The Role of Trust When Adolescents Search for and Appraise Online Health Information.

OBJECTIVE: To assess the role of trust when adolescents search for and appraise online health information. STUDY DESIGN: A systematic search of online databases (MEDLINE, EMBASE, PsycINFO, and ERIC) was performed. Google Scholar and reference lists for included studies were manually searched for additional articles. Studies were included if they examined the role of trust when adolescents (in the 13- to 18-year-old age range) searched for and/or appraised online health information. Findings were synthesized using thematic analysis. RESULTS: There were 22 studies that met the inclusion criteria. Four key themes were identified: adolescents generally distrust the Internet but use it anyway (subthemes were why adolescents distrust online health information; why adolescents still use online health information), adolescents use heuristics to appraise the trustworthiness of online health information (subthemes were different heuristics used by different adolescents, range of heuristics used by adolescents), adolescents trust websites more than social media or social networking sites, and adolescents' level of trust in online health information guides their actions and responses. CONCLUSIONS: Adolescents often distrust health information from the Internet, but continue to use it. Adolescents are aware of the need to evaluate the trustworthiness of online health information; however, their approaches vary in sophistication. As the reach and content of the Internet expands, it is important to equip adolescents with effective eHealth literacy to assess the trustworthiness of online health information.

How Adolescents Search for and Appraise Online Health Information: A Systematic Review.

OBJECTIVE: To conduct a systematic review of the evidence concerning whether and how adolescents search for online health information and the extent to which they appraise the credibility of information they retrieve. STUDY DESIGN: A systematic search of online databases (MEDLINE, EMBASE, PsycINFO, ERIC) was performed. Reference lists of included papers were searched manually for additional articles. Included were studies on whether and how adolescents searched for and appraised online health information, where adolescent participants were aged 13-18 years. Thematic analysis was used to synthesize the findings. RESULTS: Thirty-four studies met the inclusion criteria. In line with the research questions, 2 key concepts were identified within the papers: whether and how adolescents search for online health information, and the extent to which adolescents appraise online health information. Four themes were identified regarding whether and how adolescents search for online health information: use of search engines, difficulties in selecting appropriate search strings, barriers to searching, and absence of searching. Four themes emerged concerning the extent to which adolescents appraise the credibility of online health information: evaluation based on Web site name and reputation, evaluation based on first impression of Web site, evaluation of Web site content, and absence of a sophisticated appraisal strategy. CONCLUSIONS: Adolescents are aware of the varying quality of online health information. Strategies used by individuals for searching and appraising online health information differ in their sophistication. It is important to develop resources to enhance search and appraisal skills and to collaborate with adolescents to ensure that such resources are appropriate for them.

How Adolescents Trust Health Information on Social Media: A Systematic Review.

BACKGROUND: Given the potential for social media to spread health misinformation, it is important to understand how trusts impact adolescents' engagement with health content on social media. OBJECTIVE: To explore the concept of trust when adolescents (13-18 years) engage with health information on social media. Five relevant databases (MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL) were systematically searched alongside Google Scholar and reference lists of included papers. Studies were included if they examined adolescents' trust when engaging with health information on social media. STUDY APPRAISAL AND SYNTHESIS METHODS: Thematic analysis was used to synthesize the findings from this review. RESULTS: Thirty-four papers were included. Three key domains were explored: trust in the social media platform/service (general distrust of social media for health information; safety and privacy); trust in other users (mistrust of unknown users; fear of bullying or judgment; trust in friends or peers; celebrities and popularity; trust in others' experience and the importance of social support); trust in content (tone and appearance of health information; expertise and verification; advertising, pushed, and suggested content). LIMITATIONS: Narrow geographic representation of papers and limited quantitative studies. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Adolescents' trust in health information on social media involves a complex interplay between trust in: social media platforms, other users, and health content. Central to many of the findings is the social and identity work done by adolescents on and through social media.