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An Evaluation of the Quality and Contents of Asthma Education on the World Wide Web^*

^* From the Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA.

Correspondence to: Donita R. Croft, MD, MS, PO Box 2659, Madison, WI 53701; e-mail: zel2{at}cdc.gov

Study objectives: To measure the accessibility and quality of currently available asthma education World Wide Web sites using the following criteria: accessibility by readability, language, and download time; information quality based on inclusion of core educational concepts and compliance with Health On the Net (HON) principles; and utilization of innovative technology.

Design: Objective evaluation of 145 Web sites.

Measurements and results: Four search engines or directories (Yahoo, HON, Alta Vista, and Healthfinder) were searched for "asthma, patient information." A maximum of 50 Web sites from each search engine or directory was evaluated. Only 90 of the 145 Web sites actually contained asthma educational material. The mean (± SD) time necessary to open each Web site on a 28.800-bits-per-second modem was 33.6 ( ± 36.6) s. The mean number of graphics on the Web sites was 24.6 ( ± 30.2) files per page. The educational material required a mean reading level beyond the 10th grade. Only nine Web sites contained multilingual asthma education material. The mean number of HON principles with which the Web sites conformed was 6.3 ( ± 1.0) of 8 principles; 14 Web sites conformed to all the HON criteria. The average Web site contained 4.9 (± 2.5) of 8 core asthma educational concepts, and only 20 Web sites contained all 8 educational concepts. Very few Web sites utilized innovative educational technology.

Conclusions: While patient asthma education Web sites are common, asthma educational material contains many accessibility barriers, is highly variable in quality and content, and takes little innovative use of technology. Patient educational material currently available on the World Wide Web fails to meet the information needs of patients.

Key Words: asthma • information distribution • Internet • language • learning • lung disease • patient education • reading • technology • World Wide Web

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