The Literature

So far, little evidence exists about health information behavior in the Middle East & North Africa (MENA) and, more specifically, in the Gulf among adolescents:

  • Arnott-Smith and Keselman (2015) found that GCC residents of all ages “first seek information from conversations with physicians and hospital personnel, followed by family, friends, and knowledgeable elders and religious leaders in the community” (p. 174).
  • Similarly, 93 percent of respondents in Saudi Arabia first expected health information from their physicians (Al Ghamdi & Almohedib, 2011). Specifically among Saudi females, personal sources of all kinds seemed to be popular (Al Ghareeb, 2009).
  • Also, interviews with Qatar Cancer Society (QCS) educators revealed that “the most common information sources about cancer in Qatar originate in advice from friends and family in addition to the patient’s physician” (Arnott-Smith & Keselman, 2015, p. 173).

These results could be explained through the Arab world’s more relationship-based culture, instead of a rule-based one (Hooker, 2012).  This means that social behavior is more strongly determined by one’s family, peers and superiors. In his classic work in 1984, Hofstede found a value system for the Arab world that is characterized, among other features, by masculinity and “power distance,” i.e., more hierarchical relationships. These cultural characteristics should indeed make personal health communication more successful. Also, a person’s power and charisma could count more than their professional expertise.

But interestingly, at least in Qatar, this plausible pattern is not as clear-cut as it looked for Qataris’ information behavior specifically about cancer (see above). Because for health information in general, a representative sample of Qataris in 2016 named Primary Health Care Centers (PHCCs) as the most frequently used health information source, followed by family, friends, and then the internet (especially among women and younger Qataris). On the internet, Google was the most popular search tool (Choudhury et al., 2016).

There has only been one study with (some) evidence of how media use and communication channels for health information among young people in MENA countries develop. Northwestern University’s surveys titled “Media use in the Middle East” (Northwestern University in Qatar, 2013, 2015) show that in 2015, almost half (45 percent) of Qatari internet users aged 18 to 24 years looked up health information (in the widest sense of the term) at least once a day--a sharp rise from 24 percent of that same group in 2013. In 2015, for almost half (48 percent) of the same age cohort reported that the “most important source for health information” was websites; 31 percent named face-to-face personal communication, and only six percent mentioned television. Social media followed with five percent.

Not surprisingly, we find more evidence in Western countries of the important role of the internet for health communication behaviors and attitudes among teenagers: In the United States, a 2015 national survey of almost 1,200 Americans age 13 to 18 revealed that the internet is used by most adolescents (84 percent) for health information (Center on Media and Human Development, 2015). However, when asked where they got “a lot” of health information recently, only 25 percent named the internet, but more than half (55 percent) their parents. A third of the teenagers (32 percent) mentioned health classes at school and 29 percent doctors and nurses. So, yes, the internet seems an easily accessible first source for health information for U.S. adolescents. However, when it comes to finding more in-depth information, personal sources become more important.