Interactivity, Quality, and Content of Websites Promoting Health Behaviors During Infancy: 6-Year Update of the Systematic Assessment

Abstract

Background As of 2021, 89% of the Australian population are active internet users. Although the internet is widely used, there are concerns about the quality, accuracy, and credibility of health-related websites. A 2015 systematic assessment of infant feeding websites and apps available in Australia found that 61% of websites were of poor quality and readability, with minimal coverage of infant feeding topics and lack of author credibility. Objective We aimed to systematically assess the quality, interactivity, readability, and comprehensibility of information targeting infant health behaviors on websites globally and provide an update of the 2015 systematic assessment. Methods Keywords related to infant milk feeding behaviors, solid feeding behaviors, active play, screen time, and sleep were used to identify websites targeting infant health behaviors on the Google search engine on Safari. The websites were assessed by a subset of the authors using predetermined criteria between July 2021 and February 2022 and assessed for information content based on the Australian Infant Feeding Guidelines and National Physical Activity Recommendations. The Suitability Assessment of Materials, Quality Component Scoring System, the Health-Related Website Evaluation Form, and the adherence to the Health on the Net code were used to evaluate the suitability and quality of information. Readability was assessed using 3 web-based readability tools. Results Of the 450 websites screened, 66 were included based on the selection criteria and evaluated. Overall, the quality of websites was mostly adequate. Media-related sources, nongovernmental organizations, hospitals, and privately owned websites had the highest median quality scores, whereas university websites received the lowest median score (35%). The information covered within the websites was predominantly poor: 91% (60/66) of the websites received an overall score of ≤74% (mean 53%, SD 18%). The suitability of health information was mostly rated adequate for literacy demand, layout, and learning and motivation of readers. The median readability score for the websites was grade 8.5, which is higher than the government recommendations (<grade 8). Overall, 74% (49/66) of the websites obtained a poor rating for interactivity, measuring active control, 2-way communication, and synchronicity. The most common features found on websites were social media links (61/66, 92%), frequently asked questions (48/66, 73%), and videos (44/66, 67%). Only 14% (9/66) of websites presented culturally responsive information. Conclusions Quality, content, readability, and interactivity of websites promoting health behaviors during infancy ranged between poor and adequate. Since the 2015 systematic assessment, there was a slight improvement in the quality of websites but no difference in the Suitability Assessment of Materials rating and readability of information. There is a need for researchers and health care providers to leverage innovative web-based platforms to provide culturally competent evidence-based information based on government guidelines that are accessible to those with limited English proficiency.

Mothers' sociodemographic factors and use of health professionals for child feeding advice

“…With websites being a popular source of information about infant and child feeding, it is important that the information available to parents reflects best practices. A 2022 review of websites providing information about health behaviours during infancy, found that the overall scope and depth of the information provided was generally poor, with the majority of websites not catering for users with lower literacy levels and not providing culturally appropriate information for their intended audiences (Jawad et al, 2022 ). Given that many mothers report seeking infant and child feeding information online, this points to opportunities to improve the quality of the information available to parents in this format.…”

Barriers and enablers to accessing child health resources and services: Findings from qualitative interviews with Arabic and Mongolian immigrant mothers in Australia

“… 14 , 15 In a 2022 systematic evaluation of 66 infant health websites globally, it was found that the majority of the websites had a high readability level and lacked multilingual options or culturally relevant content. 16 Other studies have shown the impact of immigration on parental health decision-making, and the struggles encountered in navigating between two cultures and reconciling different health practices. 17 , 18 Mothers’ cultural values and customs (e.g.…”

“…Although some efforts have been made to understand the barriers migrant parents face when accessing health services and resources, 12 – 16 there is a lack of consolidated information about how migrant parents navigate these challenges and what resources they rely upon. This study aimed to gain further understanding of the barriers and enablers to accessing child health resources and services among migrant mothers in Australia.…”

Co-Design of a Reusable Learning Object (RLO) to Address Caregiver Responsive Infant Feeding Behaviours (CRIB) to Prevent Childhood Obesity: A Mixed-Method Protocol

“…Caregivers seeking health information for their children have reported using the internet as their main source of information and reported high levels of confidence [ 25 ], and individuals seeking health information will most often use mobile devices [ 26 ]. However, a review of websites on infant health promotion including infant feeding found that the quality, accessibility and readability of the information was poor or adequate [ 27 ], highlighting the need for the development of interventions for caregivers and HCPs to be evidence-based, appropriate and useable.…”