Information poverty has a wide-ranging negative impact on people’s health and socio-economic well-being. Over the past twenty years, researchers have used Chatman’s information poverty theory as a guide to understanding information behaviors in diverse contexts and situations, and it continues to be useful in advancing our understanding of the social dynamics and cultural contexts of information behaviors.
Information poverty is a condition in which individuals and groups in a particular context lack the skills, abilities, and tools necessary to access information appropriately, or to transform and use it optimally. The marginalization of information through institutional and contextual processes such as economic and racial inequalities, as well as information overload, negatively affects an individual’s information behavior. Marginalized groups find limited resources to meet their information needs, have limited economic and social capital, are suspicious of outside information, and engage in self-protective behaviors to reduce marginalization. Chatman (1996) proposed the information poverty theory. According to him, people who do not believe that external information can help them are inclined to engage in self-protective behaviors such as deception and secrecy, which ultimately make them unable to obtain richer information. The theory he proposed makes the following six propositions:
1. The information poor perceive themselves to be devoid of any sources that might help them.;
2. Information poverty is partially associated with class distinction;
3. Information poverty is determined by self-protective behaviors which are used in response to social norms;
4. Both secrecy and deception are self-protecting mechanisms due to a sense of mistrust regarding the interest or ability of others to provide useful information;
5. A decision to risk exposure about our true feelings is often not taken due to a perception that negative consequences outweigh benefits;
6. New knowledge will be selectively introduced into the information world of poor people. A condition that influences this process is the relevance of that information in response to everyday problems and concerns.
The components associated with Chatman's information poverty theory are: Secrecy, deception, risk-taking, and situational relevance. Risk-taking refers to a person’s perception of the value of a particular type of information and the perception of the risk involved in seeking or sharing this information. Secrecy is the intentional protection of oneself from revealing information. In contrast, deception involves the intentional presentation of a false reality, as the person shares meaningless information, and the information received is irrelevant. Situational relevance refers to the fact that, to be useful, information sources must be meaningful to the individual and accepted by others in the group. Lack of knowledge about issues leads people to resort to rumors and superstitions, to feel helpless, and to avoid actively seeking information. One area that has been particularly affected by information poverty has been the field of medicine, especially infectious diseases. The experience of illness is a phenomenon that evokes suffering, intense emotions, and a desire to talk to others. The desire to talk to others is shaped by the perception that other people who do not suffer from the disease are unable to understand the world of patients, so relevant information should only be obtained from insiders who share their experiences. One of the social concerns about pandemics is fatalism. Some attribute the information poverty during the COVID-19 outbreak to the spread of fake news through social media, and believe that fake news, conspiracy theories, poverty and hunger, a shortage of doctors for patients, and social ignorance have created challenges in combating the pandemic. A combination of fear, social stigma, criminalization, and narrow-minded laws prevent marginalized individuals and social groups from volunteering for information when they need health and medical care. Stigma has always been a social challenge in social studies of health. Social stigma caused by infectious diseases causes psychosocial stress and other social barriers. Stigma can hinder health information-seeking behaviors and delay diagnosis and treatment; and can also lead to poverty and ignorance through social marginalization, resistance to health institutions, and mistrust of information and information sources. One of the main challenges for health policymakers is to develop effective measures to reduce stigma associated with illness, which requires further research. Since Chatman's theory has been used for many years to assess information poverty, it is expected to be useful for investigating the subject of the present study.
The problem is that in such circumstances, when the level of trust between individuals (patients and non-patients) and medical staff decreases, the role of people such as healthcare workers as a bridge between specialists and non-specialists can be necessary. Healthcare workers also play the role of transferring information between these two groups. Therefore, measuring the level of information poverty of healthcare workers in relation to epidemic diseases is so important. On the other hand, if the factors affecting the information poverty of different groups of individuals, including medical staff, in the field of infectious diseases are identified, the results can also be extended to possible epidemic conditions in the future and help in appropriate interventions at different stages of managing and controlling public health emergencies as quickly as possible. Identifying the challenges and problems of information behavior of healthcare workers who face epidemic diseases and appropriate and timely planning for their management can lead to the design of effective strategies for the prevention, treatment, and recovery of affected communities.
The aim of the study was to show how the small world of Tehran healthcare workers fits into Chatman's information poverty theory. The main question of this research was to investigate their information poverty situation based on the components of Chatman's information poverty theory.
The sub-questions were as follows:
1. What is the situation of the secrecy component in healthcare workers?
2. What is the situation of the deception component in healthcare workers?
3. What is the situation of the risk-taking component in healthcare workers?
4. What is the situation of the situational relevance component in healthcare workers?
5. What is the grouping of healthcare workers based on the components of Chatman's information poverty theory?
Methods and Materoal
The method of this survey study included the identification and analysis of the key components of information poverty of healthcare workers who were working in health homes in Tehran during the Covid-19 pandemic. Because due to their direct contact with the community, they had valuable information about their health situation and health needs, and the information poverty of healthcare workers in this field could be extended to the community.
Data collection was conducted using a researcher-made questionnaire based on Chatman's information poverty theory. The reliability of the questionnaire was assessed using Cronbach's alpha formula, and the content validity ratio was used to examine the validity of the questionnaire.
A stratified random sampling method was used and 125 questionnaires were collected. In order to ensure better diversity and representation, the population was divided into subgroups, and the categories were identified based on the supervising universities, and a sample was selected from each category to ensure the necessary statistical sample size.
Results and Discussion
The findings related to the main components showed that deception had the highest mean with a value of 3.85. This indicates a conscious effort to present a false social reality. After that, the mean of secrecy, protecting oneself from revealing information, is in second place with a value of 3.728. The mean of situational relevance is also in third place with a value of 3.687. This index indicates that the healthcare workers selectively received information about their daily lives. In addition, the mean of risk-taking (3.615) also indicates the healthcare workers' fear of the consequences of seeking information in complex health conditions.The findings related to the secrecy show that the highest mean (3.924) belonged to the component of "Coping with a lack of information processing skills". This was followed by “mistrust”, “privacy protection”, “adherence to one’s own in-group culture”, “welcoming cyberspace to exchange information”, “hiding one’s position, feeling or opinion”, “establishing and maintaining superiority over unwell individuals”, “lack of information and information assets”, and “avoiding negative consequences” and finally, “adherence to a unique personal attitude”.Findings related to the risk-taking showed that “usefulness and value of information” had the highest mean of 3.752. After that, "privacy protection" with an average of 3.74, "adherence to one's own in-group culture" with an average of 3.645, "welcoming cyberspace for information exchange" with an average of 3.642, "emotional and cognitive effort to choose between true and false information" with an average of 3.64, "mistrust" with an average of 3.58, "avoidance of possible negative consequences".
The situation of the situational relevance shows that the "usefulness and value of information" component with an average of 3.726 has the highest score. This was followed by “using insider information” with an average of 3.725, “adherence to one’s own in-group culture” with an average of 3.688, “lack of information and information assets” with an average of 3.616, and the “mistrust” with the lowest average.
Analysis of the situation of the deception showed that the “risk avoidance” had the highest average (3.988). This was followed by “mistrust” with an average of 3.884, “lack of information and information assets” with an average of 3.876, “maintaining privacy” with an average of 3.876, and “failing to present the true reality, situation, or feeling” with an average of 3.828, respectively. Finally, the lowest average (3.796) was related to the “establishing and maintaining superiority over unwell individuals” component.
The findings related to the grouping of healthcare workers showed that the deception component had the highest number of observations and the situational relevance component was in second place after the deception. Also, the number of observations of secrecy was higher compared to risk-taking.
Conclusion
The results indicate the complex behaviors of healthcare workers in interacting with information and information sources, and "deception" was prominent as the main strategy among these components, while situational relevance, risk-taking, and secrecy acted as complementary behaviors.
The most effective factor on healthcare workers' secrecy was coping with the lack of information processing skills. This is while mistrust of information sources and information also played a prominent role in the process of not presenting facts, feelings, and thoughts of healthcare workers. While the most important factor on risk-taking was ignoring information that did not match their conditions, because they were afraid of its consequences and possible risks. The second factor affecting risk-taking was due to the preservation of information and personal and group privacy. Also the most effective factor on "situational relevance" was that they assessed the usefulness and value of information from the perspective of their own needs and limited information. Another factor was that the healthcare workers prioritized the use of inside information because they considered it relevant to their position. Finally the most influential factor in the deception of the healthcare workers was that they reduced the risks of seeking information. Another factor was that they did not trust the information and the sources from which it was disseminated.
The grouping of healthcare workers showed that the largest number of them was in the deceptive group. A smaller number of them also assessed the relevance and usefulness of the information to their current situation and were placed in the second group. The third group, with a smaller number, belongs to the secretive group, while the number of risk-averse individuals was lower compared to secretive healthcare workers. There are signs in the findings that place people in two groups at the same time. This phenomenon can be caused by psychological and social complexities and the effects of various factors on information poverty. On the other hand, all four components can be involved in an individual's information-seeking behavior at the same time. It is also possible for one component to have an effect on the other. For example, the concept of secrecy is closely related to risk-taking. This highlights the depth of information poverty and the complexity of human behavior, which can be influenced by multiple factors, including social and cultural contexts. It also allows us to understand that individuals do not simply fit into a particular pattern and may act differently in different situations. Overall, these findings emphasize the need to develop training programs and create safe spaces for information exchange so that healthcare workers can more confidently access and utilize new information.
The analyses lead us to conclude that in order to reduce information poverty, we need to strengthen educational infrastructure, improve access to information, and create a culture of transparency and trust. Finally, the findings provide new insights into the constraints experienced by healthcare workers in health homes, and provide evidence of systematic marginalization and classification of access to and use of information, indicating that protective, secretive, and deceptive measures were employed by healthcare workers not only to cope with living in a small world, but also to circumvent socio-cultural boundaries. The results provide further insight into the role of health professionals and policymakers in supporting the information needs of healthcare workers and guiding their information behaviors.
Keywords: Information Poverty, Chatman's theory, Primary healthcare worker.