title: Evaluation of the quality and health literacy demand of online renal diet information.
abstract: Dietary modification is critical in the self-management of chronic kidney disease. The present study describes the accuracy, quality and health literacy demand of renal diet information for adults with kidney disease obtained from the Internet and YouTube (www.youtube.com).
  
  
  
  A comprehensive content analysis was undertaken in April and July 2015 of 254 eligible websites and 161 YouTube videos. The accuracy of the renal diet information was evaluated by comparing the key messages with relevant evidence-based guidelines for the dietary management of people with kidney disease. The DISCERN tool (www.discern.org.uk) was used to evaluate the quality of the material. Health literacy demand was evaluated using the Patient Education Material Assessment Tool (www.ahrq.gov/professionals/prevention-chronic-care/improve/self-mgmt/pemat/index.html) and seven validated readability calculators.
  
  
  
  The most frequent renal diet topic found online was generic dietary information for people with chronic kidney disease. The proportion of renal diet information obtained from websites that was accurate was 73%. However, this information was mostly of poor quality with extensive shortcomings, difficult to action and written with a high health literacy demand. By contrast, renal diet information available from YouTube was highly understandable and actionable, although only 18% of the videos were accurate, and a large proportion were of poor quality with extensive shortcomings. The most frequent authors of accurate, good quality, understandable, material were government bodies, dietitians, academic institutions and medical organisations.
  
  
  
  Renal diet information found online that is written by government bodies, dietitians, academic institutions and medical organisations is recommended. Further work is required to improve the quality and, most importantly, the actionability of renal diet information found online.
authors.affiliation: Department of Clinical Nutrition, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.|School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: K
authors.identifier: 0000-0001-5935-7328
authors.initials: K
authors.lastname: Lambert
authors.affiliation: Discipline of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.|Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Mullan
authors.affiliation: Discipline of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Mansfield
authors.affiliation: School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Koukomous
authors.affiliation: School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Mesiti
mesh_terms: D004032:Diet; D055317:Evidence-Based Practice; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D007674:Kidney Diseases
keywords: dietitian; evidence-based practice; health literacy; kidney disease; patient education material