University Health Network, Toronto, ON, Canada.
William Osler Health System, Brampton, ON, Canada.
J Med Internet Res. 2024 Oct 18;26:e57698. doi: 10.2196/57698.
Osteoarthritis is more prevalent and severe among women than among men, but women are less likely to access early diagnosis and first-line management, particularly racialized immigrant women. Previous research advocated for greater access to culturally safe osteoarthritis information for both diverse women and health care professionals. The internet can reduce disparities by facilitating access to health information, but online materials can vary in quality.
This study aimed to assess the quality and cultural safety of online osteoarthritis materials for persons affected by osteoarthritis and health care professionals.
Content analysis was used to describe publicly available materials on osteoarthritis first-line management developed by Canadian organizations for affected persons or health care professionals. Searching, screening, and data extraction were performed in triplicate. We identified materials by searching Google, MEDLINE, and references of osteoarthritis-relevant guidelines and policies, and consulting our research team and collaborators. We assessed quality using DISCERN (University of Oxford) and a compiled framework for affected persons and health care professionals. We compiled frameworks to assess cultural safety. We derived an overall score, categorized as low (<50%), moderate (50%-69%), or high (≥70%+) for criteria met.
After screening 176 items and eliminating 129, we included 47 osteoarthritis materials published between 2013 and 2023. Of those, 43 were for persons with osteoarthritis, most were developed by charities (n=31, 72.1%), based on expert advice (n=16, 55.2%), and in the format of booklets (n=15, 34.9%) or text on web pages (n=10, 23.3%). Of those, 23.3% (10/43) low, 46.5% (20/43) moderate, and 30.2% (13/43) high scored quality; and 25.6% (11/43), 48.8% (21/43), and 25.6% (11/43) were rated low, moderate, and high cultural safety, respectively. Of the 47 included osteoarthritis materials, 4 were for health care professionals. They were developed by a consortium (2/4, 50%), a charity (1/4, 25%), and a professional society (1/4, 25%), and largely based on expert advice (3/4, 75%). The format included infographics (3/4, 75%) and text on web pages (1/4, 25%). Of those, 25% (1/4), 25% (1/4), and 50% (2/4) 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 the characteristics of osteoarthritis materials (eg, type of developer, development method, and format).
Overall, included osteoarthritis materials for persons with osteoarthritis and health care professionals were of low to moderate quality and cultural safety. These findings reveal the need for further efforts to improve existing or develop new osteoarthritis materials for both affected persons, including ethnoculturally diverse immigrant women, and health care professionals. Further research is needed to assess the quality and cultural safety of osteoarthritis materials developed by organizations outside of Canada and to establish a framework or instrument to assess cultural safety in the osteoarthritis context.
骨关节炎在女性中的患病率和严重程度均高于男性，但女性获得早期诊断和一线治疗的机会较少，尤其是族裔化的移民女性。先前的研究主张为不同族裔的女性和医疗保健专业人员提供更多的文化安全的骨关节炎信息。互联网可以通过促进获取健康信息来减少差异，但在线材料的质量可能存在差异。
本研究旨在评估针对受骨关节炎影响的个人和医疗保健专业人员的加拿大组织开发的一线管理骨关节炎的在线材料的质量和文化安全性。
使用内容分析法描述针对受骨关节炎影响的个人或医疗保健专业人员开发的加拿大组织的一线管理骨关节炎的公开可用材料。通过 Google、MEDLINE 搜索以及骨关节炎相关指南和政策的参考文献进行搜索、筛选和数据提取，并由三人小组进行。我们通过搜索骨关节炎相关指南和政策的参考文献、咨询我们的研究团队和合作者来确定材料。我们使用 DISCERN（牛津大学）和针对受影响者和医疗保健专业人员编制的框架来评估质量。我们编制了评估文化安全性的框架。我们得出了一个总分，根据符合标准的情况分为低（<50%）、中（50%-69%）或高（≥70%+）。
在筛选了 176 个项目并排除了 129 个项目后，我们纳入了 47 份发表于 2013 年至 2023 年之间的骨关节炎材料。其中，43 份是针对患有骨关节炎的个人的，大多数是由慈善机构（n=31，72.1%）开发的，基于专家建议（n=16，55.2%），并采用小册子（n=15，34.9%）或网页上的文本格式（n=10，23.3%）。其中，23.3%（10/43）的质量得分为低，46.5%（20/43）的质量得分为中，30.2%（13/43）的质量得分为高；25.6%（11/43）、48.8%（21/43）和 25.6%（11/43）的文化安全性分别为低、中、高。在纳入的 47 份骨关节炎材料中，有 4 份是针对医疗保健专业人员的。它们是由一个联盟（2/4，50%）、一个慈善机构（1/4，25%）和一个专业协会（1/4，25%）开发的，主要基于专家建议（3/4，75%）。格式包括信息图表（3/4，75%）和网页上的文本（1/4，25%）。其中，25%（1/4）、25%（1/4）和 50%（2/4）的质量分别评为低、中、高；并且所有材料的文化安全性都被评为低。质量和文化安全性似乎与骨关节炎材料的特征（例如，开发者类型、开发方法和格式）无关。
总体而言，针对患有骨关节炎的个人和医疗保健专业人员的骨关节炎材料质量和文化安全性为低至中。这些发现表明，需要进一步努力，为受影响者，包括族裔化的移民女性，以及医疗保健专业人员提供现有的或新的骨关节炎材料。需要进一步研究以评估由加拿大以外的组织开发的骨关节炎材料的质量和文化安全性，并建立一个框架或工具来评估骨关节炎背景下的文化安全性。
