Adolescent health brief Quality and Accuracy of Sexual Health Information Web Sites Visited by Young People Eric R. Buhi, Ph.D. a, *, Ellen M. Daley, Ph.D. a , Alison Oberne, M.P.H. b , Sarah A. Smith, M.A. a , Tali Schneider, M.P.H. a , and Hollie J. Fuhrmann, M.A. a a Department of Community and Family Health, University of South Florida, Tampa, Florida b Center for Health Services Research, Vanderbilt Medical Center, Nashville, Tennessee Manuscript received September 1, 2009; manuscript accepted January 6, 2010 Abstract We assessed online sexual health information quality and accuracy and the utility of web site quality indicators. In reviewing 177 sexual health web sites, we found below average quality but few inaccur- acies. Web sites with the most technically complex information and/or controversial topics contained the most inaccuracies. We found no association between inaccurate information and web site quality. Ó 2010 Society for Adolescent Medicine. All rights reserved. Internet use by Americans is highest among young people [1]. The Internet is also a common source for youth seeking health information. Although adolescents view health care providers as the most reliable sources of health information, the Internet provides information without risking the awkwardness many youth anticipate or experience during health care visits [2]. The Internet, then, provides a mecha- nism to learn about sensitive topics, such as sexual health, with relative anonymity. As adolescents are increasingly seeking online sexual health information (OSHI), many scholars are questioning the quality of web sites providing such information [3, 4]. To date there is no quality evaluation available of web sites catering to sexual health topics about which teens seek infor- mation. Further, considerable debate continues on whether tools to evaluate web sites can accurately identify sites that mislead or misinform consumers [5]. Our research questions were: (1) What are the quality/accuracy characteristics of websites on which adolescents find answers to sexual health questions? (2) Can commonly used quality criteria differen- tiate sexual health web sites with reliable information from web sites containing false/inaccurate information? Methods Web sites for this study were compiled from an observa- tional study examining how adolescents seek OSHI [6]. In that study, 34 participants performed online searches for answers to 12 sexual health scenarios, developed by practi- tioners/experts who identified common questions asked by their younger clients (see Buhi et al. [6] for the scenarios and Table 1 for the topics). Web sites were excluded if: (1) hyperlinks were nonfunctional, (2) they were not sexual health–related, or (3) information was found in medical arti- cles/electronic article databases. In total, 177 sexual health web sites were included in this study. Gathered from research on Internet health information seeking [5], 15 quality criteria were assessed for each web site and awarded 1 point apiece (Table 2). A total quality score was calculated by summing all points (theoretical range ¼ 0– 15); a score of 15 indicates the web site met all criteria (and was supposedly of the highest quality). Two investigators indepen- dently coded 10 web sites to ensure review accuracy. After coding discrepancies were identified and reconciled, a single reviewer performed the quality assessment on all web sites. A second reviewer independently assessed every tenth web site as a quality check (Cohen’s k ¼ .86). Two reviewers independently appraised all web sites for false or inaccurate information. Inconsistencies were dis- cussed and reconciled by additional reviewers. We defined inaccuracies as incorrect information accessible on web sites. *Address correspondence to: Dr. Eric R. Buhi, M.P.H., Ph.D., Depart- ment of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56; Tampa, FL 33612. E-mail address: ebuhi@health.usf.edu 1054-139X/10/$ – see front matter Ó 2010 Society for Adolescent Medicine. All rights reserved. doi:10.1016/j.jadohealth.2010.01.002 Journal of Adolescent Health - (2010) 1–3 ARTICLE IN PRESS