Meppelink, C. S., Van Weert, J. C. M., Brosius, A., & Smit, E. G. (2017). Dutch health websites and their ability to inform people with low health literacy. Patient Education and Counseling. Advance online publication. doi:10.1016/j.pec.2017.06.012

Abstract:
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.

Keywords: Health literacy; Online health information; Information; Processing; Readability; Message design

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