Volume 4: No. 1, January 2007
Reducing Information Pollution in the Internet Age
David E. Nelson, MD, MPH
Suggested citation for this article: Nelson DE. Reducing information pollution in the
Internet age. Prev Chronic Dis
[serial online] 2007 Jan [date cited]. Available from:
I was recently asked by an outside organization to provide comments about a proposed application for the
organization’s Web site. The individuals involved had obviously spent time and money and were far along in site development. They wanted feedback about design features such as layout, use of maps, and alternative views of the site. The developers assumed that the information they were providing was important
and would help state and local public health professionals do their planning. Those of us participating in the Web application review pointed out in a tactful way that the developers seemed to have little understanding of the public health community and
its needs and that this application would be of little interest to
public health practitioners and planners. I doubt I will be asked to participate in future
reviews of Web applications for this organization.
This story demonstrates the problems that communication technology
advancements can cause for public health and other fields.
Individuals and organizations can now provide large amounts of information
at low cost by using a myriad of information tools (1). These advances, while exciting, are seductive and can cause people to forget
some communication fundamentals, such as understanding intended audiences and how they seek,
and use information.
People who remember communication fundamentals have decided advantages in reaching audiences with their messages.
Public health officials who fail to put communication basics into practice will be unlikely to improve public health. Instead, they will contribute to the growing problem of information overload or data smog (2).
Public health organizations that use the Internet to convey information can easily fall into the trap of
providing on their sites as much information as possible for potential users. This
kitchen sink approach may seem attractive at first glance (3,4). After
all, given the potential worldwide size of the Internet audience, somebody
somewhere might find any individual piece of information useful. This approach
is highly democratic, fits well within American cultural values and freedom of
choice, and has the added advantage of reducing the possibility of criticism
from management or colleagues because information they desire is not available
on a site. Perhaps most importantly, it means avoiding having to decide, or
prioritize, what information to include or exclude on a Web site.
Simply providing more and more health information may not lead to increased
information use or desired public health improvements.
A good example is the effort to make information about health care performance by hospitals, health plans, and individual providers
widely available to the public (5,6). The rationale for publicizing health care quality
information, or report cards, was a belief that doing so would facilitate
informed choice by consumers and stimulate improvements in the quality of health
care (7). Despite
widespread availability of this information, there is little evidence that
health care consumers have sought such information on Web sites or that this
information has influenced their health care decisions (5-7). The lesson here is
that providers of health care information need to know their audiences before creating and distributing information.
Web sites are now a critical source of health information. An estimated 64%
of U.S. adults have searched for health information online for themselves or
others within the previous 12 months (8). Well-designed Web sites allow health
information seekers to find what they need quickly. In contrast, poorly designed
sites result in users becoming frustrated and impatient and often lead them to
search elsewhere (9). Many developers of and contributors to public health Web
sites have little understanding of Internet audiences —
particularly how they search for and assess information. Fortunately, research in psychology, communication, and related disciplines is providing insights
about improving Web sites.
The importance of how audiences perceive the credibility of information
sources cannot be overestimated (10). People rapidly assess the believability of
information based on how much they trust the individual or organization providing it. This
process is referred to in psychology as the expert heuristic (11). Public health departments and other health-related organizations with high
ethical standards, no perceived conflicts of interest, and high-quality, evidence-based information are normally considered credible information sources.
Public trust is invaluable because credibility, once lost, is difficult to regain. It is important that public health
professionals and organizations act ethically
to maintain trust.
Determining which audiences need to be reached and the communication channels
they prefer are crucial early steps in designing appropriate communication
strategies. Target audiences for many public health messages — people with low incomes, those with low education levels, and the elderly — are less likely to use Web sites than other demographic groups (8). Public health
professionals need to consider other communication channels to reach these audiences.
Segmenting Internet users according to their information needs and preferences is another important
way to make Web sites more relevant to particular groups. During the process of
redesigning its Web site, the Office on Smoking and Health (OSH) at the
Centers for Disease Control and Prevention (CDC) discovered it had seven major audiences with somewhat different information needs: 1) public health professionals
such as state program managers, 2) researchers and scientists, 3) CDC partner organizations
such as the Campaign for
Tobacco-Free Kids, 4) policy advocates, 5) public health educators, 6) media
professionals, and 7) the general public.
Understanding the type of information audiences need enables an organization to
develop and maintain a Web site with materials at appropriate literacy levels and
organized in ways to meet audience expectations (12). OSH, for example, discovered that
its audiences preferred information organized by tobacco topics (e.g., secondhand smoke,
smoking cessation) rather than by other classifications such as CDC organizational
areas or audience types.
It is also important to know what related information is offered on the Web sites
of other organizations.
This learning process can lead to the discovery of effective information materials or other
products that have already been developed, and there is little point in duplicating efforts. Providing effective information that is complementary to
what is offered on other sites is helpful, and having links to trusted sites is valuable for site users. Through
of searching and linking public health groups can identify interorganizational collaborative
Readers of this editorial, along with millions of other Internet users, probably rely on search engines, like Google and others, to locate Web links. Search engines have revolutionized how people access Internet information.
It is invaluable to conduct search engine research to determine whether, and
where, a site appears when common key words are entered. The large amount of
information a search engine provides results in a tendency for people to scan
Web pages rapidly. If an organization’s site is not listed within the first few
pages of a search, the organization may need to make changes to move the site
higher on search engine lists. Public health officials need to make others aware of good Web site
information through the dreaded M word — marketing. Letting audiences know
where information is available on the Web is increasingly essential because of
the large number of sources available online.
People are exposed to hundreds of media messages each day, mostly in the form of advertising. The human brain is remarkably adept at blocking information a person does not consider relevant (11).
A person can hone in quickly on information
that is salient, which explains the tendency of people to rapidly scan Web
sites. Information seekers tend to work no harder than they need to in order to find relevant information (i.e., they are cognitive misers). Once they determine
they have is good enough, they rarely search further. This tendency, first described in the 1950s, is referred to as satisficing (11) and is especially common among people
who are time-pressured, such as journalists and health care providers. People
exposed to excessive information tend to rely on simple rules such as selecting the first item from a lengthy list.
These tendencies to scan quickly for salient information and satisfice mean
that Web sites must make it easy for information seekers to find what they want
quickly (9). Materials need to be organized in ways a site user thinks about a topic. Text should be
kept to a minimum, and pages should contain sufficient open space to seem uncluttered. Few mouse clicks should be required to locate useful information, and design layout
(e.g., colors, logos, background information) should be consistent. Usability testing with intended audience members can help uncover layout problems (9).
The tendencies of Internet users to scan quickly for salient information help explain why providing too much material on a Web site (the kitchen sink approach) is counterproductive.
Barry Schwartz, in a recent review of psychology literature, refers to the effect of giving too many options as the paradox of choice
(4) (i.e., providing too many options reduces the
ability of people to make better decisions). Understanding how audiences
seek and process information from Web sites can lead to better decisions about
what information to provide and how to organize it effectively. Too much
information on a site has another downside for organizations because resources
and extensive efforts are required to update information regularly.
The Coordinating Center for Health Promotion (CoCHP) at CDC is involved in developing and improving cross-cutting efforts in public health to reduce obesity and advance newborn screening initiatives (13).
Designing a useful Web site based on effective communication concepts will be important for the health education function of CoCHP’s new site. The new
should make it easy for users to find what they need and, if done well, will
provide an important public health service rather than adding to Internet information pollution.
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David E. Nelson, Senior Scientific Advisor, Health Communications Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, Mailstop K50, Atlanta, GA 30341. Telephone: 770-488-2401. E-mail:
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