The methods discussed were designed for a qualitative study that investigated how patients of a health clinic in New York evaluate print-based consumer health information about diabetes. Evaluating information has become a major aspect of health literacy in recent years. The National Institutes of Health, the National Library of Medicine, and the Medical Library Association, for example, each disseminate guidelines to help individuals judge the quality of health information found online. An important critique of these prescriptive methods is that the criteria used fail to account for how individuals evaluate information in everyday life (Metzger, 2007). Factors like cognitive authority and personal beliefs, for instance, which have been found to impact how individuals assess information, do not figure into the checklist approach (ibid.). Several studies exist that model how people evaluate different types of information found online, including health information (Eysenbach and Kohler, 2002; Fox and Rainie, 2002; Hilligoss and Rieh, 2008; Yong, Stvilia, and Mon, 2012). Because most of these studies use convenience samples of students or academic faculty, and because they mostly focus on information resources available online, they are also limited. To address these gaps, an exploratory study was conducted at a community-based health clinic with individuals who have low literacy skills.

1. Methodological Challenges Related to Working
with Vulnerable Participants:
Adults with Low Literacy and Health Information
Behavior
Miraida Morales
Ph.D. Student, Library & Information Science
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2. The Study
 Purpose: Qualitative study to investigate health information evaluation
practices of patients of a community health clinic
 Research site: Diaspora Community Services health clinic in Brooklyn, NY
 Participants: Women with low literacy skills, no high school diploma
 Research materials: 1-page fact sheet and 6-page brochure about diabetes
 Case study: evaluation & mark-up of documents by participants, follow-up
semi-structured interview, short demographic survey questionnaire
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3. Vulnerable Class of Participants
 In this research study context, adults with low literacy skills are vulnerable
– Nature of the research task: to read health information documents, make a
judgment, and explain it during the interview
– Understanding instructions and Informed Consent
– Filling out survey forms is also problematic (writing)
 Poverty
– Transportation to/from research site
– Ethical calculation of compensation amount (non-coercive)
– Time and flexibility
– Chronic health conditions affecting eyesight, cognition/memory
 Designing the research task to avoid the perception that the participant is
being tested on reading and comprehension skills
– Selection of materials
– Instructions
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4. Question:
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In what other ways might characteristics of vulnerable communities
affect research design, data collection, and analysis?

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