An investigation of the quality of breast cancer information provided on the internet by voluntary organisations in Great Britain

The Role of Social Media and Breast Cancer: How Does It Impact Patients?

Introduction

Patients are increasingly turning to other sources for their health information. Social media has become mainstream, and the easy access to online communities, health professionals, and shared experiences of other patients has made social media a place where many patients turn to.

Methods

In this qualitative report, 2 patients who have had breast cancer describe the reasons why they use social media, what they perceive the advantages and disadvantages are, and what the impact of social media has been through their cancer treatment and beyond.

Results

The reasons why patients turn to social media are varied. These can include information gathering, peer support, shared experiences, and advocacy. There appear to be advantages and disadvantages; however, overall, the impact seems to be a positive one when used judiciously.

Discussion

It is clear that social media has a role to play in healthcare, whether by providing meaningful social connections, delivery of information, or psychological support. Healthcare professionals perhaps should consider the importance of social media in their practice.

The Impact of Smokers' Information-Seeking Behavior on Smoking Cessation

INTRODUCTION

Smoking has a harmful effect on human body and is rated to be the primary cause of preventable premature disease and death worldwide, while it is responsible for at least 25 life-threatening diseases.

METHODS

An empirical investigation has been carried out through the development and distribution of a structured questionnaire. The sample of empirical investigation consisted of 150 smokers aged over 18 years (response rate 85.7%).

ANALYSIS

Descriptive analysis and correlation control of questionnaire variables are used to report the findings of the study.

RESULTS

Information about passive smoking, smoking consequences, and current therapies in quitting smoking were rated highest among smoke-related information needs. The main sources of information were family/relatives/friends/colleagues and Internet and less important factors were formal sources like medical staff, health professionals, and primary health care services. Ε-health literacy is correlated with higher self-efficacy, positive intention to quit smoking, and better educational level while is negatively correlated with increasing age.

CONCLUSIONS

The creation of specialized programs and upgraded information services is fundamental for successful smoking cessation. These programs and services should be addressed to all socioeconomic groups and combined with the improvement in smokers' e-health literacy will contribute to a higher self-efficacy and finally drive them to quit smoking.

Evaluation of the quality and accuracy of breast cancer knowledge among persian language websites

INTRODUCTION

The internet has become a powerful worldwide information source that revolutionized access to knowledge, especially in the fields of health and medicine (health knowledge). Therefore, providing high-quality, accurate, reliable, and relevant information on dependable websites is a possible way of providing the patient with needed information and, thus, achieving the benefits of informed patients regarding outcomes. This study aimed to evaluate the quality and accuracy of breast cancer knowledge among Persian language websites.

METHODS

Two search engines were searched in the Persian language about breast cancer. The first 30 websites were selected for further evaluation based on the completeness, correctness, transparency, and accessibility of health knowledge. The DISCERN instrument was used to assess the quality of the Persian language websites on this issue.

RESULTS

Among the 30 websites, about 23% of websites provide completely correct information and about 30% provide mostly correct information. Sixty percent of the websites provided author information, and 46% of them had a healthcare professional or expert as the author. Sixty percent of the websites stated the creation date on the pages, while 40% of them did not provide any health knowledge. Scores on accessibility were always easy for most of the websites. Based on the quality rating system of DISCERN, about 60% of the websites were presented as very poor.

CONCLUSION

Website rankings enable healthcare professionals to identify and signpost patients to reliable up-to-date websites to ensure that patients receive high-quality knowledge. This review has provided evidence of inadequate and inaccurate health knowledge about breast cancer on the Persian language websites. This issue requires further investigation to understand the barriers and solutions available to provide reliable information about breast cancer and how this information affects the patient's outcomes.

TRIAL REGISTRATION

The project was found to be in accordance with the ethical principles and the national norms and standards for conducting research in Iran with the approval ID and date of IR.TUMS.IKHC.REC.1399.379 and 2021-01-01 respectively, and is registered with research project number 49890 in the Vice Chancellor for Research and Technology Development of Tehran University of Medical Sciences, Tehran, Iran. URL: https://ethics.

RESEARCH

ac.ir/EthicsProposalViewEn.php?id=170978 .

Designing a Patient-Friendly Website for Newly Diagnosed Cancer Patients with the Participatory Health Research Approach

High-quality and user-friendly patient information material (PIM) is essential for understanding and accepting a new care programme. When optimising the PIM of the integrated, cross-sectoral psycho-oncological (isPO) care programme, the design of the fifth element of the patient information strategy-the patient-friendly website-was still pending. In this paper, the iterative design process of the patient-friendly isPO website is described. We applied the participatory health research (PHR) approach to enable high levels of participation of its respective end-users (e.g., cancer survivors), service providers, and experts. The design included six steps: (1) initiation, (2) planning, (3) initial idea exploration, (4) creation of a first working version, (5) three optimisation loops, and (6) dissemination. An exploratory mixed-methods design has been used. Qualitative data collection included document analysis, interviews, and participatory action research (PAR) loops with focus groups. Finally, the quality of the newly designed website was quantitatively assessed with the UPIM-Check, a user-friendly instrument for assessing and optimising PIM. The PHR approach was indispensable for the design of our needs-oriented, patient-friendly website. Participants' high levels of participation strongly contributed to the products' quality. The final descriptive statistical evaluation shows that the final website was rated very good on average by its end-users.

Explaining the concept of maternal health information verification and assessment during pregnancy: a qualitative study

Background

Pregnant women use information sources for their own health and health of their children. However, despite the importance of trusting the information sources, pregnant women may not have the ability to verify the maternal health information, which could have negative consequences for their health. The purpose of this study was to explain the concept of maternal health information verification and assessment in pregnant women according to their experiences and perception.

Methods

This is a qualitative study that was conducted in 2017 in Tehran, Iran. The participants in this study consisted of 19 pregnant women who were selected by purposeful sampling. To collect data, semi-structured, in-depth and face to face interviews were conducted with participants and continued until saturation of data. Conventional content analysis method was used to analyze the data and to identify concepts and synthesize them into general classes. MAXQDA software version 10 was used to manage the data.

Results

In the process of data analysis, the concept of verification and assessment of maternal health information in pregnancy was explained in two main categories, including “Validity of information resources” and “Reliance on information resources.” The category of Validity of information resources had two subcategories of valid and invalid sources, and the main category of Reliance on information resources had two subcategories of indicators of assurance, and confusion and trying to obtain assurance.

Conclusion

The results indicated that pregnant women used various sources and indicators, as well as different evaluation methods to obtain information and verify it, especially when they are confused. Thus, health authorities and healthcare professionals should provide appropriate programs to familiarize mothers with credible sources, train pregnant women on standards and practices for judging the accuracy of information, and create a safe margin of information.

Quality of Novel Coronavirus Related Health Information over the Internet: An Evaluation Study

BACKGROUND

The novel coronavirus disease (COVID-19) has spread globally from its epicenter in Hubei, China, and was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The most popular search engine worldwide is Google, and since March 2020, COVID-19 has been a global trending search term. Misinformation related to COVID-19 from these searches is a problem, and hence, it is of high importance to assess the quality of health information over the internet related to COVID-19. The objective of our study is to examine the quality of COVID-19 related health information over the internet using the DISCERN tool.

METHODS

The keywords included in assessment of COVID-19 related information using Google's search engine were "Coronavirus," "Coronavirus causes," "Coronavirus diagnosis," "Coronavirus prevention," and "Coronavirus management". The first 20 websites from each search term were gathered to generate a list of 100 URLs. Duplicate sites were excluded from this search, allowing analysis of unique sites only. Additional exclusion criteria included scientific journals, nonoperational links, nonfunctional websites (where the page was not loading, was not found, or was inactive), and websites in languages other than English. This resulted in a unique list of 48 websites. Four independent raters evaluated the websites using a 16-item DISCERN tool to assess the quality of novel coronavirus related information available on the internet. The interrater reliability agreement was calculated using the intracluster correlation coefficient.

RESULTS

Results showed variation in how the raters assigned scores to different website categories. The .com websites received the lowest scores. Results showed that .edu and .org website category sites were excellent in communicating coronavirus related health information; however, they received lower scores for treatment effect and treatment choices.

CONCLUSION

This study highlights the gaps in the quality of information that is available on the websites related to COVID-19 and study emphasizes the need for verified websites that provide evidence-based health information related to the novel coronavirus pandemic.

Quality of Online Information Regarding Cervical Cancer

Introduction

The internet is an important source of health information, and yet the quality of the resources that patients’ access can vary widely. Previous research has evaluated the quality of information for several types of cancer; however, this has not yet been done for cervical cancer beyond treatment information. The goal of this project was to systematically evaluate the quality of resources for cervical cancer information available against a range of metrics, including content breadth and accuracy, readability, and accountability. 

Methods

An internet search was performed using the term “cervical cancer” using Google and two meta-search engines, Dogpile and Yippy. The top-100 websites returned across all three engines were evaluated using a validated structured rating tool. 

Results

Only 32% of websites disclosed their author and only 38% used citations, while 64% of websites had been updated in the last two years. Readability was at university-level or higher for 19% of websites, and high-school level for 78%. Coverage was highest for etiology and risk factors (93% of websites) and prevention strategies such as pap smears and vaccines (92%); coverage was lowest for prognosis (49%), staging (52%), side effects (47%), and follow-up (25%). When a topic was covered the information was predominantly accurate, and few websites had inaccurate information. At least one social-media platform was linked to by 79% of websites. 

Conclusions

This project highlights the strengths and limitations in the quality of the top-100 informational cervical cancer websites. These findings can inform the dialogue between health care providers and patients around selecting and evaluating information resources. These findings can also inform specific improvements to make online resources for cervical cancer more accessible, comprehensive, and relevant to patients.

Evaluation Breast Cancer Information on The Internet in Arabic

Nowadays, medical information regarding various diseases and disorders is available online. The Internet has become the first choice for the patient when it comes to gathering detailed information about a disease or problem. Therefore, in view of this frequent occurrence, the information that is provided online needs to be accurate; providing comprehensive facts, transparency, and quality. A study was carried out to determine the accuracy of information related to breast cancer on various websites. Websites which share information online about breast cancer, in the Arabic language, were selected. The quality of the websites was to be evaluated; however, there is no standard method for evaluating the quality of health websites. Hence, a rating form was developed for this study, to determine the completeness and transparency of a specific number of websites using three popular search engines. A 16-item questionnaire was prepared and validated to determine the quality of individual websites in addition to using the DISCERN instrument for assessing consumer health information. Most of the websites (approximately 47%) were deemed to be commercial in nature. Thirty-three percent were developed by non-profit organizations. They disseminated information concerning the risk factors (93%), screening, mammography (93%), surgical treatment (93%), chemotherapy (89%), radiotherapy (93%), and complementary medicine (0%) surrounding the treatment of breast cancer. About 67% of the websites were estimated to give completely correct information. Incidentally, only five websites had a healthcare professional or expert as the author, while nine of them had no author. Although numerous breast cancer-related websites exist, most do a poor job in providing Arabic-speaking women with comprehensive information about breast cancer surgery. Providing easily-accessible, high-quality online information has the potential to significantly improve patients' experiences.

Online Information-Seeking About Potential Breast Cancer Symptoms: Capturing Online Behavior With an Internet Browsing Tracking Tool

Background

People engage in health information-seeking online when experiencing unusual or unfamiliar bodily changes. It is not well understood how people consult the internet for health information after the onset of unfamiliar symptoms and before receiving a potential diagnosis and how online information-seeking can help people appraise their symptoms. This lack of evidence may be partly due to methodological limitations in capturing in real time the online information-seeking process.

Objective

We explored women’s symptom attribution and online health information-seeking in response to a hypothetical and unfamiliar breast change suggestive of cancer (nipple rash). We also aimed to establish the feasibility of capturing in real time the online information-seeking process with a tool designed to track participant online searches and visited websites, the Vizzata browser tracker.

Methods

An online survey was completed by 56 cancer-free women (mean age 60.34 [SD 7.73] years) responding to a scenario asking them to imagine noticing a red scaly rash on the nipple. Participants were asked to make symptom attributions when presented with the scenario (T1) and again after seeking information online (T2). The online tracking tool, embedded in the survey, was used to capture in real time participant search terms and accessed websites.

Results

The tracking tool captured the search terms and accessed websites of most of the participants (46/56, 82%). For the rest (10/56, 18%), there was evidence of engagement in online information-seeking (eg, medical terminology and cancer attribution at T2) despite their searching activity not being recorded. A total of 25 participants considered cancer as a potential cause for the nipple rash at T1, yet only one of these used cancer as a search term. Most participants (40/46, 87%) used rash-related search terms, particularly nipple rash and rash on nipple. The majority (41/46, 89%) accessed websites containing breast cancer information, with the National Health Service webpage “Paget disease of the nipple” being the most visited one. At T2, after engaging in the internet search task, more participants attributed the nipple rash to breast cancer than at T1 (37/46, 66% vs 25/46, 45%), although a small number of participants (6/46) changed from making a cancer attribution at T1 to a noncancer one at T2.

Conclusions

Making a cancer attribution for an unfamiliar breast change did not necessarily translate into cancer-termed searches. Equally, not all internet searches led to a cancer attribution. The findings suggest that online information-seeking may not necessarily help women who experience unfamiliar breast cancer symptoms understand their condition. Despite some technical issues, this study showed that it is feasible to use an online browser tracking tool to capture in real time information-seeking about unfamiliar symptoms.

Online health information and public knowledge, attitudes, and behaviours regarding antibiotics in the UK: Multiple regression analysis of Wellcome Monitor and Eurobarometer Data

Background

Antimicrobial resistance is a global public health problem with some socially patterned drivers. The objective of the study was to investigate associations between use of and trust in the Internet as a source of health-related information and the public’s knowledge, attitudes, and behaviours regarding antibiotics.

Methods

Two representative cross-sectional surveys (the 2015 Wellcome Monitor (n = 1524) and UK segment (n = 1330) of the 2016 Eurobarometer 85.1) covering knowledge about antibiotics and antibiotic consumption were analysed. Knowledge, attitude, and behaviour variables were analysed using regression in relation to demographic characteristics and use and trust in the Internet as a source of information.

Results

The key findings of the analysis are that both use of the Internet as a source of medical research information (variable from the Wellcome Monitor) and trust in the Internet as a source of information about antibiotics (variable from the Eurobarometer) were independently and positively associated with knowledge, attitude, and behaviour regarding antibiotics. Additionally, knowledge about antibiotics was positively associated with behaviour with antibiotics (Wellcome Monitor) and attitude towards finishing antibiotic prescriptions (Eurobarometer). Higher levels of education were associated with better knowledge about antibiotics in both datasets. Older age was positively associated with behaviour and attitude regarding antibiotic consumption.

Conclusions

The Internet is a resource for disseminating quality health information that has the potential to improve stewardship of antibiotics in the community. This study suggests that members of the UK public that use the Internet as a source of health-related information are more likely to be better informed about, and be more responsible with, antibiotics. This mode of information dissemination should be capitalised on to improve antimicrobial stewardship, and further research should examine what the most effective online information sources are in the UK and to what extent their association with behaviour is causal.

An evaluation of online information available for women with breast implants aged 47-73 who have been invited to attend the NHS Breast Screening Programme

INTRODUCTION

The Internet has become an innovative instrument older adults utilise to obtain health-related information. Poor quality health information may cause harm to individuals. If not accessible, or at a level comprehended by target audiences, this does not support the development of their knowledge and subsequently hinders patient's ability to make informed-decisions.

AIM

evaluate quality, readability, accessibility and usability of online information for women with breast implants invited to attend the NHSBSP.

METHODS

Eight websites were evaluated for quality and accessibility/usability using uniquely developed evaluation tools. The 'three-click' rule was used to assess usability and SMOG tool to measure readability. Quality and accessibility/usability scores were combined to give an overall score, which were then converted into percentages. A percentage categorisation system ranked the percentage scores from poor to excellent. Readability scores were represented in number of years of education required to read/understand text.

RESULTS

Average quality score = 14 (66.6%). Average accessibility/usability score = 9 (56.6%). 7 websites achieved an overall score in the poor percentage category (below 75%). Over 50% of websites had readability levels higher than the recommended level for online health information. 100% were above the UK average reading age.

CONCLUSION

Websites providing information on breast screening with implants are not easily accessible, are of poor quality and too difficult to be read by most people. The quality, readability and accessibility of each website's content should be improved to help support women make informed decisions relating-to breast-screening attendance, increase their understanding and lessen their anxiety.

General Characteristics and Quality of Stroke-Related Online Information – A Cross-Sectional Assessment of the Romanian and Hungarian Websites

Background: The quality of online health-related information may affect users’ understanding and medical decision-making with dramatic impact, particularly in case of stroke. Objective: The objective of this study was to assess the quality of information about stroke on the Romanian and Hungarian websites in terms of completeness and accuracy. Methods: The research was designed as an observational cross-sectional study. The sample included 25 Romanian and 25 Hungarian websites presenting information about stroke for the general public. General characteristics such as website ownership, main goal, website genre and medical approach were identified by the evaluators using a predetermined set of common instructions. The completeness and accuracy of the information were assessed by two independent assessors against a quality benchmark. Results: Overall, most of the websites were owned by private commercial companies (42%), had educational goal (66%), were designed as medical web-portals (46%) and had a conventional medicine approach (72%). Mean completeness score was 5.6 points (SD± 1.9) for Romanian sites and 4.1 points (SD ± 2.4) for Hungarian sites (p = 0.017). Mean accuracy score was 6.2 points (SD ± 1.1) for Romanian sites and 7.0 points (SD ± 0.7) for Hungarian sites (p = 0.02). Conclusions: The information about stroke on the Romanian and Hungarian websites had poor quality. Although we found statistically significant differences between the quality scores of the two language sub-samples and two site characteristics associated with significantly higher quality, the practical relevance of these findings for online health information seekers should be interpreted with caution.

A Comprehensive Analysis of How Environmental Risks of Breast Cancer are Portrayed on the Internet

BACKGROUND

Effective online communication about the environmental risk factors of breast cancer is essential because of the multitude of environmental exposures and debate regarding the conclusiveness of scientific evidence.

PURPOSE

The aim of this study was to assess the content, readability, and cultural sensitivity of online resources focused on the environmental risks factors of breast cancer.

METHODS

A purposive sample of webpages focused on environmental risk factors of breast cancer was obtained through a Google search using 17 search terms. Using nonparametric statistics, we assessed the content, readability, and cultural appropriateness of 235 webpages.

RESULTS

Eighty-two percent of webpages referred to research studies in their content. For the majority of sites, readability was at a high-school reading grade level. Webpages were not explicitly intended for specific racial/ethnic groups.

DISCUSSION

Technical language and non-culturally specific messages may hinder users' attention to and comprehension of online breast cancer information. Additional research is needed to examine in-depth the accuracy of this online content.

TRANSLATION TO HEALTH EDUCATION PRACTICE

Findings suggest that collaborations between scientists, health educators, website designers/media professionals, and the community will be critical to the delivery of accurate, up-to-date, plain-language, and culturally sensitive information about breast cancer and the environment.

Quality of Breast Cancer Information on the Internet by African Organizations: An Appraisal

Objective. The aim of this study was to appraise the quality of information on BC available at websites run by organizations in Africa. Methods. Three searches were conducted using Google search engine to generate a list of websites. The identified websites were assessed using European Commission (EC) quality criteria for health-related websites, which comprises different assessment areas including, completeness, transparency and honesty, authority, privacy and data protection, updating of information, accountability, and accessibility. Results. Thirteen (13) websites were included in the evaluation. Majority of the websites evaluated had low scores on the completeness and transparency of their websites. Scores on accessibility were however moderate and high for most of the websites. Breast cancer-specific organizations provided the highest quality information, particularly in terms of completeness. The overall lowest and highest quality scores were 9 and 43 out of 63, respectively, and 77% of the included websites scored less than 50% of the total quality score. Conclusion. This review has provided evidence of inadequate and inaccurate BC information provided by some cancer organizations in Africa. Considerable effort is required to make BC information on the Internet a valuable and up-to-date source for both professionals and patients.

The Quality of Online Health-Related Information – an Emergent Consumer Health Issue

The Internet has become one of the main means of communication used by people who search for health-related information. The quality of online health-related information affects the users’ knowledge, their attitude, and their risk or health behaviour in complex ways and influences a substantial number of users in their decisions regarding diagnostic and treatment procedures.

The aim of this review is to explore the benefits and risks associated with using the Internet as a source of health-related information; the relationship between the quality of the health-related information available on the Internet and the potential risks; the multiple conceptual components of the quality of health-related information; the evaluation criteria for quality health-related information; and the main approaches and initiatives that have been implemented worldwide to help improve users’ access to high-quality health-related information.

An Initial Look at the Associations of a Variety of Health-Related Online Activities With Cancer Fatalism

It has been an important public health goal to remove cancer fatalism because of its negative influence on both cancer screening and preventive behaviors. The present study examines roles of the Internet, as an emerging, crucial source of cancer information, in the effect of education on cancer fatalism. Based on our secondary analysis of a nationally representative survey (i.e., Health Information National Trends Survey 4 Cycle 1), we found that people with low levels of education are less likely than their more educated counterparts to engage in online health information seeking that is negatively linked to fatalistic beliefs about cancer prevention. In addition, the effect of education on online health information seeking was detected only among people who trust online health information. The implications of these findings for cancer control and for research on the digital divide and communication inequalities are discussed.

Seeking health- and nutrition-related information on the Internet in a large population of French adults: results of the NutriNet-Santé study

The Internet has become a major source of health and nutrition information. Little is known about the type of consulted websites (institutional v. non-institutional) and the tendency to discuss with a healthcare professional (HCP) the information found on the Internet. The aim of this cross-sectional study was to investigate health- and nutrition-related Internet use in a large French population-based study. Data were collected in 2013 using self-administered, web-based questionnaires from 42 113 participants of the NutriNet-Santé study (mean age=51·2 years, 76 % women). Unconditional multivariate logistic regression analyses and χ 2 tests were used for comparisons. In total, 85·1 % of the subjects used the Internet to search for health and/or nutrition information, and 23·6 % used the Internet to read or post messages on health/nutrition forums. Only 16·0 % discussed with a HCP the information found online. This proportion was lower in subjects with lower educational level (OR 0·77; 95 % CI 0·72, 0·82) and lower computer skills (OR 0·70; 95 % CI 0·65, 0·76). In total, 8038 health/nutrition websites were cited, with institutional websites representing only 12·9 % of that number. Only one institutional website was present in the top 10. Older subjects (OR 1·49; 95 % CI 1·28-1·74), those with lower educational level (OR 2·08; 95 % CI 1·75, 2·50) and lower nutritional knowledge (OR 1·33; 1·12, 1·59) were more likely to cite non-institutional websites. This large population-based study showed that institutional websites were infrequently accessed and that a few participants discussed the information found online with their HCP. This particular trend was especially visible among individuals who were more vulnerable regarding misleading information. This supports the need to increase awareness of high-quality websites providing reliable health/nutrition information.

Online Patient Education for Chronic Disease Management: Consumer Perspectives

Patient education plays an important role in chronic disease management. The aim of this study is to identify patients' preferences in regard to the design features of effective online patient education (OPE) and the benefits. A review of the existing literature was conducted in order to identify the benefits of OPE and its essential design features. These design features were empirically tested by conducting survey with patients and caregivers. Reliability analysis, construct validity and regression analysis were performed for data analysis. The results identified patient-tailored information, interactivity, content credibility, clear presentation of content, use of multimedia and interpretability as the essential design features of online patient education websites for chronic disease management.

'You don't know which bits to believe': qualitative study exploring carers' experiences of seeking information on the internet about childhood eczema

OBJECTIVE

We sought to explore parents and carers' experiences of searching for information about childhood eczema on the internet.

DESIGN

A qualitative interview study was carried out among carers of children aged 5 years or less with a recorded diagnosis of eczema. The main focus of the study was to explore carers' beliefs and understandings around eczema and its treatment. As part of this, we explored experiences of formal and informal information seeking about childhood eczema. Transcripts of interviews were analysed thematically.

SETTING

Participants were recruited from six general practices in South West England.

PARTICIPANTS

Interviews were carried out with 31 parents from 28 families.

RESULTS

Experiences of searching for eczema information on the internet varied widely. A few interviewees were able to navigate through the internet and find the specific information they were looking for (for instance about treatments their child had been prescribed), but more found searching for eczema information online to be a bewildering experience. Some could find no information of relevance to them, whereas others found the volume of different information sources overwhelming. Some said that they were unsure how to evaluate online information or that they were wary of commercial interests behind some information sources. Interviewees said that they would welcome more signposting towards high quality information from their healthcare providers.

CONCLUSIONS

We found very mixed experiences of seeking eczema information on the internet; but many participants in this study found this to be frustrating and confusing. Healthcare professionals and healthcare systems have a role to play in helping people with long-term health conditions and their carers find reliable online information to support them with self-care.

Use of the internet as a health information resource among French young adults: results from a nationally representative survey

BACKGROUND

The Internet is one of the main resources of health information especially for young adults, but website content is not always trustworthy or validated. Little is known about this specific population and the importance of online health searches for use and impact. It is fundamental to assess behaviors and attitudes of young people looking for online health-related information and their level of trust in such information.

OBJECTIVE

The objective is to describe the characteristics of Internet users aged 15-30 years who use the Web as a health information resource and their trust in it, and to define the context and the effect of such use on French young adults' behavior in relation to their medical consultations.

METHODS

We used the French Health Barometer 2010, a nationally representative survey of 27,653 individuals that investigates population health behaviors and concerns. Multivariate logistic regressions were performed using a subsample of 1052 young adults aged 15-30 years to estimate associations between demographics, socioeconomic, and health status and (1) the use of the Internet to search for health information, and (2) its impact on health behaviors and the physician-patient relationship.

RESULTS

In 2010, 48.5% (474/977) of Web users aged 15-30 years used the Internet for health purposes. Those who did not use the Internet for health purposes reported being informed enough by other sources (75.0%, 377/503), stated they preferred seeing a doctor (74.1%, 373/503) or did not trust the information on the Internet (67.2%, 338/503). However, approximately 80% (371/474) of young online health seekers considered the information found online reliable. Women (P<.001) and people with higher sociocultural positions (OR 0.5, 95% CI 0.3-0.9 and OR 0.4, 95% CI 0.2-0.7 for employees and manual workers, respectively, vs individuals with executive or manager positions) were more likely to use the Internet for health purposes. For a subsample of women only, online health seeking was more likely among those having a child (OR 1.8, 95% CI 1.1-2.7) and experiencing psychological distress (OR 2.0, 95% CI 1.0-4.0). Finally, for online health seekers aged 15-30 years, one-third (33.3%, 157/474) reported they changed their health behaviors (eg, frequency of medical consultations, way of taking care of one's own health) because of their online searches. Different factors were associated with different outcomes of change, but psychological distress, poor quality of life, and low income were the most common.

CONCLUSIONS

The Internet is a useful tool to spread health information and prevention campaigns, especially to target young adults. Young adults trust online information and consider the Internet as a valid source of health advice. Health agencies should ensure the improvement of online health information quality and the creation of health-related websites and programs dedicated to young adults.

Do cancer-specific websites meet patient's information needs?

OBJECTIVE

To evaluate commonly used cancer websites' information provision, we developed and applied an Information Comprehensiveness Tool to breast and prostate cancer websites.

METHODS

We first collated questions from a systematic literature review on patient information needs. We then classified the questions in terms of spectrum of care, theme, and nature of question. "Breast cancer" and "prostate cancer" were typed into Google, and websites listed on the first page of results were selected. Two researchers, blind to each others' scores, assessed the same websites using the coding system. Each question was scored on a 3-point scale as not (0%), partially (50%) and fully (100%) answered by two researchers. Average scores were calculated across all questions. Inter-rater reliability was assessed.

RESULTS

We identified 79 general, 5 breast, and 5 prostate cancer questions. Inter-rater reliability was good, with an intraclass coefficient of 0.756 (95% CIs 0.729-0.781). 17 questions were not answered thoroughly by any website. Questions about "future planning", "monitoring", and "decision-making" were discussed least. Biomedical questions scored highest.

CONCLUSIONS

More comprehensive information needs to be provided on breast and prostate cancer websites.

PRACTICE IMPLICATIONS

This ICT can improve cancer information online and enable patients to engage more actively regarding their information needs.

Evidenzbasierte Patienteninformationen im Internet – Eine Studie zur Qualität von Websites zur Posttraumatischen Belastungsstörung

Weite Teile der Bevölkerung informieren sich bei Fragen zu psychischer Gesundheit im Internet. Dabei beeinflussen die dort recherchierten Informationen Gesundheitsverhalten und -einstellungen. Umso wichtiger ist es, die Qualität medizinischer und psychologischer Internetinformationen sicher zu stellen und auf ihre Hochwertigkeit auch im Sinne der Evidenzbasierung hin zu überprüfen. Im internationalen Raum existiert eine Reihe von Studien, die Mängel an der Qualität internetbasierter Gesundheitsinformationen konstatieren. Für deutschsprachige Websites sind entsprechende Untersuchungen kaum vorhanden. Aus diesem Grund wurde exemplarisch für das Störungsbild der Posttraumatischen Belastungsstörung eine Inhaltsanalyse von N = 20 Suchergebnissen bei Google vorgenommen. Analysiert wurden u. a. die Art des Anbieters, die Qualität der Informationen, die präferierten Behandlungsansätze sowie die Benutzerfreundlichkeit der Website. Die Befunde zeigen, dass die verschiedenen Behandlungsansätze (Psychotherapie, Psychopharmakotherapie, Selbsthilfe) ausgewogen dargestellt werden, jedoch psychodynamische Psychotherapieverfahren gegenüber der Kognitiven Verhaltenstherapie deutlich unterrepräsentiert sind. Die Qualität der Informationen war generell im mittleren Bereich angesiedelt, was vor allem durch die mangelhafte Benutzerfreundlichkeit der Websites bedingt ist. Falsch- und Fehlinformationen waren wenig zu verzeichnen. Abschließend werden Modelle zur Qualitätssicherung als Beitrag für evidenzbasierte Patienteninformationen vorgestellt und damit verbundene Probleme diskutiert.

Online health information seeking: the influence of age, information trustworthiness, and search challenges

OBJECTIVE

The Internet holds great potential to support information gathering and decision making surrounding health education and self-care. Older adults, however, underutilize the Internet for health information searches relative to younger adults. The goal of the present study was to examine age differences in the role of trust and ease of search in predicting whether or not individuals use (adopters) or do notuse (nonadopters) the Internet to search for health information.

METHOD

We used logistic regressions todetermine whether there were age differences in the extent to which trust and ease of search predicted online health information searches within a nationally-representative sample of 3796 adults from the Health Information National Trends Survey (HINTS).

RESULTS

Adopters were more trusting of Internet health informationthan nonadopters. However, a significant age by trust interaction indicated that this difference increased in magnitude with age, a pattern that held even after controlling for demographic and health variables.

CONCLUSIONS

Older adults may benefit from special instructions designed to boost Internet trust, for example, learning how to distinguish between high and low quality health-related websites.

Nurses' use of online health information in medical wards

AIM

  This paper is a report of a study of nurses' access, use and evaluation of online health information in medical wards.

BACKGROUND

  Online health information is commonly used by patients with chronic illness to support their education needs. Nurses have a critical role in assisting patients to access and use this information.

METHOD

  This descriptive cross-sectional survey of a random sample of 540 nurses employed in medical wards was carried out in 2009. The response rate was 58·7% (293). The analytical approach included descriptive statistics and non-parametric tests of correlation and differences between groups. A content analysis was performed on the qualitative data.

RESULTS

  Most respondents (78·6%) were satisfied with work Internet access and 58·2% believed that the use of online information improved care delivery. Nearly half the group was aware of patient misconceptions about their illness due to incorrect interpretations of online information, but only 24·4% checked if patients used online information. There was a significant association between assessing patients use and awareness of patient misconceptions.

CONCLUSION

  The findings of this study highlight that while online resources add to education opportunities, the ongoing nursing assessment required to determine online information needs is not always incorporated into nursing practice. Patient misunderstandings of online material were also identified; developing patient competency in evaluating open access health information should now be recognized as an integral aspect of illness management education.

Correlates of consumer trust in online health information: findings from the health information national trends survey

The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N = 7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.