Health websites on COVID-19: are they readable and credible enough to help public self-care?

An evaluation of the quality of COVID-19 websites in terms of HON principles and using DISCERN tool

BACKGROUND

As many people relied on information from the Internet for official scientific or academically affiliated information during the COVID-19 pandemic, the quality of information on those websites should be good.

OBJECTIVE

The main purpose of this study was to evaluate a selection of COVID-19-related websites for the quality of health information provided.

METHOD

Using Google and Yahoo, 36 English language websites were selected, in accordance with the inclusion criteria. The two tools were selected for evaluation were the Health on the Net (HON) Code and the 16-item DISCERN tool.

RESULTS

Most websites (39%) were related to information for the public, and a small number of them (3%) concerned screening websites in which people could be informed of their possible condition by entering their symptoms. The result of the evaluation by the HON tool showed that most websites were reliable (53%), and 44% of them were very reliable. Based on the assessment results of the Likert-based 16-item DISCERN tool, the maximum and minimum values for the average scores of each website were calculated as 2.44 and 4.25, respectively.

CONCLUSION

Evaluation using two widely accepted tools shows that most websites related to COVID-19 are reliable and useful for physicians, researchers and the public.

Evaluating understandability and actionability of online education materials for home-care patients with COVID-19 in Japan

OBJECTIVE

In Japan, educational materials on the home care of coronavirus disease 2019 (COVID-19) were developed owing to limited access to medical care during the pandemic. This study quantitatively evaluated the understandability, actionability, natural flow, and readability of 87 materials published by local governments in Japan for patients with COVID-19. Their understandability and actionability were rated using the Japanese version of the Patient Education Material Evaluation Tool for Printed Materials (PEMAT-P). Natural flow and readability were rated using Global Quality Score (GQS) and jReadability, respectively.

RESULTS

Of the 87 materials, 55 (62.1%) were understandable and 33 (37.9%) were actionable according to the PEMAT-P. Regarding understandability, the materials used medical terms without providing definitions and lacked summaries. Regarding actionability, the materials did not demonstrate explicit steps or utilize visual aids to help the readers take action. The mean (SD) of GQS was 3.44 (0.98), indicating a moderate level of naturalness and comprehensiveness of the materials. The mean (SD) score for readability was 2.4 (0.6), indicating a "lower advanced" level. However, challenges regarding the materials' plain language remained, such as defining medical terms, summarizing the content for understandability, and using charts and tables that encourage patients to act.

Lessons to Build an Educational Model for Higher Education Institutions Defined as Anchor Institutions to Tackle Public Health Crises: A Pilot Study on COVID-19 Vaccine Hesitancy Among Faculty and Students in Hebert L. College in the Bronx, NY

Coronavirus disease 2019 exacerbated health inequities in Bronx Communities. This study explored vaccine hesitancy among a random sample of faculty and students from Hebert Lehman College. Findings suggest faculty are largely vaccinated (87%), while 59% of students are unvaccinated. Significant gaps in information were found related to safety and complications. This suggests universities need to adopt an educational model with a multipronged social support strategy to gain students' trust and a greater sense of belonging.

Navigating a Pandemic: A Qualitative Study of Knowledge, Sources of Information, and COVID-19-Related Precautions Taken by HBCU Students

The coronavirus (COVID-19) has spread quickly across the nation with a disproportionate impact on Black Americans. Many college-aged students receive their COVID-19-related information through social media and television even though research suggests that social media sources are more likely to be incorrect. Some students report trusting these sources over government sources such as the CDC and WHO. The purpose of this study was to understand Historically Black College and University (HBCU) students' COVID-19 knowledge, sources of information, and planned precautions. There were 21 in-depth interviews conducted with students attending a large southern HBCU during Spring 2020. Themes regarding knowledge included the following: it is a flu-like condition, it has international roots, there is inaccurate and changing information, and it is a pandemic. Themes regarding sources included: the news, US government and related officials, social media, interactions with family, and other social interactions. Themes regarding severity included the following: statistics, a distrust for hospital reporting, a belief that COVID-19 deaths were conflated with baseline health, peer influence, and familial influence. Themes regarding precautions included the following: proper mask use, hand washing/ sanitizing, avoiding large crowds/small crowds only, physical distancing, COVID-19 testing/symptom monitoring, and COVID-19 vaccination.

Analyzing COVID-19 Resources on Association of Academic Health Sciences Libraries' (AAHSL) Research Guides

In this study, the authors analyzed 147 AAHSL member libraries' COVID-19 research guides to determine the volume and origin of links included. Through stratified sampling based on total enrollment of health sciences academic institutions, 51 eligible AASHL library websites were selected for inclusion in the study. Content from COVID-19 research guides was analyzed, and the origin of each link was categorized. Most AAHSL libraries have at least one COVID-19 research guide, while some have two or more. A total of 8,848 links within examined research guides were visited. Links to academic institutions including universities' own internal links were most common while news outlets, social media, and international government were linked least. Regarding individual organizations, the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH)were most frequently linked. The overwhelming majority of sampled health sciences libraries use research guides to share COVID-19 information with their users. It is necessary to further investigate how libraries can optimize research guides to benefit their users. These results and conclusions reveal information resource patterns in research guides at health sciences academic libraries and are consistent with those reached by researchers investigating academic libraries' research guides in 2020.

An analysis of COVID-19 information sources

Background

The COVID-19 pandemic has brought new situations that require the effective delivery of health information across the world and it’s important to offer clear, consistent, and credible information on the pandemic to mitigate and control the outbreak.

Aim

To assess COVID-19 information source, need and trust among the rural community of southwest Ethiopia.

Methods

A community-based cross-sectional study design was conducted among 634 rural communities of southwest Ethiopia. The data were collected by interviewing individuals from selected households and analyzed by SPSS version 26. A multivariable logistic regression model was used to assess factors affecting information needs.

Results

Radio 484 (76.3%) was mostly used as a source of information for COVID-19, and government 404 (63.7%) and health professionals 345 (57.7%) were trusted. However, only 10 (1.6%) of the participants acquired information from health professionals. Around 395 (62.3%) of the participants needed additional information on COVID-19. Around 230 (58.2%) and 186 (47.1%) of the participants required additional information on cause and sign and symptoms, respectively. Age of < 45 years old (AOR: 2.11, 95% CI: 1.43, 3.12, P < 0.001), and absence of formal education (AOR: 2.00, 95% CI: 1.35, 2.95, P: 0.001) were factors positively affecting the information needs of the participants on COVID-19. Church goers (AOR: 3.24; 95% CI: 2.03, 5.19; P < 0.001), television (AOR: 2.39; 95% CI: 1.63, 3.49; P < 0.001) and social media users (AOR: 4.52; 95% CI: 2.26, 9.04; P < 0.001) as source of information required additional information on COVID-19, and the participants that trusted social media (AOR: 2.52; 95% CI: 1.64, 3.87; P < 0.001) and friends/relatives (AOR: 2.95: 95% CI: 1.51, 5.76; P < 0.001) were also required additional information on COVID-19.

Conclusions

The popular sources of COVID-19-related information were radio and television. The participants trusted the government and health professionals on COVID-19. However, less than 2% of the participants had information from health professionals. The majority of the participants wanted to learn more about COVID-19. The areas the participants required additional information include cause and signs and symptoms. Age, educational status, trust in social media, trust in friends, using the church, television and social media as a source were factors associated with information needs.

Evaluating the readability, quality and reliability of online patient education materials on post-covid pain

Background

The use of the Internet to access healthcare-related information is increasing day by day. However, there are concerns regarding the reliability and comprehensibility of this information. This study aimed to investigate the readability, reliability, and quality of Internet-based patient educational materials (PEM) related to "post-COVID-19 pain."

Methods

One-hundred websites that fit the purposes of the study were identified by searching for the terms "post-COVID-19 pain" and "pain after COVID-19" using the Google search engine on February 24, 2022. The website readability was assessed using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning FOG (GFOG). The reliability, quality, and popularity of the websites were assessed using the JAMA score, DISCERN score/Health on the Net Foundation code of conduct, and Alexa, respectively.

Results

Upon investigation of the textual contents, the mean FRES was 51.40 ± 10.65 (difficult), the mean FKGL and SMOG were 10.93 ± 2.17 and 9.83 ± 1.66 years, respectively, and the mean GFOG was 13.14 ± 2.16 (very difficult). Furthermore, 24.5% of the websites were highly reliable according to JAMA scores, 8% were of high quality according to GQS values, and 10% were HONcode-compliant. There was a statistically significant difference between the website types and reliability (p = 0.003) and quality scores (p = 0.002).

Conclusion

The readability level of PEM on post-COVID-19 pain was considerably higher than grade 6 educational level, as recommended by the National Institutes of Health, and had low reliability and poor quality. We suggest that Internet-based PEM should have a certain degree of readability that is in accordance with the educational level of the general public and feature reliable content.

Readability, understandability and language accessibility of Swedish websites about the coronavirus disease 2019: a cross-sectional study

BACKGROUND

The COVID-19 pandemic has caused significant morbidity and mortality. To mitigate its spread, members in the general population were prompted to apply significant behavioral changes. This required an effective dissemination of understandable information accessible for people with a wide range of literacy backgrounds. The aim of this study was to investigate the readability, understandability and language accessibility of Swedish consumer-oriented websites containing information about COVID-19.

METHODS

Websites were identified through systematic searches in Google.se (n = 76), and were collected in May 2020 when the pandemic spread started in Sweden. Readability and understandability were assessed with the Readability Index, the Ensuring Quality Information for Patients (EQIP) tool, and the Patient Education Materials Assessment Tool Understandability subscale (PEMAT-PU).

RESULTS

The median total sample score for Readability Index was 42.0, with the majority of scores being classified as moderate (n = 30, 39%) or difficult (n = 43, 57%). Median total sample scores were for EQIP 54.0% (IQR = 17.0, Range = 8-75) and for PEMAT-PU 60.0% (IQR = 14.75, Range = 12-87). The majority of the websites did not have any texts or links containing information in an alternative language (n = 58, 76%).

CONCLUSIONS

Swedish websites contained information of difficult readability and understandability at the beginning of the coronavirus disease 2019 pandemic, with few providing information available in alternative languages. It is possible that these deficits contributed to the spread and impact of the virus. There is a need for studies investigating methods aiming to enhance the readability, understandability and language accessibility of web-based information at the beginning of an epidemic or pandemic.

Developing Pathways to Health Sciences Librarianship with an Introductory Course and Mentoring Program

Because of gaps in the offerings of Library and Information Science programs and librarian continuing education programs, library students and early-career librarians may not be aware of opportunities in health sciences librarianship. There is a need for introductory educational offerings on the foundations of health sciences librarianship. There is also a need to address barriers that may obstruct members of underrepresented groups from becoming health sciences librarians. The article explores the possibility that online education and mentoring can address gaps in introductory educational offerings in health sciences librarianship. The article describes the development of a pilot program for an online Introduction to Health Sciences Librarianship course and mentoring program, reflects on results from a survey of program participants, and identifies areas for further research and program development. The article also discusses the potential implications the program may have for addressing equity, diversity, and inclusion in health sciences librarianship.

Readability of Korean-Language COVID-19 Information from the South Korean National COVID-19 Portal Intended for the General Public: Cross-sectional Infodemiology Study

BACKGROUND

The coronavirus pandemic has increased reliance on the internet as a tool for disseminating information; however, information is useful only when it can be understood. Prior research has shown that web-based health information is not always easy to understand. It is not yet known whether the Korean-language COVID-19 information from the internet is easy for the general public to understand.

OBJECTIVE

We aimed to evaluate the readability of Korean-language COVID-19 information intended for the general public from the national COVID-19 portal of South Korea.

METHODS

A total of 122 publicly available COVID-19 information documents written in Korean were obtained from the South Korean national COVID-19 portal. We determined the level of readability (at or below ninth grade, 10th to 12th grade, college, or professional) of each document using a readability tool for Korean-language text. We measured the reading time, character count, word count, sentence count, and paragraph count for each document. We also evaluated the characteristics of difficult-to-read documents to modify the readability from difficult to easy.

RESULTS

The median readability level was at a professional level; 90.2% (110/122) of the information was difficult to read. In all 4 topics, few documents were easy to read (overview: 5/12, 41.7%; prevention: 6/97, 6.2%; test: 0/5, 0%; treatment: 1/8, 12.5%; P=.006), with a median 11th-grade readability level for overview, a median professional readability level for prevention, and median college readability levels for test and treatment. Difficult-to-read information had the following characteristics in common: literacy style, medical jargon, and unnecessary detail.

CONCLUSIONS

In all 4 topics, most of the Korean-language COVID-19 web-based information intended for the general public provided by the national COVID-19 portal of South Korea was difficult to read; the median readability levels exceeded the recommended ninth-grade level. Readability should be a key consideration in developing public health documents, which play an important role in disease prevention and health promotion.

Assessing COVID-19 Health Information on Google Using the Quality Evaluation Scoring Tool (QUEST): Cross-sectional and Readability Analysis

BACKGROUND

The COVID-19 pandemic spurred an increase in online information regarding disease spread and symptomatology.

OBJECTIVE

Our purpose is to systematically assess the quality and readability of articles resulting from frequently Google-searched COVID-19 terms in the United States.

METHODS

We used Google Trends to determine the 25 most commonly searched health-related phrases between February 29 and April 30, 2020. The first 30 search results for each term were collected, and articles were analyzed using the Quality Evaluation Scoring Tool (QUEST). Three raters scored each article in authorship, attribution, conflict of interest, currency, complementarity, and tone. A readability analysis was conducted.

RESULTS

Exactly 709 articles were screened, and 195 fulfilled inclusion criteria. The mean article score was 18.4 (SD 2.6) of 28, with 7% (14/189) scoring in the top quartile. National news outlets published the largest share (70/189, 36%) of articles. Peer-reviewed journals attained the highest average QUEST score compared to national/regional news outlets, national/state government sites, and global health organizations (all P<.05). The average reading level was 11.7 (SD 1.9, range 5.4-16.9). Only 3 (1.6%) articles were written at the recommended sixth grade level.

CONCLUSIONS

COVID-19-related articles are vastly varied in their attributes and levels of bias, and would benefit from revisions for increased readability.

Declines in health literacy and health-related quality of life during the COVID-19 pandemic: a longitudinal study of the Japanese general population

Background

During the coronavirus disease 2019 (COVID-19) pandemic, the importance of health literacy (HL) was addressed by public health researchers. We longitudinally examined the changes in general HL and health-related quality of life (HRQOL) between immediately before the COVID-19 outbreak and 1 year later, and how general HL before the outbreak was related to changes in HRQOL in the Japanese general population.

Methods

Among the Japanese residents aged 20–79 years who participated in our previous study in 2017, 826 were followed-up via self-administered questionnaires in January 2020 and February 2021, for the purposes of this study. The HRQOL was measured using the SF-8, a short version of the SF-36 Health Survey, and general HL was measured using the short form of the European Health Literacy Survey Questionnaire (HL-SF12) in the 2020 and 2021 surveys.

Results

The physical and mental dimensions of HRQOL as well as general HL declined significantly from immediately before the COVID-19 outbreak to 1 year later (p = .010, p < .001 and p < .001, respectively). The decline in HRQOL, especially the mental dimension, was more significant among women. A lower economic status was also related to a greater decline in HRQOL (p = .026 for the physical dimension and p = .012 for the mental dimension). Higher general HL before the COVID-19 outbreak was associated with a lesser decline in HRQOL in both the physical and mental dimensions (p = .040 and p < .001, respectively) after controlling for possible confounding variables such as gender and economic status.

Conclusions

Healthcare support is crucial for vulnerable populations during and after the pandemic. General HL may be important for attenuating the decline in HRQOL, by enabling effective use of health information and adaptive behaviors toward health threats. Further studies are needed to better understand the association between HL and HRQOL.

Quality Evaluation of Consumer Health Information Websites Found on Google Using DISCERN, CRAAP, and HONcode

Online health misinformation is a growing problem, and health information professionals and consumers would benefit from an evaluation of health websites for reliability and trustworthiness. Terms from the Google COVID-19 Search Trends dataset were searched on Google to determine the most frequently appearing consumer health information websites. The quality of the resulting top five websites was evaluated. The top five websites that appeared most frequently were WebMD, Mayo Clinic, Healthline, MedlinePlus, and Medical News Today, respectively. All websites, except Medline Plus, received HONcode certification. Based on DISCERN and CRAAP scores, MedlinePlus was found to be the most reliable health website.

Classifications, Changes, and Challenges of Online Health Information Seekers during COVID-19

OBJECTIVES

The purpose of this study was to explore consumers' experiences before and during the COVID-19 outbreak to improve public health by providing effective consumer health information.

METHODS

Interviews were conducted with 20 health information consumers who were 18 or older until data saturation was reached. The selected participants were among users of the Korean National Health Insurance Service (NHIS). The data were collected before the COVID-19 outbreak (September 2014) and during the COVID-19 outbreak (October 2020) to describe experiences and changes before and during the pandemic. Data were analyzed according to the qualitative content analysis method.

RESULTS

As a result, 3 main domains and 10 subdomains were derived from classifications, changes, and challenges of online health information seekers.

CONCLUSIONS

The findings of this study guide the understanding of health information seekers for the development of consumer-tailored health information systems.

Access to Epidemic Information and Life Satisfaction under the Period of COVID-19: the Mediating Role of Perceived Stress and the Moderating Role of Friendship Quality

The present study mainly focused on college students amidst the COVID-19 outbreak and aimed to develop and examine a moderated mediation model between access to epidemic information and life satisfaction. Friendship quality as a moderator, and perceived stress as a mediator. A sample of 1032 college students participated in this study and completed questionnaires regarding access to epidemic information, perceived stress, friendship quality, and life satisfaction. Findings indicated that 1) access to epidemic information was strongly related to life satisfaction; 2) perceived stress acts as a mediator in the positive relationship between access to epidemic information and life satisfaction; 3) friendship quality moderated the relationship between access to epidemic information and perceived stress as well as perceived stress and life satisfaction, and such that there was a stronger association between access to epidemic information and perceived stress for college students with high friendship quality. But the relationship between perceived stress and life satisfaction became weaker for college students with high friendship quality. The results illuminate the mechanism to theoretical and practical implications for improving college students' life satisfaction during the pandemic.

Improving COVID-19 vaccine-related health literacy and vaccine uptake in patients: Comparison on the readability of patient information leaflets of approved COVID-19 vaccines

What is known and objective

Preparation of patient‐facing materials of a complex topic, such as describing new vaccines for COVID‐19, is difficult to accomplish. This study examined the readability of patient information leaflets accompanying approved COVID‐19 vaccines.

Comment

Readability of patient‐facing literature by the medicines regulator in the United States and the United Kingdom describing the recently US (FDA) and UK (MHRA) COVID‐19 approved vaccines (Pfizer/BioNTech, AstraZeneca, Moderna) was assessed employing 10 metrics. Analyses showed that showed that this material had a Flesch Ease of Reading score of 53.5 and 54, respectively and a Flesch‐Kincaid reading age of between 7th and 8th Grade (12–13 year olds) and between 8th and 9th Grade (13–14 year olds), respectively. When compared to a recent study on COVID‐19 information on healthcare websites, the vaccine literature readability was favourable.

What is new & conclusion

Adoption of readability calculators and scrutiny of materials of their readability will help authors develop materials with improved understanding for COVID‐19 vaccine recipients, carers and family, potentially leading to improved health literacy and vaccine uptake.

Positive Information of COVID-19 and Anxiety: A Moderated Mediation Model of Risk Perception and Intolerance of Uncertainty

Although COVID-19 information has been shown to play an important role in anxiety, little is known about the mediating and moderating mechanisms underlying this relationship. In the present study, we examined whether risk perception mediated the relationship between positive information of COVID-19 and anxiety and whether this mediating process was moderated by intolerance of uncertainty. A sample of 3,341 college students participated in this study and completed questionnaires regarding positive information of COVID-19, risk perception, intolerance of uncertainty, and anxiety. The results indicated that positive information of COVID-19 was significantly and negatively associated with anxiety and that risk perception partially mediated this relationship. Intolerance of uncertainty further moderated the relationship between positive information of COVID-19 and risk perception. Specifically, the relationship between positive information of COVID-19 and risk perception was significant for college students with low intolerance of uncertainty, while it became weaker for those with high intolerance of uncertainty.