Evaluating Cracks in the Ice – a digital health initiative to support families, health workers and communities affected by crystal methamphetamine (‘ice’)

Cracks in the Ice (CITI: cracksintheice.org.au) is an Australian digital health initiative that was developed in response to growing concerns about crystal methamphetamine (‘ice’). The toolkit provides evidence-based, non-stigmatising information and resources for people who use crystal methamphetamine, their family and friends, health workers, and the general community. CITI has the potential to play an important role in improving knowledge and challenging misconceptions surrounding crystal methamphetamine. An online survey was conducted from November 2018 to March 2019 to evaluate whether CITI was meeting the needs of the Australian community and to examine whether the use of CITI impacted people’s knowledge and attitudes about crystal methamphetamine.

A cross-sectional online survey was conducted among Australian residents aged 18 years and over assessing participants’ perceptions of CITI, as well as their knowledge and attitudes about crystal methamphetamine. 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. Website visitors completed a series of site evaluation questions, including the System Usability Scale (SUS). Naïve participants were also asked to undertake a guided CITI site tour before completing the evaluation questions, and repeating the knowledge and attitude scales.

A total of 2,108 Australians completed the survey to assess the toolkit. The average SUS score was 73.49 (SD 13.30), indicating good site usability. Knowledge about the drug was generally good but stigmatising attitudes were common. Naïve participants (n=1789) displayed an increase in knowledge about crystal methamphetamine (P<.001) and a decrease in stigmatising attitudes following website exposure (P<.001).

This study provides an innovative evaluation of a national eHealth resource. Results indicate CITI is achieving its aim of disseminating evidence-based, non-stigmatising information and resources to key end user groups and shows promise in improving knowledge and reducing the stigma associated with methamphetamine.