Abstract
The Internet is an easily accessible source of information for women experiencing anxiety in pregnancy and/or postpartum to use when seeking health information. However, the Internet has several drawbacks, including inaccurate content that may be perceived as being accurate, non-biased, and evidence-based. Prior research indicates that anxiety and postpartum mental health websites have poor quality in terms of describing treatment options. There is a lack of research and knowledge in the area of perinatal anxiety, and an absence of research evaluating perinatal anxiety websites. The purpose of this study was to evaluate the quality of information regarding perinatal anxiety available on the Internet. Websites concerning perinatal anxiety were selected using the Google search engine. Each website was evaluated based on quality of health information, website usability, and readability. The 20 websites included in this study had low to moderate quality scores based on the DISCERN tool. There were no associations found between website order and website quality, or between website readability and website quality. Many websites had high PEMAT scores for the understandability section, which included content, style, and layout of information; however, most did not use visual aids to enhance comprehension. Most websites had low actionability scores, suggesting that information may not be useful in describing what actions may be taken to manage perinatal anxiety. This study highlights the need for high-quality websites concerning perinatal anxiety that are easy to navigate and provide the public with evidence-based information.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington, VA
Arsenault M, Blouin MJ, Guitton MJ (2016) Information quality and dynamics of patients' interactions on tonsillectomy web resources. Internet Interventions 4:99–104. Retrieved from. https://doi.org/10.1016/j.invent.2016.05.002
Batchelor JM, Ohya Y (2009) Use of the DISCERN instrument by patients and health professionals to assess information resources on treatments for asthma and atopic dermatitis. Allergol Int 58(1):141–145. https://doi.org/10.2332/allergolint.08-SC-0022
Baxter AJ, Scott KM, Vos T, Whiteford HA (2013) Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med 43(5):897–910. https://doi.org/10.1017/S003329171200147X
Beaunoyer E, Arsenault M, Lomanowska AM, Guitton MJ (2017) Understanding online health information: evaluation, tools. and strategies Patient Education and Counseling 100(2):183–189. https://doi.org/10.1016/j.pec.2016.08.028 0738–3991/ã 2016
Brockington IF, Macdonald E, Wainscott G (2006) Anxiety, obsessions and morbid preoccupations in pregnancy and the puerperium. Archives of Women's Mental Health 9(5):253–263. https://doi.org/10.1007/s00737-006-0134-z
Buultjens M, Robinson P, Milgrom J (2012) Online resources for new mothers: opportunities and challenges for perinatal health professionals. J Perinat Educ 21(2):99–111. https://doi.org/10.1891/1058-1243.21.2.99
Cerminara C, Santarone ME, Casarelli L, Curatolo P, El Malhany N (2014) Use of the DISCERN tool for evaluating web searches in childhood epilepsy. Epilepsy Behav 41:119–121. https://doi.org/10.1016/j.yebeh.2014.09.053
Charnock D (1998) The DISCERN handbook: Quality criteria for consumer health information. Radcliffe Medical Press, Abingdon, Oxon
Charnock D, Shepperd S, Needham G, Gann R (1999) DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 53(2):105–111
Chung M, Oden RP, Joyner BL, Sims A, Moon RY (2012) Safe infant sleep recommendations on the internet: Let's google it. J Pediatr 161(6):1080–1084. https://doi.org/10.1016/j.jpeds.2012.06.004
Dalziel K, Leveridge MJ, Steele SS, Izard JP (2016) An analysis of the readability of patient information materials for common urological conditions. Canadian Urological Association Journal 10(5–6):167–170. https://doi.org/10.5489/cuaj.3578
Devine T, Broderick J, Harris LM, Wu H, Hilfiker SW (2016) Making quality health websites a national public health priority: toward quality standards. J Med Internet Res 18(8):e211. https://doi.org/10.2196/jmir.5999
Diaz JA, Griffith RA, Ng JJ, Reinert SE, Friedmann PD, Moulton AW (2002) Patients’ use of the internet for medical information. J Gen Intern Med 17(3):180–185. https://doi.org/10.1046/j.1525-1497.2002.10603.x
Elisei S, Lucarini E, Murgia N, Ferranti L, Attademo L (2013) Perinatal depression: a study of prevalence and of risk and protective factors. Psychiatr Danub 25(SUPPL.2):S258–S262
Fairbrother N, Janssen P, Antony MM, Tucker E, Young AH (2016) Perinatal anxiety disorder prevalence and incidence. J Affect Disord 200:148–155. https://doi.org/10.1016/j.jad.2015.12.082
Ferreira-Lay P, Miller S (2008) The quality of internet information on depression for lay people. Psychiatr Bull 32(5):170–173. https://doi.org/10.1192/pb.bp.107.016188
Fiksdal AS, Kumbamu A, Jadhav AS, Cocos C, Nelsen LA, Pathak J, McCormick JB (2014) Evaluating the process of online health information searching: a qualitative approach to exploring consumer perspectives. J Med Internet Res 16(10):e224. https://doi.org/10.2196/jmir.3341
Fonseca A, Gorayeb R, Canavarro MC (2016) Women's use of online resources and acceptance of e-mental health tools during the perinatal period. Int J Med Inform 94(1):228–236. https://doi.org/10.1016/j.ijmedinf.2016.07.016.
Fox S, Rainie L (2002) Vital decisions: a pew internet health report. Retrieved from Pew Research Center website: www.pewinternet.org/2002/05/22/vital-decisions-a-pew-internet-health-report/
George A, Luz RF, De Tychey C, Thilly N, Spitz E (2013) Anxiety symptoms and coping strategies in the perinatal period. BMC Pregnancy Childbirth 13. https://doi.org/10.1186/1471-2393-13-233
Grant N, Rodger S, Hoffmann T (2015) Evaluation of autism-related health information on the web. J Appl Res Intellect Disabil 28(4):276–282. https://doi.org/10.1111/jar.12127
Highet N, Stevenson AL, Purtell C, Coo S (2014) Qualitative insights into women's personal experiences of perinatal depression and anxiety. Women and Birth 27(3):179–184. https://doi.org/10.1016/j.wombi.2014.05.003
Hutchinson N, MPhil CM, Baird GL, Garg M (2016) Examining the reading level of internet medical information for common internal medicine diagnoses. Am J Med 129(6):637–639. https://doi.org/10.1016/j.amjmed.2016.01.008
iProspect (2006) Search engine user behaviour study. Retrieved from http://district4.extension.ifas.ufl.edu/Tech/TechPubs/WhitePaper_2006_SearchEngineUserBehavior.pdf
iProspect (2010) IProspect APAC consumer search behaviour & attitudes study. Retrieved from http://konradmarkham.com/wp-content/uploads/2013/06/iprospect-study-apac-consumer-search-behaviour-and-attitudes-201010.pdf
Ipser JC, Dewing S, Stein DJ (2007) A systematic review of the quality of information on the treatment of anxiety disorders on the internet. Current Psychiatry Reports 9(4):303–309. https://doi.org/10.1007/s11920-007-0037-3
Kaicker J, Debono VB, Dang W, Buckley N, Thabane L (2010) Assessment of the quality and variability of health information on chronic pain websites using the DISCERN instrument. BMC Med 8(59). https://doi.org/10.1186/1741-7015-8-59
Khazaal Y, Chatton A, Zullino D, Khan R (2012) HON label and DISCERN as content quality indicators of health-related websites. Psychiatry Q 83(1):15–27
Knapp C, Madden V, Wang H, Sloyer P, Shenkman E (2011) Internet use and eHealth literacy of low-income parents whose children have special health care needs. J Med Internet Res 13(3):e75. https://doi.org/10.2196/jmir.1697
Leach LS, Poyser C, Fairweather-Schmidt K (2015) Maternal perinatal anxiety: a review of prevalence and correlates. Clin Psychol 21:4–19. https://doi.org/10.1111/cp.12058
Lee ST, Lin J (2016) A self-determination perspective on online health information seeking: the internet vs. face-to-face office visits with physicians. J Health Commun 21(6):714–722. https://doi.org/10.1080/10810730.2016.1157651
Li N, Orrange S, Kravitz RL, Bell RA (2014) Reasons for and predictors of patients' online health information seeking following a medical appointment. Fam Pract 31(5):550–556. https://doi.org/10.1093/fampra/cmu034
Lorence DP, Park H, Fox S (2006) Assessing health consumerism on the web: a demographic profile of information-seeking behaviors. J Med Syst 30(4):251–258. https://doi.org/10.1007/s10916-005-9004-x
Moore D, Ayers S (2011) A review of postnatal mental health websites: help for healthcare professionals and patients. Archives of Women's Mental Health 14(6):443–452. https://doi.org/10.1007/s00737-011-0245-z
Reynolds K, Walker JR, Walsh K, the Mobilizing Minds Research Group (2015) How well do websites concerning children’s anxiety answer parents’ questions aboutp treatment options? Clin Child Psychol Psychiatry 20(4):555–569. https://doi.org/10.1177/1359104514534948
Schneider J, Sarrami Foroushani P, Grime P, Thornicroft G (2014) Acceptability of online self-help to people with depression: users’ views of moodgym versus informational websites. J Med Internet Res 16(3):e90. https://doi.org/10.2196/jmir.2871
Shoemaker SJ, Wolf MS, Brach C (2014) Development of the patient education materials assessment tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. Patient Educ Couns 96(3):395–403. https://doi.org/10.1016/j.pec.2014.05.027
Somers JM, Goldner EM, Waraich P, Hsu L (2006) Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Can J Psychiatr 51(2):100–113. https://doi.org/10.1177/070674370605100206
Stewart DW, Walker JR, Beatie B, Reynolds KA, Hahlweg K, Leonhart M, Tulloch A (2014) Postsecondary students’ information needs and pathways for help with stress, anxiety, and depression. Can J Couns Psychother 48(3):356–374 Retrieved from http://uml.idm.oclc.org/login?url=https://search-proquest-com.uml.idm.oclc.org/docview/1655757713?accountid=14569
Stuart S, Couser G, Schilder K, O'Hara M, Gorman L (1998) Postpartum anxiety and depression: onset and comorbidity in a community sample. J Nerv Ment Dis 186(7):420–424 Retrieved from http://dx.doi.org.uml.idm.oclc.org/10.1097/00005053-199807000-00006
Sullivan D (2013) Google still world’s most popular search engine by far, but share of unique searchers dips slightly. Retrieved from http://searchengineland.com/google-worlds-most-popular-search-engine-148089
Tietz A, Zietlow AL, Reck C (2014) Maternal bonding in mothers with postpartum anxiety disorder: the crucial role of subclinical depressive symptoms and maternal avoidance behaviour. Archives of Women's Mental Health 17(5):433–442. https://doi.org/10.1007/s00737-014-0423-x
Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS (2008) Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry 65(7):805–815. https://doi.org/10.1001/archpsyc
Vollrath ME, Sengpiel V, Landolt MA, Jacobsson B, Latal B (2016) Is maternal trait anxiety a risk factor for late preterm and early term deliveries? BMC Pregnancy and Childbirth 16(1):286. https://doi.org/10.1186/s12884-016-1070-1
Wang L-W, Miller MJ, Schmitt MR, Wen FK (2013) Assessing readability formula differences with written health information materials: application, results and recommendations. Res Soc Adm Pharm 9(5):503–516. https://doi.org/10.1016/j.sapharm.2012.05.009
Wenzel A, Haugen EN, Jackson LC, Brendle JR (2005) Anxiety symptoms and disorders at eight weeks postpartum. Journal of Anxiety Disorders 19(3):295–311. https://doi.org/10.1016/j.janxdis.2004.04.001
Funding
This article was not part of a funded research project.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical approval
This article does not contain any studies with human participants or animals performed by any of the authors. The websites that were selected are in the public domain, and therefore, review ethics board approval was not required.
Informed consent
Due to the nature of this research, informed consent was not required.
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Kirby, P.L., Reynolds, K.A., Walker, J.R. et al. Evaluating the quality of perinatal anxiety information available online. Arch Womens Ment Health 21, 813–820 (2018). https://doi.org/10.1007/s00737-018-0875-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-018-0875-5