skip to main content
10.1145/3627508.3638318acmotherconferencesArticle/Chapter ViewAbstractPublication PagesirConference Proceedingsconference-collections
research-article
Open Access

Unveiling Health Literacy through Web Search Behavior: A Classification-Based Analysis of User Interactions

Published:10 March 2024Publication History

ABSTRACT

More and more people are relying on the Web to find health information. Challenges faced by individuals with low health literacy in the real world likely persist in the virtual realm. To assist these users, our first step is to identify them. This study aims to uncover disparities in the information-seeking behavior of users with varying levels of health literacy. We utilized data gathered from a prior user experiment. Our approach involves a classification scheme encompassing events during web search sessions, spanning the browser, search engine, and web pages. Employing this scheme, we logged interactions from video recordings in the user study and subjected the event logs to descriptive and inferential analyses. Our data analysis unveils distinctive patterns within the low health literacy group. They exhibit a higher frequency of query reformulations with entirely new terms, engage in more left clicks, utilize the browser's backward functionality more frequently, and invest more time in interactions, including increased scrolling on results pages. Conversely, the high health literacy group demonstrates a greater propensity to click on universal results, extract text from URLs more often, and make more clicks with the mouse middle button. These findings offer valuable insights for inferring users' health literacy in a non-intrusive manner. The automatic inference of health literacy can pave the way for personalized services, enhancing accessibility to information and education for individuals with low health literacy, among other benefits.

References

  1. Association, A.M. 1999. Health literacy: Report of the Council on Scientific Affairs. Journal of the American Medical Association. 281, 6 (1999), 552–557.Google ScholarGoogle ScholarCross RefCross Ref
  2. Aula, A. 2003. Query formulation in web information search. Proceedings of the IADIS International Conference WWW/Internet 2003. January 2003 (2003), 403–410.Google ScholarGoogle Scholar
  3. Baker, D.W. 1999. Development of a brief test to measure functional health literacy. Patient education and counseling. 38, 1 (Sep. 1999), 33–42. DOI:https://doi.org/10.1016/S0738-3991(98)00116-5.Google ScholarGoogle ScholarCross RefCross Ref
  4. Bhavnani, S.K. 2001. Important Cognitive Components of Domain-Specific Search Knowledge. Proceedings of TREC’2001. TREC’01, (2001), 571–578.Google ScholarGoogle Scholar
  5. Chang, Y.-S. 2020. Investigating the Relationship between eHealth Literacy and Information Search Behaviors. Proceedings of the 2020 Conference on Human Information Interaction and Retrieval (New York, NY, USA, Mar. 2020), 499–502.Google ScholarGoogle ScholarDigital LibraryDigital Library
  6. Davis, T.C. 1991. Rapid assessment of literacy levels of adult primary care patients. Family medicine. 23, 6 (1991), 433–5.Google ScholarGoogle Scholar
  7. Duggan, G.B. and Payne, S.J. 2008. Knowledge in the Head and on the Web: Using Topic Expertise to Aid Search. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (New York, NY, USA, 2008), 39–48.Google ScholarGoogle ScholarDigital LibraryDigital Library
  8. Eurostat 2022. EU citizens: over half seek health information online. European Commision.Google ScholarGoogle Scholar
  9. Finney Rutten, L.J. 2019. Online Health Information Seeking Among US Adults: Measuring Progress Toward a Healthy People 2020 Objective. Public Health Reports. 134, 6 (Nov. 2019), 617. DOI:https://doi.org/10.1177/0033354919874074.Google ScholarGoogle ScholarCross RefCross Ref
  10. Ganesh, S. and Cave, V. 2018. P-values, p-values everywhere! New Zealand Veterinary Journal. 66, 2 (2018), 55–56. DOI:https://doi.org/10.1080/00480169.2018.1415604.Google ScholarGoogle ScholarCross RefCross Ref
  11. Hembrooke, H.A. 2005. The Effects of Expertise and Feedback on Search Term Selection and Subsequent Learning: Research Articles. J. Am. Soc. Inf. Sci. Technol. 56, 8 (Jun. 2005), 861–871.Google ScholarGoogle Scholar
  12. Ho, J. 2003. Relations among asthma knowledge, treatment adherence, and outcome. The Journal of allergy and clinical immunology. 111, 3 (Mar. 2003), 498–502. DOI:https://doi.org/10.1067/MAI.2003.160.Google ScholarGoogle ScholarCross RefCross Ref
  13. Hölscher, C. and Strube, G. 2000. Web search behavior of Internet experts and newbies. Computer Networks. 33, 1–6 (Jun. 2000), 337–346. DOI:https://doi.org/10.1016/s1389-1286(00)00031-1.Google ScholarGoogle ScholarDigital LibraryDigital Library
  14. Huhta, A.M. 2018. Health Literacy in Web-Based Health Information Environments: Systematic Review of Concepts, Definitions, and Operationalization for Measurement. Journal of medical Internet research. 20, 12 (2018). DOI:https://doi.org/10.2196/10273.Google ScholarGoogle ScholarCross RefCross Ref
  15. Ilona Kickbusch, J.M. ed. 2013. Health literacy - The solid facts.Google ScholarGoogle Scholar
  16. Jansen, J. 2009. Patterns of Query Reformulation During Web Searching. Journal of the American Society for Information Science and Technology. 60, (2009). DOI:https://doi.org/10.1002/asi.21071.Google ScholarGoogle ScholarCross RefCross Ref
  17. Keenan, R.S.S. and J. 2005. Health literacy: The gap between physicians and patients. American Family Physician. 72, 3 (2005).Google ScholarGoogle Scholar
  18. Kelly, D. and Cool, C. 2002. The effects of topic familiarity on information search behavior. Proceedings of the 2nd ACM/IEEE-CS joint conference on Digital libraries (New York, NY, USA, 2002), 74–75.Google ScholarGoogle ScholarDigital LibraryDigital Library
  19. Kutner, M. 2006. The Health Literacy of America's Adults: Results from the 2003 National Assessment of Adult Literacy.Google ScholarGoogle Scholar
  20. Lambert, S.D. and Loiselle, C.G. 2007. Health information-seeking behavior. Qualitative Health Research. 17, 8 (2007), 1006–1019. DOI:https://doi.org/10.1177/1049732307305199.Google ScholarGoogle ScholarCross RefCross Ref
  21. Lee, S.Y.D. 2006. Development of an Easy-to-Use Spanish Health Literacy Test. Health Services Research. 41, 4p1 (Aug. 2006), 1392–1412. DOI:https://doi.org/10.1111/J.1475-6773.2006.00532.X.Google ScholarGoogle ScholarCross RefCross Ref
  22. Liu, C. 2016. The Exploration of Objective Task Difficulty and Domain Knowledge Effects on Users’ Query Formulation. Proceedings of the 79th ASIS & T Annual Meeting: Creating Knowledge, Enhancing Lives through Information & Technology (USA, 2016).Google ScholarGoogle ScholarDigital LibraryDigital Library
  23. Liu, J. and Belkin, N.J. 2010. Personalizing information retrieval for people with different levels of topic knowledge. Proceedings of the 10th annual joint conference on Digital libraries (New York, NY, USA, 2010), 383–384.Google ScholarGoogle ScholarDigital LibraryDigital Library
  24. Lopes, C.T. and Ramos, E. 2020. Studying how health literacy influences attention during online information seeking. CHIIR 2020 - Proceedings of the 2020 Conference on Human Information Interaction and Retrieval. (Mar. 2020), 283–291. DOI:https://doi.org/10.1145/3343413.3377966.Google ScholarGoogle ScholarDigital LibraryDigital Library
  25. Lopes, C.T. and Ribeiro, C. 2016. Effects of language and terminology on the usage of health query suggestions.Google ScholarGoogle Scholar
  26. Lopes, C.T. and Ribeiro, C. 2015. Effects of terminology on health queries: An analysis by user's health literacy and topic familiarity. Advances in Librarianship. 39, (2015), 145–184. DOI:https://doi.org/10.1108/S0065-283020150000039013.Google ScholarGoogle ScholarCross RefCross Ref
  27. Lopes, C.T. and Ribeiro, C. 2013. Query behavior: The impact of health literacy, topic familiarity and terminology.Google ScholarGoogle Scholar
  28. Lopes, C.T. and Sousa, H. 2019. Assisting health consumers while searching the web through medical annotations. CHIIR 2019 - Proceedings of the 2019 Conference on Human Information Interaction and Retrieval (2019).Google ScholarGoogle ScholarDigital LibraryDigital Library
  29. Lopes, C.T. and Sousa, H. 2019. Assisting health consumers while searching the web through medical annotations. CHIIR 2019 - Proceedings of the 2019 Conference on Human Information Interaction and Retrieval. (Mar. 2019), 219–223. DOI:https://doi.org/10.1145/3295750.3298941.Google ScholarGoogle ScholarDigital LibraryDigital Library
  30. Mackert, M. 2016. Health Literacy and Health Information Technology Adoption: The Potential for a New Digital Divide. Journal of Medical Internet Research. 18, 10 (Oct. 2016). DOI:https://doi.org/10.2196/JMIR.6349.Google ScholarGoogle ScholarCross RefCross Ref
  31. Malloy-Weir, L.J. 2016. A review of health literacy: Definitions, interpretations, and implications for policy initiatives. Journal of Public Health Policy. Vol. 37, No. 3 (2016), 334–-352.Google ScholarGoogle ScholarCross RefCross Ref
  32. Mao, J. 2018. How Does Domain Expertise Affect Users’ Search Interaction and Outcome in Exploratory Search? ACM Transactions on Information Systems. 36, 4 (Jul. 2018), 1–30. DOI:https://doi.org/10.1145/3223045.Google ScholarGoogle ScholarDigital LibraryDigital Library
  33. McCormack, N.D.B. and T.C.D. and L. 2010. Health literacy: What is it? Journal of Health Communication. 15, SUPPL. 2 (2010), 9–19.Google ScholarGoogle Scholar
  34. Nangsangna, R.D. and Vroom, F.D.-C. 2019. Factors influencing online health information seeking behaviour among patients in Kwahu West Municipal, Nkawkaw, Ghana. Online Journal of Public Health Informatics. 11, 2 (2019), 13. DOI:https://doi.org/10.5210/OJPHI.V11I2.10141.Google ScholarGoogle ScholarCross RefCross Ref
  35. [35]Nielsen-Bohlman, L. 2005. Health literacy: a prescription to end confusion. National Academies Press (US).Google ScholarGoogle Scholar
  36. Nölke, L. 2015. Sociodemographic and health-(care-)related characteristics of online health information seekers: a cross-sectional German study. BMC Public Health. 15, 1 (2015). DOI:https://doi.org/10.1186/S12889-015-1423-0.Google ScholarGoogle ScholarCross RefCross Ref
  37. Oliveira, B. and Teixeira Lopes, C. 2023. From 10 Blue Links Pages to Feature-Full Search Engine Results Pages - Analysis of the Temporal Evolution of SERP Features. CHIIR 2023 - Proceedings of the 2023 Conference on Human Information Interaction and Retrieval. (Mar. 2023), 338–345. DOI:https://doi.org/10.1145/3576840.3578307.Google ScholarGoogle ScholarDigital LibraryDigital Library
  38. Oliveira, B. and Teixeira Lopes, C. 2023. The Evolution of Web Search User Interfaces - An Archaeological Analysis of Google Search Engine Result Pages. CHIIR 2023 - Proceedings of the 2023 Conference on Human Information Interaction and Retrieval. (Mar. 2023), 55–68. DOI:https://doi.org/10.1145/3576840.3578320.Google ScholarGoogle ScholarDigital LibraryDigital Library
  39. Paiva, D. 2014. Cross-cultural adaptation and validation of the health literacy assessment tool METER in the Portuguese adult population. Patient education and counseling. 97, 2 (Nov. 2014), 269–275. DOI:https://doi.org/10.1016/J.PEC.2014.07.024.Google ScholarGoogle ScholarCross RefCross Ref
  40. Parent, M.S.M. 2013. A Criança com Asma - o conhecimento dos pais e adolescentes sobre a doença. Escola Superior de Saúde do Instituto Politécnico de Viana do Castelo.Google ScholarGoogle Scholar
  41. Parker, R.M. 1995. The test of functional health literacy in adults. Journal of General Internal Medicine 1995 10:10. 10, 10 (1995), 537–541. DOI:https://doi.org/10.1007/BF02640361.Google ScholarGoogle ScholarCross RefCross Ref
  42. Parmenter, K. and Wardle, J. 1999. Development of a general nutrition knowledge questionnaire for adults. European journal of clinical nutrition. 53, 4 (1999), 298–308. DOI:https://doi.org/10.1038/SJ.EJCN.1600726.Google ScholarGoogle ScholarCross RefCross Ref
  43. Quinn, S. 2017. Quantifying health literacy and eHealth literacy using existing instruments and browser-based software for tracking online health information seeking behavior. Computers in Human Behavior. 69, (Apr. 2017), 256–267. DOI:https://doi.org/10.1016/J.CHB.2016.12.032.Google ScholarGoogle ScholarDigital LibraryDigital Library
  44. Rawson, K.A. 2010. The METER: a brief, self-administered measure of health literacy. Journal of general internal medicine. 25, 1 (Jan. 2010), 67–71. DOI:https://doi.org/10.1007/s11606-009-1158-7.Google ScholarGoogle ScholarCross RefCross Ref
  45. de Souza, J.A. 2009. Conhecimentos nutricionais: reprodução e validação do questionário. Faculdade de Medicina da Universidade do Porto.Google ScholarGoogle Scholar
  46. Tamine, L. and Chouquet, C. 2017. On the impact of domain expertise on query formulation, relevance assessment and retrieval performance in clinical settings. Information Processing and Management. 53, 2 (Mar. 2017), 332–350. DOI:https://doi.org/10.1016/j.ipm.2016.11.004.Google ScholarGoogle ScholarDigital LibraryDigital Library
  47. Teixeira Lopes, C. 2017. Effects of language and terminology of query suggestions on medical accuracy considering different user characteristics. Journal of the Association for Information Science and Technology. 68, 9 (Sep. 2017), 2063–2075. DOI:https://doi.org/10.1002/asi.23874.Google ScholarGoogle ScholarDigital LibraryDigital Library
  48. Tesfahun Melese Yilma 2019. Context-based interactive health information searchingle. Information Research. 24, 2 (2019).Google ScholarGoogle Scholar
  49. The Role of Health Literacy in Health Information Technology - Innovations in Health Literacy Research - NCBI Bookshelf: 2011. https://www.ncbi.nlm.nih.gov/books/NBK209676/. Accessed: 2022-05-20.Google ScholarGoogle Scholar
  50. Wang, X. 2021. Online Health Information Seeking: A Review and Meta-Analysis. Health communication. 36, 10 (2021), 1163–1175. DOI:https://doi.org/10.1080/10410236.2020.1748829.Google ScholarGoogle ScholarCross RefCross Ref
  51. Weiss, B.D. 2005. Quick Assessment of Literacy in Primary Care: The Newest Vital Sign. The Annals of Family Medicine. 3, 6 (Nov. 2005), 514–522. DOI:https://doi.org/10.1370/afm.405.Google ScholarGoogle ScholarCross RefCross Ref
  52. White, R.W. 2009. Characterizing the influence of domain expertise on web search behavior. Proceedings of the Second ACM International Conference on Web Search and Data Mining (New York, NY, USA, 2009), 132–141.Google ScholarGoogle ScholarDigital LibraryDigital Library
  53. White, R.W. 2008. How medical expertise influences web search interaction. Proceedings of the 31st annual international ACM SIGIR conference on Research and development in information retrieval (New York, NY, USA, 2008), 791–792.Google ScholarGoogle ScholarDigital LibraryDigital Library
  54. Wildemuth, B.M. 2004. The effects of domain knowledge on search tactic formulation. J. Am. Soc. Inf. Sci. 55, 3 (Feb. 2004), 246–258. DOI:https://doi.org/10.1002/asi.10367.Google ScholarGoogle ScholarDigital LibraryDigital Library
  55. Yom-Tov, E. 2016. The Effect of Limited Health Literacy on How Internet Users Learn About Diabetes. Journal of Health Communication. 21, 10 (Oct. 2016), 1107–1114. DOI:https://doi.org/10.1080/10810730.2016.1222033.Google ScholarGoogle ScholarCross RefCross Ref
  56. Zhang, X. 2005. Domain knowledge, search behaviour, and search effectiveness of engineering and science students: An exploratory study. Information Research. 10, (2005).Google ScholarGoogle Scholar
  57. Zhang, X. 2014. Predicting users’ domain knowledge in information retrieval using multiple regression analysis of search behaviors. J Assn Inf Sci Tec. (Jul. 2014), n/a. DOI:https://doi.org/10.1002/asi.23218.Google ScholarGoogle ScholarDigital LibraryDigital Library

Index Terms

  1. Unveiling Health Literacy through Web Search Behavior: A Classification-Based Analysis of User Interactions

      Recommendations

      Comments

      Login options

      Check if you have access through your login credentials or your institution to get full access on this article.

      Sign in
      • Published in

        cover image ACM Other conferences
        CHIIR '24: Proceedings of the 2024 Conference on Human Information Interaction and Retrieval
        March 2024
        481 pages
        ISBN:9798400704345
        DOI:10.1145/3627508

        Copyright © 2024 Owner/Author

        This work is licensed under a Creative Commons Attribution International 4.0 License.

        Publisher

        Association for Computing Machinery

        New York, NY, United States

        Publication History

        • Published: 10 March 2024

        Check for updates

        Qualifiers

        • research-article
        • Research
        • Refereed limited

        Acceptance Rates

        Overall Acceptance Rate55of163submissions,34%
      • Article Metrics

        • Downloads (Last 12 months)55
        • Downloads (Last 6 weeks)42

        Other Metrics

      PDF Format

      View or Download as a PDF file.

      PDF

      eReader

      View online with eReader.

      eReader

      HTML Format

      View this article in HTML Format .

      View HTML Format