Brief Introduction to Epidemiology XIV: Critiquing Internet Information

1. Brief Introduction to Epidemiology XIV:Critiquing Internet Information Betty C. Jung RN MPH CHES

2. Learning/Performance Objectives • This lecture seeks to provide you with some basic principles of how to evaluate the information found on the Internet with a critical eye, as most of the data and information we use are being retrieved from the World Wide Web. • It also seeks to provide a rational framework with which you can use to evaluate what you find on the Internet, so you can determine what would be the best sources to base your decisions upon.

3. Introduction Basic definitions Pointers on what to look for when searching for information International, National and Non-profit Organizational Standards for Health Information Credible Internet sources for Public Health and Healthcare Information

4. What is Information? “(OMB Circular A-130) Any communication or representation of knowledge, such as facts, data, or opinions in any medium or form, including textual, numerical, graphic, cartographic, narrative, or audiovisual forms.” Source: • American Forces Information Service/U.S. Department of Defensedodimagery.afis.osd.mil/dodimagery/html/definitions.html

5. What is Health Information? “Information in any form (oral, written or otherwise) that relates to the past, present or future physical or mental health of an individual. That information could be created or received by a health care provider, a health plan, a public health authority, an employer, a life insurer, a school or university or a health care clearinghouse.” Source: • Partners Human Research Committee (PHRC) healthcare.partners.org/phsirb/hipaaglos.htm

6. What is Health Literacy? “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”-- HP 2010: Health Communication Source: • HRSA Health Literacy Site • http://www.hrsa.gov/quality/healthlit.htm

7. 1. Is it clear who has written the information? 2. Are the aims of the site clear? 3. Does the site achieve its aims? 4. Is the site relevant to me? 5. Can the information be checked? 6. When was the site produced? 7. Is the information biased in any way? 8. Does the site tell you about choices open to you? Questions You Should AskWhen Looking for Information on the Internethttp://www.quick.org.uk/summaryprint.htm

8. Useful Pointers for Finding Credible Health Information Evaluating Internet Resources(Children’s Hospital & Health Center, San Diego) • http://www.chsd.org/1327.cfm Medical Library Association Encyclopedic Guide to Searching and Finding Health Information on the Web • http://www-personal.umich.edu/~pfa/mlaguide/urlsubj/ss1.html

9. International Standards for Health Information on the Net NHS National Health Technology Assessment Program [British Government] • http://www.hta.nhsweb.nhs.uk/ Review of Internet Health Information Quality Initiatives [WHO,2001] • http://www.jmir.org/2001/4/e28/

10. 1. Authority Medically trained and qualified professionals 2. Complementarity Information support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician 3. Confidentiality Of data relating to individual patients and visitors, including identity, is respected 4. Attribution Clear references to source data. Date when page was last modified will be clearly displayed 5. Justifiability Any claims of benefit will be supported by appropriate, balanced evidence 6. Transparency of authorship Provide contact addresses and Webmaster’s E-mail address for further information or support 7. Transparency of sponsorship. Support for this Web site will be clearly identified 8. Honesty in advertising & editorial policy Brief description of the advertising policy, differentiation between ad and original material created by the institution operating the site HON Code of Conduct (HONcode) for medical and health Web siteshttp://www.hon.ch/HONcode/Conduct.html

11. National Standards for Health Information on the Net Healthy People 2010 – Health Communication Objective • http://www.healthypeople.gov/Document/HTML/volume1/11HealthCom.htm HP2010 Information Access Project • http://phpartners.org/hp/ Health Literacy (HRSA) • http://www.hrsa.gov/quality/healthlit.htm National Institutes of Health (NIH) • http://ospp.od.nih.gov/infoquality/

12. Accuracy Availability Balance Consistence Cultural Competence Evidence based Reach Reliability Repetition Timeliness Understandability Healthy People 2010 Health Communication ObjectiveAttributes of Effective Health Communication

13. Healthy People 2010 Healthy People 2010 • http://www.healthypeople.gov/ HP 2010 Initiatives & Activities • http://www.cdc.gov/nchs/hphome.htm HP 2010 Gateway • http://hin.nhlbi.nih.gov/ CDC Healthy People 2010 Data • http://wonder.cdc.gov/data2010/

14. Related Healthy People 2010 Leading Indicator Sources • http://www.healthypeople.gov/LHI/EnglishFactSheet.htm State Healthy People 2010 Tool Library • http://www.phf.org/HPtools/state.htm Tracking Healthy People 2010 • http://www.healthypeople.gov/document/tableofcontents.htm#tracking

15. Public Health Statistics Resources Healthy People 2010 Leading Indicators Data • http://www.healthypeople.gov/Document/HTML/uih/uih_4.htm National Center for Health Statistics • http://www.cdc.gov/nchs/ HRSA – Data & Statistics • http://datawarehouse.hrsa.gov/

16. Population Statistics Resources National Center for Health Statistics • http://www.cdc.gov/nchs/ Racial & Ethnic Populations • http://www.cdc.gov/omh/Populations/populations.htm U.S. Census • http://www.census.gov/ State & County QuickFacts (U.S. Census) • http://quickfacts.census.gov/qfd/

17. Federal Health Information Centers & Clearinghouses http://www.health.gov/nhic/Pubs/clearinghouses.htm Health.gov http://www.health.gov/ Health Promotion and Health Education http://phpartners.org/hpro.html Office of Disease Prevention & Health Promotion http://odphp.osophs.dhhs.gov/ Prevention Communication Resource Database http://www.health.gov/communication/ Federal Health PromotionResources

18. Quality Government Health Information for Consumers Consumer & Patients • http://www.ahrq.gov/consumer/ MedlinePlus • http://medlineplus.gov/ Pocket Guide to Good Health for Adults (AHRQ) • http://www.ahrq.gov/ppip/adguide/ Pocket Guide for Staying Healthy at 50+ • http://www.ahrq.gov/ppip/50plus/index.html Recalls.Gov • http://recalls.gov/

19. Useful Pointers for Finding Credible Health Information Tips for Healthy Surfing Online • http://www.ihealthcoalition.org/content/tips.html Health Communication • http://phpartners.org/hp/health_comm.html Health Information Online (FDA) • http://www.fda.gov/fdac/features/596_info.html Quality of Medical Information on the InterNet • http://www.cancerindex.org/clinks18.htm

20. Non-profit Organizational Standards for Health Information Consumer Webwatch • http://www.consumerwebwatch.org/ Health on the Net Foundation (HONCode) • http://www.hon.ch/HONcode/Conduct.html Ihealthcoalition.org • http://www.ihealthcoalition.org/ethics/code-foundations.html Quackwatch.org • http://www.quackwatch.org/

21. Non-profit Organizational Standards for Health Information Evaluation of Information Sources (WWW Virtual Library) • http://www.vuw.ac.nz/staff/alastair_smith/evaln/evaln.htm Quality of Health Information on the Internet (IEEE USA) • http://www.ieeeusa.org/policy/POSITIONS/healthnet.html Stanford Guidelines for Web Credibility • http://credibility.stanford.edu/guidelines.html

22. Health ResearchWeb sites CenterWatch.Com • http://www.centerwatch.com/ • Clinical Trials.Gov • http://clinicaltrials.gov/ Food & Drug Administration (FDA) • http://www.fda.gov/ Partners HealthCare System • http://healthcare.partners.org/phsirb/infoforpublic.htm

23. Health ResearchWeb sites National Institutes of Health • http://www.nih.gov/ PubMed (National Library of Medicine) • http://www.ncbi.nlm.nih.gov/entrez/query.fcgi Reviews of Evidence for Treatments • http://www.healthinsite.gov.au/content/internal/page.cfm?ObjID=00007838-024C-1D2D-81CF83032BFA006D

24. Health Care Standards Clinical Practice Guidelines (AHCPR) • http://www.ahcpr.gov/clinic/cpgsix.htm Health Services/Technology Assessment Text (HSTAT) [NLM] • http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat National Guideline Clearinghouse (NCG) • http://www.guideline.gov/ National Committee for Quality Assurance (NCQA) • http://www.ncqa.org/

25. Health Care Standards Measuring Healthcare Quality • http://www.ahrq.gov/qual/measurix.htm National Quality Measures Clearinghouse • http://www.qualitymeasures.ahrq.gov/ Quality Indicators • http://www.qualityindicators.ahrq.gov/published.htm Quality Indicators Explained • http://www.qualityindicators.ahrq.gov/downloads/iqi/interpretative_example_iqi.ppt

26. American Public Health Association’s Selected Internet Resources for Health Education and Health Promotion http://www.apha.org/public_health/hphe.htm EpiMonitor.Net http://www.epimonitor.net/EpiSource/index.htm Health Promotion Planning Resources http://www.thcu.ca/infoandresources/planning_resources.htm Partners in Information Access for the Public Health Workforce http://phpartners.org/index.html Non-profit Health Promotion Resources

27. Finding Cardiovascular Disease Information Cardiovascular Health Partners Web Portal! • http://www.heartandstrokepartners.org/ CDC Cardiovascular Program • http://www.cdc.gov/cvh/ Heart Disease & Stroke Maps (CDC/CVH) • http://www.cdc.gov/cvh/maps/index.htm National Heart, Lung & Blood Institute • http://www.nhlbi.nih.gov/health/index.htm

28. Finding Connecticut Data Census Demographic Files • http://www.ct.gov/ecd/cwp/view.asp?a=1106&q=250616 Connecticut State Data Center (SDC) Program (CT US Census Data) • http://www.opm.state.ct.us/pdpd3/data/SDC.htm Connecticut Data Engine (Business) • http://www.ctdataengine.com/ Connecticut DPH Publications & Statistics • http://www.dph.state.ct.us/Publications/publications.htm

29. Finding Connecticut Data Connecticut Cancer Data • http://www.cdc.gov/cancer/CancerBurden/ct.htm Connecticut Cancer Incidence Data (DPH) • http://www.dph.state.ct.us/OPPE/hptumor.htm HRSA Geospatial Data (Maternal Child Health Programs) • http://datawarehouse.hrsa.gov/DWOnlineMap/default.asp?stateid=7&aoistate=Connecticut&aoitype=state&step=1&steptwo=yes&msadt=&statefipscd=09&zipcode=&hhs=All%20HHS%20Regions&border=

30. Evaluating Your Interventions What Is Evaluation? Evaluation is a systematic, objective process for determining the success of a policy or program. It addresses questions about whether and to what extent the program is achieving its goals and objectives.

31. Evaluation Models CIPP Evaluation Model Checklist • http://www.wmich.edu/evalctr/checklists/cippchecklist.htm Evaluation Models • http://www.edtech.vt.edu/edtech/id/eval/eval_models.html Evaluation Manual (Kellogg Foundation) • http://www.wkkf.org/Pubs/Tools/Evaluation/Pub770.pdf

32. Evaluation Resources Evaluation Made Easy • http://ag.arizona.edu/fcs/cyfernet/cyfar/bulletin2pg.htm Evaluation Resources on the Net • http://www.bettycjung.net/Evaluation.htm CDC Evaluation Working Group • http://www.cdc.gov/eval/resources.htm CDC Heart Disease & Stroke Prevention Evaluation Framework • http://www.cdc.gov/cvh/library/evaluation_framework/pdfs/evaluation_framework.pdf