Case Study on Patient Groups on Facebook in Turkey: Through the Lens of Critical Health Literacy

Case Study on Patient Groups on Facebook in Turkey: Through the Lens of Critical Health Literacy

Aslıhan Ardıç Çobaner, Beste Sultan Gülgün
DOI: 10.4018/978-1-7998-1534-1.ch011
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Increasing prevalence of chronic diseases and ageing population necessitate access to accurate health information for better health. The internet and social media affect and transform the communication of health-related information. Online platforms are enabling patients and patient groups to find common ground to discuss their health and diseases. Focusing on disease/patient group sites, this chapter investigates these sites through analyzing their features, inclusion of social and economic determinants of health in their contents, and level of critical health literacy calling for decision and action. Furthermore, these sites and their organization structures are analyzed by netnography. The findings show that disease/patient sites on Facebook are highly benefitted as an information and experience sharing platform. However, the critical health literacy level of the contents is quite low. Therefore, the role of social media as an improvement area for critical health literacy in health communication is getting more important.
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In the twenty-first century, digitalization in health information is indispensable and inevitable that any individual can both benefit and suffer from this conversion. Tremendous growth in the use of information technologies enable everyone who has access to the Internet to seek and find information. Today, it is possible for anyone with internet access to diagnose oneself with any disease just by searching online their possible symptoms, interpret test results on their own or learn about better health and well-being. Is this a correct way of using health-related information on the Internet or is it harmful and abusive? In our digitalized and connected world, is searching or seeking health guidance on the Internet really helping us or directing us towards misinformation. The ongoing discussions about the use of online information is also valid for health-related information. The answers to these kind of questions are and will be the subject of other studies. This Chapter attempts to connect the significance to ‘critical health literacy’, which is gaining importance after the digitalization of health information. Understanding how we make use of available information has become vital and is a topic of concern for scholars to analyze and study from multiple perspectives.

Building on an attempt to contribute to the digital use of health information through the lens of critical health literacy, this Chapter investigates patient groups’ interactions, information exchange and communication on a widely used social media platform. The study discussed focuses on the most prevalent chronic diseases to contribute to the ‘more’ component of the broadened literacy definition in the digital age as well as engaging the social determinants of health.

Until the mid- twentieth century, infectious diseases and infant deaths were the leading causes of global mortality. Progress in health, medicine and pharmaceutical sciences and sectors, such as increased use of technology in medicine, growing funding to health sciences, advances in types and availability of medicines and vaccines, has helped in reducing and controlling epidemic diseases and their mortality/morbidity rates. Hence, chronic diseases such as cardio-vascular disease, chronic pulmonary diseases, cancer and diabetes have replaced the infectious diseases in prevalence and become the leading causes of mortalities in this era (Bilir, 2014, p.62).

Today, chronic diseases kill approximately 40 million people annually. And, this figure makes up almost 70% of all deaths around the world and 80% happen in low and middle income countries. In parallel to the global trend, the prevalence and mortality rates of chronic diseases are also increasing in Turkey. 77.5% of all deaths in Turkey occur due to chronic diseases. Among them, cardiovascular diseases, chronic obstructive pulmonary diseases (COPD), cancers and endocrine diseases like diabetes constitute the primary mortality causes (WHO, 2018, pp. 1-4).

Several factors lead to chronic diseases and for this reason chronic disease control is harder than the control of many infectious diseases. Some of these factors include an individual’s residential and work environment whereas some are related to their behavior and lifestyle. Accordingly, ensuring a balance between socio-economic status (income, education, housing, social norms), culture (media, traditions, religious affinity, values, social institutions and political system) and social networking (school, job, family, religious entities) plays a significant role.

Accurate understanding of health related messages and their implementation are important for both prevention and treatment of chronic diseases. Building this competency is relevant to the health literacy level. Health literacy implies that the ability of individuals to “gain access to, understand and use information in ways which promote and maintain good health” for themselves, their families and communities as health literacy defines their cognitive and social skills determining individuals, personal decision and empowerment for good health (WHO, 1998; WHO, 2013; NAP, 2004). Studies show that individuals with insufficient health literacy are also inadequate in managing their health, illness and treatment knowledge, particularly when it comes to chronic diseases (Çiler Erdağ, 2015, p. 7). As Nutbeam (2000) argues, health literacy is clearly dependent upon levels of basic literacy. While general literacy and education are imperative determinants of health and inadequate literacy is a risk factor for low health literacy, literate people are not necessarily health literate (Kickbusch, 2001, p.295).

Key Terms in this Chapter

Media Literacy: It refers to accessing, understanding, interpreting, analyzing and self-creating media content disseminated via mass communication channels.

EHealth: The use of information and communication technologies (ICT) for health.

Health Communication: Health communication is an inter-disciplinary academic area that aims to inform people related to their health and health risks and to increase access to mass media with a view to keeping health related issues in public agenda. Health communication covers a range of areas edutainment or enter-education, health journalism, inter-personal communication, media advocacy, corporate communication, risk communication, community engagement and social marketing.

eHealth Literacy: It is defined as the skills of searching, finding, understanding, evaluating health information and exercising this information to discuss and/or resolve a health issue.

Community engagement: It is a strategic process with the specific purpose of working with identified groups of people, whether they are connected by geographic location, special interest, or affiliation to identify and address issues affecting their well-being. The linking of the term 'community' to 'engagement' serves to broaden the scope, shifting the focus from the individual to the collective, with the associated implications for inclusiveness to ensure consideration is made of the diversity that exists within any community.

Mobile Health (mHealth): The use of mobile and wireless technologies to support the achievement of health objectives.

Digital Divide: It is used to identify a situation of inequalities among individuals, communities, regions, nations and institutions in the use of new media tools. It also refers to content-related barriers, such as lack of local information, literacy barriers, language barriers and lack of cultural diversity.

Social Mobilization: It is the process of bringing together all societal and personal influences to raise awareness of and demand for health care, assist in the delivery of resources and services, and cultivate sustainable individual and community involvement. In order to employ social mobilization, members of institutions, community partners and organizations, and others collaborate to reach specific groups of people for intentional dialogue. Social mobilization aims to facilitate change through an interdisciplinary approach.

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