Abstract
Despite the fact that a large percentage of Americans go online to seek health information, literature pertaining to online health information (OHI) seeking among college men in Latino fraternities (CMLF) has been nonexistent. Thus, the purpose of this study was to (a) identify the types of OHI that CMLF seek and (b) to determine the factors motivating OHI seeking among CMLF. Four 1- to 1.5-hour focus groups were conducted in two public universities in Florida with 41 college-aged Latino males in an established Latino fraternity. E-mails were used to recruit fraternity members. Qualitative analysis of the focus group transcripts identified that CMLF search for a variety of OHI types including searches on symptoms, diagnoses, weight loss, and treatments for conditions or diseases among other types of OHI. Factors motivating OHI seeking included informational needs of others and concerns for others, worries due to lack of health insurance, preoccupations with health condition, concerns over physical appearance, and clarification through social media. CMLF may be elicited to serve as information conduits to increase access to health information on chronic diseases for older non-English-speaking Latino adults. Lack of health insurance along with other factors in this segment of the population have led to self-diagnosis and self-treatment of illness. Thus, empirical research and health promotion on the potential risks due to self-diagnosing and self-treatment of illness is warranted among CMLF.
The U.S. Census Bureau estimates one in three Americans will be of Latino heritage by the year 2050 (New American Alliance Institute, 2014). Today, Latinos are 50 million strong and growing by one million every year, making Latinos the fastest growing ethnic group in the United States (Johnson, Schaefer, Lichter, & Rogers, 2014). Despite the growth in the Latino population within the United States, Latinos have been underrepresented in research studies over the past two decades (LaVange et al., 2010; Sorlie et al., 2010). Moreover, a lack of Latino inclusion in research studies have led to gaps in knowledge about Latino health (Harris et al., 2003; Sorlie et al., 2010). These knowledge gaps include topics such as Latinos and mental health (Bellatin, Eddy, Perez, & Wolf, 2008), Latinos’ dental health profile (Crozier, 2011), and research in chronic diseases among Latinos inclusive of cancer (Boulter, Moran, & Cole, 2011).
With the growth of the Latino population, more Latinos are enrolling in colleges nationwide (Fry & Lopez, 2012). This year, Latino enrollment in college is expected to increase by 73%, more than 3 times the rate of African Americans and 15 times the rate of non-Latino Whites (Excelencia in Education, 2015; Fry & Lopez, 2012.). More Latino college enrollees have led to more Latino males becoming members of fraternal organizations than ever before (Fry & Lopez, 2012; Helem, 2004; Miranda, 1999). The National Association of Latino Fraternal Organizations, Inc. estimates that as many as 40,000 Latino students are members of fraternities, which represents a fourfold increase since the mid-1990s (Helem, 2004).
Online Health Information Seeking Among Latinos
Today, digital media play a critical role in consumer health, with the Internet as the primary medium for dissemination of health information (Atkinson & Gold, 2002; Bush et al., 2004; Madden & Fox, 2006). In a study conducted by the Pew Internet and American Life Project in 2013, 8 in 10 Internet users look online for health information (Fox & Duggan, 2013). Annually, more than 113 million American adults accessing the Internet for health information are influenced by nearly 70,000 health-related websites (Fox, 2006; Pagliari et al., 2005). Notwithstanding, with the rapid dissemination of online health information (OHI), concerns related to the quality of information arise and such concerns are only compounded by the advent of social media, where incorrect health information may be easily shared with millions in a matter of seconds (Gao, Tian, & Tu, 2014).
Despite a growing number of Americans utilizing the Internet for OHI seeking, several studies suggest that Latinos are the most underserved population in the United States in terms of access to OHI due to several barriers such as limited education opportunities and resources as well as language differences (Bodie & Dutta, 2008; Ginossar & Nelson, 2010; Lee, Boden-Albala, Larson, Wilcox, & Bakken, 2014; Mesch, Mano, & Tsamir, 2012; Peña-Purcell, 2008; White, Haas, Williams, 2012; Young, 2001). Steps are being taken to reduce these racial and ethnic disparities of access to health information by creating national initiatives such as those commenced by the National Library of Medicine in the work written by Young (2001). One such area of focus suggested by Elder, Ayala, Parra-Medina, and Talavera (2009) is to communicate health information through young adult children of immigrants, since in many Latino families, English proficiency enables the children to be the authority when it comes to health matters. Young (2001) states that Latinos value health information received from trusted sources such as family; it is recommended that when reaching out to various Latino audiences, existing networks such as family should be harnessed. Thus, understanding how and why Latino college students search for OHI may shed light on whether Elder’s and Young’s suggestions can hold true among Latino college students in relation to OHI seeking on behalf of the family.
Research examining the effects of OHI searches and its implications often underrepresents Latino college students (Burton, 2005; Easaw, 2010; Escoffery et al., 2005; Hanik & Stellefson, 2011; Ivanitskaya, O’Boyle, & Casey, 2006; Kim, Park, & Bozeman, 2011; Miller & Bell, 2011; Norman & Skinner, 2006; Nustad, Adams, & Moore, 2008; Peña-Purcell, 2008; Zuckerman, 2009). The literature describing any aspect of health for Latino college males, who are also members of a fraternal organization, is nearly nonexistent. To date, only a handful of studies have been conducted in which Latino college men comprise a small percentage of cohorts of primarily Caucasian or African American fraternal organizations (Guardia & Evans, 2008; Scott-Sheldon, Carey, & Carey, 2008). Most of the health studies that mention Latino members of larger fraternal organizations describe either alcohol consumption and its implications (Borsari & Carey, 1999; Cashin, Presley, & Meilman, 1998; Kuh & Arnold, 1993; Larimer, Anderson, Baer, & Marlatt, 2000; Larimer, Irvine, Kilmer, & Marlatt, 1997; Lo & Globetti, 1995) or describe sexual behaviors and risk factors among fraternal organizations at large (Foubert, 2000; Guardia & Evans, 2008; Scott-Sheldon et al., 2008). In light of the growing use of online sources of health information among college men in Latino fraternities (CMLF), this population provides a unique window into learning about Latino health since many Latino men in college are usually the first in the family to attend college, and often viewed as the source of health information for their families (Bell & Bautsch, 2011; Elder et al., 2009; Smith, 2014).
Thus, to begin to shed light on the dynamics behind CMLF seeking OHI, the purpose of this qualitative study is twofold: (a) to assess the types of OHI sought by a sample of CMLF and (b) to identify the factors that influence these OHI searches.
Method
A total of four focus group interviews were conducted at two Florida universities with Latino fraternal members. Focus groups were chosen as a method to identify and explore issues such as types of health information sought and factors influencing OHI searches. Focus groups were conducted following the methodological considerations published by Grudens-Schuck, Allen, and Larson (2004). Such methodological considerations included the number of participants necessary per session and time allotted to reach saturation. Other methodological considerations included the formation of homogeneous groups where participants felt free and open to discuss their ideas in the presence of people who do not differ in the terms of status, power, job, income, education, or personal characteristics.
The institutional review board at the author’s institution reviewed and approved the contents of the protocols for this study. The established institutional review board guidelines were followed in all aspects of this study including obtaining informed consent from all participants.
Data Collection
Eligible participants were enrolled in college, between the ages 18 and 26, and were members of a national Latino fraternity. A national online directory, established by the fraternity executive board, was used to assess eligible participants for the study. The fields within the directory utilized to select potential participants were an active e-mail address, between the ages 18 and 26, attending participating institution.
Purposive sampling was used and fraternity members were sent secure recruitment e-mails in early July 2013 that contained an introduction to the study, informed consent, eligibility requirement for willing participants to have searched the Internet for health information at some point in the preceding 12 months, and details on how to register for the first planned focus groups later that month.
The date of the first focus group was planned with the cooperation of the respective chapter president. A link to the scheduling page was included in the e-mails which allowed for participants to read the informed consent and input their names for the scheduled session. Participant names were kept confidential and were only visible to the researcher. A limit for registration was also imposed for the session, capping registration at 15 participants (in the hopes of having at least 12 or 80% attend). Focus groups were overscheduled by 10% to 20% to ensure sufficient participation and attendance. Participants who attended the focus group sessions were given $5 Amazon.com gift cards for their time and effort. Refreshments were also made available. The methodology followed for recruitment of focus group participants at the second institution was similar to the recruitment efforts of focus group participants at the first institution.
Participant Characteristics
Focus group sessions ranged from 9 to 11 participants and lasted between 1 and 1.5 hours. A total of 41 participants took part in the four focus groups. All of the men in the study had searched the Internet for health information in the preceding 12 months. Table 1 includes participant demographic characteristics.
Participant Characteristics.
Moderator’s Guide
A focus group moderator’s guide was synthesized for this study where icebreaker questions were included to allow each participant to introduce themselves. The moderator’s guide included questions and probes concerning where CMLF looked for OHI and the circumstances that have influenced CMLF to search for OHI. The hourglass format (funnel approach) was used in development of the guide where analysis of data from prior previous focus group sessions helped create broad questions for successive focus groups until saturation of topics occurred (Hesse-Biber & Leavy, 2003; Krueger, 1998; Krueger & Casey, 2000; Morgan, 1997; Morgan & Krueger, 1998). The appendix details the moderator’s focus group guide utilized for the study.
Data Analysis
The focus group sessions were audio recorded and followed established anonymity and confidentiality guidelines such as reminding participants to keep their experiences confidential. Immediately after each focus group session, audio recordings were transcribed. Transcriptions of the focus group discussion were documented, with any and all identifying information removed from the final record. InqScribe (2.2) was utilized to facilitate transcription with the use of custom shortcuts for audio control. Completed transcriptions were loaded to ATLAS.ti (7.1.6). The focus group sessions were analyzed solely by the principal investigator using the method described by Casey (1998) where transcriptions were followed by a simplified analysis in which themes lead to development of questions that may be clarified in subsequent focus groups by implementing them as broad questions. Once the focus groups were completed, they were analyzed (in conglomerate) systematically coding different nuances and later combed through for patterns, trends, and themes that arose. A codebook was developed where codes were grouped into families and families into resulting themes. The resulting themes, when applicable, were then listed as a type of health information sought.
Results
Types of OHI Sought by CMLF
The main health information types that study participants reported seeking on the Internet included items for their own symptoms, diagnoses, physical appearance (weight concerns and exercise, diet, nutrition), organic living (organic diet, natural products), and treatments for conditions or diseases. Additional types of health information searched included immigration (exams needed for obtaining a green card) and home remedies. Table 2 presents a summary of types of OHI-related themes and subthemes.
Types of Online Health Information Searched.
Symptoms
Seeking OHI was also prompted by a majority of CMLF with concern for different types of physical symptoms linked to suspected illnesses or conditions. Participant Kirk had specific concerns of a potential heart attack and searched the Internet for symptoms that might signal a heart attack, “I’ve felt my heart palpitating before so I’ve also searched for heart attack symptoms.” Additional online searches included searching for symptoms specific to pain and discomfort as expressed by Claudio: When I spoke to my coworker, she said she had the same thing several months before she told me I should look to see if I have carpal tunnel syndrome. I researched the net to find out if I had some of the symptoms. I thought I had carpel tunnel for sure.
The quotes above by Kirk and Claudio illustrate that the searches served to give quick clarification and direction on their suggested medical condition. The above examples suggest that the Internet serves as a quick point of reference for researching symptoms among CMLF.
Diagnoses
CMLF also sought OHI concerning specific diagnoses or used the Internet as a medium for self-diagnoses. Participant Diego searched online for health information regarding his mother’s recent diagnosis: Six years ago, my mom got diagnosed with pancreatic cancer. She was the school principal at (local elementary school). . . . When she was diagnosed I wouldn’t stop looking online, at the library . . . any place really.
In this quote example we see that the Internet provided OHI to further educate on particular diseases, in this case pancreatic cancer, and possibly served a therapeutic function by providing comfort through increased knowledge to the seeker.
Participant online searches were not only conducted to clarify recent diagnoses but also resulted in self-diagnosis. Participant Marvin made a self-diagnosis of conjunctivitis: This Saturday, I looked online to see if I had pink eye. I mean it was all red and bloodshot. I was wondering if eye drops might help. So I Googled “pink eye.” Apparently it’s really called conjunctivitis.
Both quotes illustrate that the Internet is a conduit to disseminate education on particular health topics.
Weight Loss, Diet Programs, and Body Building
Another type of OHI sought that surfaced was information on weight loss and online diet programs. Exemplary of this is the comment made by Gordon: I didn’t think my [online] search was challenging. I looked for Jenny Craig; I even went to nutrisystem.com. I just want to know which program might be best for me. I got membership to LA Fitness, but I feel exercise alone is not helping me lose weight.
Body building also surfaced as a type of OHI sought by CMLF. Such searches are exemplified by participant Kirk who uses the Internet to search for body-building techniques: “Before I started studying for my LSAT, all I used to look for was different types of body building techniques and ways to stay in shape.” Both Kirk and Gordon utilized their searches and gained knowledge to take action in improving their physical condition.
Organic Living
Other types of OHI sought can be classified as organic living and included information seeking on ingredients in food and material products. Diego sought information on food preservatives that make up certain food products.
I just wanted to know everything and anything related to pancreatic cancer, especially about treatments. The biggest thing that I ran into [online] was that changing your diet can really help you avoid a bunch of cancer causing things that you find in some foods. BHT, BHA, and nitrates, all of these can cause cancer. A bunch of major food companies put these preservatives in their food even though they’re not good for you.
Julio stated “I don’t want to get cancer from the chemicals they put in everything else.”
Both quotes by Julio and Diego exemplify a quest to clarify that the contents they are consuming are indeed not carcinogenic.
Treatments for Conditions or Diseases
Searches also included seeking information for specific diseases and conditions. A great example is the comment expressed by Brad: One thing I wish got better is my seizures. I want to get off of my medicine . . . I feel it makes me way too drowsy in the mornings. So I try to take it mostly at night even though the things I read online say I shouldn’t do that. Lately, I’ve looked for different treatments to my seizures. I found some things on this web page called WebMD. The site has a bunch of links to everything.
The quote illustrates how the OHI sought provides information for CMLF to consider options to their treatment.
Immigration
Another type of health information sought online included information on health procedures necessary to obtain U.S. resident status. This is exemplified by participant Carlos, “I can’t ask anybody I don’t know about what exams I need to get a green card. That is why I’d rather use the Internet.”
Participant Carlos went on to remark, “Last time I checked for health on the Internet was yesterday. I was seeing how to get a health check and what I need for [the] green card.” These quote illustrates that the Internet provides a sense of anonymity for the information seeker on topics not usually freely discussed in public such as immigration. A green card serves as proof that its holder, a lawful permanent resident, has been officially granted immigration benefits, which include permission to reside and take employment in the United States (U.S. Citizenship and Immigration Services, n.d.).
Home Remedies
A type of OHI sought that surfaced were searches on home remedies related to injuries or discomfort. Participant Eric simply remarked, “I look online to find home remedies to minor injuries.” Another participant, Joey, remarked, “I like home remedies, [they] may be for strained muscles or back pain.” Both participants sought OHI for concoctions to help in their ailment; muscular pain was thought to be easily remedied by a simple online search.
Factors Motivating OHI Seeking Among Participants
In addition to the types of OHI sought, motivating factors for searching for specific topics of OHI arose (Table 3). Factors are differentiated from types of OHI searched in that they help explain the reasons as to why CMLF are compelled to search for OHI. These motivating factors include information needs of others and concerns for others, financial concerns, health conditions, disease or disorder, physical appearance, and curiosity through social media.
Factors Motivating Online Health Information Seeking Among Participants.
Informational Needs of Others and Concerns for Others
OHI was sought by CMLF for health concerns of family and friends. Such instances included searching for health information online for parents, siblings, cousins, and significant others. As participant George declared, “I usually search online for my family.” Additionally, another participant, Celex, was concerned about himself, his significant other, and family, “Me, my girlfriend, and my family, we’re all going to Costa Rica in August. I looked up that we need typhoid vaccines since we’re going to travel to the jungles for zip lining.” Both George and Celex sought preventative health information for their family based on their own volition due to upcoming events in their lives.
Health information was also sought for family members who requested assistance from their children to search for health information on a variety of topics. According to participant Carlos, information was sought for his mother living in Colombia: “ . . . in Colombia, the net helps my mom. When she calls, I find things for her fast. In total, the Internet helps.” Also, another participant, Miguel, claims, “My dad called me to look up how people get gout.” Another Latino male participant, George, sought information for his mother concerning a specific condition: This is a little embarrassing, but earlier today I got a text from my mom. She asked me to help her look online for any info I find on uterine fibroids. The doctor told her [that] hers were the size of cantaloupes. She wants me to check to see if that’s normal or if it can lead to cancer.
Carlos, Miguel, and George were all called on by their parents to search OHI in their stead driven in part by barriers such as language and limited technology skills experienced by the parents. One participant, Marcus, expressed deep concern in regard to his mother’s recent diagnosis of breast cancer: My mom was also diagnosed with breast cancer. She had taken a routine mammogram. They told my mom that she had . . . breast cancer in both breasts. I remember my mom crying, and my dad telling her God will see them through. . . . Another thing . . . I know I shouldn’t . . . but . . . from time to time, I look online to see what the chances are that my mother might still get sick. I hope God always keeps watch over her.
Marcus’s concern for his mother’s continual health was a motivating factor for the occasional online search.
Significant others were also a factor that prompted participants to seek health information. Participant Adam, expressed concerns about the cravings of his pregnant girlfriend and about her general health and the health of the unborn child.
Same here . . . I worry about my girl . . . she has these crazy cravings . . . I have looked online to see if it really is normal or if she’s just bugging. I also want to make sure the baby is healthy, so I search to see if my girl should be taking vitamins or avoiding some foods.
Health Insurance Concerns
Health insurance concerns surfaced as an additional factor which prompted participants to search for OHI. Sam, a participant, expressed: I guess if I had insurance I would definitely rather go to a doctor or some type of clinic with a nurse practitioner or P.A. [physician’s assistant]. Anything is better than just relying on what you find online but for now that’s all I got.
Sam went on to state that he searches health insurance policies online due to health care provider requests, “That’s the first thing they [health care provider] ask. ‘Do you have health insurance?’ ‘What’s your insurance provider?’” Sam’s quotes are representative of OHI searches replacing doctor’s visits as a first source of diagnosis. Sam’s quest to find economical health insurance has him relying on the information found online for coping with his health concerns.
Lack of health insurance led participants to search online for less expensive alternatives to prescription drugs, economical health plans, and in some instances altogether avoided seeking assistance from medical professionals. Participant Byron commented: Remember, I told you about my finger earlier . . . I feel it’s way more feasible for me to look up what probably happened to my finger than to go to some doc’s [doctor’s] office for them to tell me the same thing I found online. I save time and money that way.
Byron’s example shows that OHI search results are quickly taking the place of professional advice for CMLF. For Sam, health insurance was unaffordable due to absorbing financial responsibilities for his family. Sam expressed the following: My mom got laid off back in 2011 . . . I’m the only one that works right now, and it’s just me and her paying the bills. Her unemployment check got renewed for a few more months, but they’ve been threatening to take that away from her for months now. So, for now, we have no insurance and hardly any money.
Clearly, health insurance is a major concern among CMLF that drives OHI searches. The quotes above give us insight as to the inaffordability of health insurance and health care for some in this population. This disparity in health care access leads some CMLF to solely depend on their findings and their interpretation of their findings as a means of health care.
Health Condition, Disease, or Disorder
Participants were also prompted to search for OHI due to personal fears of a particular health condition or diagnosis for themselves and others. Specifically, participants feared the severity of their health issues, a fear of cancer and other illnesses, as well as a fear of surgery. Participant Marcus expressed concern for his sister after his mother’s recent diagnosis of cancer: The thing is that my younger sister is now 16. She was 13 back then so it wasn’t so much a worry as it is now. It hit me that she has to get tested to make sure that she doesn’t have any of the BRCA genes. They’re the genes that put you at higher risk for cancer. I’ve been looking online, at the library . . . everywhere to see where or what my sister should do.
The diagnosis that Marcus’s mother got years ago still elicits fear that prompts Marcus to search for OHI concerning the prevention of breast cancer for his younger sister.
Fears of upcoming surgical procedures also prompted participants to search for OHI. An illustrative quote was stated by participant Tony: Hmm . . . about 3 weeks ago, I searched for what a bone spur is. I found surgery videos on YouTube. They were nasty. I also found some links on Google that I glanced at. Finding these things make me nervous about my upcoming surgery.
Marcus was motivated to seek OHI due to multiple factors: both concern over his family and also a concern over the severity of breast cancer. Tony’s motivation strictly comes from built up anxiety of interpreting videos he has watched online prior to his scheduled bone spur surgery. In both situations, OHI searches that brought up misdirecting information might have elicited unwarranted fears.
Physical Appearance
Another factor that prompted CMLF to search for OHI involved body image and weight concerns. Participant Wayne reported that his main purpose for searching OHI involved weight loss sparked by concerns stemming from his mother’s heart issues: I think she [mother] also has heart problems, but she’s not being completely honest. It’s because of that [why] I’m trying to lose weight. I don’t want to die young; I don’t want to keep being obese. That’s why whenever I go online these days I try looking for weight loss information. I’ve even tried to search for ways to get a lap band.
Wayne’s quote is illustrative that the Internet can provide health information to motivate healthy lifestyles but can also be coupled with misinformation such as suggesting lap bands for individuals seeking weight loss options.
Curiosity and Clarification Through Social Media
Another prevailing theme that surfaced from conducted focus groups is curiosity and clarification through social media. This theme encompasses participants’ search for clarification concerning certain diagnoses or for gaining greater understanding of health information, in general, from social media sources. Participant Mike used Twitter and Facebook as a means to elicit responses in his search for solutions to his health concern: Since I was kid I used to get nose bleeds. Usually it was when I was playing basketball or helping my dad mow the lawn. So I always figured that my nosebleeds were from overheating. The weird things is that it has been years since I’ve gotten nosebleeds. Recently they’ve come back out of nowhere and almost always in the morning when I’m getting ready for school . . . I tweeted a picture of my nosebleed on Twitter and Facebook the other day and got a couple comments from some of my high school friends on how they had the same thing happen to them. They told me to try some saline nose spray and to purchase a humidifier for my room. I was able to get the nose spray. The thing really freaking works. I wanted to get a humidifier soon when I save up some cash. So the last time I went online for health information I didn’t search per se but rather posted a question and got some responses from my friends.
Mike’s quote points to a new challenge. OHI is now being sought not only from stagnant content but from interactive social media sites where information miscommunication can spread quickly. Mike’s information seems to have helped him but the information gathered might only be a temporary solution to another more severe underlying health concern.
Discussion
Despite the fact that a large percentage of Americans go online to seek health information, there is a dearth of literature pertaining to OHI seeking among CMLF. CMLF comprise a unique population who are usually the first to attend college among their family and are often regarded as the health information authority for their family (Elder et al., 2009). This study attempted to understand the dynamics related to OHI searches conducted by CMLF. The study reported that types of OHI sought by CMLF can be classified as symptoms, diagnoses, weight loss, diet programs and body building, organic living, treatments for conditions or diseases, immigration, and home remedies. The study also reported that factors motivating these OHI searches include informational needs of others and concerns for others, health insurance concerns, worries about health conditions, disease or disorder, concerns over physical appearance, as well as curiosity and clarification through social media.
The findings of this study among CMLF mirror the findings for general Internet users reported by Escoffery et al. (2005) and Fox (2006). In both of the aforementioned studies, participants searched for several types of OHI, including participants’ own symptoms, diagnoses, physical appearance in terms of weight and physique, and treatments for conditions or diseases. Unique to this study are searches for organic living which comprised CMLF searching for products free of chemicals and presumed carcinogens. Immigration was another unique type of OHI searched by CMLF where health requirements for naturalization application was searched. Home remedies as a type of OHI searched was also unique to this study. In this category, home remedies, CMLF searched on creating concoctions with around the home productions for ailments and injuries.
Contrary to previous studies performed to examine OHI seeking among college students (Easaw, 2010), this college student population did not seek on topics such as substance abuse (alcohol or drugs), condoms, or safe sexual practices. Such topics may not have been disclosed of due to the nature of focus groups. However, the aformentioned topics may come up in personal interviews where privacy and anonymity may not be as contested. Thus, such topics remain to be further investigated in future studies with altered data collection methodologies. Although, such topics may not be sought online, it remains to be seen whether these topics are of priority for CMLF, outside of the Internet realm, investigating this phenomenon in future research would be a unique avenue to pursue.
Principle to this study was the finding that informational needs of others and concerns for others is a compelling factor that motivates CMLF to search for OHI. Participants were requested from both near and abroad to perform OHI searches on a variety of topics including chronic diseases such as cancer and gout. This study reasserts the findings of Elder et al. (2009) which puts forth that offspring of immigrants are the authority on health in the Latino community due to assimilation and a better handle and understanding of the English language. Of interest to further investigate in future studies is the question of what actions are taken by parents and family members with information disseminated by CMLF.
A preeminent concern this study highlights is that a lack of insurance has led this particular group of college students to self-diagnose and self-treat their apparent illnesses. Potential risks from self-diagnosing and self-treatment include incorrect self-diagnosis, severe adverse reactions, dangerous drug interactions, risk of addiction, among a multitude of other potential risks (Eichhorn, Greten, & Efferth, 2011). More data are needed to understand what actions CMLF took with regard to self-diagnosis and self-treatment. Thus, an in-depth look at the potential risks associated with CMLF self-diagnosing and self-treatment due to OHI search findings is warranted in future studies.
A better understanding of the types of OHI searched by CMLF and the factors motivating these searches has implications for health behavioral scientists and behavioral health interventionists as well as for CMLF. With an understanding that weight loss, diet programs, and body building as well as organic living are types of OHI sought by CMLF, behavioral scientists, and interventionists alike are encouraged to further investigate this nuance in future studies and develop online interventions that educate on nutrition and physical activity. The findings of this study suggest that targeted online nutrition and physical activity interventions would definitely appeal to an audience of CMLF. Nutrition education and physical activity interventions may provide this population with accurate information that will limit misunderstandings such as was evident with the participant seeking gastric banding to help with weight loss.
In understanding factors that motivate CMLF to conduct OHI searches such as informational needs of others and concerns for others, behavioral scientists and interventionists alike may elicit and encourage CMLF to be health information liaisons for older non-English-speaking Latino adults. Interventions that educate CMLF on chronic diseases such as cancer and diabetes and trains them to disseminate gained knowledge to those seeking information may prove beneficial to increasing access to health information for older Latino adults.
Further implications from this study suggest that assessing eHealth literacy skills among CMLF is a logical next step for the authors to follow. eHealth literacy is defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem (Norman & Skinner, 2006). It is imperative to determine whether CMLF have adequate abilities to seek, find, understand, and appraise the OHI sought. Findings from the study at hand suggest that indeed OHI sought by CMLF causes further concerns for said population. If CMLF are identified to have inadequate eHealth literacy levels interventionists may seek to train this population on gaining the skills necessary to increase eHealth literacy levels, such as education on database researching, computer skills training, and training on distinguishing reliable websites from nonreliable websites.
The study was not without some limitations. Interrater reliability could not be established but its implications were minimized by audio recording and transcribing focus groups within 48 hours of occurrence. During focus group sessions restating comments made by participants and asking participants, “Is this what you meant when you said . . . ,” as well as restating the same question in multiple ways helped ensure the true essence of participants’ statements were noted. Additional limitations relating to qualitative focus groups is the potential fear individuals may have in openly expressing OHI sought. Some participants may not have been inclined to discuss OHI sought due to fear of embarrassment. Also, a quantitative analysis may lead to projectable results as focus groups are representative of a smaller group of individuals as opposed to a larger group. Despite limitations, the present study is the first to provide a detailed description of OHI seeking among CMLF.
All in all, prior to this study, the types of OHI searched by CMLF and factors associated with eliciting these searches were not known. This study provides critical information regarding the types of OHI being assessed by CMLF and the factors involved in eliciting these searches. This article reveals the importance of family in eliciting OHI searches from CMLF. Understanding that family plays a large role in eliciting OHI searches among CMLF, health intervention efforts should leverage CMLF to be health information liaisons for older Latino adult populations. A cause for concern highlighted in this study is the finding that CMLF seem to be self-diagnosing and self-treating their illnesses with OHI searched due to lack of health insurance. Health interventions and empirical research addressing this matter and the potential risks associated with these concerns is urgently needed. Thus, the current study has begun to shed light on OHI-seeking behavior among CMLF.
Footnotes
Appendix
Acknowledgements
Special thanks to Dr. Cathy Meade and Dr. Clement Gwede for your valuable and much appreciated contribution to this article.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.