The aim of this evaluation is to critique a health promotion website relating to a current health promotion topic. As the internet offers a vast quantity of information from a variety of sources it is commonly used to aid evidence based practice. It is important to have an awareness of how to use information from an internet based resource as it is unregulated, therefore inaccurate or falsified information can be presented on websites to look true. It is necessary to have an understanding of how to evaluate internet based resources to check for data quality and accuracy. (Dobler and Eagleton, 2006)
The website selected for the evaluation is from the National Health Service (NHS) website:
“Immunisation the safest way to protect your child: The HPV vaccination can help protect you from cervical cancer for years to come.” (NHS, 2008)
It will be evaluated using a critique in the form of a series of questions designed by Jim Kapoun (Kapoun, 1998) with the aim to determine the accuracy of the information within the site. The critique achieves this by asking five key questions relating to the accuracy, authority, objectivity, currency and the coverage of the information.
During its introduction over the last year the Human Papillomavirus (HPV) vaccine has been publicised in the media. The vaccine is free under the NHS for girls aged between 12 and 18. The World Health Organisation (WHO) states that there are over 100 types of HPV, 13 of which it is reasonable to assume are responsible for 100% of the cases of cervical cancer (WHO, 2007).
The website was written as detailed in the site by, a team which consisted of a consultant pediatrician, senior medical officers, immunisation experts, principal and senior scientists with input from the health promotion agency (NHS, 2008).
It is not possible to contact the members of this team on an individual basis as their names are not listed, however there are contact details for general enquires including, an address, fax number and email address.
The purpose of the site is to provide information to the public about cervical cancer and its vaccine with information relating to cost, eligibility and where to access it. It also provides information for people who are outside of England on how they can access information in their own health setting. Due to the authors’ names and qualifications not being disclosed it is not possible to know if they are qualified to write the information and if they have conducted any other forms of research related to this field of study.
It is important to note the difference between the authors of the information within the site and a “webmaster”. An author of a website writes the information within the site that is used by the public. A webmaster is a:
“Person responsible for creating and maintaining a worldwide website” (Czar and Hebda, 2009, p. 539) they may also be termed as a “website designer”.
The website was published by the NHS which is part of the Department of Health (D.O.H). This can be confirmed by checking the domain of the website which is “.nhs.uk” showing it is part of the NHS and a United Kingdom website. As the information within the site can be validated back to a reputable organisation such as the D.O.H this increases the authority of the information within the site (Czar and Hebda, 2009).
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There are contact names for the head of publishing and for the head of immunisation information, which are different from the website designer, showing that the website designer is not supplying the information about the vaccine. Despite the authors and publishers qualification not being displayed, the information itself must not be dismissed due to lack of knowledge of where it was sourced from. It requires the nurse or client to evaluate the publisher of the information to establish if the organisation is credible or not, hence whether to utilise the information or not.
The goal of this website is to promote immunisation to help prevent cervical cancer (NHS 2008). The site achieves this by providing the public and healthcare professionals with information in order that the public will make an informed decision in favour of immunisation. The information within the site can be split into two parts, each of a different standard. The standards are different as they are intended for two different target audiences and there is a need to use different terminology for each section (Czar and Hebda, 2009). One section is targeted at the public, the other is aimed at health care professionals.
The information targeted at the public is presented in a manner that is easy to read and understand. There is very little use of “jargon” and where medical terminology is used it is explained. There are links to other resources which may be more appropriate for parents such as a link to the information library where parents can obtain more information. The links for teenagers consist of, a link to a social networking site called “Bebo” which is popular with young teenagers. Here girls can comment on their experience with the vaccine and to talk to others about their experience. There would be an issue as to how the information on this site was regulated, to ensure that the site is not being abused. An alternative link is to a site called “HABBO”, which is an online chat forum where girls can talk online, to other girls and to NHS advisers asking questions in relation to the vaccine.
The information targeted at healthcare professionals differs in its content. It offers more information relating to training of staff through online power points and links to upcoming conferences. The information also details about the distribution of the vaccination, protocols associated with it and printable resources. Often a problem associated with information on the internet is that it is cheaper to produce information of a poor standard that looks good, not good quality information of the same presentable standard (Coiera, 2003). However this site does not fit this statement and the information within it is of a good standard and well presented.
The site has clearly stated that it aims to promote immunisation:
“Immunisation the safest way to protect your child” (NHS, 2008) this could present issues of bias. The site presents the information in a way that shows both side of the debate. The information does have a lean towards the positives of the vaccination, however this is not great enough to have extended to a marketing strategy which would show clear bias (McCormick and Saba, 2006). The site is sponsored by the D.O.H, which would be in favour of immunisation to prevent the development of cancer, as it would be more cost effective overall to vaccinate than to treat cancer. The sponsorship by the D.O.H would indicate bias, though considering it is a health promotion website, to have a reputable organisation fund the site rather than an alternative organisation without a reputation for quality information instils confidence.
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The website does not state when it was “written, revised or reviewed” (Czar and Hebda, 2009, p.124) however it was copyrighted in 2008, so it is reasonable to assume that the information within the site is relatively up to date. According to information on the website it is updated every week although, it lacks dates to confirm this so the currency of the information is questionable.
The site contains links to other sources of information however these pages do not contain dates making it is impossible to know how current the information within them is. The links do not state if they have been updated, yet the information for healthcare professionals contains a link to a monthly newsletter published by the D.O.H. and to recent letters relating to the vaccine, all of which imply that the site is regularly updated. None of the information on the site relating to the HPV vaccination appears to be out of date irrelevant. Searching through the site, all the links take the user to their designated page and there do not appear to be any links that no longer function.
There is nothing to state that the links on the site have been evaluated, though the information within the links does complement the theme of the website. The site contains a mixture of text and images. The images are mainly promotional and do not distract the client from the text. The text itself is simplistic and easy to understand and is not overly complicated with scientific terminology. This is so that people of different levels of intellect and understanding will be able to use the information (Coiera, 2003).
The information within the site and the documents which are available online do not contain references to other authors or sources of work. The use of references allows the work from which the information was taken to be checked, (Czar and Hebda, 2009) nevertheless because there are no references it is not possible to know the quality of the original information, who the authors were and when the work was written. The lack of references reduces the credibility of the information within the site, though taking in to consideration that the site is published by the D.O.H, the information would have been checked before being placed into the public domain.
The site it is compatible with many different forms of software which are used on a variety of computers. There are links on the site, which connect to pages where it is possible to download the necessary browser software required to view the site. All the information is free and where required the client is able to print off hard copies of the information. The site is enabled to be viewed in different sizes depending on what is required. It is possible to obtain the information within it in one of nineteen other languages, however this will have to be originally sourced by someone who understands English, as it needs to be located from the site and printed.
It can be argued that due to the sites lack of information relating to the authors or publishers qualifications and credentials, the information within the site has the potential to be inaccurate. Similarly the lack of references to other sources of work and with no dates being provided for the work could in addition strengthen this argument. Nevertheless, the site does contain information within it that is useful and appropriate for the different target audiences that the site is aimed at. More over the site is published by the D.O.H, despite there being the potential for bias from this organisation it has a duty of care to the public to provide current and accurate information.
The public has access to a large source of information through the internet which can be of high or poor quality. As the number of high quality resources on the internet continue to rise, in turn will the number of poor quality sources. In the future the number of clients who have access to this information will increase as the population ages (Coiera, 2003). Nurses need to be aware of the need to critique the information found either by themselves or by the client and in turn help them to understand what they have found (McCormick and Saba, 2006) whilst encouraging them to evaluate the information for themselves. This is to ensure that clients do not put their health at risk through trusting inaccurate or unsafe information. Teaching clients how to evaluate information and where to find high quality information will ensure that poor quality sources are not mistaken for high quality and used by the client.
On the whole the internet is:
“A wonderful information delivery tool. However, it is just that – a tool. Our ability to think, to ask the right questions, to interpret, integrate, and synthesize what we find is what leads to value and makes all the difference.” (McCormick and Saba, 2006, p. 147)
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