Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature
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BACKGROUND: Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. OBJECTIVE: The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. METHODS: Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. RESULTS: After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. CONCLUSIONS: The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review, future research in this field should (1) specifically focus on health literacy, (2) devote more attention to the identification of the different criteria people use to evaluate online health information, (3) develop shared definitions and measures for the most commonly used outcomes in the field of evaluation of online health information, and (4) assess the relationship between the different evaluative dimensions and the role played by health literacy in shaping their interplay.
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Low health literacy impedes the ability to critically evaluate online health information.
“Our findings echoes Diviani et al., who highlighted that low health literacy impedes the ability to critically evaluate online health information [40].”
From Acceptance and perceived usefulness of digital health services in the management of chronic urticaria: a survey of patients and physicians (2025) · cites this paper as [40]
The Abstract (Results) reports that low health literacy is negatively related to the ability to evaluate online health information. The Discussion (Principal Findings) says it may have a negative impact but cautions that the small, heterogeneous evidence base makes its effect hard to establish. “Impedes” states that effect more definitively than the review does. (LLM, conf=0.84)
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- Authors
- Diviani, N., van den Putte, B., Giani, S., & van Weert, J. C.
- Affiliations
- University of Amsterdam (NL)
- Corresponding author
- Diviani, Nicola
- ORCID
- Diviani, Nicola
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2015-05-07
- Volume
- 17
- Issue
- 5
- Pages
- e112
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC4468598
- OpenAlex
- W1923752250
- Cited by
- 638
- References
- 87
- Citations by year
- 2026: 90 · 2025: 76 · 2024: 70 · 2023: 48 · 2022: 74 · 2021: 71 · 2020: 65 · 2019: 44 · 2018: 39 · 2017: 26 · 2016: 29 · 2015: 4
- FWCI
- 5.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (acceptedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (148345)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Physical Sciences › Computer Science › Information Systems › Information Retrieval and Search Behavior
- Social Sciences › Health › Social Media in Health Education
- Keywords
- low health literacy, online health information, information evaluation, trust in health information, evaluation criteria, health information seeking, consumer health information
- MeSH terms
- Humans, Internet, Trust, Consumer Health Information, Health Literacy, Information Seeking Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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