I would like to comment further on some of the areas mentioned in the
responses to the reposting.

1.  Access

Craig Silva emphasized the point tht although "the information has always
been there if you went to look....there has been a qualitative change in its
accessability". People can not only access information through this medium,
they can also access people.  I'm certainly not an expert in this area but I
sense the accessability factor will only increase.  There was some press
recently that they are testing something that sits on top of the TV and
provides access to the internet.  Lot's of people have TV's and most have
cable and people seem to find the money for things they want to get (hope
that doesn't sound too insensitive).


JM Dupont provided a brief overview of various theoretical perspectives in
health promotion.  Thanks, I am not up on health promotion theory so it is
useful to get a flavour of the different paradigms out there and I also
appreciated your comments that it's important for people to understand the
world view of the people that are informing them.  This medium seems to have
the potential to promote health not only through information/education but
also through changing power relations.  In the particular health care system
I worked in I noticed that the least powerful people in the hierarchy were
put in charge of the partnership programs (which were "in").  These programs
seemed to be helpful to people but they did not appear to have much impact
on the status quo of the health care system.  Somehow I think that this
increased accessability to information will have an impact and will effect
the status quo.  Perhaps the people that partake are going to lead the way
on this one.

Which leads me to my next point:

2. The development of critical thinking skills.

When I first got interested in the area of consumer health information a few
years ago I was struck by how the literature talked about the difference
between providing people with information to make their own decisions versus
education that promotes a certain agenda.   I agree with you Craig, Barbara,
Nancy and JM that people need some education about information so that they
can use it effectively.  Sort of like the old "giving the man the tools"
whatever the saying is.  It somehow seems less intrusive to this whole
process that will be taking place and less controlling.

Thanks for the sites you mentioned Karen. I will try and borrow some
PowerPoint Software  to look at your slide show on interpreting studies.
"Http://gwis2.circ.gwu.edu/~kpomeran". The document form Purdue Univ
Libraries contains some useful information as well on evaluating world wide
web info.

Are we talking about a couple of things here?  The process of the
development of critical thinking skills regarding information and the
specific topics that need to be addressed regarding health information.  For
this discussion I'll stick to some specific topics that may need to be
covered.  Karen you mentioned the 2 above, about evaluating information and
is your slide show about how to evaluate scientific research studies?  In
some of the recent medical literature there have been some very technical
articles such as "Problems with MetaAnalysis" and How to make use of Medical
Literature that I wonder if there are little nuggets that could be removed
and simplified for the public to make use of.  Understanding the medical
world view, the world of probabilities and generalizability will also help
people to critically assess the infomration they are receiving.  "The Savvy
Patient  How to be an active participant in your medical care" (by David
Stutz and Bernard Feder and the editors of consumer reports books) discuss
this medical world view and other things as well eg the limits of certainty,
the concept of normality etc.  A new book 1996 "Infomedicine A consumer's
guide to the latest medical research" by Fred Baldwin and Suzanne McInerney
has a chapter on how to learn from medical journals.  Health News December
1991 contained an article on How to Assess Medical News and general tips for
evaluating health/medical stories.  Also as Barabara mentioned peoples
direct experience of "the vast and widely differentiated types of info
available...is the first clue that there is no perfect truth in medeicine".
So in developing meaningful critical skills about health information it may
be helpful for people to do a practice search on a topic that interests them
and to critically examine what they get back.  In summary I guess it would
be helpful to have topics that help to assess medical, alternative info and
topics that inform people of the world view of the informers and to have a
meaningful experiential component to this. Any other ideas?    As there are
books coming out that help people to access and make sense of information I
wonder if a specific site on the internet for this would be useful as well.

I believe library science and information providers have knowledge and
literature that can be helpful to other professional groups in becoming more
familiar with information providing, not only the technology and information
but the human interface as well. Health care providers have direct
experience with  particular world views that need to be understood by those
who partake.

Thankyou Craig, Nancy, Barbara, and JM for your comments.  I really
appreciated them and felt they contained alot of valuable insights and
information.

Judi Quail <[log in to unmask]>