Information Gathering to Improve Health Literacy and Understand Glaucoma
Type of DegreePhD Dissertation
Education Foundation, Leadership, and Technology
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Glaucoma is a major cause of blindness among African Americans. There is currently a knowledge gap about glaucoma in the US population. The internet has emerged as a center of self-directed education in the 21st century. This study evaluated the trend in online search for glaucoma information and measured the readability of the information available to searchers. In addition, the ehealth literacy and knowledge of glaucoma of African immigrants in the United States were assessed. Google Trend data showed an increase in search volume for glaucoma in the United States from 2006 to 2016 (slope of trend line = 0.085). Searchers were interested in the causes, nature, signs, predisposing factors, and treatment of glaucoma. Peak search periods for online glaucoma information correlated with news associated with celebrities diagnosed with glaucoma (r = .57, p < .001), new legislations, and announcement of new glaucoma drugs. Of the first 85 websites available to Google searchers during peak search periods, only 6 (7.1%) were from non-commercial sources. Glaucoma information was presented at grade level 11.75 (±1.50). A total of 265 African immigrants aged 18 to >65 participated in this study. They had an average ehealth literacy score (eHEALS) of 30.94 out of 40. A multiple regression model showed the following as predictors of eHEALS: self-reported perception of online information as important, age, household income, frequency of internet search, and visiting a health care provider when sick. Surprisingly, educational level did not predict eHEALS; neither did the social media score, a measure of familiarity with social media. Only 3% (8) of participants who completed the eye-Q test had scores above 9, the cut-off score for adequate glaucoma knowledge. A linear regression analysis of participants’ scores on eHEALS and eye-Q test indicated that 8.7% (r2= .087, p<.001) of the variance in eye-Q test score is explained by eHEALS. Using multiple regression analysis, 28% of the variance (r2 =.276) in the eye-Q test score was predicted by the following: gender, household income, employment status, age, eHEALS, and frequency of online search. This study revealed that participants, despite their high level of education and eHEALS, were deficient in their knowledge of glaucoma. Online websites need to present glaucoma health information at levels easily understood by most consumers. Glaucoma education programs targeting African immigrants and other at-risk groups are urgently needed.