BMA patient information award


October 2008

The awards
The BMA patient information award is part of the BMA medical book competition. It was established in 1997 to recognise quality in written patient information leaflets and small booklets. Its aims are to encourage the production and dissemination of accessible, well-designed and clinically balanced materials which will enhance patients' understanding of health issues and their ability to participate in decisions about their care.

The awards ceremony for the 2008 competition was held on 9 September 2008.

The main award is for printed leaflets and booklets: magazine-style publications are not accepted. Special awards are made each year for materials aimed at carers, men's health, women's health, learning disabled people, electronic or web resources and young people.

The special award for electronic or web resources aims:
  • to recognise good quality patient information sources on the web
  • to encourage the development of such sites
  • to promote the use of web sources by the general public and by doctors with their patients
  • to draw attention to the need to apply critical appraisal skills to web based resources
The web sites entered may be organisational sites, subject based sites or they may be personal home pages or image-based or multimedia resources. E

Conditions of entry - printed materials
  • The competition is open to all producers of written patient information materials except the BMA and BMJ Publishing Group.
  • All titles must have been published between 1 January of the year preceding the closing date of the competition and the end of February of the year of the closing date of the competition.
  • All titles must be available in the United Kingdom.
  • Titles must be in English.
  • Titles must not contain a significant authorial or editorial contribution from a current member of BMA or BMJ staff.
  • A separate entry form must be completed for each title.
  • Three copies must be submitted of each title.
  • Entries are not returnable and may be sent to other appropriate organisations.
  • Publications must be sent to the BMA library at the entrant's expense.
  • Awards are made by the Board of Science of the British Medical Association. The decision of the board shall be final in all matters relating to the Competition and no correspondence will be entered into relating to the board's decision.
  • The publisher of each winning title will receive a certificate and shall be entitled to use the Competition result on advertising and promotional activity. Additional certificates may be purchased from the BMA.
  • Three copies of each entry should reach the BMA library by the closing date.
Conditions of entry - websites
  • The competition is open to all producers of written patient information materials except the BMA and BMJ Publishing Group.
  • All sites must be primarily in the English language.
  • Titles must not contain a significant authorial or editorial contribution from a current member of BMA or BMJ staff.
  • A separate entry form must be completed for each title.
  • Awards are made by the Board of Science of the British Medical Association. The decision of the Board shall be final in all matters relating to the Competition and no correspondence will be entered into relating to the Board's decision.
  • The publisher of each winning site will receive a certificate and shall be entitled to use the Competition result on advertising and promotional activity. Additional certificates may be purchased from the BMA.
  • Details of entries may be passed on to other appropriate organisations.
  • Entry forms should be submitted by no later than the closing date.
Appraisal process - printed materials
Each title is individually evaluated using appraisal criteria developed specifically for the award. Our team of about twenty patient information specialists study the leaflet and complete an online appraisal form.

The organisers have established a set of core criteria which all shortlisted entries must achieve:
  • It include a date of publication
  • Patients have been involved in its production, in order to represent their views
  • Health professionals been involved in the production of the leaflet
  • The target readership is clearly stated and the content is appropriate to this readership
  • The clinical information is accurate
  • The leaflet is free from spelling and grammatical mistakes
Assessements are made on the basis of:
  • Evidence-based practice
  • Content
  • Navigation
  • Layout and design
  • Accessibility
As with the main BMA Medical Book Competition, a small panel of experts meet to discuss these preliminary appraisals and to select a short list of prize-worthy titles for consideration by the final judging panel, which is chaired by the Chairman of the BMA's Board of Science.

Appraisal process - websites
Each website is carefully evaluated. The organisers have established mandatory criteria which all websites must meet if they are to be considered:
  • Are the name and status of the author(s) clearly stated?
  • Have health professionals been involved in the content creation and review of this site?
  • Have users been involved in the content creation and review of this site?
  • Is the site constantly being checked and updated?
Assessments are made on the basis of
  • Evidence-based practice
  • Navigability
  • Bias
  • Scope
  • Codes of conduct and standards
  • Content
  • Ethical considerations
  • Language
  • Interactive features
  • Accessibility
  • Design
These guidance notes were developed by the initial web appraisal team of Mary Last (University College London Hospitals NHS Trust), Fiona McLean (CancerBACUP), Robert Kiley (Wellcome Institute for the History and Understanding of Medicine) and Mark Duman. They have developed these guidelines based on their experience of judging the award over the last three years and their knowledge of good practice in web site content and design.

The features that are looked for in judging this competition are also often the same as others will be using in assessing your site. Commonly used evaluation tools are given at the end of this section.

There are three places you can put information: on the home page, on a page linked directly to it (many sites have one called ‘About this site’), and at the end of particular pages of information. Remember that your site is assessed on the basis of the information available on it, so if you are meeting these criteria, make sure that is clear on your site.

Criteria to consider (not in priority order)
Authorship and authority
The author of information and the status of author(s) need to be clearly stated. If you have a health professional or another expert involved in producing or reviewing information, state this at the end of each section, or in a page linked from the home page if it’s the same person for all the site (eg on an‘about this site’ page). For this competition, we expect medical information (eg about diagnosis or treatments) to be written or reviewed by a doctor or other relevant health professional (eg a pharmacist is qualified to check information about drug treatments.)

Evidence base/attribution
If you are giving medical information on your site, give the references to the scientific articles or books on which the information is based, if any. This is invaluable in the assessment of the site, at least by health or information professionals, and by some patients. The references can be on a page linked to the information rather than the actual page, as long as there is a clearly identified link between them. Submitted sites often fail to meet this criterion.

Date
It must be clear when the site and/or parts of the site were last checked and/or updated. Information can go out-of-date quickly, particularly in some areas of medicine. Its therefore essential that information is dated, and the date that matters is the most recent review by someone with the expertise to check if the information is still up-to-date.

The clearest way to date information is to put the date at the end of each page of information. If the same date applies to all information on the site, a less ideal option is to put a clear message on the home page (eg ‘The information on this site was checked and updated if necessary in Aug 2002’). If there is a regular update schedule, mention that as well.

Consumer involvement
Consumers must have been involved for the site to be considered for the competition. 'Consumer' in this context means the intended audience of patients and/or the public. Sites should have their involvement at all stages during development. The minimum input is evaluating the site, and their feedback being acted on. Mention this involvement on your website, ideally.

Navigability
It's important that navigation is easy, including for inexperienced web users. This includes finding their way around the site; finding what they are looking for; and knowing where they are within the site at all times Complex designs with subtle links may look good but can be difficult to use. All pages should include a link to the home page (or another suitable starting point on very large sites). A search facility which retrieves relevant results is certainly helpful, but does not replace the need for easy navigation.

Bias
The information presented should be balanced, and any advertising clearly separate from the site's content. It is useful if sponsorship/source of funding is stated.

Scope
The information needs to be in sufficient depth and breadth to meet the information needs of consumers. This is one of the reasons that consumer involvement is crucial, to identify these needs.

Codes of conduct/standards
Does your site comply with a quality standard? If so, state this clearly on your home page or in your 'about' page, with a link to the standard's home page. Various standards exist such as Health on the Net:
Visit the Net standards here http://www.hon.ch/HONcode/

Content
Sites that are mainly collections of links to other websites can be very useful in some contexts. However, sites for this competition are expected to have significant original content, in addition to any relevant external links they choose to include.

Ethical considerations
Sites including medical information should include a disclaimer saying that it does not replace the need to consult a health professional. If any personal information is submitted by users, there should be a privacy policy. Content should meet basic ethical standards eg not offer embryo sex selection procedures for non-medical reasons.

Language
The language also needs to be as jargon -free as possible (give non- technical explanations of any jargon that is essential). The average reading age is not high, so keep the language clear and simple, without being patronising. The Plain English Campaign has a free guide for medical information:
Visit the website here http://www.plainenglish.co.uk/medicalguide.pdf

Sites not in English cannot be considered, as the judges are not proficient in other languages.

Interactive features
The Internet allows a range of ways to personalise information or interact with others (eg message boards). It's not essential for this competition to have such features, but relevant ones clearly presented are seen as an asset. See also 'ethical considerations'.

Accessibility
The site design should meet recognised standards of accessibility for those with visual and/or physical disabilities. Have you taken steps to check if your site is accessible to those with visual and other impairments? Resources with more information are in the reference list below. Submitted sites often fail to meet this criterion, particularly on points such as adequate font size, text options, and contrast between text and background colours.

Design
Sites need to load reasonably fast, and be accessible on Internet Explorer and Netscape. This does not need to include all versions which have existed, but should not require the most current version. Software such as Flash can make your site look good, but offer an alternative for those without access to it. Use of special features should be considered carefully, however. For example, 'pop up' windows can be distracting and unhelpful. It should be possible to access the information on the site without payment or registering. Design should make it easier to use the site, not impede access to its content.

Accessibility resources
Visit the RNIB Accessible Web Design here http://www.rnib.org.uk/digital/hints.htm

Visit the W3C Web Content Accessibility Guidelines here http://www.w3.org/TR/WAI-WEBCONTENT/

National Cancer Institute research-based web design and usability guidelines
Visit the website here http://www.usability.gov/guidelines/

Examples of health website evaluation tools
DISCERN (research based, but only for information for consumers about treatment choices)
Visit the DISCERN website here http://www.discern.org.uk

SciPICH
Visit the website here http://www.health.gov/scipich/IHC/checklist.htm

Examples of checklists used by key organisations
The INTUTE online service contains site evaluation guidelines
Visit the website here http://www.vts.intute.ac.uk/

How to enter
An entry form is available online. The entry forms are available now for entries to the 2009 awards.

For further information on the competition and for details about becoming a reviewer, please contact:

Clare Wade
Competition administrator
BMA Medical Book Competition
BMA Library
BMA House
Tavistock Square
London
WC1H 9JP

Tel: 020 7383 6639
Fax: 020 7388 2544
email: cwade@bma.org.uk

Links to useful organisations and resources
Informing patients: an assessment of the quality of patient information materials
Coulter A; Entwistle V; Gilbert D
King's Fund, 1998.
ISBN 1857172140, £16.95
Read more about this publication here http://www.kingsfund.org.uk/resources/publications/informing.html

Producing Patient Information: How to research, develop and produce effective information resources Updated 2nd ed.
Duman M
King's Fund, 2005 £25.00 ISBN 1857174704
Read more about this publication here http://www.kingsfund.org.uk/publications/kings_fund_publications/producing.html

For further information contact:
King's Fund Bookshop
1-13 Cavendish Square
London
W1M 0AN.
tel: 020 7307 2400
email: bookshop@kingsfund.org.uk;
Visit the website here http://www.kingsfund.org.uk

This new, fully revised second edition of the best-selling Practicalities of Producing Patient Information (PoPPi) Guide is designed to support a wide range of health professionals - in the public, commercial and voluntary sectors - to develop the quality and impact of the information they produce. Fully updated in line with the latest developments in new media such as CD ROMs and the internet, the guide also shows how to use traditional media, such as print, to the best advantage.

Producing Patient Information offers a complete, step-by-step guide to each stage of the information process, from developing an information policy, to writing and disseminating print and electronic materials. Designed to be read through, dipped into or used for reference, it includes:

* section-by-section overviews and action points
* information boxes that pull together additional useful facts
* a wealth of case studies and practical illustrations
* extensive further reading and useful contact listings
* a detailed index.

Organisations
Patient Information Forum (PiF)
The Patient Information Forum is an independent group of organisations united by a common purpose – the development, production, and dissemination of high-quality information for patients, carers, and their families. Representing no particular group, PiF looks to help organisations, and individuals, source and share best practice.

PiF offers its members locally co-ordinated workshops on topics such as writing information for children and information prescriptions. Steering group members lead on a number of key themes:
  • Appraising information
  • Communicating with minority groups
  • Design of health information
  • Education and training in health information
  • Establishing and running information centres
  • Health communications
  • Researching health information literacy and behaviour
  • Setting standards for quality information
  • Sourcing health information
  • Writing and producing information
  • Using new media
PiF’s regional co-ordinators are on hand to provide support on a local basis and its web site provides an online forum for discussion and advice. The web site also lists relevant courses, maintains an up-to-date membership database, and is a growing source of essential information about the world of patient information.

Individual and corporate membership of PiF is open to all those with an interest in patient information, including patient information co-ordinators in NHS Trusts, PALS, voluntary organisations, health care librarians, commercial, academic and NHS organisations.

For further details contact the PiF President, Mark Duman
email: chair@pifonline.org.uk
Visit the website here www.pifonline.org.uk where a membership application form can be downloaded.

National Information Forum
A voluntary organisation which aims to raise awareness among service providers of the need to make information available in ways which are appropriate; to promote and publicise good practice in providing information; to develop training materials on how best to provide information to disabled people.

Post Point 10/11
BT Burne House
Bell Street
London
NW1 5BZ
tel: 020 7402 6681
Visit the website here http://nif.org.uk/

healthscotland.com (HEBS)
This is involved in ensuring that people in Scotland have adequate information about health and the factors which influence it. Its web site is the largest and most comprehensive health information site in Scotland, with over 50,000 pages of leaflets, videos, posters, databases, quizzes and games:
Visit the website here http://www.healthscotland.com/

Appraisal tools
DISCERN
An instrument designed to help health consumers and information providers assess the quality of written information about treatment choices for a health problem.

Sasha Shepherd
Division of Public Health & Primary Health Care
Institute of Health Sciences
University of Oxford
Old Road
Headington
Oxford
OX3 7LF
tel: 01865 226712`x
email: sasha.shepperd@continuing-education.oxford.ac.uk
Visit the website here http://www.discern.org.uk

The Discern instrument on the web
The Discern handbook: quality criteria for consumer health information on treatment choices (user guide and training resource)
Charnock D
Radcliffe Medical Press, 1998
ISBN 1857753100, £40.00
The handbook has been written to help users understand and use Discern effectively. It consists of detailed question-by-question instructions on using the instrument and on rating each question, including examples developed from consumer health information. The guide also includes background information on the project and explains why the quality of written consumer health information is important.
Visit the website here http://www.discern.org.uk/discern_instrument.php

Principal author Fiona McLean, in consultation with all fellow website award judges Mary Davidson, Robert Kiley, Mark Duman and Richard Jones.

© British Medical Association 2008

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