Mikki Meadows-Oliver, PhD, MPH, RN

Nancy Cantey Banasiak, MSN, PNP-BC

ACCURACY AND READABILITY OF ASTHMA WEBSITES

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

• Pathophysiology of asthma

• Knowledge of triggers

• Avoidance of triggers

• Knowledge of controller medications

• Knowledge of rescue medications

• Administration of medication

• Self-assessment

• Asthma action plan

8 CORE EDUCATIONAL NHLBI CONCEPTS

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/Asthma_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

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