摘要：Objectives. We examined the content and usability of the Web sites of agencies serving women victims of violence. Methods. We entered the names of a systematic 10% sample of 3774 agencies listed in 2 national directories into a search engine. We took (in April 2012) and analyzed screenshots of the 261 resulting home pages and the readability of 193 home and first-level pages. Results. Victims (94%) and donors (68%) were the primary intended audiences. About one half used social media and one third provided cues to action. Almost all (96.4%) of the Web pages were rated “fairly difficult” to “very confusing” to read, and 81.4% required more than a ninth-grade education to understand. Conclusions. The service and marketing functions were met fairly well by the agency home pages, but usability (particularly readability and offer of a mobile version) and efforts to increase user safety could be improved. Internet technologies are an essential platform for public health. They are particularly useful for reaching people with stigmatized health conditions because of the anonymity allowed. The one third of agencies that lack a Web site will not reach the substantial portion of the population that uses the Internet to find health information and other resources. Internet use is nearly ubiquitous in the United States, particularly among adolescents. 1,2 A great majority of online adults and adolescents use social media such as Facebook, Twitter, and Pinterest. 2,3 Thus, public health agencies can use multiple online platforms to make and keep their work accessible to the public. A growing number of studies record the prevalence, promises, and problems of online health resources. Some have analyzed Web site content to document function and usability. 4–9 Others have focused on users and concluded that the Internet is a particularly effective way to reach people with stigmatized health problems (e.g., depression, herpes, urinary incontinence); because of the anonymity it allows, the Internet is their preferred source of information. 10 In this study, we focus on agencies serving women victims of violence, specifically sexual assault and intimate partner violence. We chose violence against women because, like other conditions with multiple negative health outcomes, it is a stigmatized phenomenon despite its high prevalence in the population. 11 In addition, the delivery of information on violence prevention via the Internet is particularly important to young people because first incidents of intimate partner violence and sexual assault occur relatively early in life (about 70% of first assaults occur by 24 years of age) 11 and young people are more likely than older persons to use the Internet. 1,2 Previous studies about Web sites specific to violence against women are few, include little about sexual violence, and do not analyze the Web sites themselves. 12–16 The sole exception, which examined 172 police department Web sites for domestic violence survivors, reached 2 conclusions: the posted information was insufficient, and the design was focused on the perspective of the Web site creator rather than that of the end user. 17 We examined the service and marketing functions as well as the usability of the Web sites of 261 agencies that serve women victims of violence. In studying the content, we assessed whether the provided information addressed benefits, barriers, and other constructs of the widely used Health Belief Model, 18 which are of particular relevance to such victims because they potentially provide a “preferred path of action.” 19
