Objective: To synthesize the literature on youth suicide risk factors (RFs) and prevention strategies (PSs); evaluate quality of information regarding youth suicide RFs and PSs found on selected Canadian websites; determine if website source was related to evidence-based rating (EBR); and determine the association of website quality indicators with EBR.
Methods:Five systematic reviews of youth suicide research were analyzed to assemble the evidence base for RFs and PSs. The top 20 most commonly accessed youth suicide information websites were analyzed for quality indicators and EBR. Univariate logistic regression was conducted to determine if quality indicators predicted statements supported by evidence (SSEs). Multivariate analysis was used to calculate adjusted odds ratios for SSEs and quality indicators.Results: Only 44.2% of statements were SSEs. The 10 most highly ranked websites contained almost 80% of the total statements analyzed, and one-half had a negative EBR. Compared with government websites, nonprofit organization websites were more likely (OR 1.45, 95% CI 0.66 to 3.18), and personal and media websites were less likely (OR 0.62, 95% CI 0.26 to 1.47), to have a positive EBR. Crediting of an author (AOR 2.65, 95% CI 1.34 to 5.28), and recommendation to consult a health professional (AOR 2.08, 95% CI 1.18 to 3.68), increased the odds of SSEs.
Conclusions:Fundamental to addressing youth suicide is the availability of high-quality, evidence-based information accessible to the public, health providers, and policy-makers. Many websites, including those sponsored by the federal government and national organizations, need to improve the evidence-based quality of the information provided.Can J Psychiatry. 2009;54(9):596-604.
Clinical Implications· The Internet is an important source of health information for adults and youth, particularly for stigmatized illnesses like mental disorders. · However, web-based information sources should be approached with caution because in this study more than one-half of the statements regarding youth suicide made on popular Canadian websites were not supported by the evidence base. · Authoritative mental health organizations in Canada should create and advertise the availability of evidence-based web information pertaining to youth suicide.
Limitations· This analysis was restricted to Canadian websites dealing with issues of suicide in non-Aboriginal populations. · This analysis does not consider website design. Future studies should integrate users and their website selection criteria (for example, design) into a broader analysis. · The Internet is an ever-changing medium. It is possible that our results are not representative of the information currently accessed by people searching for information about youth suicide.