The impact of recommendations and warnings on the quality evaluation of health websites: An online experiment

With the increase in availability of online health information (OHI), consumers need to be able to properly evaluate the quality of health websites. Although several established evaluation criteria for OHI are available, these are rarely used by consumers. To improve people's ability and motivation to critically evaluate OHI, insights into how these criteria can optimally be communicated are needed. This study aims to investigate whether educational messages recommending the use of quality criteria can improve consumers' ability to evaluate OHI credibility, especially among people with low health literacy. We also test whether these messages can yield a stronger effect when combined with information warning consumers against using non-established criteria. In an online experiment, we randomly assigned 403 participants to one of four conditions and asked them to evaluate two websites of different quality. The conditions consisted of recommendations promoting the use of established evaluation criteria, warnings against using commonly adopted non-established criteria, a combination of the two, and a control group. Participants exposed to messages recommending established criteria evaluated the credibility of the lower quality website as poorer, and were better able to discriminate between high and low quality information compared to those in the control group. A combination of recommendations and warnings also improved people's ability to evaluate, but did not yield a stronger effect than the recommendations alone. Subgroup analysis, however, showed that these effects existed only for those with high health literacy. We conclude that providing consumers with criteria to evaluate OHI might be a viable way to improve people's evaluation skills of online health materials. Further research is needed to identify efficient ways to communicate these criteria to low health literate audiences

Dutch health websites and their ability to inform people with low health literacy

Objective To evaluate whether Dutch online health information (OHI) generally reflects message elements that support information processing and understanding among people with low health literacy. Methods We content-analyzed one hundred Dutch webpages about Ebola, fibromyalgia, ALS, losing weight, borderline personality disorder, hemorrhoids, ADD, bladder infection, shingles, and chicken pox. The codebook covered the following domains: images and videos, readability level, Suitability Assessment of Materials (SAM), advertising, interactive features, and reliability cues. Results Thirty-seven webpages contained informative images that visualized the text. Twelve webpages incorporated videos, six of which were animations. Readability varied widely, but 79.2% of the texts exceeded the recommended B1 level. Half of the webpages had inadequate SAM scores; five were classified as superior. Interactive features were infrequently used. Many webpages included only a few elements that help users evaluate the reliability of OHI. Four presented a quality label. Conclusion Over a wide range of health-related topics, Dutch OHI does not generally contain message elements that improve information processing among people with low health literacy. Practice implications Communication professionals should make better use of digital message features. Videos, narration, and interactivity are scarcely used but can be valuable for people with low health literacy