Internet-based Health Information Research Articles

Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: a mixed-methods study

BackgroundWomen diagnosed with gestational diabetes mellitus often rely on internet-based health information for managing their condition. This study aims to investigate the present state of electronic health literacy among women with gestational diabetes mellitus, analyze the influencing factors, and explore their experiences regarding accessing, comprehending, evaluating, and applying online health information pertinent to gestational diabetes mellitus.MethodsA sequential explanatory mixed methods research design was adopted in this study. Initially, 235 women with gestational diabetes mellitus participated in a cross-sectional survey. The research tools included general information and the Chinese version of the electronic Health Literacy Scale (eHEALS). Descriptive analyses were conducted to describe the characteristics of the sample, and multiple linear regression analyses were used to explore the factors influencing electronic health literacy among women with gestational diabetes mellitus. Secondly, 11 women with gestational diabetes mellitus joined semi-structured in-depth interviews to obtain their perceptions about online health information. The data were analyzed using inductive content analysis to develop themes.ResultsThe median score of eHEALS in the Chinese version among 235 women diagnosed with gestational diabetes mellitus was 29 (interquartile range [IQR], 26 to 32). Factors influencing electronic health literacy among these women included accessing health information from medical professionals (β = 0.137, p = 0.029) and utilizing health information from applications (β = 0.159, p = 0.013). From the qualitative phase of the study, four thematic categories emerged: reasons and basis for accessing health information from the Internet; address barriers to accessing and applying online health information; desires for a higher level of online health information services; outcomes of accessing and applying online health information.ConclusionThe electronic health literacy of women diagnosed with gestational diabetes mellitus remains suboptimal and warrants improvement. The sources of access to health information affect electronic health literacy in women with gestational diabetes mellitus. Moreover, women facing gestational diabetes encounter numerous impediments when attempting to access health-related information online, underscoring the necessity for enhanced online health information services to meet their needs.

Can Artificial Intelligence Treat My Urinary Tract Infections?—Evaluation of Health Information Provided by OpenAI™ ChatGPT on Urinary Tract Infections

Urinary tract infections (UTIs) are highly prevalent and have significant implications for patients. As internet-based health information becomes more relied upon, ChatGPT has emerged as a potential source of healthcare advice. In this study, ChatGPT-3.5 was subjected to 16 patient-like UTI queries, with its responses evaluated by a panel of urologists. ChatGPT can address general UTI questions and exhibits some reasoning capacity in specific contexts. Nevertheless, it lacks source verification, occasionally overlooks vital information, and struggles with contextual clinical advice. ChatGPT holds promise as a supplementary tool in the urologist’s toolkit, demanding further refinement and validation for optimal integration.

IJCM_417A: Internet health information seeking and its effect on patient-doctor relationship and satisfaction among patients attending a tertiary care hospital in Mangalore

Background: The doctor-patient relationship is a fundamental and essential component of healthcare that plays a critical role in patient outcomes, trust, and overall quality of care. Internet-based health information has been found to have both positive and negative effects on patients. Objectives: To assess the internet health-seeking behaviour among patients, and its effect on the doctor-patient relationship Methodology: In this facility-based cross-sectional study, 110 patients were assessed regarding their internet health-seeking behaviour and its effect on the doctor-patient relationship. Patient-Doctor Depth-of-Relationship Scale and Patient Satisfaction Questionnaire – Short form (PSQ-18) was used to assess the relationship. A comparison of patient satisfaction scores and doctor-patient relationship scores among those who use the internet for seeking health-related information with those who do not was done by independent t-test and P < 0.05 will be considered to be a statistically significant difference. Results: Sixty-seven-point three per cent use the internet for health-related information. Most of the patients felt satisfied with their medical care but there was still some scope of improvement in the domains of communication and the time devoted by the doctor to the patient. The overall level of patient satisfaction was above average. Our study also showed that 77.2% of the study participants had a good relationship with their doctor. Conclusion: In our study, we found that the internet using study participants were found to have an above average satisfaction with their doctors.

Evaluation of quality and readability of internet information on voice disorders

ObjectivesThe purpose of this study is to evaluate the readability and quality of Internet information related to vocal health, voice disorders and voice therapy. Study designThis is a cross-sectional study. MethodsEighty-two websites were included. Websites were then analyzed; their origin (clinic/hospital, non-profit, government), quality (Health On the Net [HON] certification and DISCERN scores) and readability (Ateşman readability formula and Bezirci-Yılmaz new readability formula) were assessed. Statistical analysis was used to examine differences between website origin and quality and readability scores and correlations between readability instruments. ResultsOf the 82 websites, 93% were of private clinic/hospital, 6% were of non-profit organisation and 1% were of government. None of the 82 websites were HON certification, and the mean score of the item determining the general quality measure in DISCERN was 1.83 in a five-point scale. The mean of Ateşman readability formula value was calculated as 50.46 (±8.16). This value is defined as ‘moderately hard’ according to the readability scale. The average of Bezirci-Yılmaz new readability formula value is 13.85 (±3.48). This value is defined as 13th and 14th grade. ConclusionsThe quality of Internet-based health information about the voice is generally inadequate, and the sites examined in this study may be limited due to high readability levels. This may be a problem in people with poor literacy skills. For this reason, it is very important for speech and language therapists and other health professionals to evaluate and monitor the quality and readability of Internet-based information.

Readability and Quality of Online Information on Sickle Cell Retinopathy for Patients

PurposeThis study aims to evaluate the readability and quality of internet-based health information on sickle cell retinopathy. DesignThe study is a retrospective cross-sectional website analysis. MethodsTo simulate a patient's online search, the terms “sickle cell retinopathy” and “sickle cell disease in the eye” were entered into the top three search engines (Google, Bing and Yahoo). The first 20 results of each search were retrieved and screened for analysis. The DISCERN questionnaire, the Journal of the American Medical Association (JAMA) standards and the Health on the Net (HON) criteria were used to evaluate the quality of the information. The Flesch-Kincaid Grade Level (FKGL), the Flesch Reading Ease (FRES) and the Automated Readability Index (ARI) were used to assess the readability of each website. ResultsOut of 16 online sources, 12 (75%) scored moderately on the DISCERN tool. The mean DISCERN score was 40.91 (SD 10.39; maximum possible, 80). None of the sites met all the JAMA benchmarks and only three (18.75%) of the websites had HONcode certification. All the websites had scores above the target American Medical Association grade level of six on both the FKGL and ARI. The mean FRES was 57.76 (±4.61), below the recommended FRES of 80-90. ConclusionThere is limited online information available on sickle cell retinopathy. Most included websites were fairly difficult to read and of substandard quality. The quality and readability of internet-based patient-focused information on sickle cell retinopathy needs to be improved.

712-P: Social Support, eHealth Literacy, and mHealth Use in Older Adults with Diabetes—Moderated Mediating Effect of Perceived Importance of App Design

Mobile healthcare (mHealth) for older adults with diabetes could benefit diabetes self-management. However, limited research is available regarding the factors influencing mHealth use. This descriptive study aimed to identify the factors that influence mHealth use. Participants aged 65 years or older with diabetes living in South Korea were recruited online and offline to complete a structured self-report questionnaire. With 252 valid responses, the moderated mediating effect of eHealth literacy and the perceived importance of app design in the relationship between social support and mHealth use were tested using SPSS PROCESS Macro 4.0. The results show that social support had a positive relationship with mHealth use, and eHealth literacy and perceived importance of app aesthetics had a moderated mediating effect. Moreover, when patients’ perceived importance of app aesthetics was high, eHealth literacy more positively affected mHealth use. This study implies that it is necessary to enlist the help of family, friends, and neighbors to increase access to internet-based health information and encourage mHealth use among older adults with diabetes. Furthermore, this study suggests developers should consider user experience (UX), such as font size, color, and menu configuration when developing mHealth for older adults with diabetes. Disclosure M.Kim: None. B.Kim: None. S.Park: None.

Evaluation of readability of patient education materials on lateral epicondylitis (tennis elbow) from the top 25 orthopedic institutions

Lateral epicondylitis (LE), also known as "tennis elbow," is a common orthopedic tendinosis of the elbow that affects between 1% and 3% of the overall population. LE occurs due to overuse of the extensor mechanism or muscles of supination in the forearm. The National Institute of Health and the Center for Disease Control suggest that patient education materials (PEMs) be written at a 6th or 8th grade reading level, respectively; however, PEMs are often written far beyond these recommended reading levels. The goal of this study was to assess the readability level of PEMs published by some of the top orthopedic institutions throughout the United States. A list of the top 25 ranking orthopedic hospitals in the country was compiled using the 2022 U.S. News and World Report Best Hospitals Specialty Ranking. PEMs related to LE were cataloged from each institution's website, and readability levels for each PEM were measured using the http://www.readabilityformulas.com website. This software analyzes readability using the formulas listed in Table1. While the Flesch-Kincaid (FK) Reading Ease Score formula outputs a number from 0 to 100, in which larger numbers indicate easier reading, the remaining formulas demonstrate a text's readability through assigning a grade-appropriate reading level. A Spearman regression was used to evaluate correlation between institutional ranking and FK Reading Ease Scores. Of the 25 PEM texts analyzed during this study, none were written at or below the sixth grade reading level, as recommended by the National Institutes of Health. These results suggest that the most prestigious orthopedic hospitals provide online informational resources that are unable to be read or understood by a large portion of the institution's intended audience. Additionally, there was no correlation found between institutional ranking and FK Reading Ease Score. Internet-based health information has conveniently allowed patients to educate themselves on their health care. In accordance with National Institutes of Health and Centers for Disease Control and Prevention guidelines, orthopedic institutions should strive to publish PEMs at or below an eighth grade reading level.

Exploring E-Health Literacy and Technology-Use Anxiety among Older Adults in Korea.

The COVID-19 pandemic has increased the importance of health literacy in disseminating information on health in a non-contact society. This study focused on examining the acceptance capacity by older adults of smart devices in Korea and investigating the potential differences between men and women in terms of e-health literacy and technology-use anxiety. The study included 1369 respondents who were adults over 50 years of age and used welfare centers, public health centers, senior citizen centers, and exercise centers in Seoul and Incheon. An online survey was conducted from 1 June 2021 to 24 June 2021. The study found that the older adults' low levels of digital literacy could limit their access to health information and negatively impact their health. The difference between men and women in terms of technology-use anxiety was statistically significant, with the latent mean for men being higher than that for women. The effect sizes of the potential mean differences were found to be at a medium level for e-health literacy and a significant level for technology-use anxiety. With Korea's aging population and the need for the continuous management of chronic diseases among older adults, it is essential to discuss internet-based health information for disease maintenance and treatment.

Had percutaneous coronary intervention, now what? Searching the internet for health information

Abstract Background/Introduction Health information and secondary prevention strategies after percutaneous coronary intervention (PCI) are pivotal to reduce the risk of new cardiac events and achieve good quality of life. However, whether patients are digitally active and have sufficient electronic health literacy (eHL) skills to access, understand and use internet-based health information remain unclear. Purpose To determine the extent to which patients after PCI are digitally active, and determine associations of health related internet use and socio-demographic factors with eHealth literacy. Methods This study is a sub-study of the prospective, multicenter CONCARDPCI study including >3000 patients after PCI. A total of 1956 patients were included from three Norwegian university hospitals between June 2017 and May 2019. Clinical data were collected through Norwegian Registry of Invasive Cardiology and patient medical records. Sociodemographics were obtained by self-report during index hospitalization. The eHealth Literacy Scale (eHEALS) assessed patient's eHL at baseline, measured on an 8–40 scale. De novo created questions assessed patient's health-related internet use, and use of the national health portal for information was measured at baseline and 2- and 6-month follow-up. Linear regression analysis determined the association between eHEALS, use of the internet, and sociodemographic factors. Results Most participants were men (78%), mean age 66 years (range; 20–96 years, SD 10.9). A total of 94% of the participants reported to have access to the internet, 67% had used the internet to find health information, and 54% had used the national health portal. After 6 months, patients increased their use of the national health portal (54% to 66%). Use of health applications on mobile phones or tablets increased from 10% to 40% from 2- to 6-month follow-up (P<0.001). At baseline 45% found the internet useful or very useful to make health decisions, and 57% found access to health resources on the internet to be important or very important. However, 50% were uncertain about how to use the information to make decisions about their own health. The eHEALS mean score was low; 25,66 (SD 6,24). Adjusted for sociodemographic factors there was an significant association between eHEALS and use of the internet to find health information at baseline (coefficient 11.41, 95% CI 8.05–14.57, P=0.001). At 2-month follow-up there was an significant association between eHEALS and use of the internet to find information about health, prevention, illness or treatment (coefficient 9.027, 95% CI 6.78–11.06, P=0.001), and the use of health applications (coefficient 3.197, 95% CI 0.24–6.30, P=0.046). Conclusions This study provided evidence that higher eHL predicts use of the internet to find health information and indicates that eHL and sociodemographic factors have an impact on how patients use, and can make use of, eHealth technology. Funding Acknowledgement Type of funding sources: Other. Main funding source(s): The Western Norway Health Authority

Online and offline health information seeking and the demand for physician services.

We examine the relationship between Internet-based health information seeking and the demand for physician services, using data collected from the 28 European Union states in 2014. Unlike previous research, our analysis distinguishes seekers of health information into those who use only non-Internet sources and those who use the Internet and possibly non-Internet sources. By comparing the frequencies of physician visits among the two groups of health information seekers and non-seekers, we infer the net association between online health information and the demand for physician services while partially controlling for the effects of concurrent seeking of offline health information. The following are the two key findings: (1) individuals’ health status and sociodemographic factors shape online and offline health information seeking patterns in similar ways; and (2) the demand for physician services is positively associated with offline health information seeking and not with online health information. The net association with online health information would be even smaller after controlling for the effect of concurrent offline health information seeking. These results suggest that extending the availability of online health information would potentially reinforce the unequal access to health information, which could create greater variation in individuals’ health management skills and benefits from health care in the long term. However, it would be associated with little or no increase in the demand for physician services, unlike the implications of previous research.

Quality and Readability Assessment of Internet-Based Information on Common Prosthodontic Treatments.

To evaluate the readability and quality of patient-oriented information online among different common prosthodontic search areas using multiple quality and readability assessment tools. The prosthodontic keywords most commonly searched by patients on the internet were included. The search was performed through two online search engines (Google and Yahoo) to create the study sample. The first 50 websites listed by each search engine were chosen for each keyword. The quality of each website's information was evaluated using the DISCERN questionnaire and the Health on the Net (HON) criteria. Readability assessment was performed using the Flesch-Kinkaid Reading Grade Level (FKRGL) and the Flesch Reading Ease Score (FRES). A total of 225 websites were included in the study. The median score for the DISCERN instrument indicated poor information quality. A significant difference was found between the educational and commercial websites in both quality and readability. Overall, the median readability indices showed that the websites' information was difficult to read. Internet-based health information on different prosthodontic treatments is difficult to read and poor in quality and readability. It is necessary for health care providers to establish and promote websites that have reliable, high-quality information about common prosthodontic treatments.

Quality and readability of internet information about stuttering

PurposeWe examined the quality and readability of English-language Internet information about stuttering and evaluated the results considering recommendations by experts in health literacy. MethodA search of Internet websites containing information about stuttering was conducted. Three key words (i.e., stuttering, stammering, speech disfluency) were entered into five country-specific versions of the most commonly used Internet search engine. A total of 79 websites were assessed. Their origin (commercial, non-profit, government, personal or university), quality [Health On the Net (HON) certification and DISCERN scores], and readability [Flesch Reading Ease (FRE) score, Flesch-Kincaid Grade Level Formula (F-KGL), and Simple Measure of Gobbledygook (SMOG)] were assessed. ResultsOf the 79 websites, 38 % were of commercial, 42 % were of nonprofit organization, 15 % were of government and 5% were of university origins, respectively. Only 13 % had obtained HON certification and the mean DISCERN scores was 3.10 in a 5-point scale. The mean reading grade levels were at 13th and 14th grade and 100 % of the websites exceeded the recommended 5th to 6th reading grade level for health information. ConclusionsThe quality of Internet-based health information about the treatment of stuttering is generally adequate, but actual usability of the sites examined in this study may be limited due to poor readability levels. This is problematic in persons with poor literacy skills. Since the Internet can be readily accessed as a valuable consumer information resource, speech-language pathologists and other healthcare professionals have an opportunity to direct consumers to websites that provide readable information of good quality.

Internet health information education for older adults: A pilot study

This study aimed to develop internet health information education program, and to explore the program's feasibility and preliminary effects. We made use of an intervention mapping approach and adopted as conceptual framework the information-motivation-behavioral skills model to develop the program. We evaluated the feasibility and the impact of the education program using a single-group pretest-posttest design using generalized equation estimation. Eleven older adults participated in the classes from January 25 to February 22, 2019. Each outcome of the behavioral theory-based components of the program—computer/Web knowledge (p < .001), attitude toward internet-based health information (p = .002), eHealth literacy score (p < .001), searching performance scores (p < .001), and level of understanding of internet-based health information (p = .002)—showed significant improvement immediately after the intervention. This pilot study reveals that a behavior theory-based education program for utilizing internet-based health information is an effective way to increase older adults’ eHealth literacy.

Assessment of the Quality of Internet-Based Health Information in the Indonesian Language about Polycystic Ovarian Syndrome

Objectives: To investigate health information quality about PCOS on the internet in Indonesian language.Methods: Top website from two separate search engines (Google and Bing) was collected using the keyword of “sindrom ovarium polikistik” (polycystic ovarian syndrome). Analysis of health information quality on those websites was performed.Results: Sixty-nine websites were included for analysis. The majority of those websites have good information quality in terms of content accuracy and website credibility. There was no difference in quality between the two search engines. The website was found at the top two pages in each search engine to have better quality than the later pages (p=0.02). The educational website had better quality (p=0.05). The website made by healthcare organizations had better quality (p=0.04). The non-commercial website had better information quality (p=0.01).Conclusion: Criteria affecting health information quality on the internet were as follows: found at the top two pages on a search engine; educational website; made by healthcare organization; and non-commercial purpose.Keywords: health information quality, Indonesian language, internet-based, polycystic ovarian syndrome&#x0D; Abstrak&#x0D; Tujuan: Untuk melakukan kajian kualitas informasi kesehatan tentang PCOS di internet dalam Bahasa Indonesia.Metode: Situs web teratas dari dua mesin pencari terpisah (Google dan Bing) dikumpulkan dengan menggunakan kata kunci “sindrom ovarium polikistik”. Analisis kualitas informasi kesehatan pada situs-situs tersebut telah dilakukan.Hasil: Enam puluh sembilan situs web dimasukkan untuk analisis. Mayoritas situs web tersebut memiliki kualitas informasi yang baik dalam hal akurasi konten dan kredibilitas situs web. Tidak ada perbedaan kualitas antara kedua mesin pencari tersebut. Situs web ini ditemukan pada dua halaman teratas di setiap mesin pencari memiliki kualitas yang lebih baik daripada halaman-halaman selanjutnya (p = 0,02). Kualitas situs web berbasis pendidikan menunjukkan hasil lebih baik (p = 0,05). Kualitas website yang dibuat oleh organisasi kesehatan menunjukkan hasil lebih baik (p = 0,04). Situs web non-komersial memiliki kualitas informasi yang lebih baik (p = 0,01).Kesimpulan: Kriteria yang mempengaruhi kualitas informasi kesehatan di internet adalah sebagai berikut: ditemukan pada dua halaman teratas pada mesin pencari; situs web berbasis pendidikan; dibuat oleh organisasi kesehatan; dan tujuan non-komersial.Kata kunci : bahasa indonesia, berbasis internet, kualitas informasi kesehatan, sindrom ovarium polikistik.

A Content Analysis of YouTube Videos Related to Hearing Aids.

Increasingly, people access Internet-based health information about various chronic conditions including hearing loss and hearing aids. YouTube is one media source that has gained much popularity in recent years. The current study examines the source, content, understandability, and actionability of YouTube videos related to hearing aids. Cross-sectional design by analyzing the videos at single point in time. One hundred most frequently viewed videos in YouTube. Not applicable. The 100 most-viewed English language videos targeting individuals seeking information regarding hearing aids were identified and manually coded. Data collection included general information about the video (e.g., source, title, authorship, date of upload, duration of video), popularity-driven measures (e.g., number of views, likes, dislikes), and the video source (consumer, professional, or media). The video content was analyzed to examine what pertinent information they contained in relation to a predetermined fact sheet. Understandability and actionability of the videos were examined using the Patient Education Material Assessment Tool for Audiovisual Materials. Of the 100 most-viewed videos, 11 were consumer-based, 80 were created by professionals, and the remaining 9 were media-based. General information about hearing aids, hearing aid types, and handling and maintenance of hearing aids were the most frequently discussed content categories with over 50% of all videos commenting on these areas. Differences were noted between source types in several content categories. The overall understandability scores for videos from all sources were 74%, which was considered adequate; however, the actionability scores for all the videos were 68%, which is considered inadequate. YouTube videos about hearing aids focused on a range of issues and some differences were found between source types. The poor actionability of these videos may result in incongruous consumer actions. Content and quality of the information in hearing aid YouTube videos needs to be improved with input from professionals.

Superdiversity, migration and use of internet-based health information \u2013 results of a cross-sectional survey conducted in 4 European countries

BackgroundStudies of factors associated with the use of Internet-based health information generally focus on general, rather than migrant populations. This study looked into the reasons why Internet-based health information is used and the effects of migration-related factors, other socio-demographic characteristics and health-related factors on the tendency to consult the Internet.MethodsIn a cross-sectional survey conducted in eight superdiverse neighbourhoods - two each in Birmingham, United Kingdom; Bremen, Germany; Lisbon, Portugal and Uppsala, Sweden - participants were presented with six scenarios and asked to indicate the resources they most relied on when addressing a health concern from a given list. The scenarios included establishing the underlying causes of a health concern and seeking information about prescription drugs, treatments and services available as part of the public healthcare system. The list of resources included the public healthcare system, alternative medicine, family and friends, and the Internet. Frequencies for which the Internet was consulted for each different scenario were calculated and compared across the participating cities. The association between consulting Internet-based health information and migration-related factors, and further socio-demographic characteristics as well as health-related factors such as self-reported health and health literacy was assessed using multivariable logistic regressions.ResultsOf the 2570 participants from all four cities who were included in the analyses, 47% had a migrant background and 35% originated from non-EU countries. About a third reported relying on Internet-based health information for at least one of the given scenarios. The two most frequently chosen scenarios were to find out about other possible treatments and prescription drugs. Generally, using Internet-based health information was negatively associated with being a first generation migrant (OR 0.65; 95% CI 0.46–0.93), having poor local language competency (OR 0.25; 95% CI 0.14–0.45), older age (≥60 years, OR 0.21; 95% CI 0.15–0.31), low education (OR 0.35; 95% CI 0.24–0.50) and positively associated with low trust in physicians (OR 2.13; 95% CI 1.47–3.10).ConclusionOur findings indicate the need to consider migration background and language competency when promoting the provision of healthcare services via the Internet so that information and services are widely accessible.

Internet-Based Health Information-Seeking Behavior of Students Aged 12 to 14 Years: Mixed Methods Study.

BackgroundMany children and adolescents are surrounded by smartphones, tablets, and computers and know how to search the internet for almost any information. However, very few of them know how to select proper information from reliable sources. This can become a problem when health issues are concerned, where it is vital to identify incorrect or misleading information. The competence to critically evaluate digital information on health issues is of increasing importance for adolescents.ObjectiveThe aim of this study was to assess how children and adolescents rate their internet-based health literacy and how their actual literacy differs from their ratings. In addition, there was a question on how their search performance is related to their self-efficacy. To evaluate these questions, a criteria-based analysis of the quality of the websites they visited was performed. Finally, the possibility to increase their internet-based health literacy in a 3-day workshop was explored.MethodsA workshop with a focus on health literacy was attended by 14 children and adolescents in an Austrian secondary school. After prior assessments (Culture Fair Intelligence Test, revised German version; Reading Speed and Reading Comprehension Test for Grades 6 to 12, German; electronic health literacy scale [eHEALS]; and General Self-Efficacy Scale, Reversed Version, German), the students were asked to perform an internet-based search on a health-related issue. Browser histories and screenshots of all internet searches were gathered, clustered, and analyzed. After the workshop, the health literacy of the students was assessed again by using the eHEALS.ResultsThe 14 students opened a total of 85 homepages, but only eight of these homepages were rated as good or fair by two experts (independent rating) based on specific criteria. The analysis showed that the students judged their own internet-based health literacy much higher than the actual value, and students who had rated themselves better did not visit websites of high quality. Internet-based health literacy correlated significantly with the self-efficacy of the students (rs=0.794, P=.002).ConclusionsOur study showed that it is possible to draw the attention of students to critical aspects of internet search and to slightly improve their search competence in a workshop. Targeted improvement of health literacy is urgently required, and students need special instruction for this purpose. Further investigations in this area with larger sets of data, which could be feasible with the help of a computer program, are urgently needed.

EMental Health Literacy and Knowledge of Common Child Mental Health Disorders among Parents of Preschoolers

The purpose of the study was to assess the eMental health literacy of parents of preschool children and explore the relationships between their eMental health literacy skills and their knowledge of common child mental health disorders and their child difficulties. Online survey data were collected using Mechanical Turk (MTurk). Parents of preschool children completed questionnaires related to internet-based mental health information seeking behavior, knowledge of common child mental health disorders using case vignettes, and child difficulties. Data were analyzed using descriptive statistical methods. eMental health literacy of parents was high but knowledge of the child mental health disorders was low. Only 14% of parents correctly identified all three disorders; 41.1% identified attention deficit hyperactivity disorder (ADHD), 64.9% recognized autism spectrum disorder (ASD), and 19.1% identified separation anxiety disorder (SAD). Parents with high eMental health literacy (≥30) were more likely to endorse professional help and seek information on how to manage problem behaviors for all three disorders. Parents with low eMental health literacy (<30) were more likely to have a child with a high risk of a mental health disorder. The findings will be used to inform educational initiatives on the use of online resources and recognition of child mental health disorders to promote early intervention and appropriate help seeking.

Assessment of quality and readability of internet-based health information related to commonly prescribed angiotensin receptor blockers.

IntroductionHypertension is a global public health burden. Angiotensin receptor blockers (ARBs) have proven efficacy in the management of hypertension and related complications. The Internet has become a major source of health information for patients and healthcare professionals. The study aimed to assess the quality and readability of internet-based information related to selected Angiotensin Receptor Blockers (ARBs).MethodsThe three most widely used ARBs were identified from published literature, after which internet-based patient information was identified from the first five pages of three search engines (Google, Yahoo and Bing). Quality of identified websites were assessed using the DISCERN instrument, while readability was evaluated using the SMOG instrument and the Flesch-Kincaid readability algorithm. Final ratings were then calculated as described by the instruments developers. Further, inter-class correlation coefficients (ICC) were calculated using the Statistical Package for Social Sciences.ResultsThe average overall DISCERN score in this study was 2.99 (SD±1.05). No website received an excellent rating, 15% were rated good, 66% as moderate and 19% as poor. The inter-class reliability was 0.804 for losartan and 0.695 for valsartan. The mean Flesch Reading Ease score for the websites was 48.87 (SD±16.12), mean Flesch-Kincaid Reading Grade Level was 9.29 (SD±1.98) while mean SMOG value was 11.29 (SD±1.70).ConclusionOverall, patient information on the reviewed ARBs websites was found to be of moderate quality and suboptimal readability. Content providers on websites should ensure that health information is of favorable quality and easy to read by patients with varying degree of health literacy.

A Revised Model of Trust in Internet-Based Health Information and Advice: Cross-Sectional Questionnaire Study.

BackgroundThe internet continues to offer new forms of support for health decision making. Government, charity, and commercial websites increasingly offer a platform for shared personal health experiences, and these are just some of the opportunities that have arisen in a largely unregulated arena. Understanding how people trust and act on this information has always been an important issue and remains so, particularly as the design practices of health websites continue to evolve and raise further concerns regarding their trustworthiness.ObjectiveThe aim of this study was to identify the key factors influencing US and UK citizens’ trust and intention to act on advice found on health websites and to understand the role of patient experiences.MethodsA total of 1123 users took part in an online survey (625 from the United States and 498 from the United Kingdom). They were asked to recall their previous visit to a health website. The online survey consisted of an updated general Web trust questionnaire to account for personal experiences plus questions assessing key factors associated with trust in health websites (information corroboration and coping perception) and intention to act. We performed principal component analysis (PCA), then explored the relationship between the factor structure and outcomes by testing the fit to the sampled data using structural equation modeling (SEM). We also explored the model fit across US and UK populations.ResultsPCA of the general Web trust questionnaire revealed 4 trust factors: (1) personal experiences, (2) credibility and impartiality, (3) privacy, and (4) familiarity. In the final SEM model, trust was found to have a significant direct effect on intention to act (beta=.59; P<.001), and of the trust factors, only credibility and impartiality had a significant direct effect on trust (beta=.79; P<.001). The impact of personal experiences on trust was mediated through information corroboration (beta=.06; P=.04). Variables specific to electronic health (eHealth; information corroboration and coping) were found to substantially improve the model fit, and differences in information corroboration were found between US and UK samples. The final model accounting for all factors achieved a good fit (goodness-of-fit index [0.95], adjusted goodness-of-fit index [0.93], root mean square error of approximation [0.50], and comparative fit index [0.98]) and explained 65% of the variance in trust and 41% of the variance in intention to act.ConclusionsCredibility and impartiality continue to be key predictors of trust in eHealth websites. Websites with patient experiences can positively influence trust but only if users first corroborate the information through other sources. The need for corroboration was weaker in the United Kingdom, where website familiarity reduced the need to check information elsewhere. These findings are discussed in relation to existing trust models, patient experiences, and health literacy.