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A reliability and content analysis of Italian language anorexia nervosa-related websites

Authors Bragazzi NL, Prasso G, Re TS, Zerbetto R, Del Puente G

Received 1 November 2018

Accepted for publication 11 July 2019

Published 1 August 2019 Volume 2019:12 Pages 145—151

DOI https://doi.org/10.2147/RMHP.S193088

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Kent Rondeau


Nicola Luigi Bragazzi,1–4 Giulia Prasso,5,6 Tania Simona Re,3,4 Riccardo Zerbetto,3 Giovanni Del Puente2

1School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; 2Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; 3Centro Studi Terapia Della Gestalt (CSTG), Milan, Italy; 4UNESCO Chair “Anthropology of Health-Biosphere and Healing System”, University of Genoa, Genoa, Italy; 5Department of Psychology (DISFOR), University of Genoa, Genoa, Italy; 6School of Psychotherapy “Associazione Italiana di Psicoterapia Psicoanalitica dell’Infanzia dell’Adolescenza e della Famiglia” (AIPPI), Milan, Italy

Objective: Internet represents a major source of information related to health issues, increasingly used by providers. Indeed, there are numerous websites concerning eating and weight disorders, such as anorexia nervosa. The aim of the current investigation was to systematically perform a reliability and content analysis of Italian language anorexia nervosa-related websites.
Methods: Reliability of the anorexia nervosa website pages was assessed using the Health on the Net Foundation Code of Conduct Standards (HonCode®) certification mark. A comprehensive content analysis (thematic cluster analysis, correspondence analysis of emerging themes and topics, density and degree-centrality analysis, and co-word analysis) was performed using the commercial software T-Lab.
Results: 402 unique website pages were included and analyzed in the current study. Statistically significant differences related to the accomplishment or less to the items of the HonCode® certificate mark were found for all items, except for confidentiality and webmaster/additional contact. From the thematic cluster analysis, four clusters were identified: namely, treatment (26.6%), vomiting (24.7%), weight (24.4%) and onset-age (24.3%). Treatment (in particular, cognitive-behavioral psychotherapy) was the most represented theme (with a frequency of 97.76%, recurring in 393 websites). Pro-ana content characterized 147 website pages (with a frequency of 36.57%).
Conclusion: The quality of Italian language anorexia nervosa-related websites was rather moderate-poor, being generally inconsistent with the principles of the HonCode® certification mark. Therefore, physicians and health authorities should be aware of such findings to provide their patients with proper answers and education.

Keywords: anorexia nervosa, internet, content analysis, qualitative analysis

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