JMIR Publications

ABSTRACT

Background:

The Cracks in the Ice Community Toolkit (cracksintheice.org.au) was developed to provide, evidence-based, up-to-date information and resources around crystal methamphetamine to Australians. Given the high rates of Internet use in the community and the potential for misinformation, Cracks in the Ice has the potential to play an important role in improving knowledge and challenging misconceptions surrounding crystal methamphetamine.

Objective:

This study aimed to: 1) determine if Cracks in the Ice is achieving its aim of disseminating evidence-based information and resources to people who use crystal methamphetamine, family/friends, health professionals and the general community and 2) to examine the association between use of Cracks in the Ice and knowledge and attitudes about crystal methamphetamine.

Methods:

A cross-sectional online survey, open to Australian residents (aged 18+ years), was conducted from November 2018 to March 2019. People who had previously visited the website (website visitors) and those who had not (naïve) were recruited. At baseline, knowledge, attitudes and demographics were assessed. Cracks in the Ice website visitors then completed a series of site evaluation questions including system usability scale (SUS) and naïve participants were asked to undertake a guided site tour of a replicated version of the site prior to completing the evaluation questions and repeating knowledge and attitudes scales.

Results:

Of a total 2108 participants, 27% reported lifetime use of crystal methamphetamine, 21% were family/friends, 14% health professionals and 39% community members. Average SUS scores were 73.49 (SD 13.30) indicating good site usability. Health professionals reported significantly higher SUS scores than community member (P=.02) and people who use crystal methamphetamine (P<.01). Website visitors had significantly higher baseline knowledge than naïve participants (P<.001). Among naïve participants, average knowledge scores increased following exposure to the website (Mean = 15.2, SEM = 0.05) compared to baseline (Mean = 14.4, SEM = 0.05, P<.001). Largest shifts in knowledge were observed for items related to prevalence, legal issues and the effects of the drug. Stigmatising attitude scores among the naïve group were significantly lower following exposure to Cracks in the Ice (Mean = 41.97, SEM = 0.21) compared to baseline (Mean =44.3, SEM =0.21; P<.001).

Conclusions:

This study provides an innovative evaluation of a national e-health resource. Cracks in the Ice is achieving its aim of disseminating evidence-based, non-stigmatising and useful information and resources about crystal methamphetamine to key end-user groups, and received good usability scores across its target groups. Interaction with Cracks in the Ice led to immediate improvements in knowledge about crystal methamphetamine, and a decrease in stigmatising attitudes. Cracks in the Ice demonstrates the important role of digital information and support platforms for translating evidence into practice as well as improving knowledge and reducing stigma.