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Recent Insights Into Cyberchondria

Vladan starcevic.

1 Discipline of Psychiatry, Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, University of Sydney, Sydney, NSW Australia

2 Department of Psychiatry, Nepean Hospital, PO Box 63, Penrith, NSW 2751 Australia

David Berle

3 Graduate School of Health, Discipline of Clinical Psychology, University of Technology Sydney, Ultimo, NSW Australia

4 University of New South Wales, School of Psychiatry, Sydney, NSW Australia

Sandra Arnáez

5 Facultad de Psicología, Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, University of Valencia, Valencia, Spain

Purpose of Review

The construct of cyberchondria was introduced relatively recently. This article aims to review the conceptualization, theoretical basis and correlates of cyberchondria, as well as its prevention and management.

Recent Findings

Although there is no consensus, most definitions of cyberchondria emphasize online health research associated with heightened distress or anxiety. The two theoretical models of cyberchondria involve reassurance seeking and specific metacognitive beliefs. Cyberchondria has relationships with health anxiety, problematic Internet use and symptoms of obsessive-compulsive disorder, with public health implications pertaining to functional impairment and altered healthcare utilization. Suggestions about prevention and management of cyberchondria have been put forward, but not tested yet.

Research interest in cyberchondria has steadily increased. It is uncertain whether cyberchondria can be considered a distinct entity. Future research should aim to clarify the conceptual status of cyberchondria, quantify its impact and develop evidence-based approaches for a better control of cyberchondria.

Introduction

The concept of cyberchondria has an interesting 20-year history. There is some controversy as to where the term first appeared and to whom it can be attributed: the main contenders are a 1999 Wall Street Journal article and a 2001 article published in The Independent , but others also occasionally pop up [ 1 ]. Regardless of who coined the term cyberchondria, it is certain that its creator was not a mental health clinician or researcher. Cyberchondria was introduced in the context of the early days of the Internet, at the time of an increasing interest in the “negative side” of this new and revolutionary information and communication medium. There was much fascination with the newspaper stories depicting cases of “Internet addiction” and other novel Internet-related afflictions, often with a sensationalist slant. Therefore, it is not surprising that these terms were promoted by journalists, which may also help explain why cyberchondria was not taken seriously by clinicians and researchers for about a decade.

Two landmark articles in 2009 by White and Horvitz [ 2 , 3 ] served as a catalyst for further academic investigations in the area. These Microsoft researchers conducted a large-scale study of the factors that led to an escalation of health worries during online searches for health-related information and in the quest for self-diagnosis on the Internet. Over the subsequent years, academic researchers started paying more attention to cyberchondria, and both theoretical articles on the subject and empirical studies of cyberchondria started to appear. In 2014, the first instrument for the assessment of cyberchondria, the Cyberchondria Severity Scale (CSS) [ 4 ], was published, which gave a significant impetus to research activity and scholarly work. This is reflected in many research, review and theoretical articles published on cyberchondria and related topics since then.

The aim of the present article is to review selected key issues about cyberchondria. These include the conceptualization and definition, theoretical perspectives, relationships with other constructs, impairment, cost, public health implications and prevention and management aspects. Assessment issues will also be addressed briefly, as will the topic of cyberchondria during the COVID-19 pandemic.

Conceptualization of Cyberchondria

Defining cyberchondria has proved to be challenging. There are two main approaches to defining it. The first emphasizes the link with health anxiety and conceptualizes cyberchondria as an excessive and/or repetitive pattern of online health research (OHR) that is associated with an increase in health anxiety or distress [ 5 ]. The second approach is broader and suggests that cyberchondria is syndrome-like and multidimensional in that it reflects both “anxiety and an element of compulsiveness” and includes several components: repetitive and time-consuming OHR, negative emotional states (e.g., anxiety) or distress associated with OHR, interruption of other activities as a result of OHR and consulting a physician in response to an increased distress or anxiety, usually to seek reassurance [ 4 ]. With its construal of cyberchondria as a syndrome-like entity, the second approach also paves the way for potentially considering cyberchondria as a distinct construct. Indeed, the results of a study using a network analysis approach were consistent with a syndrome-like conceptualization and a relatively independent status for cyberchondria [ 6 ••]. However, this may be partly due to some circularity, as this study relied on the instrument (CSS) developed on the basis of the multidimensional conceptualization of cyberchondria. Interestingly, the network analysis also showed that features of cyberchondria were interrelated, with no feature clearly emerging as more central to the construct of cyberchondria—a finding that calls for further investigation of the structure of the cyberchondria construct. No conceptualization of cyberchondria includes a disease or diseases that drive OHR. This is likely to be a consequence of the shifting focus of OHR between the different individuals and perhaps even within a single individual over time.

A consensus about the meaning and scope of cyberchondria is still missing. Some authors reject the term because of the “confusion” surrounding its various meanings [ 7 ••]. A recent systematic review [ 8 ••] reported that definitions of cyberchondria in various publications most commonly mentioned an “increase in anxiety” (89.8% of articles), followed by “compulsive or repetitive behaviour” (66.1%). One element that is common to all definitions is a behavioural pattern of OHR, regardless of how it is further characterized (e.g., as excessive, time-consuming, problematic, repetitive or compulsive). The second element that unifies various definitions is a recognition that OHR is associated with a negative emotional state, such as distress, anxiety or health anxiety.

Recently, an “extended” or “working definition” of cyberchondria has been proposed [ 8 ••]. It includes several components: (1) pattern of excessive OHR; (2) characterization of OHR as “compulsive”, “hard to resist” and serving the purpose of seeking reassurance; (3) short-lived relief with OHR because “anxiety or distress usually worsens…and persists afterwards”; (4) prioritization of OHR over other interests or activities and its continuation or escalation despite its negative consequences. While this definition is certainly comprehensive, it is unclear whether all the proposed components of cyberchondria need to be present. Also, it remains to be ascertained whether some of these components are more important than others, i.e., whether they always need to be present, whereas others may be optional. Furthermore, this definition implicitly gives cyberchondria a disorder-like or diagnosis-like status and emphasizes the similarities with behavioural addictions. Although the relationship between cyberchondria and problematic Internet use (PIU) as a potential behavioural addiction has been demonstrated [ 6 ••, 9 – 13 ], conceptualizing cyberchondria as a behavioural addiction seems premature because it reflects a more severe variant of the condition. Finally, cyberchondria may be better defined as a dimensional construct, on a continuum from a mild to severe behavioural and psychopathological pattern.

Further research on cyberchondria crucially depends on the adoption of a consensus-based definition and conceptualization. Given the present state of understanding and knowledge, the most useful definition may be the one that relies on the description of the relevant behaviours and phenomena, without suggesting potential psychopathological mechanisms and relationships. From this perspective, a succinct and effective definition of cyberchondria would include OHR as a behaviour that is associated with distress or anxiety; interference with functioning might be added to emphasize clinical and public health significance.

Theoretical Perspectives on Cyberchondria

The first theoretical account of cyberchondria was the reassurance-seeking model [ 1 ], which posits that individuals with high levels of health anxiety engage in OHR to be reassured about their health concerns. As the outcome of reassurance seeking on the Internet is largely unpredictable because of the nature of the Internet, some people are reassured by what they find online, whereas others are not. Those who fail to experience reassurance or feel only partially reassured and are therefore more anxious continue with OHR in an effort to find reassurance. OHR also persists owing to the factors that reinforce it, including a need for definitive explanations, information overload, uncertainty inherent to an online search process and questionable trustworthiness of the sources of online information. In short, OHR in cyberchondria is regarded as a maladaptive coping with health anxiety that creates a vicious cycle and perpetuates itself. This pattern corresponds to what was later called “problematic OHR” [ 7 ••].

According to the metacognitive model of cyberchondria [ 11 , 14 , 15 ], OHR and its negative effects, including increased anxiety and distress, are related to certain metacognitive beliefs. These beliefs may be about the usefulness of the Internet for coping with health-related distress and anxiety (positive metacognitive beliefs) or about the loss of control over OHR and a sense that OHR is detrimental (negative metacognitive beliefs). If the negative metacognitive beliefs are more prominent, a perceived threat then comes from OHR itself so that OHR is experienced as distressing, compulsive and out of control—a pattern labelled as “compulsive OHR” [ 7 ••]. While problematic OHR and cyberchondria based on reassurance seeking is more clearly and more strongly related to health anxiety, compulsive OHR and cyberchondria related to negative metacognitive beliefs may have a stronger link with PIU. Therefore, there may be potentially two types of “pathological OHR”: problematic OHR and compulsive OHR [ 7 ••].

The idea about the two types of pathological OHR and, by extension, two “subtypes” of cyberchondria, needs to be elaborated and tested. At present, it is not clear whether these two patterns are relatively separate and if so, what implications that may have for understanding, prevention and management of cyberchondria. In fact, it was suggested that cyberchondria might be a “unitary construct” and include both problematic OHR and compulsive OHR, although these components may be present in different proportions in different individuals and perhaps at different times in the same individuals [ 16 ]. If so, a better understanding of cyberchondria at an individual level calls for a meticulous formulation that specifies the possible mechanisms and reinforcing factors.

One aspect of cyberchondria that needs further theoretical development is its compulsive nature. This is because of the relationships with PIU and obsessive-compulsive disorder (OCD) and the need to understand and target the person’s motivation for continued OHR despite its negative consequences and previous experience of it being ineffectual with regard to reassurance. The negative metacognitive beliefs, especially those about the loss of control over OHR, may contribute to persistent OHR. Other potential reasons are more clearly related to compulsivity, with an expectation of further negative consequences if OHR were to stop. Such consequences may pertain to a fear of missing out on some information deemed to be relevant and important for one’s health concerns. These considerations might help in better intertwining the various features and aspects of cyberchondria: OHR, health anxiety (or health-related distress), reassurance seeking and compulsivity.

The conceptual independence of cyberchondria is another important issue. As already noted, the network analysis study has suggested that cyberchondria might be relatively specific and distinct from all related constructs [ 6 ••]. This finding needs to be replicated before cyberchondria can be conceptualized as an entity in its own right—a difficult task because there are no clear guidelines about the minimum requirements for any psychopathological entity to be considered separate and distinct from related conditions.

Relationships Between Cyberchondria and Other Constructs

The concept of cyberchondria was developed on the basis of its hypothesized relationships with health anxiety and hypochondriasis. Many studies [ 11 , 12 , 14 , 17 – 26 ] have confirmed moderate to strong correlations between cyberchondria and health anxiety ( r s ranging from 0.48 to 0.68, depending on the instrument used for the assessment of health anxiety). Only one study [ 13 ] found this correlation to be relatively weak ( r  = 0.23). A recent systematic review and meta-analysis [ 27 ••] confirmed a positive and strong correlation between cyberchondria and health anxiety ( r  = 0.62, 95% CI = 0.52–0.71, p  < 0.0001). The direction of any causal relationship between these two constructs remains uncertain because most research has used a cross-sectional design. Although heightened levels of health anxiety precede cyberchondria and lead to it, which is the usual assumption, excessive OHR may induce health anxiety or increase its levels in vulnerable individuals. One longitudinal study has demonstrated the latter pathway [ 28 ].

In addition to health anxiety, PIU and symptoms of OCD also have important relationships with cyberchondria, although these have not been studied so extensively. The correlations between cyberchondria and PIU have been robust and ranged between 0.43 and 0.59, depending on the instrument used for measuring PIU [ 11 – 13 ]. These correlations reflect features that are common to both cyberchondria and PIU: excessive participation in online activities , diminished control over them so that online engagement cannot decrease and persistence of online activities despite their negative consequences. Moreover, individuals with cyberchondria were found to be more likely to take part in other types of problematic online activities [ 9 ].

The correlations between cyberchondria and OCD symptoms have similarly been robust and ranged from 0.38 to 0.56 [ 14 , 17 , 21 , 22 ] for the total scores on the Dimensional Obsessive-Compulsive Scale. When the correlations were calculated for scores on the subscales of the Dimensional Obsessive-Compulsive Scale, they were lower ( r s = 0.21–0.44) [ 22 , 29 ], as were the correlations with scores on the subscales of the Maudsley Obsessive-Compulsive Inventory ( r s = 0.27–0.40) [ 30 ]. These findings may suggest that the specific symptom subtypes of OCD have different relationships with cyberchondria, but this has not been reported consistently. Compulsivity and reassurance-seeking behaviour that characterize both cyberchondria and OCD may account for the relationship between cyberchondria and OCD symptoms.

Intolerance of uncertainty is a construct related to cyberchondria on theoretical grounds [ 1 ]. Moreover, both health anxiety and OCD, constructs associated with cyberchondria, have independent and strong relationships with intolerance of uncertainty. Not surprisingly, studies have repeatedly shown moderate to strong correlations between cyberchondria and intolerance of uncertainty. These correlations were stronger with inhibitory intolerance of uncertainty ( r s = 0.31–0.52) than with prospective intolerance of uncertainty ( r s = 0.24–0.44) [ 11 , 14 , 18 , 19 , 30 , 31 ]. Inhibitory intolerance of uncertainty refers to a tendency to inhibit behaviour and feel paralyzed in response to uncertainty, whereas prospective intolerance of uncertainty denotes an anxious anticipation of the future and need for greater predictability of future events. Some studies suggested that intolerance of uncertainty might be a specific risk factor for cyberchondria [ 18 , 19 , 30 , 31 ]. Other research reported a nonspecific association between intolerance of uncertainty and cyberchondria [ 11 , 14 ], which is in line with the transdiagnostic nature of intolerance of uncertainty. Consequently, intolerance of uncertainty may relate to cyberchondria indirectly, for example, via their common link with health anxiety [ 31 ]. Regardless of the exact nature of this relationship, it appears to be important and should be taken into account in an effort to better understand cyberchondria.

The relationships between cyberchondria and other constructs were also investigated by means of a network analysis approach [ 6 ••]. Using this method, the authors demonstrated that although cyberchondria was strongly related to both PIU and health anxiety, it was closer to the former than to the latter.

In view of these findings, it can be concluded that cyberchondria may overlap with health anxiety/hypochondriasis, PIU and OCD, despite some research suggesting that this overlap is relatively small [ 6 ••]. Other studies have found that cyberchondria and health anxiety may represent distinct constructs [ 29 , 32 ], although they are closely related, overlap and similarly pertain to various feared illnesses. Therefore, it is simplistic to consider cyberchondria only a modern counterpart to hypochondriasis. Likewise, cyberchondria should not be portrayed only as a form of PIU or as an entity solely related to OCD. The ways in which these constructs interact may be more complex and future studies are expected to shed more light on their interactions.

Impairment, Cost and Public Health Implications of Cyberchondria

Cyberchondria refers to a time-consuming activity over which there is little or no perceived control. Individuals with cyberchondria are therefore prone to neglecting or de-prioritizing their duties and activities at home, work or learning environments. Relationships and social life may be adversely affected as well. Research confirms an association between cyberchondria and functional impairment, even when controlling for the effect of health anxiety [ 32 ]. However, a better understanding of the impact of cyberchondria on various domains of functioning calls for more research.

Cyberchondria may also have effects on seeking and receiving healthcare, which has public health implications. Thus, cyberchondria may drive help- and treatment-seeking behaviour as a result of the anxiety induced by excessive OHR. This may lead people with cyberchondria to ask for more frequent consultations with their primary care physicians and other doctors or to request various medical investigations. Indeed, cyberchondria has been associated with an increased healthcare utilization, measured by the number of visits to various healthcare professionals [ 20 ].

Some individuals may attempt to cope with cyberchondria-induced distress by avoiding contact with healthcare professionals. Such avoidance may lead to a failure to seek appropriate healthcare, with further negative consequences. Another problematic aspect of cyberchondria is a negative impact on the patient-physician relationship [ 4 , 10 ], for example, via tendency of some individuals with cyberchondria to challenge physicians about diagnosis and treatment. Research findings in this domain have been conflicting, partly because of the failure to distinguish between normal and pathological OHR. Thus, some studies reported arguments and disputes between patients and physicians occurring in the context of OHR [ 33 , 34 ], whereas others found the opposite pattern, i.e. an improved communication and interaction [ 35 – 37 ]. The frequency of adversarial interactions between individuals with cyberchondria and physicians and consequently poor treatment adherence remains unknown.

The cost of cyberchondria and the harm associated with it have not been calculated. Likewise, economic burden of cyberchondria and its public health significance remain to be ascertained more precisely. Given the observations and preliminary findings about functional impairment associated with cyberchondria and its effects on health-related behaviours, healthcare utilization and communication and relationships with healthcare professionals, there are reasons to believe that the personal and societal impacts of cyberchondria is significant.

Assessment of Cyberchondria

Several instruments for the assessment of cyberchondria have been developed, but the CSS [ 4 ] has been by far the most frequently used tool. The CSS is based on a multidimensional conceptualization of cyberchondria [ 4 ], and in addition to the total score, it provides scores on 5 subscales, which represent each cyberchondria dimension: compulsion (interference with other activities), distress, excessiveness, reassurance and mistrust of medical professionals. The original version of the CSS consists of 33 items, but its shorter and modified versions (with 30, 15 and 12 items) have also been used. The CSS has been translated into several languages.

A recent review of the instruments developed for the assessment of cyberchondria [38•] commented that much of our current understanding of cyberchondria is derived from research in which the CSS was used and suggested that the dominant status of the CSS among the measures of cyberchondria resulted from its very good to excellent psychometric properties and its reliance on a solid theoretical framework. However, there is room for improvement of the CSS, and it deserves further research scrutiny, especially with regard to its factor structure, divergent validity, test-retest reliability, use in clinical populations and scoring system. Moreover, questions have been raised about the construct validity of the CSS, i.e. the unresolved issue of what this instrument measures, whether it can distinguish between normal and pathological OHR and whether it taps all the relevant components of cyberchondria [ 7 ••]. With regard to the latter, it has been suggested that a comprehensive cyberchondria instrument might also need to include items that assess the perception of OHR, especially in terms of its controllability, intrusiveness and notion about the amount of the needed health information [ 7 ••].

Finally, the use of the CSS implies a direct or indirect endorsement of the theoretical framework on which it is based [ 38 •], while there remains a lack of consensus about the definition of cyberchondria. Consequently, in addition to the need for refinement of the CSS, there is also a need for the multidimensional conceptualization of cyberchondria to be tested.

Cyberchondria During the COVID-19 Pandemic

The COVID-19 (coronavirus) pandemic has been an unprecedented event of the digital era, considering the disruption that it has caused in all areas of life worldwide. The pandemic has been a fertile soil for cyberchondria because of the fear induced by COVID-19 (“coronaphobia”, “COVID-19 anxiety”); the uncertainty associated with the fact that COVID-19 is a novel disease for which the world was poorly prepared; the abundance of online, unverified and constantly updated information on this disease; questionable trustworthiness of much information found online; and the decreased ability to filter out unnecessary information and the consequent information overload. Therefore, the pandemic has offered a unique opportunity to study coping with the specific, naturally occurring health-related threat in countries around the world.

Thus far, several studies have investigated cyberchondria during the COVID-19 pandemic. One study has reported that trust in online information and perceived information overload both intensified manifestations of COVID-19-related cyberchondria and suggested “healthy scepticism” about health information and avoidance of information overload as ways of preventing or addressing cyberchondria [ 39 ]. This study also found cyberchondria to be a “side effect” of the COVID-19 pandemic. Another study found that during the pandemic, cyberchondria was more prominent among people who used social media as the main source of information about COVID-19 [ 40 ], possibly because much information about the pandemic obtained via social media was distorted and untrustworthy [ 41 ]. Not surprisingly, cyberchondria was reported to be a risk factor for “coronavirus anxiety” in yet another study conducted during the COVID-19 pandemic, with this anxiety decreasing in the context of being (well) informed about the pandemic [ 42 ]. Further studies on cyberchondria during the COVID-19 pandemic are expected to give us a deeper insight into cyberchondria in general.

Prevention and Management of Cyberchondria

Prevention of cyberchondria does not entail avoidance of OHR because the Internet is the main source of health information in the twenty-first century. As most people who engage in OHR do not develop cyberchondria, this online activity cannot on its own be considered a risk factor for cyberchondria. Therefore, any suggestion to “abstain” from OHR is both unrealistic and misleading.

Prevention efforts need to focus on the way online health information is accessed, interpreted and managed in an effort to improve online health information literacy. The first step is to ensure information is accessed from reliable, reputable and trustworthy sites. Internet users can avail themselves of guides that direct them to such sites and assist them in distinguishing between trustworthy and untrustworthy ones. These guides are usually produced by governments and health or academic organizations and use simple, non-technical language to help individuals with diverse educational backgrounds. It is also important to keep in mind that as valuable as health information may be, it is just that—information. The expectations that Internet users may have of information accessed online need to be adjusted accordingly. That means, for example, that even a large quantity and high quality of health information do not necessarily bring a person closer to a diagnosis. If one is after a diagnosis, reliance on “symptom checkers” is problematic [ 43 ] and self-diagnosis should be discouraged.

Online health information should empower people so that they are capable of understanding what, if anything, needs to be done about their health at the time the specific enquiry is made. This requires an ability to critically appraise the information. People can also bring that information to an encounter with a healthcare professional, which allows them to be better prepared for the ensuing discussion. When the information causes distress or anxiety and especially in the presence of symptoms, this should probably not be dealt with by further OHR because such coping is likely to induce more distress or anxiety. In other words, seeking further explanation and reassurance via OHR may lead to an interaction between an individual and the Internet in which the individual is likely to feel alone, unsupported, confused and helpless and is therefore likely to “lose”. Instead, distressing information needs to be managed via consultation with a healthcare professional, which is an opportunity for any misunderstanding to be clarified and for concerns to hopefully be alleviated or completely quashed.

In the context of prominent cyberchondria, the first task is to ascertain whether there is any associated or underlying psychopathology (e.g. hypochondriasis or OCD). If there is significant associated psychopathology, treating it may alleviate the features of cyberchondria. In other cases, both the co-occurring condition and cyberchondria may need to be targeted in order for cyberchondria to subside. An example of the second approach is a randomized controlled trial evaluating Internet-delivered cognitive-behaviour therapy (CBT) for health anxiety and modified to also target cyberchondria, which demonstrated an improvement in several aspects of cyberchondria, especially excessive OHR, high level of distress and interference with functioning [ 44 ••]. Cyberchondria-specific components incorporated into treatment package included enhancement of online health information literacy, provision of information about helpful and unhelpful patterns of OHR, clarification of the role of (mis)interpretation of online health information in driving further OHR and education about strategies to engage in OHR in a way that would minimize uncertainty and confusion. Furthermore, a decrease in health anxiety was apparently mediated by improvement in cyberchondria.

The cyberchondria-specific modification of CBT used in this study or a similar program might be effective for cyberchondria occurring in different contexts. Such a program might include techniques derived from metacognitive therapy or those based on exposure and response prevention, which is used for OCD. However, no other treatment studies of cyberchondria have been conducted, and as yet, there are no evidence-based treatments for this behavioural and psychopathological constellation.

In the meantime, before the results of controlled treatment studies become available, treatment approaches to cyberchondria might be based on a good understanding of each individual with cyberchondria and the corresponding case formulation. This would allow specific aspects of cyberchondria and specific factors implicated in its maintenance to be targeted. From this perspective, it is important to understand the following:

• Trigger(s) for OHR, e.g. a symptom that has appeared recently and caused concern;
• Purpose of OHR, e.g. seeking reassurance about the symptom;
• Factors that reinforce repeated or persistent OHR, e.g. difficulty in tolerating uncertainty generated by OHR or a belief about being unable to stop OHR;
• Consequences of cyberchondria, e.g. a conflict with a partner or frequent visits to one’s general medical practitioner.

The goal of any therapeutic endeavour in cyberchondria should be to make the person feel confident about their ability to perform OHR. Such confidence would come from the knowledge that the person is able to cope with online health information and its vagaries, i.e. its abundance, inconsistence, contradictory aspects and uncertainty-amplifying potential. The same confidence would make it very unlikely for OHR to be experienced as threatening or overwhelming and to be performed without a sense of control. Ultimately, OHR would feel empowering, not overwhelming.

Cyberchondria has evolved from being an object of journalistic curiosity to the appropriate focus of a professional interest and scientific enquiry, as reflected in an ever-increasing number of publications devoted to it. Despite this transition, some key questions about cyberchondria remain unanswered. Although its main features have been well described, there is no consensus about its definition and conceptualization. Likewise, theoretical understanding of cyberchondria is yet to be integrated. The status of cyberchondria as a distinct entity or as part of other psychopathology is also unresolved, with some researchers considering it as an epiphenomenon of a “parent” condition, such as hypochondriasis/health anxiety. Not surprisingly, the number of people seeking professional help for cyberchondria as their main complaint or problem seems to be very small. Regardless of these issues, the negative impact of cyberchondria and its public health significance are increasingly recognized but remain to be systematically researched. There are various ideas about prevention and management strategies, but these need to be refined and tested. The current situation can therefore be succinctly described as an acceptance that the problem (cyberchondria) exists and that something should be done about it, although its exact nature has not been completely elucidated.

More research is obviously needed to overcome these uncertainties and contradictions about cyberchondria. Future studies need to test the existing and novel theoretical frameworks and conceptualizations and management approaches based on them. Such studies should not only rely on convenience online samples but need to be conducted in clinical populations to establish more clearly the relevance of cyberchondria within the realm of psychopathology.

Compliance with Ethical Standards

Vladan Starcevic, David Berle and Sandra Arnaez each declare no potential conflict of interest.

This article does not contain any studies with human or animal subjects performed by any of the authors.

This article is part of the Topical collection on Anxiety Disorders

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Open access for community partners, impactful outputs for scholars: Leveraging scholarly communication movements to enhance reciprocity in community based research

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Many corners of the academy are actively working to build bridges between research in the ivory tower to outcomes and needs in the community. Our study seeks to unify two such efforts – community-based/service-learning research and open access scholarly communication. Open access is an implicit value in community-based and service-learning research, and is part of the symbiotic relationship value, but has not been explicitly discussed, framed, or embraced as a value or goal. We explore existing literature on the desire for research-informed practices from community members and practitioners, the current state of open informational practices from scholarly publications dedicated to work happening in community spaces, and make recommendations for good practices for editors, publishers, researchers, and institutions looking to link the work of scholars to the needs of the community and evaluate impact.

Keywords: Open Access, Reciprocity, Scholarly Impact, Community Impact, Community Based Research, CBR, Service Learning, Scholarly Communication

Ivey, O. & Borchardt, R., (2024) “Open access for community partners, impactful outputs for scholars: Leveraging scholarly communication movements to enhance reciprocity in community based research”, Michigan Journal of Community Service Learning 30(1). doi: https://doi.org/10.3998/mjcsl.3682

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Published on 26 apr 2024, peer reviewed, creative commons attribution-noncommercial-noderivs 4.0, introduction.

From the cooperative extension service at public land grant institutions to the vision and values statements of private liberal arts institutions, and the mission of community colleges, engagement with communities beyond the walls of the academy are notable values of higher education. Service-learning, and community-based research (CBR) are important tools for institutions of higher learning to bridge town-gown divides, enhance student learning, and make a case for the value of higher education. While these values of community engagement have deep roots, the 21st century has seen significant growth in the deliberate articulation and promotion of community integration into classroom activities and research. This growth can be seen in the inclusion of service-learning as a “high impact practice” by the American Association of Colleges & Universities ( Kuh, 2008 ) and the growth of organizations like Campus Compact, which launched with three founding institutions in 1985 and now has state and regional affiliates serving and organizing hundreds of institutions ( Campus Compact, 2022 ). Stated values from CBR and service-learning scholars include reciprocity and mutual benefit ( Israel et al., 1998 ; Maiter et al., 2008 ). Simultaneously, the open access movement in scholarly communication has worked to open previously paywalled scholarship to all interested readers. The open access movement has its roots in the removal of barriers, particularly subscription barriers to access research. This helps combat unsustainable journal pricing while satisfying funder mandates to openly publish funded research for the benefit of the funder and the public or broader community it serves ( BOAI, 2002 ; Larivière et al., 2015 ). The mutual benefit and reciprocity values of CBR and the public benefit of open access research seem well aligned. Our research seeks to determine if the definition of reciprocity has come to include open access publishing by CBR journals by giving access to published scholarship to the communities who helped produce it. We will further explore how these scholarly publishing practices do or do not meet the needs of scholars as they build their careers in academic research institutions. Finally, we will make recommendations on leveraging the knowledge and tools of both movements to further advance the value each.

Key Definitions and Concepts

Over the years a range of vocabulary and jargon has grown to describe work that ties the teaching and research goals of the academy to their communities. While each term has its own purpose and nuance, not all town-gown relations are in scope for this paper. Likewise, open research principles are far-reaching in its aims and formats. Our emphasis will be on the following:

Community-Based Research (CBR)

As defined by Strand et al. ( 2003 ) in Community-Based Research in Higher Education “CBR is a partnership of students, faculty, and community members who collaboratively engage in research with the purpose of solving a pressing community problem or effecting social change” (p. 3). Of all the forms of working beyond the boundaries of campus, CBR taps directly into the research mission of colleges and universities, naturally raising questions about how these research findings are published and who has access. Some publications, institutions, and research methodology guides use the terms Community Engaged Research, Community Based Participatory Research , or Community Based Qualitative Research . These modifiers each seek to emphasize the inclusive and active nature of research with the community. For our purposes, we will discuss CBR as inclusive of these variants.

Service-Learning and Extension Service

Service-learning is “a form of experiential education in which students engage in activities that address human and community needs, together with structured opportunities for reflection designed to achieve learning outcomes.” ( Jacoby & Howard, 2014, p. 2 ). The value of reciprocity – that students and community partners find mutual benefit in the interaction – is deeply emphasized in service-learning. On the campus side of the hyphen, service-learning is more deeply rooted in student learning than the pursuit of research. Even so, the reflection piece results in written student outputs suitable for publication, and for the scholarship of teaching and learning; service-learning provides a rich opportunity to study the pedagogical and community benefits of the practice. For this reason, there are scholarly publications outlets with a service-learning focus and we have chosen to include those in our scope of review, and given the shared value of balancing community and academic needs with benefit for all.

Cooperative Extension Service

Established by the Smith-Lever Act ( 1914 ), public land grant universities have established cooperative extension services to use the knowledge built by the academy to support their communities (7 U.S.C. 341 § 1). While restricted to universities with these programs, there are journals dedicated to extension service work and are in scope for this review.

Open Access Publishing

Open access (OA) is a complex and ever-changing area of scholarly communications with a clear goal: making information openly available and accessible. Open access publishing arose in response to subscription-based models of scholarly publication, most notably with journal articles. For many years, increases in subscription rates have outpaced inflation, resulting in unsustainable subscription pricing in order to access paywalled content, and leaving institutions or individuals who cannot afford subscriptions without access to needed scholarly literature ( Larivière et al., 2015 ). Many models of open access publication have emerged as an alternative to the subscription-based model of access, all of which provide an alternative structure of financial support for journals other than the traditional subscription-based model.

Today, for-profit publishers see some open access models as a promising revenue stream to supplement subscription revenues ( Butler et al., 2022 ). For example, Elsevier’s parent company, RELX, noted in its 2022 annual report that “pay-to-publish open access articles [are] growing particularly strongly” ( 2023. ). Initiatives like OA2020, paired with a rise in library subscription cancellations, mean that open access funding is increasingly important to publishers in order to maintain or increase revenues ( n.d. ). However, the sustainability of different open access models is a growing concern for those who financially support open access publishing, including libraries and research funders ( Willinsky & Rusk, 2019 ). Publishing is not free (though it does rely on unpaid labor and contributions), and as a result, open access publications must be supported financially. Financial and sustainability issues have forced many independent journal publications to sign deals with for-profit publishers, who manage and financially support the reviewing, editing, publishing, indexing, and marketing on behalf of the journal ( Fyfe et al., 2017 ). However, this support comes at the expense of control: in open access terms, this often means that the journal cannot always freely decide on how to make its content open access, if it is an option offered by the publisher at all ( Clarke, 2020 ).

Different open access publication models are often described with color terminology, though these terms are not always straightforward. For the purposes of this research, the publications studied fell into three primary categories. The first is diamond, also called platinum, which designates a journal where all articles are openly available, and the author does not pay any fees for publication. These journals are funded through other means – for many university presses, these costs are incorporated into a university’s budget ( Hudson Vitale & Ruttenberg, 2022 ). This model is considered to be the most equitable model for both readers and authors ( Meagher, 2021 ). Second is hybrid, or “pay to publish”, which is a dominant model among profit-driven publishers – in this model, a journal requires a subscription in order to access the full contents, but authors may choose to pay a publication fee to make their article openly available ( Piwowar et al., 2018 ). Thus, a hybrid journal will have a mix of articles that are open or closed to non-subscribers ( “Hybrid Open-Access Journal,” 2022 ). The third category is green OA – this is a broad set of criteria relating to the ability to store a version of the research article in a research repository, personal web site, or other approved website. Green OA is largely dictated by the journal and/or publisher – many publishers will only allow a prior version of an article, such as the author accepted manuscript rather than the published version of record and may impose an embargo period before this version of the research can be made publicly available ( Open Access Glossary , n.d. ).

Data on overall rates of open access publishing is imprecise, given the range of definitions and methods used to collect the data. A 2018 study estimated that, at a minimum, 28% of the scholarly literature published between 1950 and 2015 is OA with year-over-year data showing a steady increase including exponential growth beginning in 2000 ( Piwowar et al., 2018 ). However, open access growth varies by discipline, leaving CBR and service-learning research out of the analysis due to its interdisciplinary nature ( Maddi, 2020 ; Severin et al., 2020 ).

Discussions in the literature on why journals – or in the case of hybrid, individual authors – choose to publish open access tend to focus on scholarly impact and citation metrics, disciplinary norms, or the demographic characteristics of the authors ( Langham-Putrow et al., 2021 ; Piwowar et al., 2018 ; Severin et al., 2020 ; Zhu, 2017 ). However, some research has been devoted to why specific disciplines may have a stronger imperative to publish open access due to the needs of their audience(s) ( Wirsching et al., 2020 ).

Knowledge Sharing and Impact Assessment for Scholars and Community Partners

The results of campus-community scholarly endeavors matter to both parties, necessitating thoughtful communication and assessment strategies. Comprehensive program assessment is not straightforward and assessment tools that have been developed and honed over time tend to leave published scholarly work out of their scope of review. Building on early attempts at impactful measures focused on student learning, Portland State University developed a framework that is inclusive of students, the institution, faculty, and community ( Driscoll et al., 1998 ; Gelmon et al., 2018 ). While this expansion of review adds value to our understanding of community-engaged work, the continued absence of the distribution of information/knowledge as a specific outcome leaves a gap in our understanding if community partner information needs are being fulfilled. While researchers may see publication as primarily impacting academia, community and practitioner partners may feel excluded from the published results of the partnership, particularly when research is locked behind a subscription-based ‘paywall’.

The gap between scholarly publications and assessment of community and service-learning partnerships partly arises from a lack of attention, or articulation of the need, to share information. Additionally, institutional and academic research evaluation models also encourage the researcher to think of their impact in two entirely different contexts: one is how their research impacts community partners – which is often included as a measure of service – and an entirely separate context is the evaluation of the researcher’s scholarly impact. These evaluations are most commonly associated with promotion, tenure and/or rank (PRT), where scholarship and service are usually separated and evaluated using different scales and levels of expectation and reward. In fact, pre-tenured faculty interested in research methods that engage the community report facing pressure to delay such work in favor of more traditionally valued scholarship ( Changfoot, 2020 ). Even as engaged scholars have made headway in aligning institutional values of service and engagement to PRT policies, advocates see “a long way to go to fully align promotion and tenure policies to encourage and support scholarly outreach and engagement.” ( D. M. Doberneck, 2022, p. 15 ). Evaluation of scholarship, or “research impact”, has been traditionally dominated by bibliometrics, which are quantitative indicators based on citation counts designed to showcase ‘impact’ narrowly focusing on other academics as the sole impact audience ( Chin Roemer & Borchardt, 2015 ). The absence of non-scholarly audiences in scholarship evaluation is the operationalization of a value deficit where community impact is severely downplayed if not entirely absent from the traditional scholarly evaluation model. This separation of community impact and scholarly impact is clearly documented in advice for getting tenure for community-engaged scholars, who encourage researchers to publish “translated” research outputs, and separately recommend publishing in high-impact journals ( Morgridge Center for Public Service, n.d. ). Similarly, one of the most commonly-used rubrics for evaluating the institutionalization of service-learning, presented by Furco ( 1999 ), the rubric mentions promotion and tenure, but does not discuss publications as a measure of service-learning.

The scholarly evaluation process advocates and research translation advocates alike fail to fully acknowledge or assess the demand for access to published articles coming from the broader community. The community based research literature promotes alternative forms of information dissemination for community: community meetings, blog posts, op-eds, policy briefs, or even skits are recommended research outputs for meeting community information needs ( Hacker, 2013 ; Strand, 2003, p. 115 ). This “translation” of research is commonly assumed to be necessary to overcome a perceived language barrier to accessing publications. However, communities are diverse in their information needs and some describe the challenge as one of access and timing rather than intellectual accessibility. In Karen Hacker’s book chapter, Translating Research into Practice: View from Community , community partners like Alex Pirie expressed frustration with the time lag between data collection and publication/dissemination of results. ““The time delay between the conclusion of a research project and the publication of papers is always a problem. This is a period of time when, because of the constraints of journal publication, there is a virtual embargo on the results except in the most general way, and it drives the community side nuts. ‘Hey, we know this, we want to do something with/about it!’” Alex Pirie, Somerville, MA” ( 2013, p. 12 ). Similarly, when nursing home social workers were asked what academia could do to support their daily work, they asked that academic research not be kept behind a paywall ( Miller et al., 2022 ). This demonstrates an unmet need for access to scholarly research publications that translated outputs cannot meet. This unmet need may arise from considering community partners as a homogenous population, rather than separately considering the information needs of subgroups with more differentiated information needs, such as practitioners and other professionals. While translation materials can play an important role in meeting the diverse audiences of CBR where they are, researchers and journal editors should not assume an absence of interest in access to published scholarly work.

Given the assessment that open access movements and CBR scholars have shared values of information sharing with communities beyond the academy, and a commitment to mutual benefit for all parties, we wanted to examine the degree to which community-based research and service-learning journals are fulfilling these values. In particular, we assess the extent to which they are identifying practitioners and other community members as audiences, making their research openly available to these audiences, and assisting researchers in measuring their impact. To do this, a range of sources was analyzed to identify a corpus of journals in these fields, then collected information about them including the publisher, open access policy, and stated target audiences. Our results show that open access practices in service-learning and community-based research journals exceed the norm for scholarly publishing but is still not a standard expectation for journals in the field. Further, openness is aligned with community service and service-learning research values, but not always explicitly articulated or adopted by the fields. Finally, tools for scholars to assess their impact through these venues varies widely. We discuss why open access is vital to CBR and service-learning partnerships and suggest potential pathways to fully closing the loop between scholars and their community partners in ways that would ultimately benefit both, as well as the development of reward systems for researchers that would value open publishing as a community impact practice.

We started with identifying scholarly journals focused on community service or service-learning. This began by identifying a corpus of journals that fall within our parameters: an appropriate content focus, peer-reviewed, and actively publishing content. Two Campus Compact resources provided a total of 27 journals ( D. Doberneck, 2021 ; “Journal Section Comparison Table,” n.d. ). We added 11 community-based qualitative research journals from a book focused on the topic ( Johnson, 2017 ). Illinois State University offers its faculty and students a list of publication opportunities, largely affirming the Campus Compact list while giving us two additional titles to include ( 2022 ). A total of 6 journals were removed from our list due to being out of scope (1, not peer-reviewed) or no longer in active publication (5), giving us a total of 34 journals for our analysis. One publication was erroneously listed in Campus Compact as “Journal of Health Sciences and Extension” but is included in our study under its correct title, “Journal of Human Sciences and Extension”. For a complete list of journals included in the study, see Appendix A.

We identified categories of information we wanted to gather for each journal in order to learn more about the journal’s stated mission, scope, history, open access policy, available impact metrics, and how this information reflected the journal’s stated values, audience, and intentions.

For each publication we used a variety of sources to gather the information for the identified categories. We used each journals’ website when possible, gathering data on how the journal itself made the information available to readers and authors. Websites were used to collect information for: publisher, open access policy, targeted audience, targeted authors, article-level impact measures/metrics, any indications of policy change regarding openness of content when available, and any other relevant notes or content we discovered. To collect narrative data on intended authors and audience, we reviewed and collected relevant statements from the journal’s stated aims and scopes, missions, and journal introductions. In some cases, we also looked up the journal introduction found in volume 1, issue 1: where editors often expanded on who the journal was for and what it hoped to achieve. We gathered journal-level metrics from Scopus (CiteScore), Google Scholar Metrics (H5-index), and Cabell’s Publishing (acceptance rate). Date of first issue was pulled from Ulrichsweb Global Series Directory.

The resulting dataset was compiled and analyzed in an Excel spreadsheet. Most variables were easily observed on the journals’ website, including open access, publisher, and impact metrics. To establish author and reader intent, statements were copied from the “about us” or “aims and scope” sections of the websites and coded according to the themes that emerged: Mentions multi/interdisciplinary contributors, emphasis on methodology, by/for students, mentions practitioners or community partners, discipline specific scholars, and targets new or emerging scholars. Peer debriefing, pulling content from websites during a confined time period, and researchers’ expertise in scholarly communications were employed to aid in establishing credibility ( Anfara et al., 2002, p. 30 ). For several categories including metrics and open access status, criteria were established based on the authors’ expert analysis of the journal website information.

Open Access Status

Overall, the set of journals is predominantly open – the most common model is diamond, with a variety of university or society publishers hosting these titles, with 25/34 titles operating under this model ( Figure 1 ). The remaining nine titles were all considered to be hybrid titles, and all had various conditions set for green OA for ‘closed’ articles, or those published articles where authors do not pay to make their article open.

Figure 1 Dominance of Open Access Models.

We did not attempt to record the range of institutions hosting diamond titles, but grouped them together as “university presses”, which accounted for 71% of titles ( Figure 2 ). Most of these university presses are mostly considered to be small or medium-sized university presses. A total of 8 titles, or 23% of those analyzed, are published through a for-profit publisher: four titles are published by Sage, three titles published by Taylor & Francis, and one title is published by Wiley. Sage, Taylor & Francis, and Wiley are all “top five” for-profit publishers in terms of market share and profit ( Larivière et al., 2015 ). In addition to the for-profit titles, one non-profit title is published by Project MUSE, a journal subscription package owned by Johns Hopkins with over 700 individual journals, and one is published by a professional society.

Figure 2 Dominance of Journal Publishers or Content Hosts.

Journal Level Metrics

The overall rate of article level metrics for the journals was low. The most common metric was Google Scholar’s H5-index, which was available for 13 or 38% of the journals, followed by Scopus / Elsevier’s CiteScore, which was available for 11 or 32% of the journals, and we found acceptance rates for eight or 24% of the journals ( Figure 3 ).

Figure 3 Availability of Journal-Level Metrics.

15 of the 34 journals, 44%, did not have any of these metrics. The 11 journals indexed in Scopus were associated with a total of 12 separate subject classifications, with education the only subject appearing for more than two journals. The breakdown of subjects and individual titles in each classification are shown in Table 1 .

Prevalence of Journal Categories for Journals Indexed in Scopus

Article Level Metrics

Publicly-available article level metrics were available for 50% of the journals, with views (29%) and downloads (26%) being the most common of the available metrics ( Figure 4 ). Two vendors that collate various sources of altmetrics, Altmetric and PlumX, were available for four (12%) and three (9%) of the journals respectively. Citations, available for seven (21%) of the journals, came from different sources, such as CrossRef. The lack of altmetrics standardization between journals appears to be a result of the variety of publishers, who use a diversity of open access platforms to host content, that likely drove the availability of these metrics. More careful analysis of hosting platforms would be needed to verify this observation, but was outside the scope of this study.

Figure 4 Availability of Article-Level Metrics.

Targeted Authors and Audience

For each journal included in the study, we pulled language from their website that indicated their intended contributors and audiences. While there is no standardized place for this information, “about us,” “aims and scope,” or mission/vision statements were common sources. In some cases, authorship criteria or peer review standards illuminated explicit intent to include community partners or practitioners as both contributors and readers. For example, the Journal of STEM Outreach describes itself as “a bridge between the STEM and education world,” demonstrating a desire for academic and practitioner readership, and the Interdisciplinary Journal of Partnership Studies seeks “interdisciplinary contributions from both scholars and practitioners worldwide,” indicating a desire for authors from many disciplines, community partners, with a global audience. Practitioners and community partners are more likely to be identified as readers than contributors, with 14 of the journals mentioning this group as either co-authors or potential contributors and 26 identifying them as beneficiaries of the content. Nine journals have at least a partial focus on advancing CBR methodology. Two of these, however, stand out in their commitment to including community partners through all aspects of the research process. Both Progress in Community Health Partnerships: Research Education and Action and Gateways: International Journal of Community Engagement and Research encourage the voices of community leaders as contributors and co-authors, and they also include them in their pool of peer reviewers. Two others from our sample – Collaborations: A Journal of Community-Based Research and Practice and Engage! Co-Created Knowledge join in this practice, for a total of four journals with peer reviewers outside of traditional academic institutions.

While the review sought to understand the roles faculty researchers and community partners played in the production of, and audience for, the research, other groups emerged as an intentional focus. Six of the journals target students, and five explicitly mentioned emerging scholars. In some cases, this took the form of a dedicated section of journal contents, while other journals instead encouraged co-authorship. This holistic approach breaks down not only town-gown barriers but acknowledges every member of the research and learning process of the value their voice brings to the table.

The journals selected for this study have OA practices that far exceed the norm for academic publishing. This shows consistency between the reciprocity values of CBR and the publishing practices of journals devoted to publishing the scholarly outputs of scholar-community relations. While overall values alignment is strong, a few exceptions stand out when comparing the target author and audience analysis to publishing practice. One of the journals that recommends the inclusion of community partners as authors publishes on a hybrid/green model. Similarly, 19% of journals that encourage community readership are hybrid rather than diamond.

If community engagement in authorship and readership cannot fully predict diamond open access status, it is worth considering other factors such as timing and publishing platforms. Severin, et al. note three distinct phases of OA, arcing from formation in the 1990s to transformation from the early 2000s to the mid-2010s, to stabilization running through the present ( 2020 ). The mean start date for the journals under review was 2004. Indeed, some older publications show a transition to OA in keeping with the times, having come to life under traditional subscription models. This can be seen with Journal of Extension ( 1963 ) where the inaugural volume was sponsored by a university consortium with the expectations that subscription fees would cover the cost moving forward, and Michigan Journal of Community Service Learning (1994) which initially funded itself through subscriber fees with content openly available after a six month embargo, shifting to a fully open access model with Volume 23 Number 1 in 2017 ( Ferguson & Carter Jr., 1963 ; Howard, 2017 ).

A bigger factor currently, however, seems to be the nature of the publisher. We saw near-perfect alignment between open access status and publishing model – all of the journals published with a for-profit publisher are hybrid/green publications, as well as Project MUSE, which is published by a university press, Johns Hopkins, but operates more like a traditional content publisher due to the size of Project MUSE’s journal portfolio. Thus, we classified Project MUSE separately as a non-profit publisher, distinct from the for-profit and other university press publications. Conversely, all titles published by a university press are diamond publications. These two results show that OA practices are influenced by both date of journal establishment as well as publisher.

Both journal-level and article-level metrics are somewhat limited for the set of journals used in this study. Ultimately, this limits the extent to which researchers publishing in these publications can demonstrate how their research publications are impacting scholarly and other intended audiences, however it does underline the importance for community-based researchers to demonstrate research impact in a way that is often distinct from other, more traditional approaches to impact, such as the use of journal-level metrics. While we see some impact frameworks for CBR and service-learning research, they largely bypass the role of metrics, as well as that of impact audiences. A robust set of metrics of measures allows researchers to more fully craft their impact story – which audiences benefited from their research, and in what context. For these researchers, their story will also include qualitative measures that are appropriate to their community partners – surveys and other assessment measures, as well as documentation of ways in which research results are appropriately shared with these partners. As discussed, this may include publication in fully open access venues with journals whose stated scope and audience are aligned as well as other ‘translated’ outputs that are tailored to individual community partners or other audiences such as practitioners, a broader community, or the general public.

We began our investigation looking for open access publishing as a way for the academy to meet its obligations of inclusiveness to their community partners. Reciprocity, however, also includes the need for researchers to meet their scholarly goals. While these publications are largely open to the community, they could improve their impact on the scholar’s career by enhancing available metrics, allowing the scholar to better make the case of the value of CBR scholarship.

It is tricky to draw definite conclusions from studying the target author and audience. While some journals do see community members as playing a more active role in the publication process, as discussed in the results, it is likely that other journals see community members primarily as readers rather than as contributors. In that context, the content of the journals may contain messaging more closely aligned with this audience than the journal’s website, which we hypothesize is catered more toward potential authors. Furthermore, it is likely that there are private formal or informal policies in place in journals related to how and to what degree community plays a role in the journal, making our findings incomplete. However, clearly communicating those intentions on the website would help increase transparency and give those community members greater understanding of the role they play.

Limitations

Defining the set of journals proved challenging – some of the journals on this list are more squarely focused on community-based research or service-learning, while others are larger journals who regularly publish research that cover these two topics, often within a disciplinary mindset, as Table 1 shows. However, focusing more narrowly on the most highly relevant journals, or expanding our set to include other journals whose scopes are inclusive of community-based research or service-learning perspectives, would likely have altered many of our findings: as we noticed with many of the non-diamond journals falling into the latter, larger category of journals. More work to define this set of journals is still needed, given the disparity we encountered in the lists we used to construct our set.

We were also limited in the information we were able to collect. For example, some journals offer authors the ability to log in to their journal’s system, at which point additional article-level metrics may have been made available. Policies or other types of information are likewise not always obvious or made publicly available on the journal’s website, or may not have been available at the time of our study as journal websites are updated. Our research took place over the course of a few months, so we were able to observe some “real-time” updates, such as a journal ceasing publication while still remaining on a recommended list, however, we did not have definitive historical access to shifting policies, changes in scope, etc. This limits our ability to measure the scope or rate of changes we observed in a more meaningful way than chance observation.

Recommendations and Future Research

Recommendations for journals, editorial boards, and journal editors.

Altmetrics can assist researchers in demonstrating the attention, engagement, and impact of their research. However, 50% of the titles examined do not seemingly offer any article-level metrics, which limits this impact demonstration. Journals should consider adopting practices that are beneficial for their authors, including a diamond OA model, and adoption and incorporation of a variety of metrics to assist its authors in demonstrating their impact.

It is unlikely, however, that Wiley, Sage, Taylor & Francis, and Project MUSE will adopt a diamond OA model in the near future. Project MUSE will debut a “Subscribe to Open” model of OA support for some of its titles beginning in 2025, but for the three for-profit publishers, it is likely that all three will continue relying on the hybrid publication model as their dominant revenue model unless external forces necessitate a shift to an alternate source of funding and support ( Project MUSE , n.d. ). Therefore, any possibility for many remaining non-diamond titles to adopt equitable OA models is uncertain as long as these publishers continue to own and operate these publications.

Journals could more carefully consider adopting practices that account for the role of the community in the journal process, particularly if they see a role for community members in the publication process. We likewise recommend that the role of community members be clearly articulated on the journal’s website, and ideally, also mentioned in their mission and scope.

Recommendations for Authors

Authors should consider the availability and impact of their research when deciding where to publish and prepare a dissemination strategy for both scholarly and community audiences that is timely and accessible. They should also ask about ways hybrid journals in this field can work toward diamond open access to reach and impact their stated or presumed broader, non-scholarly audiences; in the hopes that community pressure can bring about positive change for these journals and further align disciplinary values with publication outlets.

Recommendations for the Fields of Community-Based Research and Service-Learning

Models for measuring impact in these fields could be revised to explicitly endorse and prioritize open access publications as a high impact practice. For example, the Furco model rubric’s highest level of institutional achievement, “Sustained Institutionalization”, would be enhanced by inclusion of open access publications as a pathway toward reward for service-learning scholars beyond the more generic goal of “recognition”, which further disincentives these faculty to prioritize open access rather than “high impact” when choosing a publication outlet ( 1999 ).

Updated impact models could include distinct impact audiences, relevant measures, ways to demonstrate appropriate outreach to audiences, and evidence of how research is impacting these audiences, including publishing in a journal that actively considers the role of one or more of these groups in their publishing and/or readership. These impact audiences include the broader community: including specific subgroups such as practitioners, and community members, as well as the general public. This kind of approach to defining and outlining measures is already happening elsewhere in academia; two notable examples are the Becker Model, which defines five distinct areas of impact for biomedical research, and the ACRL Framework for Impactful Scholarship and Metrics, which outlines ways for academic librarians to document scholarly and practitioner impact of their scholarship ( Bernard Becker Medical Library, 2018 ; Borchardt et al., 2020 ). In addition to establishing impact frameworks, researchers may also consider using the newly-created Researcher Impact Framework, which is designed to support researchers in defining and evaluating impact audiences ( De Moura Rocha Lima & Bowman, 2022 ). A dissemination strategy and gathering of relevant metrics can then be incorporated into the full description of scholarly and non-scholarly impact of the research.

Recommendations for Evaluators of Community-Based and Service-Learning Research

Further support for this approach to impact documentation can and should be added to PRT guidance for institutions that prioritize community-based research or service-learning. This strategy can likewise be adopted by grant funders to assist in the evaluation of grant proposals and resulting impact of funded research. Professional organizations and societies with close ties to community-based research and service-learning should consider describing and endorsing a full range of measures and metrics to demonstrate impact of this research.

Further Research

We see several avenues for further research, such as working with journals in our list that have ceased open access publication in order to examine and even help resolve sustainability issues. Alternately, working with editors of hybrid journal publications to better understand the factors that may help encourage a move to a fully open access model, in partnership with individuals associated with journals who have already made such a move. Surveying community-based research scholars would help to better clarify the role and value of open access and different metrics for these scholars when making strategic publication decisions, and how these decisions may differ based on type of appointment, such as tenure-track vs. non-tenure-track. On the other hand, surveying community members would help to understand how they interact with journal content, and where they see gaps in communication, partnership, or availability of research, and if there are differences in opinion between different types of community members. We hope that this publication will encourage creation of a more holistic impact model for community-based research and service-learning that acknowledges open access publications as a form of community impact and establishes community impact as a value and goal for research and researchers operating under a scholarly impact-dominant model of evaluation. Finally, we see an avenue for future research that elucidates the specific information needs of different population groups such as practitioners that are commonly seen as community partners, in order to better understand when and how information can be provided to these partners that fully satisfy their respective needs.

Community-based research and service-learning aim to bring research out of the ivory tower and positively impact community partners. Making research publications openly available for use by community partners, or specific subgroups of partners such as practitioners, has not been commonly identified as a best practice or assessment standard for evaluating the success of these research partnerships, and may constitute a lack of understanding between the academic and community researchers. This study determined that, while the majority of journals that publish research in these fields are fully open access, there is room for improvement to fully integrate and incentivize open access publications for academic researchers. These researchers would also benefit from being able to access robust altmetrics in order to demonstrate non-scholarly engagement with their research, and this effort could also be meaningfully supported through revised evaluation guidelines. Researchers in this field could consider discussing open access support for publications that are not already fully open access in order to try to fully align these journals’ values with their stated non-scholarly audiences.

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Willinsky, J., & Rusk, M. (2019). If research libraries and funders finance open access: Moving beyond subscriptions and APCs . College & Research Libraries.   http://doi.org/10.5860/crl.80.3.340

Wirsching, H., Penny, D., Lucraft, M., Franssen, J., Vanderfeesten, M., van Wesenbeeck, A., & Jansen, D. (2020). Open for all: Exploring the reach of open access content to non-academic audiences .   http://doi.org/10.5281/zenodo.4143313

Zhu, Y. (2017). Who support open access publishing? Gender, discipline, seniority and other factors associated with academics’ OA practice. Scientometrics , 111(2), 557–579.   http://doi.org/10.1007/s11192-017-2316-z

Olivia Ivey , MSSW, MLS, is an associate librarian supporting research, teaching, and learning in American University’s School of Public Affairs. She has previously worked in the law library and the U.S. Department of Labor. Prior to her library career, she worked as a program director at a senior center in New York City. Her research interests center on the practical application of information literacy, including research skills and implementation in community settings.

Rachel Borchardt , MLIS, is the Scholarly Communications Librarian at American University in Washington, DC. Rachel previously worked as the Science Librarian at American, as well as the Biology and Neuroscience and Behavior Biology Librarian at Emory University. In her current job, Rachel supports open access, open education resources, and research impact initiatives through the library. Her scholarly interests concern equitable models for research production and evaluation, including diverse models for measuring and rewarding non-scholarly impact and translated research outputs.

Journals Included for Review

Action Research Journal

Anthropology & Education Quarterly

Collaborations: A Journal of Community-Based Research and Practice

Community Health Equity Research & Policy

Engage! Co-Created Knowledge

Engaged Scholar Journal: Community Engaged Research, Teaching and Learning

Ethnography & Education

Gateways: International Journal of Community Engagement and Research

Interdisciplinary Journal of Partnership Studies

International Journal of Service Learning in Engineering

International Journal of Research on Service-Learning and Community Engagement (IJRSLCE)

International Journal of Science Education, Part B: Communication & Public Engagement

International Journal of Service-Learning in Engineering and Social Entrepreneurship

Journal of Community Engagement & Scholarship

Journal of Community Engagement and Higher Education

Journal of Community Informatics

Journal of Community Practice

Journal of Deliberative Democracy

Journal of Experiential Education

Journal of Extension

Journal of Health Sciences and Extension

Journal of Higher Education Outreach and Engagement

Journal of Participatory Research Methods

Journal of STEM Outreach

Michigan Journal of Community Service Learning

Progress in Community Health Partnerships: Research, Education, and Action

Public: A Journal of Imagining America

Purdue Journal of Service-Learning and International Engagement

Qualitative Inquiry

Reflections: A Journal of Community-Engaged Writing and Rhetoric

Research for All

Science Education & Civic Engagement

The Journal of Service-Learning in Higher Education

Undergraduate Journal of Service-Learning and Community-Based Research

Harvard-Style Citation

Ivey, O & Borchardt, R. (2024) 'Open access for community partners, impactful outputs for scholars: Leveraging scholarly communication movements to enhance reciprocity in community based research', Michigan Journal of Community Service Learning . 30(1) doi: 10.3998/mjcsl.3682

Show: Vancouver Citation Style | APA Citation Style

Vancouver-Style Citation

Ivey, O & Borchardt, R. Open access for community partners, impactful outputs for scholars: Leveraging scholarly communication movements to enhance reciprocity in community based research. Michigan Journal of Community Service Learning. 2024 4; 30(1) doi: 10.3998/mjcsl.3682

Show: Harvard Citation Style | APA Citation Style

APA-Style Citation

Ivey, O & Borchardt, R. (2024, 4 26). Open access for community partners, impactful outputs for scholars: Leveraging scholarly communication movements to enhance reciprocity in community based research. Michigan Journal of Community Service Learning 30(1) doi: 10.3998/mjcsl.3682

Show: Harvard Citation Style | {% trans 'Vancouver Citation Style' %}

Non Specialist Summary

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Advancing social justice, promoting decent work ILO is a specialized agency of the United Nations

Occupational accidents and diseases lead to devastating impacts on workers, enterprises and entire communities and economies. Despite many improvements, the prevention of accidents and work-related diseases continues to have a considerable importance on a global scale.

Climate change and safety and health at work

World Day for Safety and Health at Work

News and articles

OSH and climate change

Climate change creates a ‘cocktail’ of serious health hazards for 70 per cent of the world’s workers

Media Advisory

New ILO report to reveal dangerous and long-lasting effects of climate change on workers’ health and safety

Areas of Work

• Chemical Hazards  
• Biological Hazards  
• Psychosocial Factors 
• Physical Hazards  
• Learn more 
• Global Strategy on Occupational Safety and Health 2024-2030 and plan of action for its implementation  
• National OSH Profiles, Policies and Programmes (coming soon)
• Labour administration and Inspection
• International Classification of Radiographs of Pneumoconioses  
• ILO List of Occupational Diseases (revised 2010) 
• Diagnostic and exposure criteria for occupational diseases - Guidance notes for diagnosis and prevention of the diseases in the ILO List of Occupational Diseases (revised 2010)  
• Gender 
• Young Workers
• Economic Aspects  

Development Cooperation

Safety + Health for All

The Programme mobilizes development cooperation resources to improve the safety and health of workers worldwide.

• Sub programme - The Vision Zero Fund

Social safety nets

ILO/Japan Fund for Building Social Safety Nets in Asia and the Pacific (SSN Fund)

Improving Workers' Rights in Rural Sectors of the Indo-Pacific with a Focus on Women

Normative instruments

Occupational Safety and Health Standards and Instruments

• The Occupational Safety and Health Convention, 1981 (No. 155)
• The Promotional Framework for Occupational Safety and Health Convention, 2006 (No. 187)
• Other Conventions and Recommendations
• Codes of practice (link TBC)

Publications

Overview of the key findings of the report

Report at a glance: Ensuring safety and health at work in a changing climate

Global Report

Ensuring safety and health at work in a changing climate

International labour standards

Pakistan’s tanning and leather industries : An overview of trends and labour and environmental conditions

• INTEROSH - ILO Database on Occupational Safety and Health Agencies, Institutions and Organizations around the world
• Encyclopaedia of Occupational Health and Safety
• LEGOSH - Global database on occupational safety and health legislation
• CISDOC - Archived bibliographic database
• International Chemical Safety Cards (ICSCs)

Training Courses

The International Training Centre of the ILO (ITC-Turin) provides a variety of free and paid courses online and in-person courses related to occupational safety and health.