ACCURACY AND READABILITY
OF ASTHMA WEBSITES
Mikki Meadows-Oliver, PhD, MPH, RN
Nancy Cantey Banasiak, MSN, PNP-BC
PRESENTER DISCLOSURES
• The following personal financial
relationships with commercial
interests relevant to this
presentation existed during the past
12 months:
• Neither presenter has any disclosures
PURPOSE OF THE STUDY
• The purpose of the current descriptive study was to
assess the accuracy of health information on the
Internet regarding asthma using the 8 core
educational concepts developed by the NHLBI (2007)
on sponsored and unsponsored Internet sites.
• A secondary aim was to assess readability
information on the Internet sites that contained
accurate information on all 8 core educational NHLBI
concepts
ASTHMA
• Asthma is a chronic illness that requires
continuous supervision by parents as well as
ongoing communication between parents and
their children around treatment management.
• Because of shorter appointments, parents spend
less time in the health care providers office
• Many have questions that arise after the visit.
HEALTH INFORMATION & THE
INTERNET
• Parents may turn to the Internet, a 24 hour
source of information.
• Helps parents to obtain immediate answers
• Helps to reinforce learning
HEALTH INFORMATION & THE
INTERNET
(FOX & JONES, 2009)
• 61% of internet users search for health
information.
• Population referred to as e-patients
• Most e-patients access user generated
health information
HEALTH INFORMATION & THE
INTERNET
• Researchers have begun to assess the
quality and accuracy of pediatric health
information on the internet.
• Most research indicates that information
presented is inaccurate or incomplete
• Readability levels have also been found to
be high for the average consumer .
ACCURACY OF ASTHMA
INFORMATION
• Croft & Peterson (2002) examined 90 asthma
websites. Average asthma website contained 4.9
of the 8 core NHLBI asthma educational concepts
• Oermann & colleagues (2003) found that only
30/70 (42.9%) contained information on all 8 core
educational aspects
• Park and colleagues (2004) examined 32 Korean
Internet websites. The mean number of
educational concepts was 2.7/8
READABILITY
NATIONAL PATIENT SAFETY FOUNDATION (2006)
• Average reading level in the U.S. is 8th grade, and
20 percent read at the 5th grade level or below.
• 40 % of seniors read at or below the 5th grade level
• 50 % of African Americans and Hispanics read at or
below the 5th grade reading level
• Most health-related material is written at the 10th
grade reading level or higher (Institute of Medicine)
READABILITY OF ASTHMA
INFORMATION
• Forbis & Aligne (2002) found that written asthma
management plans presented in National guidelines
were written at an 8.1 grade reading level.
• Wallace & colleagues (2006) examined the readability
characteristics of consumer medication information for
asthma inhalation devices and found that the materials
were written at an 8.2 grade reading level.
• Smith and colleagues (1998) evaluated the readability
of asthma information pamphlets and found that the
pamphlets were written at an average reading grade
level of 8.7.
METHODS
• 16 English language search engines
searched
• Key word: asthma
• Inclusion criteria: US websites; Written in
English
METHODS
• First 10 unsponsored and first 10
sponsored websites selected
• Total of 320 sites initially
• After discarding duplicates, final sample 68
websites
• 36 unsponsored websites
• 32 sponsored websites
8 CORE EDUCATIONAL NHLBI
CONCEPTS
• Pathophysiology of
asthma
• Knowledge of rescue
medications
• Knowledge of triggers
• Administration of
medication
• Avoidance of triggers
• Knowledge of
controller medications
• Self-assessment
• Asthma action plan
RESULTS
• 6/68 (8.8%) websites provided accurate
information on all 8 NHLBI core educational
concepts
• Unsponsored: 4/36 (11.11%) and Sponsored: 2/32
(6.25%) provided accurate information on all 8
NHLBI criteria
• Sponsored sites no more likely that unsponsored
sites to contain accurate information on all 8
NHLBI criteria (X2[1, N=68], p = 0.82)
UNSPONSORED WEBSITES
• www.asthma.about.com/mbody (HON certified)
• www.nhlbi.nih.gov/health/dci/Diseases/Asthma/A
sthma_WhatIs .html (available in Spanish)
• www.aafa.org (available in Spanish)
• www.aaaai.org (available in Spanish)
UNSPONSORED WEBSITES
• Most common on the pathophysiology of
asthma (47%)
• Least common--administration of
medication and asthma action plans
SPONSORED WEBSITES
• www.everydaykidz.com
• www.asthma.nationaljewish.org (available
in Spanish)
SPONSORED WEBSITES
• 47% had NO information on any of the core
educational concepts
• 25% had information on pathophysiology
and triggers
• Least common—medication administration
READABILITY
• Flesch Reading Ease
• Range 46.6-63.5
• Mean=54.33
• Flesch Grade Level
• Range 8.0-10.3
• Mean=9.73
DISCUSSION
• Majority of websites did not contain
comprehensive, accurate information
regarding asthma
• Concepts such as medication
administration were the least discussed
• Readability was high for the average
consumer
DISCUSSION
• Variability in the quality of information of
the websites
• Internet provides great opportunities for
health care education
• Internet also carries the risk of
inaccurate/outdated information
LIMITATIONS
• Cross sectional design
• Small number of websites included
• Comprehension was not tested directly
IMPLICATIONS
• As nurses, we can provide information re:
previously assessed websites for patients
• Educate ourselves to, in turn, educate families
• Written patient education materials listing the
accurate websites can be provided to reinforce
verbal teaching by nurses in a variety of setting
• Access to accurate information may enable
greater self and family management
QUESTIONS
????????