Comparison of quality of internet pages on human papillomavirus immunization in Italian and in English.

PURPOSE Information available on the Internet about immunizations may influence parents' perception about human papillomavirus (HPV) immunization and their attitude toward vaccinating their daughters. We hypothesized that the quality of information on HPV available on the Internet may vary with language and with the level of knowledge of parents. To this end we compared the quality of a sample of Web pages in Italian with a sample of Web pages in English. METHODS Five reviewers assessed the quality of Web pages retrieved with popular search engines using criteria adapted from the Good Information Practice Essential Criteria for Vaccine Safety Web Sites recommended by the World Health Organization. Quality of Web pages was assessed in the domains of accessibility, credibility, content, and design. Scores in these domains were compared through nonparametric statistical tests. RESULTS We retrieved and reviewed 74 Web sites in Italian and 117 in English. Most retrieved Web pages (33.5%) were from private agencies. Median scores were higher in Web pages in English compared with those in Italian in the domain of accessibility (p < .01), credibility (p < .01), and content (p < .01). The highest credibility and content scores were those of Web pages from governmental agencies or universities. Accessibility scores were positively associated with content scores (p < .01) and with credibility scores (p < .01). A total of 16.2% of Web pages in Italian opposed HPV immunization compared with 6.0% of those in English (p < .05). CONCLUSIONS Quality of information and number of Web pages opposing HPV immunization may vary with the Web site language. High-quality Web pages on HPV, especially from public health agencies and universities, should be easily accessible and retrievable with common Web search engines.

[1]  N. Constantine,et al.  Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative statewide analysis. , 2007, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[2]  C. Chronaki,et al.  European citizens' use of E-health services: A study of seven countries , 2007, BMC public health.

[3]  Jane Wardle,et al.  Parental attitudes to pre-pubertal HPV vaccination. , 2007, Vaccine.

[4]  D. Lorence,et al.  Setting the Public Agenda for Online Health Search: A White Paper and Action Agenda , 2004, Journal of medical Internet research.

[5]  M. Ouakki,et al.  Human Papilloma Virus vaccine and cervical cancer screening acceptability among adults in Quebec, Canada , 2007, BMC public health.

[6]  E. Barr,et al.  Quadrivalent-human-papillomavirus-vaccine , 2007, Reactions Weekly.

[7]  R. M. Wolfe,et al.  Content and design attributes of antivaccination web sites. , 2002, JAMA.

[8]  M. McMullan Patients using the Internet to obtain health information: how this affects the patient-health professional relationship. , 2006, Patient education and counseling.

[9]  S. Salmaso,et al.  Introduction of human papillomavirus (HPV) vaccination into national immunisation schedules in Europe: Results of the VENICE 2007 survey. , 2008, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[10]  R. M. Wolfe,et al.  Vaccine Criticism on the World Wide Web , 2005, Journal of medical Internet research.

[11]  G La Torre,et al.  HPV vaccine efficacy in preventing persistent cervical HPV infection: a systematic review and meta-analysis. , 2007, Vaccine.

[12]  Stéfan Jacques Darmoni,et al.  MedCIRCLE: Collaboration for Internet Rating, Certification, Labelling and Evaluation of Health Information on the World-Wide-Web , 2003, MIE.

[13]  Noel T Brewer,et al.  Predictors of HPV vaccine acceptability: a theory-informed, systematic review. , 2007, Preventive medicine.

[14]  G. Zimet,et al.  Chapter 24: Psychosocial aspects of vaccine acceptability. , 2006, Vaccine.

[15]  Noel T. Brewer,et al.  Disparities in How Parents Are Learning about the Human Papillomavirus Vaccine , 2009, Cancer Epidemiology Biomarkers & Prevention.

[16]  Virginie Migeot,et al.  Parental use of the Internet to seek health information and primary care utilisation for their child: a cross-sectional study , 2008, BMC public health.

[17]  G. Tomlinson,et al.  YouTube as a source of information on immunization: a content analysis. , 2007, JAMA.

[18]  Steven Muncer,et al.  Reliability of Health Information on the Internet: An Examination of Experts' Ratings , 2002, Journal of medical Internet research.

[19]  F. Rodríguez-Salvanés,et al.  Vaccines and Internet: characteristics of the vaccine safety net web sites and suggested improvements. , 2008, Vaccine.

[20]  W. Melchers,et al.  Parental acceptance of Human Papillomavirus vaccines. , 2008, European journal of obstetrics, gynecology, and reproductive biology.

[21]  H. Lawson,et al.  Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). , 2007, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[22]  Howard Bauchner,et al.  Parental acceptance of the human papillomavirus vaccine. , 2005, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[23]  T Delamothe,et al.  Quality of websites: kitemarking the west wind , 2000, BMJ : British Medical Journal.

[24]  M. Lehtinen,et al.  Anticipated acceptance of HPV vaccination at the baseline of implementation: a survey of parental and adolescent knowledge and attitudes in Finland. , 2007, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[25]  L. Lindley,et al.  An evaluation of printed HPV educational materials. , 2005, Cancer control : journal of the Moffitt Cancer Center.

[26]  G. Zimet,et al.  Psychosocial aspects of vaccine acceptability , 2006 .

[27]  P. Salkovskis,et al.  Understanding and predicting parental decisions about early childhood immunizations. , 2004, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[28]  L. Wallace,et al.  Human papillomavirus vaccination coverage on YouTube. , 2008, American journal of preventive medicine.

[29]  L. Ravà,et al.  Attitudes towards HPV immunization of Italian mothers of adolescent girls and potential role of health professionals in the immunization program. , 2009, Vaccine.

[30]  J. Powell,et al.  Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. , 2002, JAMA.

[31]  Eric Bouffet,et al.  Quality of health information on the Internet in pediatric neuro-oncology. , 2006, Neuro-oncology.