(This article was originally written for the CAPPA newsletter and blog for birth professionals. However, the techniques I discuss here are useful for anyone who is wanting to do their own research regarding their health or their family’s health!)
We are evidence-based doulas and educators! Our training and our practices are founded on the most recent scientific research. So, when a client asks you for the latest research on a concern they have… where do you go?? Books? A textbook? Journal articles? Popular blogs? Special interest sites? Social media???
There is not one type of source that will guarantee accuracy. There is not one type of source that is always, inherently false. So, those of us who are professionals — but not professional researchers — need a reliable method of evaluating our sources of information. After all, we have a responsibility to give our students and clients the most up-to-date, factual information. Likewise, when someone asks you where you got your information, you need to have a good answer!!
Levels of Sources
First, let’s look at various levels of sources. There are a few different ways to categorize sources. Here is a simplified method:
Primary Sources
This is information that’s straight from the researcher’s mouth. It could be the study itself or a lecture or article written by the researcher about the results of his/her study.
Secondary Sources
Secondary sources contain information that is one step away from the researcher. This is another researcher or scientist’s take on the study. An example is an editorial article in a peer-reviewed journal.
Primary and Secondary Sources are written by researchers and scientists for other researchers and scientists. There is an assumption that you “speak the language”. The author assumes that you have a knowledge of statistics and of the research methods that were used. This can make it tricky for a lay person to correctly interpret these sources.
Tertiary Sources
Most tertiary sources are reference books and other sources you would find in a library: encyclopedias, almanacs, dictionaries, textbooks. However, sources that are directed at professionals in a particular field (sometimes called Trade Literature) could also be included in this category.
Tertiary Sources are written by people or organizations for the sole purpose of educating professionals or the public. They do the interpretation of the studies for us. In the childbirth field, this could include information from the CDC, WHO, or Mayo Clinic. It also includes publications from the American Academy of Pediatrics and ACOG. Although, those organizations’ intended audiences are doctors – doctors are not researchers, either! Subsequently, they also rely heavily on trade literature for their evidence-based information.
If you are a non-researcher birth professional, tertiary sources are going to be your go-to source for quality, up-to-date info.
Be sure to compare these sources against each other for accuracy and consistency, and use the most recent publications possible. If a study is more than 5 years old, look to see if there is more current research.
Popular Press
Popular Press sources include magazines, popular books (as opposed to text books), blog posts, special interest sites, pregnancy apps, social media, etc. This has become the #1 source for the average lay person seeking information. So, it is important for us to learn how to carefully scrutinized and evaluate popular press publications.
In our current internet era, anyone can create a blog, put out some content and call themselves an expert. The loudest voices draw the most attention regardless of their qualifications or accuracy. According to Childbirth Connection’s Listening to Mothers III survey, mothers get the majority of their pregnancy health information from their care providers, their childbirth classes and popular websites. The striking part is that most of the parents who were interviewed listed a nearly equal amount of confidence in these three sources. So, how do we determine whether a popular press resource is trustworthy and reliable??
My new, favorite method of evaluating popular press sources is the CRAAP Test. (Mostly, because I thoroughly enjoy saying “Did it pass the CRAAP test??”) It stands for Currency, Relevance, Authority, Accuracy and Purpose. Now, when a client sends you a blog post they’ve been reading, or a distant family member tags you in every birth-related article that pops up in their Facebook feed, you can use this test to determine whether or not it is a credible and useful source!
Currency
How much is this article worth to me? When was it published? Does that matter? Is the information outdated? Is there a newer source that I should be using? In the birth field, we are generally looking for research that has been done in the last 3-5 years. Also, how does the information in this publication align with the rest of the body of research on this topic? Does it back up data that we already know, or is this something brand new and maybe even out of left field? (If so, we will probably need to wait for more research to be done before applying the findings to our practice.)
Relevance
Does the information apply to my client(s)? Is this an appropriate article to share with my students or to share publicly on social media? This could be as simple as checking the main points to see if they are relevant to your client’s situation. It could also be as detailed as digging in and looking for red flags. Three common red flags I see in my research are: testimonials, FUD, and distraction.
* Does the author use a testimonial as the main form of evidence? A sample pool of one person is not generalizable to the population at large. If you want to continue researching this information, you will need a more reliable source.
* Does the author use Fear, Uncertainty & Doubt (FUD) as a theme? Fear is a widely used psychological tactic used in sales and marketing to persuade people to do what you want them to do. Unfortunately, it is also used in the health field with appalling frequency. It is manipulative at best and destructive at worst. Conspiracy theories and click-bait titles also fit into this category. I would not recommend ever sharing articles that use these tactics with your clients or students.
* Distraction techniques are also used frequently in popular press sources. There are two main ways this is seen in health publications: (1) Using a part to prove a whole. For example “A new study says that Vitamin C does not cure the common cold. Therefore, all vitamins are a scam and not worth your money.” This is throwing the baby out with the bath water, so to speak. (2) Using something related to prove the main point. For example “A newborn baby died of anaphylactic shock after receiving a vitamin K shot. [Article describes in detail the dangers of anaphylactic shock.] Therefore, no baby should ever receive a vitamin K shot.”
This vitamin K example was from an actual article that I read. The author gave no citations, but a quick google search revealed that this was, indeed, a factual occurrence. It also revealed that it was the only recorded instance of anaphylaxis in a newborn from a vitamin K shot in the U.S. It is indeed a tragic incident and one that we should make all effort to avoid repeating. However, this author used a related issue – the dangers of anaphylactic shock – to prove the original argument: to ban vitamin K for all newborns. Distraction can be overt or it can be difficult to detect. Often, the author has no idea they are doing it, but it is common in emotionally charged topics.
Authority
Why are they qualified to speak on this subject? Is their degree relevant to the subject? Do they have any experience, education or training in on this topic? If they are evaluating a study, do they understand the research methods involved? A lack of author qualifications doesn’t inherently disqualify them from writing on a particular topic. For example, the bulk of the post may be quoting an expert in the field rather than the author’s own interpretation. However, it is definitely something to take note of. If you cannot find information on the author, consider the reputation of the publication. Do they consistently provide accurate, balanced information? Or do they have a habit of sensationalizing topics or dismissing evidence that doesn’t agree with their narrative?
Accuracy
We need something to give this popular source legitimacy. If an author makes a claim that is common knowledge, it doesn’t necessarily need to be cited. But if they make a claim that is not common knowledge, something that is new, they will need to cite a primary source. Or often in our field, they will cite to a tertiary source that then links to a primary source. There is a lot of breadcrumb following in research! So, look for citations, and check those links!! Special interest group often cite their own previous publications. Bloggers will frequently cite other bloggers or a special interest group that agrees with them. I have even seen these link back to the bloggers in one giant echo-chamber-type circle. Somewhere in the chain there needs to be a link to actual scientific evidence that backs up the claims. Otherwise, we need to dismiss this information or start looking elsewhere for the evidence.
Purpose
Why did the author write this article? Are they selling something associated with this topic? Are they promoting a particular cause that could sway their information? Do they have connections to anyone related to that cause? Or are they educators whose sole purpose is to inform? You can often find this information in the author’s bio or on the sidebar of the website. If an article is heavily promoting an essential oil or a supplement as a cure for a particular ailment, and you see in the side bar that they happen to sell that same product, that should give pause to question whether the information given is swayed by a desire to sell the product. It doesn’t mean the information is inherently false, but at the very least, it should be verified by other sources.
Reliable Sources
Now that you know what to look for, you will begin to grow your own collection of reliable sources where you can turn for information. These are some quality resources to get you started:
To search for links to studies
http://www.cochranelibrary.com/topic/Pregnancy%20%26%20childbirth
https://scholar.google.com
https://www.ncbi.nlm.nih.gov/pubmed
Public health organizations
https://www.cdc.gov/pregnancy
http://www.who.int/topics/pregnancy/en
http://www.bfmed.org/Resources/Protocols.aspx
Reliable popular press sources
https://evidencebasedbirth.com
http://www.nancymohrbacher.com
www.llli.org
http://www.childbirthconnection.org
If you are a parent looking for an evidence-based childbirth class, check out the two online options below. There is a full 12-module course that covers every topic from pregnancy nutrition through breastfeeding and newborn care. That course has also been broken down into mini-courses so that you can pick and choose which topics you want to learn, or you can spread out the cost of the full course into smaller payments!
References
Evaluating Information Sources: Evaluate Your Sources. (2020, April 7). University of Southern California. http://libguides.usc.edu/evaluate
Evaluating Internet Resources. (n.d.) Georgetown University Library. https://library.georgetown.edu/tutorials/research-guides/evaluating-internet-content
Evaluating Resources: Scholarly & Popular Sources. (2021, February 16). University of California Berkeley. http://guides.lib.berkeley.edu/c.php?g=83917&p=3747680
Is your source CRAAP tested? (n.d.) Illinois State University. https://guides.library.illinoisstate.edu/ld.php?content_id=14672390
Listening to Mothers Reports and Surveys. (n.d.) Childbirth Connection. https://www.nationalpartnership.org/our-work/health/maternity/listening-to-mothers.html