title: Evaluation of online disaster and emergency preparedness resources.
abstract: BACKGROUND
  Increasingly, individuals are relying on the Internet as a major source of health information. When faced with sudden or pending disasters, people resort to the Internet in search of clear, current, and accurate instructions on how to prepare for and respond to such emergencies. Research about online health resources ascertained that information was written at the secondary education and college levels and extremely difficult for individuals with limited literacy to comprehend. This content analysis is the first to assess the reading difficulty level and format suitability of a large number of disaster and emergency preparedness Web pages intended for the general public.
  
  
  OBJECTIVE
  The aims of this study were to: (1) assess the readability and suitability of disaster and emergency preparedness information on the Web; and (2) determine whether the reading difficulty level and suitability of online resources differ by the type of disaster or emergency and/or Website domain.
  
  
  METHODS
  Fifty Websites containing information on disaster and/or emergency preparedness were retrieved using the Google search engine. Readability testing was conducted on the first Web page, suggested by Google, addressing preparedness for the general public. The reading level was assessed using Flesch-Kincaid (F-K) and Flesch Reading Ease (FRE) measures. The Suitability Assessment of Materials (SAM) instrument was used to evaluate additional factors such as graphics, layout, and cultural appropriateness.
  
  
  RESULTS
  The mean F-K readability score of the 50 Websites was Grade 10.74 (95% CI = 9.93, 11.55). The mean FRE score was 45.74 (95% CI = 41.38, 50.10), a score considered "difficult."A Web page with content about both risk and preparedness supplies was the most difficult to read according to F-K (Grade level = 12.1). Web pages with general disaster and emergency information and preparedness supplies were considered most difficult according to the FRE (38.58, 95% CI = 30.09, 47.08). The average SAM score was 48% or 0.48 (95% CI = 0.45, 0.51), implying below average suitability of these Websites. Websites on pandemics and bioterrorism were the most difficult to read (F-K: p = 0.012; FRE: p = 0.014) and least suitable (SAM: p = 0.035) compared with other disasters and emergencies.
  
  
  CONCLUSIONS
  The results suggest the need for readily accessible preparedness resources on the Web that are easy-to-read and visually appropriate. Interdisciplinary collaborations between public health educators, risk communication specialists, and Web page creators and writers are recommended to ensure the development and dissemination of disaster and emergency resources that consider literacy abilities of the general public.
authors.affiliation: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29208, USA. dfriedma@gwm.sc.edu
authors.forename: Daniela B
authors.initials: DB
authors.lastname: Friedman
authors.forename: Manju
authors.initials: M
authors.lastname: Tanwar
authors.forename: Jane V E
authors.initials: JV
authors.lastname: Richter
mesh_terms: D022126:Access to Information; D016001:Confidence Intervals; D004189:Disaster Planning / Q000458:organization & administration*; D004521:Educational Measurement; D004522:Educational Status; D006801:Humans; D009862:Online Systems; D011932:Reading; D012111:Residence Characteristics