title: Comparison of quality of internet pages on human papillomavirus immunization in Italian and in English.
abstract: OBJECTIVE
  Information available on the Internet about immunizations may influence parents' perception about human papillomavirus (HPV) immunization and their attitude toward vaccinating their daughters. We hypothesized that the quality of information on HPV available on the Internet may vary with language and with the level of knowledge of parents. To this end we compared the quality of a sample of Web pages in Italian with a sample of Web pages in English.
  
  
  METHODS
  Five reviewers assessed the quality of Web pages retrieved with popular search engines using criteria adapted from the Good Information Practice Essential Criteria for Vaccine Safety Web Sites recommended by the World Health Organization. Quality of Web pages was assessed in the domains of accessibility, credibility, content, and design. Scores in these domains were compared through nonparametric statistical tests.
  
  
  RESULTS
  We retrieved and reviewed 74 Web sites in Italian and 117 in English. Most retrieved Web pages (33.5%) were from private agencies. Median scores were higher in Web pages in English compared with those in Italian in the domain of accessibility (p < .01), credibility (p < .01), and content (p < .01). The highest credibility and content scores were those of Web pages from governmental agencies or universities. Accessibility scores were positively associated with content scores (p < .01) and with credibility scores (p < .01). A total of 16.2% of Web pages in Italian opposed HPV immunization compared with 6.0% of those in English (p < .05).
  
  
  CONCLUSIONS
  Quality of information and number of Web pages opposing HPV immunization may vary with the Web site language. High-quality Web pages on HPV, especially from public health agencies and universities, should be easily accessible and retrievable with common Web search engines.
authors.affiliation: Bambino Gesù Hospital, 400165 Rome, Italy. alberto.tozzi@gmail.com
authors.forename: Alberto Eugenio
authors.initials: AE
authors.lastname: Tozzi
authors.forename: Paola Sabrina
authors.initials: PS
authors.lastname: Buonuomo
authors.forename: Marta Luisa
authors.initials: ML
authors.lastname: Ciofi degli Atti
authors.forename: Emanuela
authors.initials: E
authors.lastname: Carloni
authors.forename: Marco
authors.initials: M
authors.lastname: Meloni
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Gamba
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D017589:Immunization Programs; D033181:Information Dissemination; D020407:Internet / Q000592:standards*; D007558:Italy; D027383:Papillomaviridae / Q000276:immunology; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010290:Parents / Q000193:education*; D011786:Quality Control; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines