Currently submitted to: Journal of Medical Internet Research
Date Submitted: Feb 23, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The quality and cultural safety of online osteoarthritis information for affected persons and healthcare professionals: A content analysis
ABSTRACT
Background:
Osteoarthritis (OA) is more prevalent and severe among women compared to men, but women are less likely to access early diagnosis and first-line management, particularly racialized immigrant women. Prior research advocated for greater access to culturally-safe OA information for both diverse women and healthcare professionals. The Internet can reduce disparities by facilitating access to health information, but online materials can vary in quality.
Objective:
We aimed to assess the quality and cultural safety of online OA materials for persons affected by OA and healthcare professionals.
Methods:
We employed content analysis to describe publicly-available materials on OA first-line management developed by Canadian organizations for affected persons or healthcare professionals. Searching, screening and data extraction were done in triplicate. We identified materials by searching Google, MEDLINE and the references of OA-relevant guidelines and policies, and consulting our research team and collaborators. We assessed quality using DISCERN and a compiled framework for affected persons and healthcare professionals, respectively. We compiled frameworks to assess cultural safety. We derived an overall score, categorized as low (<50%), moderate (50% to 69%) or high (≥70%+) for criteria met.
Results:
After screening 176 items and eliminating 129, we included 47 OA materials published between 2013 and 2023. Of those, 43 were for persons with OA. Most were developed by charities (31, 72.1%), based on expert advice (16, 55.2%), and in the format of booklets (15, 34.9%) or text on web pages (10, 23.3%). Of those, 10 (23.3%), 20 (46.5%) and 13 (30.2%) scored low, moderate and high for quality; and 11 (25.6%), 21 (48.8%) and 11 (25.6%) were rated low, moderate and high cultural safety, respectively. Of the 47 included OA materials, 4 were for healthcare professionals. They were developed by a consortium (2, 50.0%), charity (1, 25.0%) and a professional society (1, 25.0%), and largely based on expert advice (3, 75.0%). Format included infographics (3, 75.0%) and text on web pages (1, 25.0%). Of those, 1 (25.0%), 1 (25.0%) and 2 (50.0%) were rated low, moderate and high quality, respectively; and all were rated low for cultural safety. Quality and cultural safety did not appear to be associated with OA material characteristics (e.g. type of developer, development method, format).
Conclusions:
Overall, included OA materials for persons affected by OA and healthcare professionals were low to moderate quality and cultural safety. These findings reveal the need for further efforts to improve existing or develop new OA materials for both affected persons, including ethno-culturally diverse immigrant women, and healthcare professionals. Further research is needed to assess the quality and cultural safety of OA materials developed by organizations outside of Canada, and to establish a framework or instrument to assess cultural safety in the OA context.
Citation
