BACKGROUND
In recent years, we have seen both an increase in the utilization of complementary and integrative health (CIH) care, and an increase in information-seeking behavior focused on complementary and integrative health. Thus, understanding the quality of CIH information that is available on the Internet is an imperative. Though there have been a limited number of studies that have evaluated the quality of websites providing information about specific CIH-related topics, a broad evaluation of CIH websites has yet to be conducted.
OBJECTIVE
This study was designed to fill that gap. We set out to perform an assessment of website quality in five CIH domains: acupuncture, homeopathy, massage, reiki and yoga. Our research had three main aims: 1) to evaluate the quality of these websites; 2) to evaluate characteristics of websites which may affect readers’ perceptions of websites, specifically message content, structural features, and presentation style; and 3) to investigate the extent to which harms, benefits and purposes of use are stated on websites.
METHODS
This study employed a systematic search strategy to identify websites in each of the target domains to be evaluated. The websites were then classified by type, and a set of checklists focusing on quality, message content, structural features, and presentation style were used to evaluate the websites. Lastly, we performed content analysis to identify harms, benefits, and perceived purposes of use.
RESULTS
There were similarities across domains in terms of their overall quality and their message content. Across all domains, a high proportion of websites received a score of 2 on ownership, currency, interactivity and navigability. Scores were more variable with respect to authorship, balanced presentation of information and the use of sources of information. However, there were differences in terms of their structural features and presentation style. Acupuncture and reiki sites tended to include more external links, and yoga, fewer. The presence of physical locations was more common among homeopathy and massage websites. Additionally, there was variation across domains in the extent to which the websites contained domain-specific terminology. Websites tended to provide a large list of potential benefits, while reporting of harms was scarce.
CONCLUSIONS
There is a need to emphasize inclusion of authorship attribution, balanced presentation of information, and source attribution in online CIH information. There is also a need to better understand how individuals may interact with CIH websites, and to develop tools to assist people to interpret the CIH-related information that they encounter.