A new study from Weill Cornell in Qatar has provided the region’s first assessment of the quality of information available on health websites in the Gulf region.
Their analysis identified 925 health-related websites across the six nations which make up the Gulf Cooperation Countries (GCC). The countries which make up the GCC are Bahrain, Oman, Kuwait, Qatar, Saudi Arabia, and the United Arab Emirates.
The research team: Zahra Rahman, Nadeen Al-Baz, Dr. Mohamud A. Verjee, Fathima Ameerudeen and Dr. Alan S. Weber. Copyright Weill Cornell College.
The study, entitled “Typology and Credibility of Gulf Cooperation Council (GCC) Internet Health Websites” appeared in the World Health Organization (WHO) publication Eastern Mediterranean Health Journal, and used a checklist to rank the quality of the sites. The researchers found that in 8 out of 10 quality categories identified and measured by the authors, Qatari based sites scored higher than the GCC average.
Elements captured by the researcher’s checklist included whether sites included privacy policies, advertising policies, current date, attribution of information to qualified medical professionals, and other essential information required by health consumers to determine the accuracy and validity of the information being provided.
As a result of this analysis, the team found that:
- Only 5 sites (0.5%) fulfilled all checklist categories.
- All websites except one were in English or Arabic languages.
- 2.7% stated the authorship of information.
- 51.0% disclosed website ownership.
- 80.6% provided contact details and 58.5% dated information.
- Only 1.7% reported their advertising policy with 23.5% revealed sponsorships.
To address some of the issues emerging from these findings, the report authors recommend that GCC health website owners should consider working with the Health On the Net Foundation (HON), or similar organizations, to improve the credibility of their sites in line with international best practise.
“Although this study identified specific weaknesses in consumer health on the Internet in the GCC, governments and web site owners could address these concerns simply through new regulations and better site development,” said Dr. Alan S. Weber, Associate Professor of English in the Pre-medical Department.
User concerns and behaviours
These moves are important given the increasing prevalence of consumers to research health information online. One in twenty Google searches is for health information, and as Pam Baker recently noted here on nuviun, “the majority of U.S. Internet users (72%) look up health information online.”
As a result, Google has announced they will be adding health information into search results, a move which may help to address risks of false or inaccurate information being conveyed to users.
This new approach from the search giant is potentially important, because trust in health information online is often low, despite the prevalence of Internet users who go online and search for it.
A US study found low levels of trust in the Internet as a reliable source of information. In the Middle East, this concern can clearly be found in the health arena.
Cornell’s researchers cite a 2011 survey of Riyadh outpatients which found that only 5.7% of respondents always trusted health-related information from the Internet and only 51.4% sometimes trusted the information, whilst an earlier survey of 450 Saudi women from 2009 found that the Internet ranked 5th out of 6 potential health information resources. This is despite the fact that Arab women are a potentially key audience for online health information, given the frequent shortage of female physicians to treat them, and the reluctance some women may have to being examined by male physicians.
Addressing these wider concerns is important Dr. Weber says, because:
as Internet infrastructure matures in the region and GCC citizens gain greater health literacy, e-health will be able to provide accurate and up to date consumer health information for patients to supplement advice from their doctors, as well as technical information for medical professionals.
His colleague, Dr. Mohamud A. Verjee, Associate Professor of Family Medicine, agrees:
Both physicians and websites should provide the best possible information to the patient without any commercial bias or potential conflicts of interest.
For Dr. Weber and his colleague Dr. Verjee, health websites in the GCC can address the deficiencies that their study identified by undertaking a number of clear remedies:
- Technical medical information needs to be dated, and the authorship and credentials disclosed.
- Websites should be available in languages other than Arabic and English, due to the large Asian expatriate populations of the Gulf.
- Sponsorships, site ownerships, and advertising policies should be disclosed clearly.
- Privacy and security policies need to be implemented and disclosed.
The last of these is especially important given increasing concerns – and awareness – related to health information and privacy. A paper by Tim Libert, a doctoral student at the Annenberg School For Communication at the University of Pennsylvania, recently explored what happens when users search online for health information, revealing that over 90% of the 80,000 health-related pages he examined exposed potentially sensitive personal health information to third parties.
Meanwhile, the issue of the language that health information is provided in is also important given that “the GCC has the highest percentage of immigrant labour in the world, approaching 50% of the entire workforce overall, while in Qatar and the UAE it comprises 80–90% of the total workforce.”
Considering “the widespread use of Hindi, Tamil, Nepali, Urdu and Filipino (Tagalog) among immigrant labourers in the region” that only one site identified in this study was not in English or Arabic “is surprising,” the study comments.
Alongside these four specific recommendations, the study also calls for more research into online behaviours by consumers and health professionals, as well as studies into the usability and accessibility of GCC-based health websites.
“Although patients are increasingly seeking health information on the Internet,” Dr Verjee notes, “the physician should [still] be the primary source of information on medical matters.”
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.