Empowering People with Lived Experience: Assessing the Quality of Online Self-Management Educational Resources for Knee Osteoarthritis

Abstract

Knee osteoarthritis (KOA) is a debilitating chronic condition, which necessitates self-management to improve symptoms of pain and disability. While many online educational materials are available to foster individual’s self-management, their quality remains to be investigated. Additionally, people with lived experience (PwLE) may also face difficulties evaluating these online materials for themselves and need reliable tools to do so. Our aims were two-fold for this thesis: 1. Explore and evaluate the quality of online educational materials for self-management of KOA, and 2. Determine the reliability of the Patient Education Materials Assessment Tool (PEMAT) when it is used by PwLE. First, we conducted an environmental scan through Google to identify online educational resources for KOA self-management. We then evaluated each included resource for its readability and quality using the Flesch-Kincaid grade level and reading ease, and the PEMAT understandability and actionability scores. Second, we performed a reliability study of the PEMAT, measuring both item-level and domain-level inter-rater reliability (IRR), and internal consistency.The first study included 36 resources and found that most educational resources had high readability scores and low understandability and actionability scores. In the second study, we had 21 PwLE use the PEMAT-print version and found that it had substantial item-level IRR, moderate domain-level IRR, and acceptable internal consistency. PwLE also noted the PEMAT-print version to be user-friendly and serve its purpose. In general, online educational resources were found to be difficult to read, understand and use for the general public. In addition, the PEMAT-print version was deemed to be a reliable tool for PwLE to assess the quality of online self-management resources for themselves. Overall, this thesis highlights the gaps in accessibility of online health teaching resources and how PwLE may interact with these resources to make lifestyle changes that promote self-management behaviors.