WELCOME TO MODULE 9: Evaluating Health Websites

Helping Older Adults Search for Health Information Online:

A Toolkit for Trainers from the National Institute on Aging

In this module, you will find

• An introduction
  
• A lesson plan for the trainer
  
• Handouts for students

To teach the module, you will need

• A PC with Internet access for each student and the trainer
  
• A computer projector and a screen
  
• A 3-ring binder to store materials

To get started, you should

• Read the Introduction
  
• Read and print out the lesson plan and insert it in a binder
  
• Print out and make copies of the handouts for students

Questions or comments about the Toolkit? Contact the National Institute on Aging at (301) 496-1752 or e-mail daileys@nia.nih.gov

Evaluating Health Websites: Introduction

LESSON OVERVIEW

Lesson Goals

In this lesson, students will learn to recognize and locate:

1. Reliable health information websites.
   
2. The sponsor of a health website.
   
3. The purpose of a health website.
   
4. The authors of the health information.
   
5. The reviewers of the health information.
   
6. The most recent update of the health information.
   
7. The privacy policy of a health website.
   
8. Clues about the accuracy of a website’s health information.
   
9. The contact information for a health website.

Lesson Materials

In this lesson, students will need:

• Handout 9A: Lesson Goals
  
• Handout 9B: Glossary*
  
• Handout 9C: Who do You Trust? (Acts I and II)
  
• Handout 9D: Federal Health Websites of Interest to Older Adults
  
• Handout 9E: Mock Website
  
• Handout 9F: Lesson Review with Screen Shots
  
• Age Page: Online Health Information: Can You Trust It?
  
• Pens or pencils

*This glossary only includes Internet terms relevant to this lesson. An alphabetical list of all glossary terms introduced in the nine Toolkit lessons is available online at www.nihseniorhealth.gov/toolkit.

Lesson Length

This lesson should last:
Approximately 1 hour and 30 minutes.

LESSON PREPARATION

Before the lesson, you should:

• Read over the entire lesson plan. Also look at the Lesson Review with Screen Shots handout to get a quick overview of what students will learn.
  
• Store the lesson plan in a 3-ring binder to use while teaching.
  
• Make copies of the handouts for students. To avoid distraction, we recommend that you wait to distribute handouts until indicated in the lesson.
  
• Check out the links that you and your students will be visiting in the lesson.

When you arrive in the classroom, you should:

• Write your name and the title and level of the lesson on the board. [Searching for Health Information Online – Lesson 9: Evaluating Health Websites – Intermediate Students]
  
• Make sure your computer projector and students’ computers are working and that there is Internet access.
  
• Set students’ screens to your organization’s home page.

You should also

• Read Quick Tips for a Senior Friendly Computer Classroom at www.nihseniorhealth.gov/toolkit.
  
• Watch the short video Introducing the Toolkit at www.nihseniorhealth.gov/toolkit.

LESSON STRUCTURE – Senior Friendly, Trainer Friendly

The senior-friendly lesson structure includes:

• Set-up activities to prepare students for learning.
  
• Core activities to teach the website features and how to navigate to them.
  
• Practice activities to let students apply web skills they have learned.
  
• Reinforcement activities to summarize and reiterate the learning.

The trainer-friendly lesson plan features:

• An easy-to-read layout.
  
• Short, well-defined segments of teaching material per page.
  
• Clearly marked, scripted transition boxes at the top of each page announcing the next learning point and ensuring a smooth transition between segments.
  
• Suggested teaching times for each skill.
  
• Time checks and optional stopping points, offering flexibility in total class length.
  
• Helpful sidebars, providing teaching and navigation tips and describing the purpose for activities.
  
• Meaningful icons.

About the Scripted Transition Boxes

[IMAGE: page with Scripted Transition box circled]

This lesson plan uses a combination of scripted and descriptive sections. The colored, scripted transition boxes which appear at the top of each page of the lesson plan are designed as “anchor points,” marking the end of one part of the lesson and the start of another. It is important to convey the content in these transition boxes, although you may use your own wording as you become more familiar with the material. The steps that follow each scripted box are descriptive. Move through them according to your personal training style.

This approach is useful in maintaining lesson focus and keeping trainers and students on track.It also makes the lesson plan easy to use.

Important Note

In the discussions of health issues that may occur during class, refrain from offering medical advice or advocating specific treatments, physicians, hospitals, insurance plans, etc. Also, discourage this type of activity among students. Always emphasize that students should consult their health care providers about any medical information they may hear about in class or find on the Internet.

Icons Used in the Lesson Plan

• Handout required
  
• Trainer demonstrates with computer projector
  
• Students navigate at their computers (with assistance if needed)
  
• Indicates when a discussion should take place

REACHING THE OLDER STUDENT

To help your students grasp, apply, and retain the skills and information they are taught, be sure to:

• Proceed slowly through the lesson. Some older adults will take longer than younger people to get the knack of using the Internet. If you move too quickly, they may not be able to keep up. They need time to practice and to absorb new information.
  
• Circulate to make sure students are following you. Check students’ screens frequently to make sure they are not lost. If possible, arrange to have one or more classroom assistants work with students individually during the lesson.
  
• Speak slowly and repeat information as often as necessary. Don’t make assumptions based on students’ age. They are learning new skills, and they will probably need to hear the information more than once to retain it.
  
• Encourage questions. Pause frequently to ask if there are questions. After soliciting questions, allow at least 10 seconds for students to formulate them.
  
• Create a senior-friendly environment. It is important to read Quick Tips for a Senior Friendly Computer Classroom for help on setting up the classroom to accommodate the needs of older adults.

These training techniques from the lesson can also help you be successful:

• The use of scripted transition boxes to announce each new segment helps the class stay focused and on track.
  
• Presenting material in small, well-defined steps makes it easier for students to grasp new skills and information.
  
• Frequent summarizing and hands-on practice helps students retain what they’ve learned.
  
• Handouts and printed screen shots help students understand and recall what is taught.
  
• Group discussions and short dialogues help put students at ease.

Evaluating Health Websites: LESSON PLAN

OPENING COMMENTS (5 Minutes)

“Welcome to Lesson 9: Evaluating Health Websites. My name is _________. (This is our classroom assistant_________.) Before we start the class, I’d like to review a few general points.”

Tell students the following:

1. This Lesson…
   • Is intended for beginning and intermediate students.
     
   • Is the last in a series of nine lessons developed by the National Institute on Aging to help older adults learn to find accurate online health information on their own.
2. In this lesson, you will visit various websites, including ones from these agencies that are part of the U.S. Department of Health and Human Services:
   • the National Institutes of Health (NIH)
     
   • the Centers for Disease Control and Prevention (CDC)
     
   • the Centers for Medicare and Medicaid (CMS)
     
   • the Food and Drug Administration (FDA).
3. Please be aware that…
   • Online health information is in no way meant to substitute for medical advice from a doctor.
     
   • In class discussions, students should not attempt to provide medical advice to classmates, however well-intentioned it may be.
4. Housekeeping Issues…
   • Class will last about __minutes with stretch break(s) lasting ___minutes.
     
   • Bathroom breaks can be taken anytime. Restrooms are located______.
5. Ask students if they have any questions.

INTRODUCTIONS (3 Minutes)

“Before we get started, let’s introduce ourselves.”

1. Introduce yourself, giving your name and your experience teaching computers and the Internet. If you have a classroom assistant or peer coach, introduce that person.
2. Ask students to give their names and tell whether they are at a beginning, intermediate, or advanced level with regard to their Internet experience.
3. If time permits, ask each student to tell something about his or her background (family, work, travels, education…), why they decided to take this class, and what they hope to learn.

Purpose of Activity

• Introductions help students feel more at ease.
  
• Sharing computer or Internet experience may help the class be patient with less experienced students who need more time with an activity.

CLASS PROCEDURES (3 Minutes)

“Let’s talk for a moment about how the class will proceed. You will be learning new ways to use technology, and in order for everyone to be successful, here are some things we need to do.”

Tell students the following:

1. To make sure everyone grasps the information and learns the skills…
   • We will proceed in a step-by-step manner and at a slow-to-moderate pace.
     
   • I (or my assistant) will circulate frequently during class to make sure everyone is keeping up with the lesson.
     
   • There will be plenty of hands-on practice activities to let you apply the skills that you learn.
     
   • There will be plenty of handouts to help you learn the skills while in class and to use as a reference once you leave class.
2. As students, you should…
   • Feel free to raise your hand and ask a question if you do not understand something.
     
   • Feel free to ask me to repeat anything I’ve said.
     
   • Not worry about hurting the equipment because it is very sturdy.
     
   • Not worry about making mistakes because that is to be expected when learning a new technology.
     
   • Have a binder or folder to store the handouts you will receive.
3. Ask students if they have any questions about class procedures.

Purpose of Activity

To communicate expectations, put students at ease, and facilitate learning.

TAKE-HOME ASSIGNMENT (5 Minutes)

“Before we get started with the new material, let’s go over the take-home assignment from the last class.”

1. Restate the take-home assignment from Module 8.
   • Finding a recent news story about a disease or condition of your choice and bringing to class one piece of important information about it, writing down the source of the story and the date.
2. Ask students to share their results with the class.
3. Ask students to share any questions about navigating the MedlinePlus website or finding the information they were searching for. Respond to their questions.

Note

• This activity assumes use of the previous module. If you did not teach that module, you can skip this activity.

Purpose of Activity

• Let’s you see how well students understood the previous lesson.
  
• Serves as a kind of icebreaker, promoting interactivity and discussion early in the class.
  
• Let’s you see what you might need to emphasize in the first parts of this lesson.

LESSON GOALS (2 Minutes)

“In this lesson, we will learn how to tell if a health information website is reliable or not. Let’s take a look at the specific goals for today’s lesson.”

Pass out Handout 9A: Lesson Goals.

1. Go over the handout with students.
2. Tell students that in this class they can use the Lesson Goals handout to write down information they find important after discussing each of the goals.
3. They will also receive a brochure at the end of the class which contains much of the information presented during class.

GLOSSARY TERMS (5 Minutes)

“Before we actually get into the heart of the lesson, let’s review a few basic Internet terms.”

Pass out Handout 9B: Glossary.

1. Knowing the meaning of these Internet terms will help students understand the lesson. All of these terms have been introduced in previous lessons, but going over them again may help students recall their meaning.
2. You may want to demonstrate the terms for students from your computer projector.

INTERNET TERMS

1. back arrow
   
2. browse
   
3. home page
   
4. link (or hyperlink)
   
5. menu
   
6. navigate
   
7. scroll
   
8. scroll bar
   
9. web address or URL
   
10. window

Tips for Glossary review

• Refer students to the page and item number of the term.
  
• Make sure students locate the term.
  
• Read, or have a student read, the definition aloud. Point out details in the illustration or on your computer screen.
  
• Tell students they will understand these terms better as they use them in the lesson.

DIALOGUE: WHO DO YOU TRUST? (5 Minutes)

“Let’s begin by listening to some students who are getting ready to go into a computer class for older adults. Let’s see how they feel about the health information websites they find on the Internet.”

Pass out Handout 9C: Who Do You Trust?

1. Assign students to read the parts in Act I.
2. Pair students up and ask them to discuss what important issues were raised in the dialogue. Then have each pair give their impressions to the class.
3. Tell students that this class will address those issues.

TIME CHECK: 28 minutes elapsed; about 1 hour, 5 minutes left.

CORE ACTIVITY: WHERE TO START (5 Minutes)

“Let’s begin with Goal 1 – where to start if you want to locate reliable health information websites.”

1. Tell students:
   • Anyone can put up a health-related website. You want a reliable source.
     
   • Look at the end of the web address to determine what kind of an organization it is (i.e., .edu, .org, .gov, .mil, .com).
     
   • A good place to start is with government websites whose web addresses end in .gov such as NIHSeniorHealth.gov or MedlinePlus.gov.
     
   • Other websites likely to be reliable are reputable non-profit organizations such as the American Cancer Society or the American Heart Association. Their website addresses end in .org. Reputable medical schools with websites ending in .edu are also usually good bets.

Pass out Handout 9D: Federal Health Websites of Interest to Older Adults.

2. Briefly go over the list with students, pointing out that .gov indicates a government (state or federal) website.
3. Take students to the website of the National Institutes of Health at www.nih.gov to see an example of a reputable medical website. Tell students you will be visiting several of the other websites on the list during class.
4. Give students a minute or so to jot down the most important information they learned about Goal 1 on their Lesson Goals handout.

WHO SPONSORS THE WEBSITE? (5 Minutes)

“Now, for Goal 2 – learning to locate a website’s sponsor. It’s important to know who is responsible for the content on a website”

1. Tell students:
   • To find out who runs the website, look for links that say About Us, About this Site, or simply About, often located at the bottom or top of the home page.
2. Demonstrate as students navigate with you. Go to the NIHSeniorHealth website at www.nihseniorhealth.gov and look at the bottom of the page to find the website sponsors. Ask students for the names of the sponsors.
3. Give students a minute or so to jot down the most important information they learned about Goal 2 on their Lesson Goals handout.

WHAT IS THE WEBSITE’S PURPOSE? (5 Minutes)

“Now let’s look at Goal 3 – learning to recognize and locate the purpose of the website. You should look for a statement that tells what the purpose is.”

1. Tell students:
   • The About Us link should tell the goals of the organization and why they are sponsoring this site.
2. Demonstrate as students navigate with you. Go to MedlinePlus by typing in www.medlineplus.gov and click on About MedlinePlus. Ask students to read the first paragraph silently.
3. Ask students to read the paragraph under Message from the Director to see what the MedlinePlus policy is about advertisements.
4. Lead students in finding information about a website’s purpose using another website. Type in a health topic in the MedlinePlus search box (i.e., high blood pressure), click Enter and then find a non-governmental website. Seek out the About Us information on that website and read some of the information together.
5. Ask students to check to see if there are ads on the site, and if there are, ask them if it is possible to tell the ads from the health information.
6. Give students a minute or so to jot down the most important information they learned about Goal 3 on their Lesson Goals handout.

Before class, remember to…

• Check out the non-governmental website in Step 4 to make sure you can locate the correct information.

WHO WROTE THE INFORMATION? (5 Minutes)

“Goal 4 is learning to recognize and locate the authors of the health information on the website. Authors and contributors should be clearly identified.”

1. Tell students:
   • On Federal websites the information is contributed by the agency sponsoring the website.
     
   • Good sites should rely on scientifically-based medical information, not opinion.
     
   • The material should be written by qualified authorities, with expertise in the subject matter.
     
   • Their affiliation and any financial interest (if any) in the content should be made clear.
2. Demonstrate as students navigate with you. Go to NIHSeniorHealth at www.nihseniorhealth.gov and at the bottom of the page click on Read more about NIHSeniorHealth. On the page you come to, click on Background. Read, or have a student read, the information about who writes the materials on the website.
3. Give students a minute or so to jot down the most important information they learned about Goal 4 on their Lesson Goals handout.

IS THE INFORMATION REVIEWED? (5 Minutes)

“Now for Goal 5 – finding out if the information is reviewed. Reliable websites will tell you if their health information is reviewed and how often.”

1. Tell students:
   • On Federal websites the information is contributed by the agency sponsoring the website.
     
   • On other websites, the About Us page should tell if there is an editorial board that checks the information before it goes online.
     
   • The editorial board should have credentials that relate to the health information they are reviewing.
2. Demonstrate as students navigate with you. Return to MedlinePlus at www.medlineplus.gov. Click on About Medline Plus and then click on Quality Guidelines located in the right-hand column. Ask students to read the second paragraph to see how the information on the website is reviewed.
3. Give students a minute or so to jot down the most important information they learned about Goal 5 on their Lesson Goals handout.

REINFORCEMENT ACTIVITY: SUMMARIZING (2 Minutes)

“Let’s take a look at our goals again to see what we have covered.”

Refer students to Handout 9A: Lesson Goals.

1. Summarize the main points of Goals 1, 2, , 4 and 5 using the NIHSeniorHealth and MedlinePlus websites.
   • Where to start looking for reliable health information online
     
   • How to recognize and locate a website’s sponsor
     
   • How to recognize and locate a website’s purpose
   • How to recognize and locate the authors of the health information
     
   • How to recognize and locate the reviewers of the health information
2. Ask students if they have any questions.
3. Ask students to check off Goals 1, 2, , 4 and 5 on their handouts.

TIME CHECK: 50 minutes elapsed; about 40 minutes left.

CORE ACTIVITY: IS THE INFORMATION UPDATED? (5 Minutes)

“Let’s look at Goal 6 – learning to recognize and locate the most recent update of the health information. It’s important to find out when the information you are reading was written.”

1. Tell students:
   • Out-of-date information can be harmful because it may not reflect the latest research findings or treatments.
     
   • The date of the last updating often can be found at the bottom of the home page.
2. Demonstrate as students navigate with you. Go to the website of the Centers for Medicare and Medicaid Services at www.medicare.gov. Scroll down to the bottom of the page to see when the home page was last updated.
3. Give students a minute or so to jot down the most important information they learned about Goal 6 on their Lesson Goals handout.

IS YOUR PRIVACY PROTECTED? (5 Minutes)

“Let’s go to Goal 7 – learning to recognize and locate a website’s privacy policy. It is important to know if the website has a privacy policy, and if so, what it is.”

1. Tell students:
   • To look for a Privacy Policy link near the top or bottom of the home page.
     
   • If they are asked to register or sign up for an online newsletter, they should find out how their information will be used by contacting the website sponsor or by reading the site’s privacy policy.
2. Demonstrate as students navigate with you. Go to the website of the Centers for Disease Control and Prevention at www.cdc.gov. Scroll to the bottom and click on Policies and Regulations and then click on Privacy Policy. Let students scan the main points.
3. Give students a minute or so to jot down the most important information they learned about Goal 7 on their Lesson Goals handout.
   

HOW ACCURATE IS THE INFORMATION? (5 Minutes)

“Let’s move on to Goal 8 – learning to recognize and locate clues about the accuracy of a website’s information. If a website has information that sounds unbelievable, then it probably IS unbelievable.”

1. Tell students:
   • To be skeptical of sensational writing or dramatic cures.
     
   • To notice if the information is well written and free of spelling or grammatical errors.
     
   • To check with several sources to confirm the accuracy of the information.
2. Demonstrate as students navigate with you. Go to NIHSeniorHealth at www.nihseniorhealth.gov, click on any health category and then on any health topic, and read through several pages.
3. Then click on the MedlinePlus button on the left menu to go to more in-depth information on the same topic. Once on MedlinePlus, click on a link and scan the information. See where there is reinforcement of the information on NIHSeniorHealth.
4. Finding information repeated on reputable websites is one way to test the reliability of information.
5. Give students a minute or so to jot down the most important information they learned about Goal 8 on their Lesson Goals handout.

Before class, remember to…

• Check out the website you access through MedlinePlus in Step 3 to make sure the information you seek is there.

CAN YOU CONTACT THE SPONSOR? (5 Minutes)

“The final goal – Goal 9 – is to recognize and locate the contact information for a website. Trustworthy websites make it easy for you to contact them.”

1. Tell students:
   • To look for Contact Us, often located at the top or very bottom of the page.
     
   • That the site should give an e-mail, phone, and/or street address to contact.
     
   • That a link to Webmaster is not likely to provide sufficient information on health matters.
2. Demonstrate as students navigate with you. Go to www.fda.gov, the website for the Food and Drug Administration and scroll to the bottom of the page. Click on Contact FDA. Briefly describe for students what they would have to do to send in a comment.
3. Give students a minute or so to jot down the most important information they learned about Goal 9 on their Lesson Goals handout.

REINFORCEMENT ACTIVITY: SUMMARIZING (2 Minutes)

“Let’s take a look at our goals again to see what we have covered.”

Refer to Handout 9A: Lesson Goals.

1. Summarize the main points of Goals 6, 7, 8, 9:
   • How to recognize and locate the most recent date of the information
     
   • How to recognize and locate the privacy policy
     
   • How to determine if the health information is accurate
     
   • How to contact the organization sponsoring the site
2. Ask students if they have any questions.
3. Ask students to check off Goals 6, 7, 8, 9 on their handouts..

TIME CHECK: 1 hour, 5 minutes elapsed; about 25 minutes left.

PRACTICE ACTIVITY: CHECKING FOR UNDERSTANDING (10 Minutes)

“Let’s apply what we have learned to a mock, or fake, website. This website does not represent any organization. It was developed as an exercise for this class.”

Pass out Handout 9E: Mock Website.

1. Pair students up and ask them to assess the quality of the 3 pages from the mock website on Handout 9E (the Home Page, the High Cholesterol page, and the About Us page). Tell them to use the 9 goals on their Lesson Goals handout (Handout 9A) as a checklist to determine how reliable the health information on this website would be. Ask them to assign a grade to the website (A - F).
2. Have a class discussion about each pair’s impressions and grades. Ask them what the key factors were in their grading.
3. Let students know that the website would probably rate a D in reliability using the list from the Lesson Goals (Handout 9A) as a checklist. Details are below:
   1. Type of website: .com, a business, perhaps looking to make a profit
      
   2. Sponsor: WellVita Herb, Inc., a group of health professionals whose credentials are not listed
      
   3. Purpose: To sell medical products, although on the home page the focus appears to be providing health information
      
   4. Authors: None listed
      
   5. Reviewers: None listed
      
   6. Update: None
      
   7. Privacy Policy: None
      
   8. Accuracy: The information about cholesterol – taken from public domain information at the National Institutes of Health — is accurate. There is no information on high cholesterol.
      
   9. Contact: Only the webmaster

CORE ACTIVITY: WHO DO YOU TRUST, REVISITED (5 Minutes)

“Let’s go back to our group of friends and see what they think about the importance of evaluating health websites after taking their class.”

Refer to Handout 9C: Who Do You Trust?

1. Ask students to read the parts in Act II.
2. Ask them what important issues were raised by the classmates in the dialogue.
3. Ask students what they will do differently as a result of this class.

REINFORCEMENT ACTIVITY: WRAPPING UP (5 Minutes)

“Today, you have learned about the things to look for to determine whether a health information website is reliable. You should:

1. Pay attention to a website’s URL (i.e., .gov, .edu, .org, .com, etc.)
   
2. Find out who the sponsor is
   
3. Find out what the purpose is
   
4. Find out who writes the information
   
5. Find out who reviews the information
   
6. Find the most recent update of the information
   
7. Find out what the privacy policy is
   
8. Look for clues about the content’s accuracy
   
9. Find the contact information

Here is a handout to help you recall what you learned.”

Pass out Handout 9F: Lesson review with Screen Shots.

1. Read the cover description, How to Use this Handout, to students.
2. Go over each screen shot, reading the captions to remind students of the navigation steps they learned on each page. (You do not need to refer back to the computer screen at this point.)
3. Encourage students to use the handout as a reference when checking out health information websites.

Purpose of Activity

• Summarizes all of the skills taught in the lesson.
  
• Handout gives students a visual map of the lesson to remind them of the web pages visited and the skills learned.

WRAPPING UP (continued) (5 Minutes)

“Here is some information that will help you recall what you learned about evaluating health information websites.

Always consult your doctor or health care provider about any health information you find on the Internet.”

Pass out Age Page: Online Health Information: Can You Trust It? [downloadable at www.niapublications.org]

1. Tell students they can use the checklist in this Age Page along with their notes and handouts from class to help determine if a website’s health information is reliable.
2. As a final take-home assignment, ask students to take the 20-minute online tutorial Evaluating Internet Health Information: A Tutorial from the National Library of Medicine. It is available on MedlinePlus. They can click on About MedlinePlus, and then click on Training Materials.
   They will need a Flash plug-in to view the tutorial.
3. Ask students if they have any final questions

END OF LESSON 9

Evaluating Health Websites: HANDOUTS

HANDOUT 9A: Lesson Goals

During this lesson, you will learn to recognize and locate:

1. ____ Reliable health information websites.
   Your Notes:
2. ____ The sponsor of a health website.
   Your Notes:
3. ____ The purpose of a health website.
   Your Notes:
4. ____ The authors of the health information.
   Your Notes:
5. ____ The reviewers of the health information.
   Your Notes:
6. ____ The most recent update of the health information.
   Your Notes:
7. ____ The privacy policy of a health website.
   Your Notes:
8. ____ Clues about the accuracy of a website’s health information.
   Your Notes:
9. ____ The contact information for a health website.
   Your Notes:

HANDOUT 9B: Glossary

1. Back arrow
   This arrow, often green, is found at the top of most browsers. When you click on the back arrow, it takes you back – in order – through all of the web pages you’ve seen. (Sometimes called the back button.)
   [IMAGE: screenshot of browser with Back button circled]
2. Browse
   To explore a website or a number of websites by scanning and reading the information.
3. Home page
   The first thing you see when you come to a website, or the opening page of a website. It provides information about the site and directs you to other pages on the site.
   [IMAGE: screenshot of NIH and MedlinePlus home pages]
4. Link (or hyperlink)
   A highlighted or underlined feature on a web page that, when clicked, will take you to another web page. A link most often appears as underlined words or an image.
   One sure way to tell if something is a link or not: Whenever your cursor turns into a pointing hand, the image or word you are pointing to is a link.
   [IMAGE: three screenshots with links circled]
5. Menu
   A list of options, or topics, on a website that users can choose from.
   [IMAGE: screenshot with left nav menu circled]
6. Navigate
   To move through a website or through various websites.
7. Scroll
   To move text or other information on a computer screen up, down, or sideways, with new information appearing as the old disappears.
8. Scroll bar
   A narrow, rectangular bar on the right edge and bottom edge of a web page that lets you move the page to see more of the information it contains. The scroll bar on the right moves the web page up and down, and the scroll bar on the bottom moves the web page right and left.
   [IMAGE: screenshot with scroll bars labeled]
9. Web Address or URL The address for a website. (URL stands for Uniform Resource Locator.)
   U.S.-based web addresses usually start with the letters www (for World Wide Web) and end with a dot followed by letters that indicate the type of website it is:

.com = commercial enterprise or business
.org = non-profit organization
.edu = educational institution
.gov = government agency
.mil = military agency
.net = another ending for a commercial website

On the Internet, you get to a website by typing in the web address (or URL) into the address box of the browser. For example, to get to the website of the National Institute on Aging (NIA), a Federal agency, you would type www.nia.nih.gov in the address box.

10. Window
    A framed area of a computer screen that appears in front of the web page. Sometimes the appearance of a window means that you have entered another website. At other times, it means you may still be on the same website.
    [IMAGE: screenshot of overlapping windows]

HANDOUT 9C: Who Do You Trust?

ACT I

(Four students are talking before classes. Shirley and Howard are a married couple.)

Walter: Hi, Maria. Fancy meeting you here! Are you signed up for this class about health on the Internet?

Maria: Yes, I am. I just found out I have diabetes and my son said I could find a lot of information on the Internet that could help me manage the disease. He loves the Internet. Says it’s the best thing since sliced bread.

Shirley: You know, I like the Internet too, but sometimes I’m not always sure everything I read on it is really true. Some of those websites make some wild claims.

Walter: They sure do. Why, just last night, I was trying to find out something about Alzheimer’s because I think my mother may have had it. I came across this website that said it could sell you a miracle cure that would take years off your life. Make you a young whippersnapper again.

Howard: Really? (Laughing.) Could you give me the name of that website? I’m all ears.

Shirley: Howard! Now, you know you don’t mean that.

Howard: Yeah, okay. I was just joking. But seriously, Walter, if a website is trying to sell you a miracle cure, can you really trust it?

Walter: I’m not sure. That’s one reason I’m taking this class – to find out how to search wisely, so I won’t get taken.

Shirley: Howard and I are here because we want to find out more about the cataract surgery that our eye doctor recommended. He says that the procedure is quite safe these days, but –

Howard: – but we wanted to get more information. So we thought we could try looking on the Internet. Trouble is, we don’t know how to tell what’s accurate information and what’s not.

Maria: Well, my son told me there are ways you can tell if a site is a good one or not. Let’s see if this class helps us find out.

ACT II

(After class, the students converse before going home.)

Maria: Now, I understand what my son meant when he said there are ways to tell the good websites from the bad ones.

Howard: Yeah, locating good health information online is kind of like looking for a good doctor or a good hospital. You have to know what to look for and you have to know the right questions to ask.

Walter: That’s right, kind of like a detective.

Shirley: From now on, when I go to a health website, I’m going to make sure I can easily see who sponsors it. And if I can’t easily tell the difference between advertisements and health information, that’ll put me on my guard.

Howard: And sometimes you have to look closely. The website for the Academy of Health Studies had a home page that focused on health information, but that information led mostly to ads for a product they were selling.

Maria: One thing my son does when he wants to find answers to a health question is visit several websites as a way to cross check the information.

Shirley: Hey, that’s a good idea. That way, you know that the content is probably not just a figment of one person’s imagination.

Walter: Well, in hindsight I guess that the website I saw with a miracle cure claiming it could take years off my life was probably a fraud.

Howard: No doubt about it. Pure fraud.

Walter: But what if—

Howard: What if “what”?

Walter: What if they know something we don’t? Isn’t there an off chance that they’re on to something that we just haven’t heard of yet? What if that “miracle cure” really works?

Howard: Earth to Walter….

Walter: Hey, a guy can dream, can’t he?

Maria: Yeah, and that’s just what those websites are banking on.

HANDOUT 9D: Federal Health Websites of Interest to Older Adults

*** Websites visited in Lesson 9

1. Administration on Aging (AOA) www.aoa.gov
   AOA plans and delivers home and community-based services to older adults and their caregivers.
2. Centers for Disease Control and Prevention (CDC) ***www.cdc.gov
   The CDC promotes health and quality of life by preventing and controlling disease, injury, and disability.
3. Centers for Medicare and Medicaid Services (CMS) ***www.cms.gov
   CMS administers Medicare and Medicaid. Medicare is the Federal health insurance program for people age 65 and older and for people with disabilities. Medicaid is a joint Federal-State program that provides health insurance coverage to low-income people including children, older adults, and people with disabilities.
4. Clinical Trials.gov www.clinicaltrials.gov
   This website contains information about clinical trials sponsored by the National Institutes of Health, other Federal agencies, and private industry. Clinical trials are research studies with human volunteers to find out if a drug, treatment, or therapy is safe and effective.
5. Department of Health and Human Services www.dhhs.gov
   The Department of Health and Human Services is the U.S. government’s principal agency for protecting the health of all Americans and providing essential human services.
6. Food and Drug Administration (FDA) ***www.fda.gov
   The FDA regulates the safety and effectiveness of food products, additives, drugs, medical devices, and cosmetics.
7. Healthfinder.gov www.healthfinder.gov
   This website features consumer health information from government agencies, nonprofit organizations, and universities.
8. MedlinePlus.gov ***www.medlineplus.gov
   This website from the National Library of Medicine features health information on more than 700 topics for patients, the family, and the public.
9. National Institute on Aging (NIA) www.nia.nih.gov
   NIA, part of the National Institutes of Health, leads the Federal effort supporting and conducting research on aging and the medical, social, and behavioral issues of older people.
10. National Institutes of Health (NIH) ***www.nih.gov
    NIH, part of the U.S. Department of Health and Human Services, is the primary Federal agency conducting and supporting medical research. It includes 27 Institutes and Centers whose collective goal is to investigate ways to prevent, treat, and cure common and rare diseases.
11. NIHSeniorHealth.gov ***www.nihseniorhealth.gov
    This senior-friendly website from the National Institutes of Health features health and wellness information for older adults.

HANDOUT 9E: Mock Website

[IMAGE: screenshot of mock web site]

[IMAGE: screenshot of mock web site]

[IMAGE: screenshot of mock web site]

Evaluating Health Websites: LESSON REVIEW WITH SCREEN SHOTS -- Handout 9F

How to Use this Handout

• Use this handout to help you review the lesson.
  
• The screen shots (pictures of web pages) will help you recall the places you visited in class, and the descriptions will remind you of the navigation skills you learned.
  
• You may wish to refer to this handout when searching the websites you visited in class.

LESSON REVIEW

1. To find reliable health websites, you learned that you could start with those sponsored by the U.S. or state government, reputable non-profit organizations, or medical schools. This is the home page of the website for the National institutes of Health (NIH) located at www.nih.gov.
   [IMAGE: screenshot of NIH home page]
2. You learned to locate the sponsors of a website by scrolling to the bottom of the home page, or by looking for the About Us link. You scrolled to the bottom of the NIHSeniorHealth home page at www.nihseniorhealth.gov to find its sponsors.
   [IMAGE: screenshot of NIHSeniorHealth page with sponsors circled]
3. You learned to look for the About link on a website to find out the purpose of a website. On MedlinePlus at www.medlineplus.gov, you clicked on About MedlinePlus at the top of the home page, which took you to this page describing the website’s purpose.
   [IMAGE: screenshot of About MedlinePlus page]
4. You learned to locate the authors of the content, which is often found by clicking on the About link. You went to NIHSeniorHealth at www.nihseniorhealth.gov and clicked on Read more about NIHSeniorHealth.
   [IMAGE: screenshot of NIHSeniorHealth page with "Read more about NIHSeniorHealth" link circled]
5. You learned to find out if the health information is reviewed. On the MedlinePlus website at www.medlineplus.gov, you read about the way information is selected for the website. You clicked on About MedlinePlus and then clicked on Quality Guidelines to get to this page.
   [IMAGE: screenshot of MedlinePlus page with "MedlinePlus Quality Guidelines" circled]
6. You learned to recognize and locate the most recent update of a website’s health information. You found the most recent day the Centers for Medicare and Medicaid services website was updated at the bottom of the home page at www.medicare.gov.
   [IMAGE: screenshot of Medicare.gov page with Page Last Updated circled]
7. You learned to recognize and locate a website’s privacy policy. You found the privacy policy on the website of the Centers for Disease Control and Prevention at www.cdc.gov. You scrolled to the bottom of the home page, clicked on Policies and Regulations, and then clicked Privacy Policy.
   [IMAGE: screenshot of CDC page with Privacy Policy circled]
8. You learned to look for clues that a website’s health information is accurate. Information should be well written and based on research. Check with several sources to confirm the accuracy of the information.
   [IMAGE: overlapping screenshots of NIHSeniorHealth and MedlinePlus pages on osteoporosis]
9. You learned to locate the contact information for a website. You went to the website of the Food and Drug Administration at www.fda.gov and scrolled to the bottom of the home page to find the Contact FDA link.
   [IMAGE: screenshot of FDA page with Contact FDA link circled]