Widespread and growing use of the Internet for disseminating and gathering information has raised concerns about users' ability to assess the quality of the health and medical information presented on Internet websites. The Office of Disease Prevention and Health Promotion (ODPHP) has created a national objective as part of the Healthy People 2010 initiative to "increase the proportion of health-related World Wide Web sites that disclose information that can be used to assess the quality of the site" (Objective 11-4 in the Health Communication Focus Area).

In the absence of existing national data related to this objective, ODPHP has recognized the need to create a methodology that would make the objective measurable and to develop a baseline estimate against which progress can be measured over time. This in turn requires (1) a reliable estimate of the total number of health-related websites (the denominator); (2) consensus about what information should be disclosed to users to assess website quality (disclosure criteria); and (3) a reliable estimate of the number of health-related websites that disclose this information (the numerator).

The ODPHP and the Objective 11-4 Technical Expert Workgroup have made substantial progress on the second requirement, having identified six types of information that should be publicly disclosed to users of health-related websites: (1) information on the identity of the website sponsors, (2) the purpose of the site, (3) the authorship or source of the health information provided, (4) policies for protecting the confidentiality of users' personal information, (5) how the site is evaluated, and (6) how often the health content is updated. The ODPHP subsequently contracted with Mathematica Policy Research, Inc. (MPR) in September 2005 to develop, test, and implement a methodology for estimating the proportion of health websites that disclose information consistent with the identified criteria.

This project had two main objectives:

• To develop and test, for assessing website quality, a methodology that (a) reflects the way lay consumers actually use the Internet to seek health information; (b) is credible, feasible, and replicable; and (c) is consistent with other recognized and established online health quality initiatives
• To establish a baseline estimate of the proportion of health websites that comply with identified disclosure criteria, using this methodology

In this report, we (1) describe our methodological approach, (2) present baseline estimates and other key findings, and (3) discuss implications of findings and study limitations as they relate to Healthy People 2010 Objective 11-4. A technical manual for conducting the website review is provided separately.

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