Health Information on Pre-Exposure Prophylaxis From Search Engines and Twitter: Readability Analysis

• Type of Material: Article
• Authors: Albert Park, University of North Carolina Charlotte; Fatima Sayed, University of North Carolina Charlotte; Patrick Robinson, University of North Carolina Charlotte; Latesha Elopre, University of Alabama at Birmingham; Yaorong Ge, University of North Carolina Charlotte; Shaoyu Li, University of North Carolina Charlotte; Christian Grov, City University of New York; Patrick S Sullivan, Emory University
• Language: English
• Date: 2023-09-01
• Publisher: JMIR
• Publication Version: Final Published Version
• Copyright Statement: ©Albert Park, Fatima Sayed, Patrick Robinson, Latesha Elopre, Yaorong Ge, Shaoyu Li, Christian Grov, Patrick Sean Sullivan. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 04.09.2023.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.2196%2F48630
• Title of Journal or Parent Work: JMIR Public Health and Surveillance
• Volume: 9
• Start Page: e48630
• Keywords: health education materials; health literacy; electronic health education; Twitter; health information; infection; prophylaxis; HIV; readability; PrEP; pre-exposure prophylaxis
• Research Categories: Education, Health; Health Sciences, Health Care Management

Abstract

Background Pre-exposure prophylaxis (PrEP) is proven to prevent HIV infection. However, PrEP uptake to date has been limited and inequitable. Analyzing the readability of existing PrEP-related information is important to understand the potential impact of available PrEP information on PrEP uptake and identify opportunities to improve PrEP-related education and communication. Objective We examined the readability of web-based PrEP information identified using search engines and on Twitter. We investigated the readability of web-based PrEP documents, stratified by how the PrEP document was obtained on the web, information source, document format and communication method, PrEP modality, and intended audience. Methods Web-based PrEP information in English was systematically identified using search engines and the Twitter API. We manually verified and categorized results and described the method used to obtain information, information source, document format and communication method, PrEP modality, and intended audience. Documents were converted to plain text for the analysis and readability of the collected documents was assessed using 4 readability indices. We conducted pairwise comparisons of readability based on how the PrEP document was obtained on the web, information source, document format, communication method, PrEP modality, and intended audience, then adjusted for multiple comparisons. Results A total of 463 documents were identified. Overall, the readability of web-based PrEP information was at a higher level (10.2-grade reading level) than what is recommended for health information provided to the general public (ninth-grade reading level, as suggested by the Department of Health and Human Services). Brochures (n=33, 7% of all identified resources) were the only type of PrEP materials that achieved the target of ninth-grade reading level. Conclusions Web-based PrEP information is often written at a complex level for potential and current PrEP users to understand. This may hinder PrEP uptake for some people who would benefit from it. The readability of PrEP-related information found on the web should be improved to align more closely with health communication guidelines for reading level to improve access to this important health information, facilitate informed decisions by those with a need for PrEP, and realize national prevention goals for PrEP uptake and reducing new HIV infections in the United States.