Health Information Websites Research Articles

Accessibility of digital healthcare in 2023: insights from a Dutch national survey study

Abstract Background Digital technology is reshaping healthcare, offering potential improvements in accessibility, efficiency and quality. However, to realize potential benefits, ensuring equal access for all is crucial. We investigated digital healthcare usage and studied differences in use across age groups and educational backgrounds in the Netherlands. Methods Surveys were conducted among general healthcare users (n = 837, any citizen living in the Netherlands with access to healthcare) and healthcare users with chronic conditions (n = 1437). We studied their digital skills (can you independently use a computer, tablet or smartphone; digital applications; email and apps?) and their use of digital selfcare (did you use websites for health-related information or treatment?). Findings are stratified for educational level (low/medium/high) and age (15 -39, 40-64, over 65 years). Data collection occurred between April and August 2023, focusing on the twelve months preceding the survey. Results The majority of respondents use digital devices independently (range: 78-91%), but these percentages vary between subgroups, from 48-65% for users with lower education vs 86-99% for users with higher education. Similar differences exist across age groups: 98-100% of users aged 15-39 use a computer, tablet or smartphone, in contrast with 59-78% in the over 65 years age group. Similarly, the use of websites for health information is 22-31% among lower educated users to 68-70% among higher educated users; and 36-48% among those ≥65 years to 73-75% among respondents aged 15-39. Conclusions Substantial variation exists in the use of digital tools and digital selfcare across ages and educational levels. These findings underscore the urgency of addressing inequalities in access to digital healthcare, serving as a call to action for policymakers, healthcare providers, and developers to collectively strive for an accessible (digital) healthcare system for all. Key messages • Differences in use of digital tools and digital selfcare among people of different ages and educational levels warrants the need for co-creation and tailored development and implementation. • Differences in use of digital tools and digital selfcare among people of different ages and educational levels warrants the need for co-creation and tailored development and implementation.

Using quick response codes to access digital health resources in the general practice waiting room

Background Quick response (QR) codes are an established method of communication in today’s society. However, the role of QR codes for linking to health information in general practice waiting areas has not yet been explored. Methods This mixed-methods study used both quantitative data measuring QR scans and qualitative data from follow-up semi-structured interviews with visitors to two general practice waiting areas to determine access to an online health information site and their experience of using the QR code. The technology acceptance model was used to guide the interview questions. Quantitative data were analysed descriptively, and qualitative data were analysed thematically using an inductive approach. Results A total of 263 QR scans were recorded across the two sites between October 2022 and October 2023. Twelve participants were interviewed. Eleven themes were identified; six were categorised as facilitators and five were barriers to QR code engagement. Motivation for engagement included boredom and curiosity. Facilitators for engaging with the QR code included familiarity secondary to the recent COVID-19 pandemic, benefits of accessing potentially sensitive information with anonymity, convenience of revisiting later and reduced paper waste. Barriers included size and location of the QR code as a limiting factor to engagement, waiting room wait time, privacy and security concerns, and the potential to exclude those without access to technology or those with low technological literacy. Conclusion Using QR codes in the general practice waiting area is a convenient method of presenting health information to visitors and patients. Our findings indicate that this may be an appropriate method to share health information in waiting areas. Facilitators and barriers identified in this study may assist with optimising engagement with health information via QR codes while waiting for appointments.

Using online health information for unknown symptoms common among young adults: a qualitative analysis of health-related web pages illustrating the need for numeracy skills, the ability to deal with uncertainty, and the risk of ruling out self-care

Young adults experiencing unfamiliar symptoms commonly seek health information online. This study’s aim was to explore how health information websites express and communicate health information about symptoms common among young adults and guide readers in regard to health, illness, and care. Symptoms commonly searched for by young adults were used as search terms. The resulting data comprised material from 24 web pages and was analyzed using content analysis. The foremost purpose of online health information is to try to narrow down the user’s symptoms and then advise the user on what actions to take. This is done by first forming a foundation of knowledge through descriptions and explanations, then specifying the symptom’s time, duration, and location, and finally giving advice on whether to self-manage symptoms or seek additional information about them. However, the uncertainty of the diagnosis may rule out self-care. For readers inexperienced with health care, forming a decisive conclusion about diffuse symptoms on the sole basis of online health information could be challenging. The necessity of numeracy skills and the ability to deal with uncertainty are highlighted. There is a discrepancy between health advice given online and readers’ accessibility to health care that needs to be addressed in future policy and research.

Cross-cultural adaptation of the writer-reader relationship in non-translated and translated English health information websites on HIV and TB diagnostic testing

The ideal multilingual health information website is relatable to all readers. Natives and immigrants should have a culturally adapted website in their language hosted by their place of residence that imparts the facts and incites a call to action to improve health, and ultimately reduces disease in the diverse community. The writer’s word choices and attitude as conveyed through the text influence the reader’s decision-making process. This paper will examine the differences between the non-translated and translated English versions of multilingual health information websites on HIV and TB diagnostic testing. These samples pertain to a large interdisciplinary study whose purpose is to determine whether the multilingual health communication websites are appropriately written regarding health literacy, and whether each cultural population, in terms of language adaptation, would receive the health information as intended. The study questions whether there exist differences between the translated and non-translated texts in English, Spanish and Catalan; this paper focuses on the two English sub-corpora. A comparable corpus of seventy-three multilingual health information websites underwent a quantitative and a qualitative analysis. The methodology is based on adaptations of Clerehan et al.’s (2005) Evaluative Linguistic Framework to assess the writer-reader relationship. The findings show statistically significant differences between the two English subcorpora as regards the writers’ and translators’ approach; the non-translated English sub-corpus contained more relational and engagement markers, whereas the translated English sub-corpus had more persuasion markers. These results should serve researchers and professionals in the translation and language sciences as well as the public health field for, respectively, future studies and techniques to improve the composition of multilingual health information texts in culturally diverse countries.

Diverticulosis and Diverticulitis on YouTube: Is Popular Information the Most Reliable?

Background Patients utilize online health information to inform their medical decision-making. YouTube is one of the most popular media platforms with abundant health-related resources, yet the quality of the disseminated information remains unclear. This study aims to evaluate the quality and reliability of content pertaining to diverticulosis and diverticulitis on YouTube. Methods One author queried the terms "diverticulosis," "diverticulitis," "acute diverticulitis," and "chronic diverticulitis" on YouTube. The first 50 videos per search were selected for analysis. Duplicates, non-English videos, or procedural content were excluded. Video characteristics including view count, likes, comments, duration, days since upload, view ratio, video power index, and video sources (professional organizations (POs), health information websites (HIWs), and entertainment/independent users (EIUs)) were collected. Videos were scored using the mDISCERN and Global Quality Score (GQS). Results Sixty-four videos were included. DISCERN scores significantly differed between POs (n=20, mean=4.35), HIWs (n=29, mean=2.97), and EIUs (n=15, mean=1.83). GQS also significantly differed between POs (n=20, mean=4.47), HIWs (n=29, mean=3.62), and EIUs (n=15, mean=2.5). Video characteristics significantly differed between groups, with most user engagement seen in EIUs. Conclusion POs and HIWs disseminate higher quality health information about diverticular disease on YouTube. The higher viewer engagement with EIUs is concerning, as these sources were found to have lower quality content. Although YouTube has the capability to provide valuable information on diverticulosis and diverticulitis, enhanced content screening is needed to ensure accuracy and validation.

Web scraping of user-simulated online nutrition information for people with multiple sclerosis

BackgroundPeople diagnosed with multiple sclerosis (MS) often seek to modify their diet guided by online advice, however this advice may not align with national dietary guidelines. The aim of this study was to simulate an online search for dietary advice conducted by a person with MS and evaluate the content. It was hypothesised that a variety of eating patterns are promoted for MS online and these dietary approaches can be contradictory. MethodsAn online search was simulated using Google Trends-informed search terms and Google and Bing search engines. URLs were extracted using R. Nutrition data were extracted including recommendations for diets, foods, supplements, and health professional consultation. Statistical analyses were conducted using R. Results73 URLs from 49 websites were extracted, with only 14 results common to both search engines. Dietary recommendations included overall eating patterns (58 webpages, 79%), individual foods (55 webpages, 75%), and supplements (33 webpages, 45%). The most promoted eating pattern for MS was a balanced diet (33 recommendations, 48%), more likely by nonprofit organisations and health information websites (14 and 17 recommendations, 100% and 89%); lifestyle program websites were more likely to recommend restrictive diets (19 recommendations, 100%) (p<0.001). 52% pages advised consulting a health professional, most often a doctor or dietitian. ConclusionA balanced diet is the most recommended eating pattern for MS online, though advice promoting restrictive diets persists.

Disseminating a health information website to teens using a three-pronged approach with social media outreach

ObjectiveTo disseminate iuveo.org, a new health information website, primarily to teens in the United States using a three-pronged approach of social media, in-person, and emails. MethodsDissemination methods included a combination of in-person, email, and social media campaigns starting in August 2022 to reach teens and stakeholders focused on teen health. Following the Social Marketing Theory framework, a social media campaign was implemented utilizing Instagram and X (formerly Twitter). Website analytics, including monthly usage of iuveo, was measured utilizing Google Analytics. The intrinsic analytics from X and Instagram were also tracked. ResultsFrom August 2022–July 2023, iuveo attracted 1338 unique users to the website. In the same time frame, 1085 accounts were reached on Instagram, and 14,367 impressions were received on X. Most website users (84.8%) were classified as ‘direct’ acquisition, meaning that they directly typed in the URL or clicked on a link, and 7.3% of users visited iuveo from a social media platform. ConclusionA three-pronged dissemination strategy is beneficial when disseminating a new health information website. InnovationUtilizing a three-pronged approach with a social media campaign based on Social Marketing Theory, a health information website was disseminated to youth in the United States.

The reliability and quality of YouTube videos about isotretinoin treatment and suicide.

Seeking health information online has drastically increased. Isotretinoin is one of the agents used to treat acne. In this study, we aimed to investigate the reliability and quality of YouTube videos related to acne treatment. There is a misconception that use of isotretinoin increases risk of suicide. We used the terms 'isotretinoin suicide' and 'acne treatment suicide' to search YouTube videos. Videos that were not in English, were irrelevant, or were devoid of audio were not included. The information in the videos was primarily categorized as 'reliable' or 'unreliable' based on its scientific validation. DISCERN and the Global Quality Score were used to evaluate the videos' overall quality. In total, 200 videos were examined and 112 videos were included in the study. Of these, 39 videos (34.8%) were found to be reliable, and 73 videos (65.2%) were found to be unreliable. The DISCERN values of videos uploaded by physicians or professional organizations, and health information websites were found to be significantly higher. There were statistically significant negative correlations between DISCERN score and both video length and the length of time the video was on YouTube, while a positive correlation was observed between DISCERN score and the number of subscribers. Although videos created by dermatologists have become widespread in recent years, they are still insufficient. Patient experience videos mostly contain information that does not reflect reality, and they emphasize that isotretinoin increases the risk of suicide without evidence. As the number of dermatologists posting videos on YouTube increases, the chances of people accessing correct information will increase.

A Randomized Evaluation of MoodFX, a Patient-Centred e-Health Tool to Support Outcome Measurement for Depression: Une évaluation randomisée de MoodFX, un outil de santé en ligne centré sur le patient pour soutenir la mesure du résultat dans la dépression.

e-Health tools using validated questionnaires to assess outcomes may facilitate measurement-based care for psychiatric disorders. MoodFX was created as a free online symptom tracker to support patients for outcome measurement in their depression treatment. We conducted a pilot randomized evaluation to examine its usability, and clinical utility. Patients presenting with a major depressive episode (within a major depressive or bipolar disorder) were randomly assigned to receive either MoodFX or a health information website as the intervention and control condition, respectively, with follow-up assessment surveys conducted online at baseline, 8 weeks and 6 months. The primary usability outcomes included the percentage of patients with self-reported use of MoodFX 3 or more times during follow up (indicating minimally adequate usage) and usability measures based on the System Usability Scale (SUS). Secondary clinical outcomes included the Quick Inventory of Depressive Symptomatology, Self-Rated (QIDS-SR) and Patient Health Questionnaire (PHQ-9). Forty-nine participants were randomized (24 to MoodFX and 25 to the control condition). Of the 23 participants randomized to MoodFX who completed the user survey, 18 (78%) used MoodFX 3 or more times over the 6 months of the study. The mean SUS score of 72.7 (65th-69th percentile) represents good usability. Compared to the control group, the MoodFX group had significantly better improvement on QIDS-SR and PHQ-9 scores, with large effect sizes and higher response rates at 6 months. There were no differences between conditions on other secondary outcomes such as functioning and quality of life. MoodFX demonstrated good usability and was associated with reduction in depressive symptoms. This pilot study supports the use of digital tools in depression treatment.

Evaluation of Turkish videos about breast self-examination on YouTube

Objectives: Breast self-examination (BSE) is very important to early detect breast cancer in women in addition to imaging methods. The easiest way to access information concerning how to perform this examination is undoubtedly the internet, and the most popular platform is YouTube. However, the most important disadvantage of this massive platform is the risk of spreading false information since it cannot be audited. This study aimed to evaluate Turkish videos on BSE on YouTube in terms of quality and content. Methods: On January 17, 2022, a search was conducted on YouTube using the keyword “breast self-examination”, and the first 210 videos presented on the first five pages were obtained. After applying the study criteria, 156 were included in the sample and evaluated by two general surgeons in terms of educational value, content, and upload source. Results: Of the 156 videos, 23 were categorized as useful (14.7%) and 133 as misleading (85.3%). When examined according to the upload source group, universities/professional organizations/non-profit physicians/physicians had the highest rate of misleading videos (96.9%), while stand-alone health information websites had the highest rate of useful videos (24%). There was no significant difference between the upload sources in terms of video length, number of views, content score, or quality score. Conclusions: The number of useful Turkish videos on BSE is very low. Our results indicate the need for more educational and useful videos to be produced, especially by healthcare professionals who use the YouTube platform.

Quality of Patient-Centered eHealth Information on Erosive Tooth Wear: Systematic Search and Evaluation of Websites and YouTube Videos.

Due to the declining prevalence of dental caries, noncarious tooth defects such as erosive tooth wear have gained increased attention over the past decades. While patients more frequently search the internet for health-related information, the quality of patient-centered, web-based health information on erosive tooth wear is currently unknown. This study aimed to assess the quality of patient-centered, web-based health information (websites and YouTube videos) on erosive tooth wear. German-language websites were systematically identified through 3 electronic search engines (google.de, bing.de or yahoo.de, and duckduckgo.com) in September 2021. Eligible websites were independently assessed for (1) technical and functional aspects via the LIDA instrument, (2) readability via the Flesch reading-ease score, (3) comprehensiveness of information via a structured checklist, and (4) generic quality and risk of bias via the DISCERN instrument by 2 different reviewers. An overall quality score (ie, higher scores being favored) generated from all 4 domains was used as the primary outcome. Quality scores from each domain were separately analyzed as secondary outcomes and compared by the Friedman test. The effect of practice-specific variables on quality scores of websites from private dental offices was assessed using generalized linear modeling. Eligible YouTube videos were judged based on (1) the comprehensiveness of information, (2) viewers' interaction, and (3) viewing rate. The comprehensiveness of information was compared between websites and YouTube videos using the Wilcoxon rank-sum test. Overall, 231 eligible websites and 7 YouTube videos were identified and assessed. The median overall quality of the websites was 33.6% (IQR 29.8%-39.2%). Secondary outcome scores amounted to 64.3% (IQR 59.8%-69.0%) for technical and functional aspects, 40.0% (IQR 34.0%-49.0%) for readability, 11.5% (IQR 3.9%-26.9%) for comprehensiveness of information, and 16.7% (IQR 8.3%-23.3%) for generic quality. While the comprehensiveness of information and generic quality received low scores, technical and functional aspects as well as readability resulted in higher scores (both Padjusted<.001). Regarding practice-specific variables, websites from private dental offices outside Germany (P=.04; B=-6.64, 95% CI -12.85 to -0.42) or from dentists who are a dental society member (P=.049; B=-3.55, 95% CI -7.09 to -0.01) resulted in lower readability scores (ie, were more difficult to read), while a shorter time since dentists' examination resulted in higher readability scores (P=.01; B=0.24 per year, 95% CI 0.05-0.43). The comprehensiveness of information from YouTube videos was 34.6% (IQR 13.5%-38.5%). However, the comprehensiveness of information did not vary between websites and YouTube videos (P=.09). Additionally, viewers' interaction (1.7%, IQR 0.7%-3.4%) and viewing rates (101%, IQR 54.6%-112.6%) were low. The quality of German-language, patient-centered, web-based information on erosive tooth wear was limited. Especially, the comprehensiveness and trustworthiness of the available information were insufficient. Web-based information on erosive tooth wear requires improvement to inform patients comprehensively and reliably.

Using Google Analytics with Health Information-Seeking Model to Evaluate the Design of Health Information Websites.

Health information websites can be useful for information seekers, and their design is crucial for the success of accessing the needed information. While web analytical tools (e.g. Google Analytics) used by such websites can provide descriptive measures of users, there is a disconnection between this data and the current understanding of health information-seeking behaviour. In this work, we leverage a theoretical model to interpret the Google Analytics data. Drawn on the visualisation of user behaviours based on this model, our research shows that better website design can be informed, and the evaluation of health websites can be performed on the basis of different user profiles.

The efficacy and reliability of English YouTube videos as a source of information for pregnant rheumatoid arthritis patients.

Online platforms are used by many patients to access health care information, but the quality and accuracy of information on these platforms are unknown. Our goal was to assess the quality and reliability of YouTube video content for pregnant rheumatoid arthritis (RA) patients. YouTube was searched on January 13, 2022, using the keywords "rheumatoid arthritis pregnancy," "rheumatoid arthritis conception," "rheumatoid arthritis fertility" and "rheumatoid arthritis breastfeeding". The top 200 videos were viewed. Two rheumatologists then categorized the videos into useful and misleading groups. Videos were excluded if they were irrelevant or duplicates. To assess the reliability and quality of the videos, a modified DISCERN tool and the Global Quality Score (GQS) were applied. Patient interaction was assessed using predictors of video popularity such as the like ratio, view ratio, and video power index scales. A total of 54 videos were examined; the majority (51.8%) of them were uploaded by health information websites. A total of 94.4% of the videos were useful, and 5.5% were misleading. All three misleading videos were uploaded by patients. The GQS, the modified DISCERN score, and usefulness differed significantly by uploader source (p < 0.001 for both). According to the GQS evaluation, health information websites were the source of high-quality videos with more useful information and higher modified DISCERN scores. The GQS and modified DISCERN score had moderately negative (r = -.526, r = -.548, respectively) and very significant (p < 0.001 for both) correlations with the assessment of usefulness. Almost all YouTube videos for pregnant RA patients were educational and useful. Similar patient interactions in videos with misleading and useful information showed that patients were unable to differentiate between videos based on video quality. Patients should be informed about the importance of video sources when viewing YouTube videos. Key Points • Most YouTube videos for pregnant RA patients were useful, were uploaded by health information websites and had physicians as the speakers • All misleading YouTube videos were uploaded by patients using their own accounts • In terms of patient interactions, there was no noticeable difference between useful and misleading videos • When dealing with a sensitive topic such as pregnancy, patients should be educated on the importance of video sources.

Effective Health Communication and Required Competencies - the Case of Race and Gender Blindness in Major Online Health Information Sites

Effective Health Communication and Required Competencies - the Case of Race and Gender Blindness in Major Online Health Information Sites

Acceptance of a French e-Mental Health Information Website (CléPsy) for Families: A Web-Based Survey.

Childhood mental health issues concern a large amount of children worldwide and represent a major public health challenge. The lack of knowledge among parents and caregivers in this area hinders effective management. Empowering families enhances their ability to address their children's difficulties, boosts health literacy, and promotes positive changes. However, seeking reliable mental health information remains challenging due to fear, stigma, and mistrust of the sources of information. This study evaluates the acceptance of a website, CléPsy, designed to provide reliable information and practical tools for families concerned about child mental health and parenting. This study examines user characteristics and assesses ease of use, usefulness, trustworthiness, and attitude toward using the website. Platform users were given access to a self-administered questionnaire by means of mailing lists, social networks, and posters between May and July 2022. Findings indicate that the wide majority of the 317 responders agreed or somewhat agreed that the website made discussions about mental health easier with professionals (n=264, 83.3%) or with their relatives (n=260, 82.1%). According to the ANOVA, there was a significant effect between educational level and perceived trust (F6=3.03; P=.007) and between frequency of use and perceived usefulness (F2=4.85; P=.008). The study underlines the importance of user experience and design in web-based health information dissemination and emphasizes the need for accessible and evidence-based information. Although the study has limitations, it provides preliminary support for the acceptability and usefulness of the website. Future efforts should focus on inclusive co-construction with users and addressing the information needs of families from diverse cultural and educational backgrounds.

Comprehensiveness of online sources for patient education on hereditary hearing impairment.

The present study aimed at investigating the readability of online sources on hereditary hearing impairment (HHI). In August 2022, the search terms "hereditary hearing impairment", "genetic deafness", hereditary hearing loss", and "sensorineural hearing loss of genetic origin" were entered into the Google search engine and educational materials were determined. The first 50 websites were determined for each search. The double hits were removed and websites with only graphics or tables were excluded. Websites were categorized into either a professional society, a clinical practice or a general health information website. The readability tests to evaluate the websites included: Flesch Reading Ease, Flesch-Kincaid grade level, Gunning-Fog Index, Simple Measure of Gobbledygook, Coleman-Liau Index, Automated Readability Index. Twentynine websites were included and categorized as from 4 professional societies, 11 from clinical practices and 14 providing general information. All analyzed websites required higher reading levels than sixth grade. On average 12-16 years of education is required to read and understand the websites focused on HHI. Although general health information websites have better readability, the difference was not statistically significant. The readability scores of every type of online educational materials on HHI are above the recommended level indicating that not all patients and parents can comprehend the information they seek for on these websites.

Preference For Cervical Cancer Education: A Multisite Cross-Sectional Survey of Female Senior High School Students in Ghana.

Cervical cancer incidence continues to rise in Ghana. To enhance knowledge and prevention of cervical cancer among young people in Ghana, there is a need to better understand their education preferences. The study aimed to describe female senior school students' preferences for receiving cervical cancer education. A cross-sectional survey of students from 17 schools in the Ashanti Region of Ghana assessed the strength of preference for receiving cervical cancer education from a range of sources, settings and delivery mediums. Of the 2400 participants (aged 16-24years), the majority endorsed doctors (87%, 95%CI: 85-88%), nurses (80%, 95%CI: 78-82%) and credible health organisations (78%, 95%CI%: 76-79%) as their preferred source of education, and hospitals 83% (95%CI: 81-84%) as the preferred setting. Nearly all students (92%) endorsed at least three cervical cancer education delivery mediums, with at least three quarters endorsing television (78%, 95%CI: 77-80%), one-on-one health consultation in-person or online (77%, 95%CI: 75-79%; 75%, 95%CI: 73-77%), and health information websites (75%, 95%CI: 73-77%). Findings suggest that cervical cancer education efforts among female senior school students in Ghana should consider the use of a range of more resource-intensive individualised approaches to low-cost anonymous, generic approaches from credible sources and institutions.

Editorial introductions.

Editorial introductions.

A comprehensive analysis of YouTube videos on gender affirmation surgery.

The objective was to comprehensively analyze YouTube™ videos focusing on genital gender-affirmation surgery (GAS) from the perspective of urologists and gynecologists and to utilize results to create educational videos for transgender individuals with accurate and engaging content. A YouTube search was performed using the keywords "Metoidioplasty," "Phalloplasty," "Gender affirmation surgery," "Transgender surgery," "Vaginoplasty," and "Male-to-female surgery." Video results that were duplicated, non-English, of low relevance, non-audio, and/or short duration (under 2 min) were excluded. The upload source was classified as university/nonprofit physician or organization, health information websites, medical advertisement/for-profit organizations, or individual patient experience. Viewer engagement metrics were obtained for each video. Each video was evaluated using the DISCERN, Global Quality Score (GQS), and Patient Education Materials Assessment Tool for audio-visual content (PEMAT A-V) tools. A total of 273 videos were evaluated. Viewer engagement metrics of videos from the patient experience group were higher than those of both universities/nonprofit physicians and medical advertisement/for-profit groups. DISCERN and GQS scores were significantly lower in videos uploaded by the patient experience group than in each of the other upload sources. More videos covered female-to-male (FtM) transition (168, 61.5%) than covered male-to-female (MtF; 71, 26.0%), and both (34, 12.5%). MtF transition videos had significantly higher total view counts than videos from the other groups (p<0.001). The like counts of videos were significantly higher in both MtF transition and FtM transition groups than for videos explaining both types of transition within the same video. The total DISCERN score was significantly lower in FtM transition videos than in the other content groups. Two educational videos were prepared, informed by the tools and results of this study, and hosted on YouTube. The findings suggest that genital GAS videos with less technical content have higher audience engagement. This information should be used to aid medical organizations when creating YouTube content to provide accurate information to larger audiences in the transgender community.

A Potential Systematic Barrier to Community Health Literacy about Epilepsy Surgery: A Preliminary Readability Analysis of Online Health Education Materials in the United States (P6-1.006)

<h3>Objective:</h3> Analyze readability of online health education materials designed to provide epilepsy surgery information to patients. <h3>Background:</h3> Epilepsy surgery is an effective albeit underused treatment for refractory epilepsy. The workup and procedure explanations are complex and further compounded by the cognitive difficulties many people with epilepsy face. A previous United Kingdom study showed poor readability of online resources used for epilepsy surgery. However, there is still much to explore regarding the readability of resources in the United States, and what kinds of sites are associated with better readability. <h3>Design/Methods:</h3> A private browser was used to search Google for the top 100 search results for the terms “epilepsy+surgery”. Scientific papers, insurance pages, pay-wall access sites, and non-text content were excluded. The website text was re-formatted to exclude graphics, contact information, links, and headers. Readability metrics were calculated using an online readability tool (Datayze Readability Analyzer). Analysis was done through R using the Kruskal-Wallis test, and statistical assumptions were assessed. <h3>Results:</h3> Here we present the preliminary analysis of the top 100 items from a Google search yielding 76 websites and 24 exclusions. Websites were categorized as US based organizations or non-US, content from level 4 epilepsy centers, and if the sources were community health websites not associated with academic institutions. The Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) showed significantly better readability in community health websites (FRE p=.03, FKGL p=.03), non-level 4 epilepsy centers (FRE p=.002, FKGL p=.002), and international websites (FRE p=.02, FKGL =.03). <h3>Conclusions:</h3> Health information source characteristics associated with better readability levels included non-academic centers, non-level 4 epilepsy centers and community health information websites. This analysis suggests that academic centers, especially level 4 epilepsy centers, should consider involving community members, advocacy organizations and non-medical writers in the designing of online epilepsy surgery health education materials. <b>Disclosure:</b> Mr. Seneviratne has nothing to disclose. Ms. Ho has nothing to disclose. Dr. Correa has received personal compensation in the range of $0-$499 for serving as a Consultant for Independent Medical Consultants. Dr. Correa has received personal compensation in the range of $0-$499 for serving as a Consultant for Atheneum Partners. Dr. Correa has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology. Dr. Correa has stock in Aidin Inc. Dr. Correa has received research support from Genentech. Dr. Correa has received research support from Psi Upsilon Foundation Inc.