Portal de Periódicos da CAPES

Health Web Sites for Teens

2011; Elsevier BV; Volume: 25; Issue: 2 Linguagem: Inglês

10.1016/j.pedhc.2010.11.005

1532-656X

Jennifer P. D’Auria,

Social Media in Health Education

Department EditorJennifer P. D’Auria, PhD, RN, CPNPUniversity of North Carolina at Chapel HillSchool of NursingChapel Hill, North Carolina Jennifer P. D’Auria, PhD, RN, CPNP University of North Carolina at Chapel Hill School of Nursing Chapel Hill, North Carolina According to the results of a Pew Internet & American Life Project (Purcell and Lenhart,Purcell, K., & Lenhart, A. (2010, September 29). Trends in teen communication: Opportunities and challenges for public health campaigns [PowerPoint slides]. Retrieved from http://www.pewinternet.org/∼/media/Files/Presentations/2010/Sep/ONDCP slides.pptGoogle Scholar), 93% of teens (12 to 17 years of age) go online. Thirty-one percent of teens reported going online to search for information about general health, dieting, and fitness, with 17% reporting that they search for sensitive health information. The most enthusiastic searchers for online health information are female, with 38% of teens who go online to search for health information being between the ages of 14 to 17 years. While the Internet provides free access to a wealth of health-related resources, it also presents challenges to teens who may not know how to access or evaluate the quality of online health information. This article will provide a brief overview of key issues for parents and health care professionals to consider when guiding teens who search online for health information and educational resources. Links to Web sites focused on teen health will be provided. The Web 2.0 environment provides incredible opportunities for making connections with people and interacting with media. However, with Web 2.0 have come even more risks for teens who go online. McAfee, 2010McAfee, Inc. (2010). The secret online lives of teens. Retrieved from http://us.mcafee.com/en-us/local/docs/lives_of_teens.pdfGoogle Scholar commissioned a large online survey (1375 teens, 10 to 17 years of age) to investigate how teens in the United States use the Internet. The findings of this survey indicated that 85% of teens go online outside the home and 28% chat with people they do not know. Although more than 95% of teens reported that they were able to stay safe on the Internet, 52% reported knowing of someone who had been cyber bullied and 25% indicated they would not know how to handle being bullied online. It is difficult for parents to help teens learn how to deal with the risks associated with Internet use if they do not know what teens are doing or where they are surfing on the World Wide Web (Web). In the McAfee, 2010McAfee, Inc. (2010). The secret online lives of teens. Retrieved from http://us.mcafee.com/en-us/local/docs/lives_of_teens.pdfGoogle Scholar survey, more than 90% of teens reported that their parents trusted them to act responsibly online. Yet 43% of girls 16 to 17 years of age reported chatting online with people they did not know, 56% hid their online activities from their parents, 36% would change their online behaviors if their parents were watching, and 26% reported that their parents did not have time to monitor their online activities. More than 50% of teens reported viewing and downloading media, and 45% of boys aged 16 to 17 years indicated they had downloaded media with “adult” content without parental permission. Parents must help teens learn how to stay safe online. An online survey conducted by Cox Communications and Inc, 2007Cox Communications, Inc. (2007). Teen Internet safety survey, wave II [PowerPoint slides]. Retrieved from http://www.cox.com/TakeCharge/includes/docs/survey_results_2007.pptGoogle Scholar in collaboration with the National Center for Missing and Exploited Children investigated online teen behavior and the role of parents regarding teen activities on the Internet. More than 40% of teens reported that their parents talk to them about Internet safety. Teens with parents who talked “a lot” about Internet safety reported less sharing of personal information on the web and were less likely to consider meeting someone they had chatted with online. These data demonstrate that it is important to assess not just the online dangers for teens but also the level of parental involvement and knowledge about what teens do on the Internet. Open communication and a great deal of listening by parents or other significant others will provide a firm foundation for safe and increasingly critical use of the web by teens. Teens, like adults, accidentally stumble into “bad and ugly” Web sites. The challenge is help teens develop strategies for managing the information or media they may encounter. Whereas blocking and filtering software may be useful for protecting younger children, it is probably not the best approach to take with teens. Many strategies exist for circumventing filters, and teens can easily locate them by entering “unblock web page” into the search box of a search engine. However, teaching teens different ways to configure the search engine or browser they are using to filter the types of information they access may be an important step in helping teens learn how to control their Internet environment.Whereas blocking and filtering software may be useful for protecting younger children, it is probably not the best approach to take with teens. Whereas blocking and filtering software may be useful for protecting younger children, it is probably not the best approach to take with teens. The OnGuard Online Web site (Table 1) provides tips, games, videos, and other tools to help parents, teens, and educators stay as safe as possible when going online. The Net Cetera campaign on the OnGuard Online Web site provides information and resources for parents to help teens make good choices when socializing and communicating online. Additional Internet safety sites that may be helpful to parents, teens, and professionals are found in Table 1.Table 1Internet safety sites for parents, teens, and professionalsSite nameURLConnectSafelyhttp://www.connectsafely.orgFamily Online Safety Institutehttp://www.fosi.orgGetNetWise.orghttp://www.getnetwise.orgOnGuard Onlinehttp://www.onguardonline.govStaySafeOnlinehttp://www.staysafeonline.orgWiredSafetyhttp://www.wiredsafety.org/youth.html Open table in a new tab The information age has redefined literacy. What was once the three R’s has become the four R’s: Reading, wRiting, aRithmetic, and Retrieval (Anderson and Rainie,Anderson, J., & Rainie, L. (2010, February 19). Future of the Internet IV (Pew Internet and American Life Project). Retrieved from http://pewinternet.org/Reports/2010/Future-of-the-Internet-IV/Overview.aspxGoogle Scholar). Knowing how to navigate and take advantage of the search capabilities of online search engines has put more relevant and often more credible search results at our fingertips. However, search engines are also powerful distributors of inaccurate as well as accurate information. Users must still understand how to determine the reliability of health information. Hansen et al., 2003Hansen D.L. Derry H.A. Resnick P.J. Richardson C.R. Adolescents searching for health information on the Internet: An observational study.Journal of Medical Internet Research. 2003; 5 (Retrieved from): e25http://www.jmir.org/2003/4/e25Crossref PubMed Google Scholar conducted a study with 12 teens in which they observed a total of 68 search sessions focused on finding accurate answers to a health question. Again, 77% of the participants retrieved information from search engine results. More than 80% of the links that teens clicked came from the top nine results. Factors that limited the ability of a participant to be successful included incorrect spelling of a search term and not having an overall search strategy or a site to directly access. The findings supported that teens did not check the source of the health information they retrieved. Ypulse et al., 2008Ypulse, ISIS, Inc., & Youth Noise. (2008). Youth health and wellness: Core issues and views on existing resources. Retrieved from www.isis-inc.org/in.../Youth_Health_and_Wellness_Report_2008.phpGoogle Scholar collaborated on an online survey to explore how teens and young adults (13 to 24 years of age) use the Internet for support with mental heath and wellness issues. More than 50% of the respondents reported that they used the Internet to search for health information. The top health education sources used by these 1628 respondents were WebMD (15%) followed by the Google search engine (12%). The researchers note that the high ranking of Google as well as other browsers as sources for information may suggest that there are few well-known Web sites focused on their health information needs (Ypulse et al., 2008Ypulse, ISIS, Inc., & Youth Noise. (2008). Youth health and wellness: Core issues and views on existing resources. Retrieved from www.isis-inc.org/in.../Youth_Health_and_Wellness_Report_2008.phpGoogle Scholar). The top four mental health and wellness issues identified by these youth included sexually transmitted diseases and human immunodeficiency virus, drugs and substance abuse, unplanned pregnancy, and unhealthy relationships. Hargittai et al., 2010Hargittai E. Fullerton L. Menchen-Trevino K. Yates T. Trust online: Young adults’ evaluation of web content.International Journal of Communication. 2010; 4: 468-494Google Scholar conducted a survey on the Internet uses of 1060 first-year students at an urban research university. Based on participant answers to online abilities, the skill index for participants was greater than 80%. To determine credibility of a Web site, most participants indicated that knowing the ownership or sponsorship of a Web site was less important than being able to easily locate the information they wanted on the site. The researchers interviewed and observed the Internet search sessions of a stratified random sample of participants (limited to 18- and 19-year-olds). It was observed that participants frequently initiated a search by opening a specific search engine and clicking on the first Web site in the search results. The majority of the students did not know how to determine the credibility of search results and favored search engine rankings as a way to determine a Web site’s credibility. Only 10% of the participants mentioned a site’s author or author’s credentials as being important when evaluating the credibility of a Web site, and few actually check for this information. Google was the search engine trusted by many of the participants, as were Web sites with.gov or.edu suffixes. Despite the high Internet skill index of these college students, few understood how to assess the credibility of online information. From a developmental perspective, it is important to emphasize that teens are not kids. Nielsen Norman Group (Nielson,Nielson, J. (2005, January 31). Usability of websites for teenagers. Retrieved from http://www.useit.com/alertbox/teenagers.htmlGoogle Scholar) conducted a Web site usability study with a sample of 38 teens aged 13 to 17 years. Teens reported they did not like visiting Web sites that used the word “kids” as a way to categorize information focused on both children and teens; they wanted a section that was clearly labeled for teens. They preferred Web sites that had a clean design, short understandable portions of text, visual illustrations, and opportunity for interaction. In usability testing, teens struggled with performing tasks on 55% of the Web sites, primarily because of poor reading skills, poor research skills, and a low patience level (Nielson,Nielson, J. (2005, January 31). Usability of websites for teenagers. Retrieved from http://www.useit.com/alertbox/teenagers.htmlGoogle Scholar). It will be key for health care professionals to refer teens to Web sites that are easy to use but also deliver high-quality health information designed and written specifically for teens.Adolescence is a critical time to develop interventions to affect the ability of teens to acquire health information as they prepare for adulthood (Manganello, 2008Manganello J.A. Health literacy and adolescents: A framework and agenda for future research.Health Education Research. 2008; 23: 840-847Crossref PubMed Scopus (250) Google Scholar). Factors related to Web site usability are critical to consider when designing or evaluating health Web sites for teens. It will be key for health care professionals to refer teens to Web sites that are easy to use but also deliver high-quality health information designed and written specifically for teens. It will be key for health care professionals to refer teens to Web sites that are easy to use but also deliver high-quality health information designed and written specifically for teens. Table 2 includes the names of some health Web sites geared toward teens in the United States. How were these located? They were Googled. In retrospect, it was surprising and reassuring how many “good” Web sites for teens were at the top of the search results. However, no formal quality assessment was made of these Web sites for the purposes of this article. Only two sites lit up the HONcode (Health on the Net Code of Conduct) tool bar on the search engine used: Teenshealth (Kidshealth.org) and Cool Nurse. This means that users will need to carefully locate and read the policies and terms of use sections on the remaining Web sites to determine the trustworthiness of the information on those sites. Many of the Web sites incorporate other tools that teens use such as Facebook, Twitter, and YouTube. Several sites include separate sections devoted to teens, parents, educators, and health care professionals.Table 2Health Web sites for teensName and URLAuthor/sponsorGeneral descriptionAbove the Influencehttp://www.abovetheinfluence.comNational Youth Anti-drug Media Campaign, Office of National Drug Control PolicySubstance abuseAvert: Teens’ Pageshttp://www.avert.org/teens.htmAVERT: AVERTing the spread of HIV and AIDSHIV and AIDSBeinggirlhttp://www.beinggirl.comThe Proctor & Gamble CompanyTopics include growing up and puberty (girls only)Center for Young Women’s Healthhttp://www.youngwomenshealth.org/sexuality_menu.htmlDivision of Adolescent & Young Adult Medicine and Division of Gynecology, Children’s Hospital, BostonTeen and young adult healthCool Nursehttp://www.coolnurse.comYou Living Healthy Inc. (contact)Sexuality and sexual healthGirlshealth.govhttp://www.girlshealth.govOffice on Women’s Health, U.S. Department of Health and Human ServicesTeen healthGo Ask Alicehttp://www.goaskalice.columbia.eduHealth Services at Columbia, Columbia UniversityTeen health (Internet question and answer resource)I wanna know!http://www.iwannaknow.orgAmerican Social Health AssociationSexual health and sexually transmitted infection preventionLiveWirehttp://www.golivewire.comLiveWire Peer Support NetworkForums and discussions boards for peer support and adviceMypyramid.govhttp://www.mypyramid.govCenter for Nutrition Policy and Promotion, U.S. Department of AgricultureDietary guidelines and toolsReach Outhttp://us.reachout.comInspire USA FoundationTeen healthScarleteen: Sex Ed for the Real Worldhttp://www.scarleteen.comIndependent Sexual Education & Support OrganizationSexuality and sexual healthSex, Etc.http://www.sexetc.orgTeen-to-Teen Sexuality Education Project, Rutgers UniversitySexuality and sexual healthStandUpGirlhttp://www.standupgirl.comStandupgirl.com FoundationUnexpected pregnancyStaying Alive Campaignhttp://www.staying-alive.org/enHIV/AIDS largest youth-focused HIV and AIDS prevention campaignHIV and AIDSTeen Talkhttp://www.plannedparenthood.org/teen-talkPlanned Parenthood Federation of AmericaReproductive healthTeenGrowthhttp://www.teengrowth.comFlorida Pediatricians, Pediatric Health Care Alliance, TampaTeen healthTeenHealthFXhttp://www.teenhealthfx.com/answers/Sexuality/index.phpGoreyeb Children’s Hospital, Morristown, NJTeen healthTeensHealthhttp://kidshealth.org/teenThe Nemours Center for Child Health Media, The Nemours FoundationTeen HealthYoung Men’s Healthhttp://youngmenshealthsite.orgDivision of Adolescent and Young Adult Medicine, Children’s Hospital BostonTeen and young adult health Open table in a new tab Governmental portals continue to be good places to start when searching for health information. The Centers for Disease Control and Prevention (http://www.cdc.gov), Medline Plus (http://www.nlm.nih.gov/medlineplus), the National Institutes of Health (http://health.nih.gov/topic/TeenHealth), and USA.gov (http://www.usa.gov/Topics/Teens.shtml) are reliable sources of high health information relevant to teens. However, they are not always the most bright, colorful, or inviting designs for teens. Medline Plus does have a “Videos and Cool Tools” section, interactive tutorials, and health calculators and quizzes. Health subdirectories are available from the search page of most major search engines. The Google directory includes a Health section with a subdirectory focused on “Teen Health” (http://www.google.com/Top/Health/Teen_Health), as does Yahoo! Health (http://health.yahoo.net/channel/teen-health.html). Bias, controversy, and anxiety surround many topics related to teen health. Even Web sites that provide accurate and developmentally appropriate health information can be biased in the way they present the information and the facts they choose to write about. Information regarding the credentials of authors and/or the sponsorship of a Web site, including members on an advisory board, will provide teens and parents with a way to determine the point of view conveyed about teen issues on the Web site. For example, StandUpGirl has a pro-life perspective and Scarleteen has a pro-choice perspective regarding pregnancy choices of women. The perspective offered by a Web site may not be readily apparent unless a teen or parent reads the “About” section carefully or spends time in the discussions forums on a site. It is important to remember that even a credible health information Web site may contain inaccurate information. After reviewing 35 highly trafficked health Web sites, Tolani and Yen, 2009Tolani, A.T., & Yen, S. (2009, March). Many websites fail to dispel myths about IUDs, emergency contraception, birth control, and proper timing of pap smears. Poster presented at the Annual Meeting of the Society for Adolescent Medicine, Los Angeles, CA. Retrieved from http://www.lpch.org/pdf/clinical/adolescent-medicine/yenPosterWebsitesInfoTeens.pdfGoogle Scholar concluded that six teen health myths about the use of intrauterine devices, emergency contraception, and age at first Papanicolaou (Pap) smear were affirmed on several Web sites, including some highly reputable sites. They advised teens to surf toward Web sites associated with academic medical centers, which have a higher likelihood of having an adolescent specialist on their advisory board. Several excellent Web sites such as Go Ask Alice and Young Men’s Health are sponsored by academic institutions or academic medical centers. Many Web sites include interactive features that allow teenagers to ask questions of a health professional, which allows teens to clarify health information without embarrassment or fear of self-disclosure. Because of the unique communication patterns of teens, checking for a peer advisory board that includes a short description about each member is equally important to evaluate. The teens of today will increasingly turn to the Internet and other technologies to access health information and actively participate in decisions about their health. Parents and health care providers are pivotal links in helping them learn how to critically appraise and identify accurate and relevant health information and resources on the Web. Health professionals have the unique opportunity to help teens find relevant information sources and also foster critical appraisal skills for evaluating quality health information. Health care visits for teens should include an assessment of technology and its impact on their lives. More important, get informed. Ask teens to share the names of some of their favorite health sites. Surf and evaluate some of the teen health Web sites listed in Table 2. Consider prescribing high-quality information Web sites for the teens in your practice (Coberly et al., 2010Coberly E. Boren S.A. Davis J.W. McConnell A.L. Chitima-Matsiga R. Ge B. Hodge R.H. et al.Linking clinic patients to Internet-based, condition-specific information prescriptions.Journal of the Medical Library Association. 2010; 98: 160-164Crossref PubMed Scopus (23) Google Scholar).Health professionals have the unique opportunity to help teens find relevant information sources and also foster critical appraisal skills for evaluating quality health information. Health professionals have the unique opportunity to help teens find relevant information sources and also foster critical appraisal skills for evaluating quality health information. Jennifer P. D’Auria, Associate Professor, The University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, NC.