Academic Papers

Assessing the health information source perceptions of tweens using card-sorting exercises


St. Jean, B., Taylor, N. G., Kodama, C., & Subramaniam, M. (2018)

Journal of Information Science (2018)

As young people are increasingly turning to the Internet to meet their information needs, it is imperative to investigate their perceptions regarding various potential sources of health information. A series of card-sorting exercises were administered to new participants in an after-school program (HackHealth) to find out which sources of health information these greater Washington DC metro area middle school students would turn to, which they would not, and their reasons behind these judgements. The findings revealed that participants were very aware of the importance of trustworthiness when looking for health information and they valued both professional expertise based on formal education and expertise born of personal experience with a particular health condition. However, they also valued convenience, ease, and speed, and sometimes sacrificed information quality. Some important implications of these findings for healthcare and information professionals are identified and suggestions for future research in this area are offered.

Assessing the digital health literacy skills of tween participants in a school-library-based after school program


St. Jean, B., Taylor, N. G., Kodama, C., & Subramaniam, M.

Journal of Consumer Health on the Internet (2017)

Although young people are increasingly turning to the Internet for health-related information, very little is known about the state of their digital health literacy skills. At the beginning of an after-school program (HackHealth) to assist middle school students (aged 12 to 15) with their digital health literacy skills, a specially-designed Digital Healthy Literacy Assessment Tool (DHLAT) was administered to 19 participants. Results suggest that while tweens are familiar with search engines and have a rudimentary sense of how to use them, they often lack important knowledge and skills that are needed to be fully digitally health literate. More research is needed to develop more broadly applicable tools for assessing tweens’ digital health literacy skills and to discover additional ways to work with youth to ensure they are equipped with the digital health literacy skills they need to successfully find, understand, assess, manage, and make use of online health information.

“There’s a creepy guy on the other end at Google!”: Engaging middle school students in a drawing activity to elicit their mental models of Google


Kodama, C., St. Jean, B., Subramaniam, M., & Taylor, N. G.

Information Retrieval Journal (2017)

Although youth are increasingly going online to fulfill their needs for information, many youth struggle with information and digital literacy skills, such as the abilities to conduct a search and assess the credibility of online information. These skills require the possession of an accurate and comprehensive understanding of the ways in which a system, such as a Web search engine, functions. In order to investigate youths’ conceptions of the Google search engine, a drawing activity was conducted with 26 HackHealth after-school program participants to elicit their mental models of Google. The findings revealed that many participants personified Google and emphasized anthropomorphic elements, computing equipment, and/or connections (such as cables, satellites and antennas) in their drawings. Far fewer participants focused their drawings on the actual Google interface or on computer code. Overall, their drawings suggest a limited understanding of Google and the ways in which it actually works. However, an understanding of youths’ conceptions of Google can enable educators to better tailor their digital literacy instruction efforts and can inform search engine developers and search engine interface designers in making the inner workings of the engine more transparent and their output more trustworthy to young users. With a better understanding of how Google works, young users will be better able to construct effective queries, assess search results, and ultimately find relevant and trustworthy information that will be of use to them.

Bit by bit: Using design-based research to improve the health literacy of adolescents.


Subramaniam, M., St. Jean, B., Taylor, N.G., Kodama, C., Follman, R., & Casciotti, D.

JMIR Research Protocols, 4(2), e62. Available:

Although a low health literacy level has been found to be among the most powerful predictors of poor health outcomes, there is very little research focused on assessing and improving the health literacy skills of adolescents, particularly those from socioeconomically disadvantaged backgrounds. The vast majority of existing research focuses solely on reading comprehension, despite the fact that health literacy is actually a multifaceted concept, which entails many different types of skills. The aim of this paper is to first mine existing literature to identify the many different skills that have been posited to constitute health literacy, and then, using this collection of skills as an overarching structure, to highlight the challenges that disadvantaged youth participating in our HackHealth after-school program encounter as they identify and articulate their health-related information needs, search for health-related information online, assess the relevance and credibility of this information, and manage and make use of it. We identified the various challenges that the 30 HackHealth participants faced in completing various health-related information activities during the program. Based on these findings, we describe important implications for working with youth from socioeconomically disadvantaged backgrounds, how to assess and improve their health literacy skills, and offer specific recommendations for health literacy instruction aimed at this population. Working with adolescents to help them develop and practice their health literacy skills will help to break the cycle between poor health literacy and poor health outcomes, thereby reducing health disparities and improving the long-term outlook for the health of our nation.

Bit by bit: Unpacking health literacy instruction for young people


Subramaniam, M., St. Jean, B., Greene Taylor, N., Follman, R., Kodama, C., & Casciotti, D.

2015 ALISE/LMC Paper Award, ALISE Youth Services and School Library Media SIGs and Library Media Connection (LMC Magazine)

Although low health literacy is a powerful predictor of poor health outcomes, there is little research focused on assessing and improving the health literacy skills of adolescents. This paper aims to identify strategies that disadvantaged adolescents use to conduct their online health-information seeking, and map those strategies to the different skills that constitute health literacy; and to examine the challenges they encounter while seeking health information online.

The influence of positive hypothesis testing on youths’ online health-related information seeking


St. Jean, B., Subramaniam, M., Greene Taylor, N., Follman, R., Kodama, C., & Casciotti, D.

New Library World (2015)

We conducted an exploratory field experiment with HackHealth participants to determine whether positive hypothesis testing occurs when youth search for health information online and to ascertain the potential impacts of this phenomenon on their search behaviors, their ability to accurately answer health-related questions, and their confidence in their answers.

As simple as that?: Tween credibility assessment in a complex online world


Subramaniam, M. Taylor, N.G., St. Jean, B., Follman, R., Kodama, C. & Casciotti, D.

Journal of Documentation (2015)

This paper explains the ethnographic approach we used to describe disadvantaged tweens’ strategies for making predictive and evaluative judgments of the credibility of health information online. More specifically, this paper identifies the features of Google search results pages and Websites that signal credibility (or lack thereof) to this population and the reasons behind their perceptions.