Quality comparison of websites related to developmental disabilities

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Highlights

  • Of 208 websites on developmental disabilities only 50% contained relevant information.

  • Websites containing references had higher quality than those without.

  • Websites with a top-level domain of .gov or .org had higher quality than those with .com.

  • Sponsored ads and websites with advertisements had poorer quality than those without.

  • The Internet should not replace information obtained from other professionals.

Abstract

The Internet is commonly used to seek health-related information, but little is known about the quality of websites on developmental disabilities. Therefore, we sought to evaluate the characteristics and quality of websites located by searching ten common terms related to developmental disabilities and explore relations between website characteristics and website quality in order to make recommendations on ways to ensure locating good online information. We located 208 unique websites in our November 2012 US searches of Google and Bing. Two independent coders evaluated 10 characteristics of the websites and two different coders assessed the quality of the websites. From the 208 websites, 104 (50%) provided relevant information about the disability being searched. Of these 104 websites, those found to be of highest quality were least likely to be a sponsored result, contain advertisements, be from a for-profit company, and did contain references to peer-reviewed publications or had a top-level domain of .gov or .org. Individuals with developmental disabilities and their family members who choose to obtain disability-related information online should remain vigilant to ensure that they locate high-quality and accurate information and should not replace information obtained from health-care professionals and educational specialists with information found online.

Introduction

The Internet is one of the main resources people use to find information on health-related issues (Fox and Duggan, 2013, Fox and Jones, 2009, Khoo et al., 2008, Moretti et al., 2012, Wainstein et al., 2006). A 2012 survey indicated that 72% of American Internet users searched for health information online (Fox & Duggan, 2013), typically using popular search engines such as Google and Yahoo (Eysenbach and Kohler, 2002, Khoo et al., 2008), although the use of mobile software applications (apps) for health purposes is increasing (Fox & Duggan, 2012). Although people report having much trust in health-related information that they locate online (Fox & Rainne, 2002), the World Wide Web is characterized by uncontrolled and unmonitored publishing. Website consumers report relying more on esthetics than content (Kim et al., 1999, Stanford et al., 2002), leaving open the possibility that malicious sites with ‘official looking’ pages will mislead consumers into believing they are authoritative (Cline & Haynes, 2001). There are tools for assessing website quality (e.g., DISCERN (Charnock, 1998), Stratchclyde Website Evaluation Form (SWEF) (Akram, Thomson, Boyter, & Morton, 2008), and HONcode (Foundation, 2010)) (Wilson, 2002), and one tool, DISCERN, has been shown to be sensitive in distinguishing good treatment oriented informational websites (Khazaal et al., 2012, Khazaal et al., 2009). However, the utility and appropriateness of these tools for consumer use has been questioned (Bernstam et al., 2005, Gagliardi et al., 2003), and it is likely that consumer adoption and use of the tools is low.

Using the Internet to locate information is also true of parents of children with developmental disabilities (Bussing et al., 2012, Porter and Edirippulige, 2007, Roche and Skinner, 2009, Zaidman-Zait and Jamieson, 2004) and adolescents and adults who have developmental disabilities (Bussing et al., 2012, Davis, 2002, Karras and Rintamaki, 2012, Moreno et al., 2012). Examinations of parents using the Internet to locate information on developmental disabilities has shown that parents are often seeking general information on topics such as characteristics, treatment options, and resources (Porter and Edirippulige, 2007, Roche and Skinner, 2009, Zaidman-Zait and Jamieson, 2004), as well as for emotional and social support (Zaidman-Zait & Jamieson, 2004). Zaidman-Zait and Jamieson (2007) found that mothers of young children with disabilities expressed serious concerns regarding the reliability of the information. This fear has been confirmed by research showing many general health-related websites (Eysenbach et al., 2002, Scullard et al., 2010) and websites specifically pertaining to developmental disabilities including autism (Chowdhury et al., 2002, Di Pietro et al., 2012, Reichow et al., 2012, Stephenson et al., 2012), ADHD (Akram et al., 2008, Mitchell and Read, 2012), speech impairments (Ghidella, Murray, Smart, McKenna, & Worrall, 2005) and hearing impairments (Laplante-Lévesque et al., 2012, Porter and Edirippulige, 2007) have inaccurate or misleading information. Examination of Internet use by individuals with disabilities has shown that while they find it useful, they cannot always access the information (Davis, 2002) and have difficulty distinguishing good from bad information (Karras and Rintamaki, 2012, Moreno et al., 2012).

There are millions of websites with information on developmental disabilities on the World Wide Web. The few studies referenced above provide but a glimpse of what can be found online and the paucity of research on websites related to developmental disabilities does not allow us to make general conclusions about the quality of information on developmental disabilities contained on the Internet. This paper presents the results of a study evaluating the characteristics and quality of websites that were located by searching ten common terms related to developmental disabilities, and analyses of whether certain characteristics predicted quality across sites.

Section snippets

Sample

The sample consisted of the websites (including sponsored advertisements) appearing on pages containing the top 10 results returned when one of ten terms related to developmental disabilities was entered into the Google (http://www.google.com) and Bing (http://www.bing.com) online search engines on November 16, 2012. We chose to use the Google and Bing search engines because they are the two search engines in the United States with the largest market share. All searches were formed on a new

Results

Our searches returned 295 websites; after eliminating 87 duplications the final sample included 208 websites. Of the 208 websites, 104 (50%) were coded as being relevant, ranging from 23% for “deaf” to 75% for “developmental delay” and “learning disability”. We used descriptive statistics to describe characteristics of the relevant websites by disability category, which are shown in Table 1.

The overall mean WQS was 8.49 (SD = 1.49). We used Spearman correlations for dichotomous and ordinal

General findings

This study and its findings have important because they present the first analyses of websites related to a broad array of developmental disabilities. As stated previously, most people, including parents of children with developmental and other disabilities, are increasingly relying on information from the Internet to help inform healthcare decisions. Given the findings that people generally trust the information they find online (Fox & Rainne, 2002), it is imperative that they are able to

Conclusions

The Internet, and specifically the World Wide Web, continues to be a source that individuals with developmental disabilities and their families use to obtain disability-related information. In our examination of websites related to ten common developmental disability terms, if someone was searching for general information on a disability, we found many good sites providing current, accurate and comprehensive information. However, we also found that 50% of the websites that were returned in our

Acknowledgments

The authors wish to thank Kerry DeBenidictis and Abigail Bushley for their assistance collecting data for this study and Timothy Steinhoff and Jason Halpern for comments on an earlier draft of this manuscript. Funding for this study was provided by the Health Resource Services Administration Bureau of Maternal and Child Health University Centers of Excellence on Developmental Disabilities, Grant # 90DD0650. The authors declare no competing interests that might have influenced their work on this

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