy-People-2030/ Framework
• HealthyPeople.gov. (2019b). Proposed Objectives for Inclusion in Healthy People 2030 Public Comment for Healthy People 2030 | Healthy People 2020. Developing Healthy People 2030. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.https://www.healthypeople. gov/2020/About-Healthy-People/Development-healthy-People- 2030/Public-Comment
• İstanbul Tabip Odası (2023). Kızamık Vakalarındaki Artışa Yönelik Rapor. https://www. istabip.org.tr/7602-basin-toplantisi-istanbul-da-kizamik-hastaligindaki-artis- endise-verici.html Erişim Tarihi: 12.08.2023.
• Jacks, R., Baumann, I., Juvalta, S., ve Dratva, J. (2019). Parental digital health information seeking behavior in Switzerland: a cross-sectional study. BMC Public Health, Vol (19):225, 1-11.
• Jackson, D.N., Trivedi, N. ve Baur, C. (2021) Re-Prioritizing Digital Health and Health Literacy in Healthy People 2030 to Affect Health Equity, Health Communication, 36:10, 1155-1162, DOI:10.1080/10410236.2020.17488
• Jacobs, W., Amuta, A.O., ve Jeon, K.C. (2017). Health information seeking in the digital age: An analysis of health information seeking behavior among US adults. Cogent Social Sciences, 3, 1.
• Juvalta S., Kerry, M.J., Jaks, R., Baumann, I., Dratva, J (2020). Electronic Health Literacy in Swiss-German Parents: Cross-Sectional Study of eHealth Literacy Scale Unidimensionality. Journal of Medical Internet Research, 13:22, 1-11.
• Kartiwi, M., Gunawan, T.S., ve Rahman, J.A. (2021). Factors Affecting Continued Use of Online Health Information Seeking Behaviour Among Parents in Developing Countries. Turkish Journal of Computer and Mathematics Education, 12:3, 1371-1376.
• Kim, H. ve Xie B. (2017). Health literacy in the eHealth era: a systematic review of the literature. Patient Education Counselling,100, 1073–1082.
• Knapp, C., Madden, V., Marcu, M., Wang, H., Curtis, C., Sloyer, P., ve Shenkman, E. (2011). Information seeking behaviors of parents whose children have life-threatening illnesses. Pediatric Blood & Cancer, 56, 5, 805–811. doi:10.1002/ pbc.22674
• Kreps G. L. (2017). The Relevance of Health Literacy to mHealth. Studies in health technology and informatics, 240, 347–355.
• Kutner M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America’s adults: Results from the 2003 national assessment of adult literacy. National Center for Education Statistics. https://nces.ed.gov/pubs2006/2006483. pdf
• Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159-174. doi:10.2307/2529310.
• LaValley, S. A., Kiviniemi, M. T., ve Gage-Bouchard, E. A. (2017). Where people look for online health information. Health information and Libraries Journal, 34:2, 146–155. https://doi.org/10.1111/hir.12143
• Lee, H. Y., Jin, S. W., Henning-Smith, C., Lee, J., ve Lee, J. (2021). Role of Health Literacy in Health-Related Information-Seeking Behavior Online: Cross-sectional Study. Journal of medical Internet research, 23(1), e14088. https://doi. org/10.2196/14088.
• Madathil, K. C., Rivera-Rodriguez, A. J., Greenstein, J. S., ve Gramopadhye, A. K. (2015). Healthcare information on youtube: a systematic review. health informatics journal, 21(3), 173–194. https://doi.org/10.1177/1460458213512220.
• Mantwill, S., Umana, S.M., ve Schulz, P. J. (2015). The Relationship between Health Literacy and Health Disparities: A Systematic Review. Plos One,10:12, doi:10.1371/journal.pone.
• McCool, M.E., Wahl, J., Schlecht, I. & Apfelbacher, C. (2015). Evaluating written patient information for eczema in german: Comparing the reliability of two instruments, discern and eqip. PLoS ONE 10, 10. doi:10.1371/journal.pone.
• Mills, A., ve Todorova, N. (2016). "An Integrated Perspective on Factors Influencing Online HealthInformation Seeking Behaviours". ACIS 2016 Proceedings. 83. https:// aisel.aisnet.org/acis2016/83
• Muscat, N.A., ve Sorensen, K. (2019). Towards an equitable digital public health era: promoting equity through a health literacy perspective. European Journal of Public Health, 29,3, 13–17.
• Nadia K. A. (2010). Health literacy now: developing a WEB site for communicating clearly with patients, Journal of Consumer Health on the Internet, 14,4 341-357, DOI: 10.1080/15398285.2010.524091
• National Institute for Children’s Health Quality (2019). The Intersection of HealthEquity and Health Literacy. https://www.nichq.org/insight/intersection-health- equity-and-health-literacy (Erişim Tarihi:11.08.2023).
• Nicholl, H., Tracey, C., Begley, T., King, C., ve Lynch, A.M. (2017). Internet use by parents of children with rare conditions: findings from a study on parents' WEB information needs. Journal of Medical Internet Research, 28,19.
• Nielsen-Bohlman L, Panzer AM, Kindig DA. Institute of Medicine. Health literacy: a prescription to end confusion. Washington, DC: National Academies Press.
• Nikoloudakis, I.A., Vandelanotte, C., Rebar, A.L., Schoeppe, S., Alley, S., Duncan, M.J., ve Short, C.E. (2018). Examining the correlates of online health ınformation– seeking behavior among men compared with women. American Journal of Men’s Health, 12(5), 1358-1367. doi:10.1177/1557988316650625
• Nutbeam, D., Zamir, D.L., ve Rowlands, G. (2019). Health literacy in context settings, media, and populations. IJERPH, https://doi.org/10.3390/books978-3-03897-472-7
• Nutbeam, D., McGill, B., ve Premkumar, P. (2018). Improving health literacy in community populations: a review of progress. Health promotion international, 33(5), 901–911. https://doi.org/10.1093/heapro/dax015.
• Nutbeam, D. (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259-267.
• Otu, M., ve Karagözoğlu, Ş. (2022). Fibromiyalji sendromu ile ilgili türkiye’deki bilgi sunan WEB sitelerinin okunabilirlik, içerik ve kalite açısından incelenmesi. Turk Osteoporos Dergisi, 28, 19-25.
• Park, H., Rodgers, S., ve Stemmle, J. (2013). Analyzing Health Organizations' Use of Twitter for Promoting Health Literacy, Journal of Health Communication,18(4), 410-425.
• Percheski, C., ve Hargittai, E. (2011). Health information-seeking in the digital age. Journal of American College Health, 59, 379–386.
• Pho, A. T., Bakken, S., Lunn, M. R., Lubensky, M. E., Flentje, A., Dastur, Z., ve Obedin-Maliver, J. (2022). Online health information seeking, health literacy, and human papillomavirus vaccination among transgender and gender-diverse people. Journal of the American Medical Informatics Association, JAMIA, 29(2), 285–295. https://doi.org/10.1093/jamia/ocab150.
• Plantin, L., Daneback, K. Parenthood, information and support on the internet. A literature review of research on parents and professionals online. BMC Family Practice,10(34), 1-12.
• Powell, J.A., Darvell, M., Gray, J.A. (2003). The doctor, the patient and the world-wide WEB: how the internet is changing healthcare. Journal of the Royal Society of Medicine. 96(2), 74-76.
• Powell, J., Inglis, N., Ronnie, J., ve Large, S. (2011). The characteristics and motivations of online health information seekers: Cross-sectional survey and qualitative interview study. Journal of Medical Internet Research, 13(1), ss.1-11.
• Ratzan SC, Parker RM. 2000. Introduction. In: National Library of Medicine Current Bibliographies in Medicine: Health Literacy. CR, Selden, M, Zorn, SC, Ratzan, RM, Parker (Eds.) NLM Pub. No. CBM 2000-1. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services.
• Reifegerste, D., Bachl, M., ve Baumann, E. (2017). Surrogate health information seeking in Europe: Influence of source type and social network variables. International Journal of Medical Informatics, 10, 7–14.
• Rudd R. (2003). Objective 11-2: Improvement of health literacy. In: Communicating Health: Priorities and Strategies for Progress. Washington, DC: Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services
• Rüegg, R. (2022). Decision-making ability: a missing link between health literacy, contextual factors, and health. Health Literacy Research and Practice , 6(3), e213-e223
• Schulz, P.J. ve Nakamoto, K. (2013). Health literacy and patient empowerment in health communication. Patient Education and Counseling, 90(1), 4-11.
• Sillence, E., Briggs, P., Harris, P. ve Fishwick, L. (2006). A framework for understanding trust factors in WEB-based health advice. International Journal of Human Computer Studies, 64, 697-713.
• Seurer, A. C., & Vogt, H. B. (2013). Low health literacy: a barrier to effective patient care. South Dakota medicine: The journal of the South Dakota State Medical Association, 66(2), 51–57.
• Sørensen, K., Van den Broucke, S., Fullham, J., Doyle, G., Pelikan, J., Slonska, Z., Brand, H. (2012). (HLS-EU) Consortium European Health Literacy Project. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health,12(80), 1-13.
• Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., Fullam, J., Kondilis, B., Agrafiotis, D., Uiters, E., Falcon, M., Mensing, M., Tchamov, K., van den Broucke, S., Brand, H., & the HLS-EU Consortium. (2015). Health literacy in europe: comparative results of the european health literacy survey (HLS-EU). European Journal of Public Health, 25(6), 1053-1058.
• Similiar WEB (2023). Ülke genelinde arama motorları Pazar payı: Türkiye. Erişim Tarihi: T.C Sağlık Bakanlığı (2018). Türkiye Sağlık Okuryazarlığı Düzeyi ve İlişkili Faktörleri Araştırması. Ankara: Özyurt Matbaacılık23.05.2023. https://www.similarWEB.com/tr/engines/turke
• Tekin, A., Kaya, Er., Demirel, M. ve Yazıcı, S.Ö. (2013). “Güçlendirme Bağlamında İnternetin Hasta-Hekim İlişkilerine Etkisi”, Selçuk İletişim, 6(1), 23–36.
• Tennant B, Stellefson M, Dodd V, Chaney B, Chaney D, Paige S, Alber J. eHealth literacy and WEB 2.0 health information seeking behaviors among baby boomers and older adults. Journal of Medical Internet Research,17(3), 1-17.
• TUIK (2022). Ulusal Eğitim İstatistikleri. https://data.tuik.gov.tr/Bulten/Index?p=Ulusal-Egitim- Istatistikleri-2022-49756 Erişim tarihi: 12.08.2023.
• Uğulu, Z., ve Akgün, H.S. (2019). Sağlık kurumlarına başvuran hastaların sağlık okuryazarlığının ve kullanılan eğitim materyallerinin sağlık okuryazarlığına uygunluğunun değerlendirilmesi. Mersin Universitesi Sağlık Bilimleri Dergisi,12(1), 96-106 doi:10.26559/mersinsbd.449973
• Von Wagner C., Steptoe, A., Wolf, M.S., ve Wardle, J. (2009). Health literacy and health actions: A review and a framework from health psychology. Health Education and Behaviour, 36, 860–877.
• Wald, H.S., Dube, C.E., Anthony, D.C. (2007). Untangling the WEB--the impact of Internet use on health care and the physician-patient relationship. Patient Education Counselling, 68(3), 218-224. doi: 10.1016/j.pec.2007.05.016
• Wathen, C. N., ve Harris, R. M. (2007). “I try to take care of it myself.” How rural women search for health information. Qualitative Health Research, 17, 639-651.
• Wei, X., Du, Z., ve Zhang, S (2016). Analysis of barriers to health information seeking and utilizing in patients with diabetes. Cross-Cultural Communication.12, 48–51.
• Wu, Y., Wang, L., Cai, Z., Bao, L., Ai, P., & Ai, Z. (2017). Prevalence and risk factors of low health literacy: A community-based study in Shanghai, China. International Journal of Environmental Research and Public Health, 14(6), 1-10. https:// doi.org/10.3390
• Yardi, S., Caldwell, P. H., Barnes, E. H., ve Scott, K. M. (2018). Determining parents' patterns of behaviour when searching for online information on their child's health. Journal of paediatrics and child health, 54(11), 1246–1254. https:// doi.org/10.1111/jpc.14068.
• Yusoff, H. A. M., Hamzah, M. R., Manaf, A. R. A., İsmail, A., Ahmad, Y., ve Hussin, H. (2021). The influence of health literacy on health outcomes: A systematic literature review perspective. AIP Conference Proceedings 2339, 020105
• Zamir, D.L., Leung, A. Y. M., Dodson, S., ve Rowlands, G. (2017). Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective. Information Services and Use, 37(2), 131-151. https://doi.org/10.3233/ISU-170834.