Trustworthiness, Readability, and Suitability of Web-Based Information for Stroke Prevention and Self-Management for Korean Americans: Critical Evaluation

Abstract

BackgroundWebsites are common sources of health information to stroke survivors and caregivers for continual management of stroke and its long-term sequelae. The presence of risk factors and mortality rates related to stroke are high in Korean Americans. A vast majority of this group are active Web users and rely on the Web-based information due to lack of insurance and, thus, limited access to long-term stroke care. Thus, it is critical to evaluate existing stroke websites for their trustworthiness, readability, and suitability.ObjectiveThe objective of our study was to provide a systematic evaluation of stroke-related websites regarding (1) trustworthiness, (2) readability, and (3) suitability for stroke prevention and self-management for Korean Americans.MethodsWe selected a total of 156 websites using search terms “stroke,” “CVA,” “중풍 (jungpung),” and “뇌졸증 (noejoljung)” on Google and Yahoo. After eliminating duplicates and irrelevant websites (n=116), we evaluated a total of 42 websites (15 in English and 27 in Korean) using the National Library of Medicine’s health website’s evaluation tool for trustworthiness; Simple Measure of Gobbledygook for readability; and Suitability Assessment of Materials for suitability. All three instruments used the 3-point Likert scale: superior (=2), adequate (=1), or not suitable (=0).ResultsOf the 42 websites evaluated, we rated 62% (26/42) websites as “adequate” or above for trustworthiness. The information on 48% (20/42) websites had not been updated for more than a year, which indicates poor currency; 33% (14/42) websites failed to provide the publisher and contact information, which yields poor authority; 50% (21/42) websites did not cite sources of health information, which indicates lack of accuracy. Only 2 websites met the recommended readability (5th grade or lower reading level). The suitability was also suboptimal; only 1 website was rated as “superior”; 60% (25/42) websites were “adequate,” and 38% (16/42) were “not suitable.” Most websites were limited in graphical directions, interactive motivations for desired healthy behaviors, and multiple language translations.ConclusionsThe existing stroke-related websites in either English or Korean are trustworthy and suitable, yet precise citation of evidence-based information will improve trustworthiness. The contents requiring high reading level may set a barrier to the utilization of Web-based health information for Korean Americans with a lower level of education. In addition, supplementing graphical examples, interaction features, and culturally relevant information in multiple languages are the areas for improvement in suitability. The improved features can reduce the reading burden of stroke patients or caregivers and build their confidence when applying the information for stroke management in daily living. These strategies are especially crucial to Korean Americans, who inevitably seek Web-based information to fill the gap between their demand and access to health care for a long-term self-management after a stroke.

Everyday life information‐seeking behaviors of nomadic pastoralists in their oral culture

“…In the case of an urgent need for access to information, elders and chiefs are usually the first source of information that nomadic people try to use. Some of the abovementioned factors (e.g., trustworthiness, timeliness and accessibility) have been found to be important in all kinds of contexts (e.g., Leckie, Pettigrew, & Sylvain, ; Lee, Shin, & An, ). However, the practicality of information and successful past utilization seem to be specific to the lives of nomadic people and similar contexts.…”

Descriptive Review of Online Information Resources for People With Stroke: Protocol for a Scoping Review

“…Online, internet, or web-based stroke resources could be beneficial for people with stroke and their caregivers, specifically for those with information and support needs living in the community who have limited access to stroke care and rehabilitation. Apart from the benefit of easy access, users or consumers of these online resources may still experience unmet needs if other quality criteria, such as accuracy and readability, are not in place [1,2]. Stroke is the second most common cause of death [3], accounts for 102 million disability-adjusted life years (DALYs) globally [4], and is ranked as the third most common cause of DALYs worldwide [5].…”

“…The internet, or the World Wide Web, is increasingly being used for health-related inquiries by the general public [ 1 ]. There is also a growing body of literature into the use of technology as an adjunct or replacement for face-to-face stroke rehabilitation, education, and self-management strategies [ 12 , 13 ].…”

“…Digital health in stroke may take the form of various technologies, including websites; computer software; health apps, which could be used on mobile devices, such as smartphones or tablets; and even gaming consoles. Overall, online information on health conditions and their management has become accessible and inexpensive, which attracts the general public to use it for self-diagnosis or management [ 1 ], sometimes well before seeking assistance from health care professionals. A few benefits for users of using digital health include patient empowerment and engaging patients in their own health care [ 14 ].…”

“…Previous studies evaluating online resources for stroke found that the quality, content, and readability of these websites were highly variable [ 1 , 2 , 13 , 24 ]. Even though internet connectivity and access to the internet through improved telecommunications, such as cellular phones and faster fiber-optic cables, have been improving, information on stroke will continue to remain inaccessible to users if it is not at an appropriate reading level [ 13 ].…”