Research Article: A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan

Date Published: November 7, 2018

Publisher: Public Library of Science

Author(s): Somayeh Esmaeilzadeh, Hasan Ashrafi-rizi, Leila Shahrzadi, Firozeh Mostafavi, Hesam Seyedin.


The characteristics and conditions of growth and development have made adolescence one of the most vital and influential ages for prevention and health promotion, especially in the area of high-risk behaviors. Accordingly, the aim of this study was to determine adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan (Iran).

The present study was of an applied type, which was conducted using the survey research method. The statistical population consisted of adolescent students at public schools in Isfahan (6519 subjects), and the sample size was determined to be 364 based on Cochran’s formula. The sampling method was of a cluster sampling type, and the data collection tool was a researcher-made questionnaire. The validity of the questionnaire was approved by medical librarians, and using the Cronbach’s alpha method, the reliability was obtained to be 0.85. SPSS 16 software was used for data analysis at two statistical levels: descriptive and inferential (independent t-test, one-sample t-test, chi-square, Pearson correlation coefficient and Mann-Whitney).

“Lack of mobility” was the most important health information need related to adolescent high-risk behaviors. The most important sources to obtain health information related to high-risk behaviors were “the Internet” with a mean score of 3.69 and “virtual social media” with a mean score of 3.49 out of 5. Adolescents had a positive attitude towards health information. The most important barriers to seeking health information were mentioned as follows: “difficulty in determining the quality of information found”, “absence of appropriate information”, and “concerns about the disclosure of their problems or illness to others”. From the perspective of adolescents, the most important criterion for the evaluation of information quality was “the trueness and correctness of the information” and the need for health information related to high-risk behaviors was higher in girls than in boys.

Considering adolescents’ positive attitude towards use of health information, it is necessary to put valid information at their disposal through different information resources, taking into account their level of information literacy. Accordingly, medical librarians’ abilities are suggested to be used for the production, evaluation, and introduction of health-related reading materials in the field of high-risk behaviors in easy language and suitable for adolescents.

Partial Text

Provision of health to adolescents is the basis of national development goals, and attention to adolescents and their exclusive health needs are among the goals of health services. This is a prerequisite for the health and development of mankind’s future, and any effort to promote health without consideration of adolescences will be incomplete [1]. On the other hand, statistics show that one-fifth of the world’s population is between 10 and 19 years old, 85% of whom live in developing countries [2]. According to the latest report by the Statistical Center of Iran, and based on the 2016 Iranian census, adolescents were 12 million accounting for 8% of the country’s population [3]. Adolescence is a period, during which environmental demands increase and a lot of serious mental disorders begin [4]. Changes occurring during this period of growth may cause certain problems, in a way that if the characteristics of people in this period are not properly directed, the ground will be prepared for the incidence of health threatening behaviors such as high-risk behaviors [5]. High-risk behaviors are defined as behaviors associated with some undesirable results [6]. Cigarette smoking, high-fat and low-fiber foods, physical inactivity, alcohol consumption, high-risk sexual behaviors, substance abuse, and injury and violence-related behaviors are regarded as high-risk behaviors [7–9]. In order to realize the goals of the Fifth Development Plan, they have compiled a document called the “Comprehensive Adolescent and Youth Health Plan” with an emphasis on social harms and high-risk behaviors, which, in turn, emphasizes the importance of addressing the issue of high-risk behaviors. Changing adolescents’ behavior require provision of information, informing the adolescents, and search for information [7]. Awareness of information about high-risk behaviors creates a group of needs in adolescents, some of which lead to information seeking behavior in the health domain. If a search for information is done for health purposes, it will be considered as a component of the decision-making process to adopt a health behavior, and will be called “health information seeking behavior” [10]. Health information seeking behavior refers to ways, through which people obtain information about health, diseases, health promotion, and health threatening behaviors, such as high-risk behaviors [11]. It is among medical librarians’ responsibilities to obtain more information about health information seeking in the area of high-risk behaviors, inform about different types of information sources, and validate high-risk behaviors. Because they play an essential role in delivering timely, valid, and accurate information to users, as well as evaluating the information and its sources. In fact, they are able to take effective steps to inform adolescents and prevent the incidence of these behaviors in them.

The present study was of an applied type, which was conducted on Dec. 31, 2016 using the survey research method. The study population consisted of 6519 adolescent students at a selection of public schools in Isfahan. The schools are divided into two groups in Iran: public (state) and private schools. Since it was not possible to select both groups of schools due to the number and extent of the community, and the number of public schools was more than the private ones, and public schools were less-equipped, the doctors decided to select only the public schools because this selection would help homogeneity of society and generalization of the results. Moreover, all the teenager students aged between 15 and 18 of the public schools in District 2 in Isfahan, who were studying in September 2017 in the above-said schools, and who wanted to participate in the research were considered as the inclusion criteria, and the dissatisfaction of students and parents and failure to complete the questionnaire were considered as the exclusion criteria.

Interestingly, the return rate for the questionnaire was 100%. In terms of gender, girls made up 51.8% of the population, and boys 48.2%. The studied adolescents were ranging in age from 15 to 18 years, and the mean value of their families’ monthly income was Rls. 26,445,600 ($ 755). From among the adolescents, 73.7% were familiar with a language other than Persian, and 75.5% had needed medical and health information during the past six months.

The findings showed that the most important needs for health information related to high-risk behaviors among adolescents were the needs for obtaining information about “lack of mobility”, “high-risk sexual behaviors”, and “incidents and injuries”. This finding was consistent with the results of a study by Merghati-Khoei et al. on the prioritization of high-risk health behaviors among students [16], a study by Obasola and Agunbiade on the online health information seeking behavior pattern among undergraduate students [21], and a study by Garmaroudi et al. on high-risk health habits among students [22], and was inconsistent with the findings of a study by Esmaeilzadeh et al. on the prevalence of high-risk behaviors among adolescents [17]. The most important reason for the inconsistency of the findings can be the difference between the characteristics of the statistical populations and the places where the studies carried out. Only the degrees of needing information on “incidents and injuries” and on “physical violence” were higher in boys than in girls, and no differences were observed between boys and girls in the other areas.

It is important to pay attention to social behaviors and lifestyle of adolescents due to their impact on the quality of their life; and health knowledge is the background to health behaviors. Therefore, a healthy lifestyle due to increased health knowledge can improve the quality of life of individuals and cause minimum illness, disability, and injury. The important point here is that health behaviors such as high-risk behaviors are different in adolescence compared to adulthood, so knowing the mental structure and attitude of adolescents and trying to use health and medical information allow assessing the lifestyle in a precise manner based on their main essence, and providing them with valid health information through different information sources regarding the level of skill and informational literacy. Moreover, increasing the adolescents’ level of knowledge, new and proper preventive approaches can be developed, adolescents’ abilities can be promoted, and their unhealthy behaviors can be modified. According to the results obtained in this research, in general, adolescents have a positive attitude towards health information, and believe that it is useful. Inactivity is the most important health information requirement related to high-risk behaviors of adolescents. This information may be acquired through different channels such as medical teams, official or unofficial channels, traditional channels, and media channels. According to the findings of this research, difficulty in determining the quality of information found, lack of suitable information, and concern about the disclosure of the problem or disease to others are the most important problems in the search for medical and health information related to high-risk behaviors among teenager students. The internet and social media are the most important information sources used by adolescents to obtain health information related to high-risk behaviors. According to the features of the society under study, development of modern technologies, increased access to the internet, and development of the social media in recent years, this finding is natural to a large extent. The most important criteria to evaluate the quality of information in the view of adolescents include the accuracy of information, its validity and understandability. According to the findings, the need for health information related to high-risk behaviors in girls was more than that in boys. This is while there was no significant relationship between the mean scores of the curiosity and tendency to search for health information related to high-risk behaviors, the attitudes towards the importance of health information related to high-risk behaviors, and barriers to obtaining health information related to high-risk behaviors and sex, age, household income level, and understanding non-Persian languages. Regarding the positive attitude of adolescents towards using health information, it is necessary to provide them with valid information through different information sources in accordance with the adolescents’ information literacy level. This can have a significant role in the preventive activities and reduction of medical costs. It can also minimize the disability, injury and illness. In order to obtain health information, adolescents stated barriers such as difficulty in the determination of the quality of information and lack of suitable health information indicating the need for effective measures in this field. To overcome these obstacles and problems, it is necessary to design databases, websites, and valid apps through official centers and institutes by the Ministry of Health and Medical Education, and Ministry of Education. On the other hand, through providing trainings about the health and media literacy, creating native health databases proportionate to the age group of adolescents, and identifying and introducing valid resources in the field of health information, especially adolescents’ high-risk behaviors, we can try to overcome these obstacles. Accordingly, the following solutions are suggested: