Developing health information literacy in disengaged at-risk populations. Insights to inform interventions
| DOI | https://doi.org/10.1108/JD-06-2018-0086 |
| Pages | 172-189 |
| Published date | 14 January 2019 |
| Date | 14 January 2019 |
| Author | Steven Buchanan,Emma Nicol |
| Subject Matter | Library & information science,Records management & preservation,Document management,Classification & cataloguing,Information behaviour & retrieval,Collection building & management,Scholarly communications/publishing,Information & knowledge management,Information management & governance,Information management,Information & communications technology,Internet |
Developing health information
literacy in disengaged
at-risk populations
Insights to inform interventions
Steven Buchanan and Emma Nicol
University of Strathclyde, Glasgow, UK
Abstract
Purpose –The purpose of this paper is to advance our understanding of the challenges of health information
literacy (IL) education in disadvantaged and disengaged at-risk populations; and from the perspective of
professionals out with information professions occupying everyday support roles.
Design/methodology/approach –A qualitative in-depth case study. The participants were a team
of UK Family Nurses providing outreach support to young expectant mothers from areas of multiple
deprivations, and the mothers themselves. The data collection methods were observation, survey, interviews
and focus groups.
Findings –Information needs of mothers are multiple, and not always recognised as information problems,
or revealed. Several felt overwhelmed, and actively avoided health information. There is low awareness and/
or use of state sources of online health information. Family nurses provide an important information
intermediary role, but are unfamiliar with IL concepts and models; consequently, there is limited evidence of
client transitions to independent information seeking, or underpinning pedagogical practices to achieve
such goals.
Research limitations/implications –Further research is requi red into appropriate pe dagogical
approaches to IL educatio n adaptable to semi-structured everyday situ ations. Recognition of information
need requires particular attention, including methods of elicitation and specification in the
problematic context.
Practical implications –In an era of digital transitions and public service reforms, the authors raise
important questions regarding the true reach of public health policy.
Originality/value –The paper holistically examines nurse–client information behaviours, and extends the
discussion of low IL in nurses beyond issues of evidence-based practice to issues of developing healthcare
self-efficacy in at-risk clients.
Keywords Information literacy, Health education, Health information literacy, Mothers,
Information behaviour, Information intermediary
Paper type Research paper
1. Introduction
This paper advances our understanding of the theoretical and practical challenges of
developing health information literacy (IL) (understood as IL in the health context) amongst
disadvantaged (socioeconomic) and dependent (support) populations; and from the
perspective of professionals out with information professions occupying everyday support
roles (e.g. health and social care). Such a perspective is important as two recent information
behaviour studies (Buchanan and Tuckerman, 2016; Buchanan et al., 2018a) conducted with
at-risk (health and well-being) groups in areas of multiple deprivations (e.g. employment,
education, health and crime), which evidence significant IL issues and also evidence general
disengagement with information professionals (e.g. librarians and educators) and associated
learning programmes, and a localised dependence upon support workers when seeking
everyday information. Cognisant to correlations between low IL and poor health outcomes
Journal of Documentation
Vol. 75 No. 1, 2019
pp. 172-189
© Emerald PublishingLimited
0022-0418
DOI 10.1108/JD-06-2018-0086
Received 4 June 2018
Revised 6 September 2018
Accepted 17 September 2018
The current issue and full text archive of this journal is available on Emerald Insight at:
www.emeraldinsight.com/0022-0418.htm
This research was funded by ESRC Grant No. ES/L012634/1: understanding the Information Needs of
Young First Time Mothers from Areas of Multiple Deprivation.
172
JD
75,1
(e.g. Berkman et al., 2011), this study raises important questions regarding approaches to
IL education in at-risk populations, and the role of primary healthcare professionals in
everyday support roles.
2. Background
Our understanding of IL in the everyday context, i.e. out with formal education programmes
and the workplace, is limited. Martzoukou and Sayyad Abdi (2017), in a recent review of
research examining IL in the everyday context, report that, “Despite the clear value of
information literacy within the everyday life context, most empirical research has been
conducted within educational and workplace settings”(p. 2). In relation, they report that,
“[…] the implications of lacking IL skills within the everyday life environment have not been
sufficiently researched […] It is further unclear how people can be supported and
empowered to develop effective information literacy practices within the different realms of
everyday life”(p. 29).
A broader perspective is also called for within health fields. McCormack et al. (2017),
reporting calls for a broader perspective of health literacy that shifts the focus of current
research from, “[…] examining patient-level skills and deficits to more in-depth and
cross-cutting studies that includ e individuals and populations as wel l as health
professionals and health systems”(p. 8), conclude that, “Despite these calls for a broader
perspective, there have been no systematic attempts to expand conceptualization of health
literacy and increase patient engagement”(p. 9). McCormack et al. (2017) argue that to
effectively address issues of low literacy require a broader social ecological perspective that
takes into account multiple and complex levels of influence and interaction (i.e. individual,
interpersonal, organisational, community and macro-policy). Similar to Martzoukou and
Sayyad Abdi (2017), understanding of context is identified as important to effective IL
interventions. Similar issues are raised with regard to the digital health aspects of health
literacy. For example, in a systematic review of factors influencing digital health
interventions, O’Connor et al. (2016) conclude that, “Further research is needed on novel
ways to engage and educate the public about digital health”(p. 11), including better
understanding of how demographic variables such as low socioecomic status influence
engagement with health information.
Two recent information behaviour studies amongst at-risk populations (Buchanan and
Tuckerman, 2016; Buchanan et al., 2018a) have contributed to our understanding of IL in the
everyday context, and provided direction for this current work.
Buchanan and Tuckerman (2016) in a study of adolescent information behaviours in
disadvantaged and disengaged circumstances, worked with UK young people aged 16–19
not in education, employment or training (NEET) and their support workers. NEET youth
are an at-risk group as delinquency rates are higher than peers, as is the prevalence of
substance abuse and mental health issues (O’Dea et al., 2014; Princes Trust, 2014). Buchanan
and Tuckerman evidence low levels of IL amongst NEET youth; with NEET youth
demonstrating a wide range of unmet everyday needs, a dependence upon support workers
when seeking and processing information, and passive non-motivated information seeking
behaviours often abandoned. Such issues are compounded by an impoverished and insular
existence, and general disengagement with state services. Buchanan and Tuckerman report
that due to such issues, support workers would not leave NEET youth to find information
independently, but would instead provide or guide them to information. An important
everyday support role is identified, but, in relation, Buchanan and Tuckerman (2016) found,
“no evidence of proactive transitions to independent information seeking from either party,
nor of basic literacy issues being explicitly addressed”(p. 543). Buchanan and Tuckerman
(2016) recommended remedial IL education as an, “immediate priority for public and third
sector agencies, addressing both immediate and long-term needs”(p. 533). Cognisant of
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Developing
health
information
literacy
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