A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication

The call for science communication and public scholarship

This commentary calls for a collective shift in the sciences and academia to prioritize and invest in communicating research in ways that are engaging, relevant, and accessible to public audiences. We provide the context and rationale for increasing and enhancing science communication, and identify barriers that prevent health researchers, educators, and practitioners from engaging with the public. Academic institutions need to develop and implement policies that encourage and support science communication and public scholarship initiatives that are sustainable and scalable.

Low educational quality and trustworthiness of YouTube videos by physiotherapists on shoulder joint mobilization techniques: a descriptive study

INTRODUCTION

Physiotherapists and students may be vulnerable to false information and may learn faulty treatment techniques due to inadequate educational quality and uncertainty about sources and trustworthiness of YouTube videos.

OBJECTIVE

To investigate educational quality, trustworthiness, and content completeness of joint mobilization techniques demonstrating videos available on YouTube.

DESIGN

This is a descriptive study.

METHODS

We performed a YouTube search on 1^st April 2019, using the keyword 'Maitland joint mobilization technique for shoulder joint'. Three academic physiotherapists independently rated each video for educational quality, trustworthiness, and content completeness using the Global Quality Score, Journal of American Medical Association (JAMA) Benchmark Criteria and joint mobilization content completeness scale, respectively.

RESULTS

Fifteen videos were included in the study. The median number of views for videos was 1263 (IQR 578-1478), and the median duration was 140 seconds (IQR 71-301 seconds). Most videos had low content quality (87%), poor joint mobilization content completeness (80%), and limited trustworthiness. All videos had low source quality (100%).

CONCLUSIONS

There is a lack of quality information on shoulder joint mobilization techniques on YouTube, which makes it a limited educational tool for physiotherapists and students.

Social Media and Cardiovascular Health: Implications for Women

PURPOSE OF REVIEW

Cardiovascular disease (CVD) is the leading cause of mortality in adult women in the USA, yet CVD is underrecognized in women. Disparities in care are further pronounced in women of racial/ethnic minority backgrounds. In this review, we discuss the role of social media (SoMe) as a tool to (i) promote women's cardiovascular (CV) health and (ii) address and potentially reduce gaps in care, particularly in general cardiology (targeting atherosclerotic cardiovascular disease), cardio-oncology, and cardio-obstetrics. We also briefly discuss women's CV health as a common, although not unique, focus of women in cardiology on SoMe.

RECENT FINDINGS

Studies have suggested the utility of social media to help advance subspecialties of cardiology. Leaders within general cardiology, cardio-oncology, and cardio-obstetrics have curated social media strategies to advance their respective fields and call attention to cardiovascular health disparities in female populations and racial/ethnic minorities. In addition to these types of uses, women in cardiology also frequently use SoMe to encourage a career in cardiology and to share experiences, challenges, and resources for support and career advancement as healthcare professionals; men in cardiology and especially those who are allies for sex and racial/ethnic minorities also use SoMe for these means. Herein, we highlight the role and myriad applications of social media in the promotion of women's cardiovascular health. We discuss five primary roles of social media: increasing public awareness, disseminating medical literature in a rapid and accessible fashion, facilitating professional networking, serving as a platform for medical conferences, and empowering patients. These core strategies are discussed through the lens of general cardiology, cardio-oncology, and cardio-obstetrics. We also demonstrate how these applications can be leveraged to increase representation of women in cardiology, also supporting an increased focus on women's cardiovascular health.

Factors Associated with Cancer Message Believability: a Mixed Methods Study on Simulated Facebook Posts

The ability to share and obtain health information on social media (SM) places higher burden on individuals to evaluate the believability of such health messages given the growing nature of misinformation circulating on SM. Message features (i.e., format, veracity), message source, and an individual's health literacy all play significant roles in how a person evaluates health messages on SM. This study assesses how message features and SM users' health literacy predict assessment of message believability and time spent looking at simulated Facebook messages. SM users (N = 53) participated in a mixed methods experimental study, using eye-tracking technology, to measure relative time and message believability. Measures included individual health literacy, message format (narrative/non-narrative), and information veracity (evidence-based/non-evidence-based). Results showed individuals with adequate health literacy rated evidence-based posts as more believable than non-evidence-based posts. Additionally, individuals with limited health literacy spent more relative time on the source compared to individuals with adequate health literacy. Public health and health communication efforts should focus on addressing myths and misinformation found on SM. Additionally, the source of message may be equally important when evaluating messages on SM, and strategies should identify reliable sources to prevent limited health literate individuals from falling prey to misinformation.

A comparative study on HIPAA technical safeguards assessment of android mHealth applications

Protecting personal health records is becoming increasingly important as more people use Mobile Health applications (mHealth apps) to improve their health outcomes. These mHealth apps enable consumers to monitor their health-related problems, store, manage, and share health records, medical conditions, treatment, and medication. With the increase of mHealth apps accessibility and usability, it is crucial to create, receive, maintain or transmit protected health information (PHI) on behalf of a covered entity or another business associate. The Health Insurance Portability and Accountability Act (HIPAA) provides guidelines to the app developers so that the apps must be compliant with required and addressable Technical Safeguards. However, most mobile app developers, including mHealth apps are not aware of HIPAA security and privacy regulations. Therefore, a research opportunity has emerged to develop an analytical framework to assist the developer to maintain a secure and HIPAA-compliant source code and raise awareness among consumers about the privacy and security of sensitive and personal health information. We proposed an Android source code analysis framework that evaluates twelve HIPAA Technical Safeguards to check whether a mHealth application is HIPAA compliant or not. The implemented meta-analysis and data-flow analysis algorithms efficiently identify the risk and safety features of mHealth apps that violate HIPAA regulations. Furthermore, we addressed API level checking for secure data communication mandated by recent CMS guidelines between third-party mobile health apps and EHR systems. Experimentally, a web-based tool has been developed for evaluating the efficacy of analysis techniques and algorithms. We have investigated 200 top popular Medical and Health & Fitness category Android apps collected from Google Play Store. We identified from the comparative analysis of the HIPAA rules assessment results that authorization to access sensitive resources, data encryption-decryption, and data transmission security is the most vulnerable features of the investigated apps. We provided recommendations to app developers about the most common mistake made at the time of app development and how to avoid these mistakes to implement secure and HIPAA-compliant apps. The proposed framework enables us to develop an IDE plugin for mHealth app developers and a web-based interface for mHealth app consumers.

Making decisions about health information on social media: a mouse-tracking study

Health misinformation is a problem on social media, and more understanding is needed about how users cognitively process it. In this study, participants’ accuracy in determining whether 60 health claims were true (e.g., “Vaccines prevent disease outbreaks”) or false (e.g., “Vaccines cause disease outbreaks”) was assessed. The 60 claims were related to three domains of health risk behavior (i.e., smoking, alcohol and vaccines). Claims were presented as Tweets or as simple text statements. We employed mouse tracking to measure reaction times, whether processing happens in discrete stages, and response uncertainty. We also examined whether health literacy was a moderating variable. The results indicate that information in statements and tweets is evaluated incrementally most of the time, but with overrides happening on some trials. Adequate health literacy scorers were equally certain when responding to tweets and statements, but they were more accurate when responding to tweets. Inadequate scorers were more confident on statements than on tweets but equally accurate on both. These results have important implications for understanding the underlying cognition needed to combat health misinformation online.

Development, Validation, and Utilization of a Social Media Use and Mental Health Questionnaire among Middle Eastern and Western Adults: A Pilot Study from the UAE

OBJECTIVES

We aimed to develop and validate a mental health stigma measurement tool for use within the social media context, utilizing the tool to assess whether the stigma shown in face-to-face interactions translates to social media, coupled with comparing whether social media use can cause the stigma among a sample of Middle Eastern and Western populations.

METHODS

The development and validation phase comprised a systematic process that was used to develop an assessment tool that could be used within the social media context and establish its validity and reliability. A 5-point Likert-type scale (1 = strongly disagree to 5 = strongly agree) was developed to assess mental health stigma. The anonymous questionnaire was distributed from June 2022 to August 2022 on various social media platforms and groups predominated by the two demographics of interest, enrolling 1328 participants (with only 1001 responses deemed valid). The utilization phase consisted of bivariate and multivariable analysis of the data. The cutoff points for low, medium, and high scores were the 25th, 50th, and 75th percentil, respectively.

RESULTS

The instrument comprised three dimensions: acceptance, intolerance, and digital care sentiment. In the Middle Eastern subset of participants, a higher score of intolerance (more stigma) toward mental illness was found in 72.4% of the participants, with a higher score of acceptance being 35.1% and of digital care sentiment being 46.4%. The mean scores for all the scales were as follows: intolerance (3.08 ± 0.64), acceptance (3.87 ± 0.71), and digital care sentiment (3.18 ± 0.69). For Westerners, a higher score of intolerance toward mental illness was found in 24.0% of the participants, with a higher score of acceptance being 56.8% and of digital care sentiment being 38.2%. The mean scores for all the scales were as follows: intolerance (2.28 ± 0.73), acceptance (4.21 ± 0.61), and digital care sentiment (3.08 ± 0.62). Various results were obtained regarding the effect of individual social media platforms on the different subscales.

CONCLUSIONS

Stigma does follow people on social media, whether they are Middle Easterners or Westerners, although to varying degrees. The results of social media interaction and activity varied based on the group that used them, with some having an impact on one group but not the other. For these reasons, proper guidance is advised when utilizing and interacting with social media platforms.

Evaluating Information About Osteochondritis Dissecans Shared Across Social Media Platforms

BACKGROUND

With the rise of social media, patients are using a variety of online resources to gather information about medical conditions and connect with others for support. Osteochondritis dissecans (OCD) occurs most commonly among children and adolescents, necessitating early diagnosis and management. The purpose of this study is to evaluate content on social media about OCD to quantify the reach of information shared and themes of discussion surrounding this condition.

METHODS

A search was performed across Facebook, Instagram, YouTube, and TikTok using the term "osteochondritis dissecans" to identify information shared related to this topic which was then analyzed based on engagement using number of followers, posts, and/or views.

RESULTS

Facebook groups provided a forum for online support and information sharing among patients with OCD and their families. The 4 identified groups had a cumulative following of over 4000 people with posts that shared personal recovery stories, solicited treatment advice, and provided updates on patient progress. Review of related Instagram hashtags revealed over 4500 posts, many of which shared personal accounts of living with OCD. The top 5 most viewed YouTube videos collectively had over 189,000 views and were focused on educational information about OCD, relevant surgical techniques, and pertinent anatomy. The top 3 OCD-related TikTok hashtags had over 4 million total views centered on factual knowledge and sharing changes before and after surgical treatment.

CONCLUSION

Patients with OCD and their families seek information about their condition and treatment on online sources including social media. Although social media provides a supportive community to share and receive advice, the quality of information shared in these groups is a subject for concern. Increasing physician involvement and awareness of the information shared across social media platforms may improve accuracy of information and content available to patients.

CLINICAL RELEVANCE

It is important for physicians treating patients with OCD to be aware of all sources of information and support, including content shared on social media as these platforms allow for the sharing of personal stories, recommendations for treatment, and educational content.

Online Peer Support for People With Multiple Sclerosis: A Narrative Synthesis Systematic Review

BACKGROUND

People with multiple sclerosis often experience depression and anxiety, negatively affecting their quality of life, especially their social life. Peer support, whether in person or online, could improve social connection and coping. Online peer support allows people to engage from their home at a time that suits them. We sought to explore the benefits and challenges of online peer support and to identify successful elements of online peer support for people with multiple sclerosis.

METHODS

Using the narrative synthesis method, 6 databases were searched in April 2020 for articles published between 1989 and 2020; the search was updated in May 2022. The quality of the included studies was assessed using the Critical Appraisal Skills Programme qualitative research checklist and the Downs and Black checklist.

RESULTS

Of 10,987 unique articles identified through the database search, 11 were included. Benefits of online peer support included sharing information and experiences and emotional support. Successful elements included having a dedicated space to save information and the convenience of online peer support. Challenges included verification of information and the lack of nonverbal communication.

CONCLUSIONS

Online peer support can help those unable to access in-person support groups and can reduce the risk of social isolation. However, multiple sclerosis symptoms may make it difficult to use technological devices. Research is needed to further explore potential barriers to online peer support.

Orthopaedic Program Reputation and Association With Social Media Utilization and Engagement

BACKGROUND

The associations of orthopaedic social media metrics with US News & World Report (USNWR) scores have not been well defined and are the focus of this study.

METHODS

Orthopaedic surgery departments and residency programs were matched to the USNWR overall orthopaedic score and professional opinion subscore. Corresponding Instagram and Twitter accounts were evaluated for the number of followers, number following, and posts. Correlations between these metrics and rank/reputation were assessed. Pearson correlations and Student t tests were used with significance set at P < 0.05.

RESULTS

Of the 192 departments associated with residency programs, there were social media accounts for 150 (78.1%) and USNWR rankings for 186 (96.9%), with an overlap of 147 (76.6%). Instagram accounts were identified for 138 (93.9%) and Twitter accounts for 85 (57.8%). Correlations were highest for the opinion subscore and number of followers (Instagram department R = 0.894, Instagram residency R = 0.338, Twitter department R = 0.808, and Twitter residency R = 0.878, P < 0.001 for each), less for the number of posts (Instagram department R = 0.590, Twitter department R = 0.521, and Twitter residency R = 0.696, P < 0.001 for each).

CONCLUSION

Social media metrics correlated with USNWR scores. Focusing on such social media platforms may help further the reputation, audience engagement, and ranking of orthopaedic departments and residencies.

Impact of information timeliness and richness on public engagement on social media during COVID-19 pandemic: An empirical investigation based on NLP and machine learning

This paper investigates how information timeliness and richness affect public engagement using text data from China's largest social media platform during times of the COVID-19 pandemic. We utilize a similarity calculation method based on natural language processing (NLP) and text mining to evaluate three dimensions of information timeliness: retrospectiveness, immediateness, and prospectiveness. Public engagement is divided into breadth and depth. The empirical results show that information retrospectiveness is negatively associated with public engagement breadth but positively with depth. Both information immediateness and prospectiveness improved the breadth and depth of public engagement. Interestingly, information richness has a positive moderating effect on the relationships between information retrospectiveness, prospectiveness, and public engagement breadth but no significant effects on immediateness; meanwhile, it has a negative moderating effect on the relationship between retrospectiveness and depth but a positive effect on immediateness, prospectiveness. In the extension analysis, we constructed a supervised NLP model to identify and classify health emergency-related information (epidemic prevention and help-seeking) automatically. We find that public engagement differs in the two emergency-related information categories. The findings can promote a more responsive public health strategy that magnifies the transfer speed for critical information and mitigates the negative impacts of information uncertainty or false information.

Quality Assessment of Hypertension Treatment–Related Information on WeChat: Cross-sectional Study

Background

The WeChat platform has become a primary source for medical information in China. However, no study has been conducted to explore the quality of information on WeChat for the treatment of hypertension, the leading chronic condition.

Objective

This study aimed to explore the quality of information in articles on WeChat that are related to hypertension treatment from the aspects of credibility, concreteness, accuracy, and completeness.

Methods

We searched for all information related to hypertension treatment on WeChat based on several inclusion and exclusion criteria. We used 2 tools to evaluate information quality, and 2 independent reviewers performed the assessment with the 2 tools separately. First, we adopted the DISCERN instrument to assess the credibility and concreteness of the treatment information, with the outcomes classified into five grades: excellent, good, fair, poor, and very poor. Second, we applied the Chinese Guidelines for Prevention and Treatment of Hypertension (2018 edition) to evaluate the accuracy and completeness of the article information with regard to specific medical content. Third, we combined the results from the 2 assessments to arrive at the overall quality of the articles and explored the differences between, and associations of, the 2 independent assessments.

Results

Of the 223 articles that were retrieved, 130 (58.3%) full texts were included. Of these 130 articles, 81 (62.3%) described therapeutic measures for hypertension. The assessment based on the DISCERN instrument reported a mean score of 31.22 (SD 8.46). There were no articles rated excellent (mean score >63); most (111/130, 85.4%) of the articles did not refer to the consequences—in particular, quality of life—of no treatment. For specific medical content, adherence to the Chinese Guidelines for Prevention and Treatment of Hypertension was generally low in terms of accuracy and completeness, and there was much erroneous information. The overall mean quality score was 10.18 (SD 2.22) for the 130 articles, and the scores differed significantly across the 3 types (P=.03) and 5 sources (P=.02). Articles with references achieved higher scores for quality than those reporting none (P<.001). The results from the DISCERN assessment and the medical content scores were highly correlated (ρ=0.58; P<.001).

Conclusions

The quality of hypertension treatment–related information on the WeChat platform is low. Future work is warranted to regulate information sources and strengthen references. For the treatment of hypertension, crucial information on the consequences of no treatment is urgently needed.

Exploring low-income migrant workers' health information-seeking behavior during COVID-19 in Taiwan: A qualitative study

Background

COVID-19 pandemic is reported to exacerbate existing vulnerabilities of marginalized groups, and the lack of self-care can lead to the spread of the virus across society. Therefore, effective responses to the challenges imposed by the health crisis should consider the health information needs of migrant workers.

Objective

We aimed to explore how migrant low-income workers seek health information and how their health-related information needs were met during a health crisis. We also investigated migrant workers’ preferred information sources and types of content with the theoretical concept of health literacy to understand the development of health competencies among migrant workers.

Methods

We conducted semi-structured interviews with Thai low-income migrant workers. A total of 13 Thai migrant workers participated in the study, among whom five were undocumented. The interviews were audio-taped, transcribed, and analyzed with the thematic analysis approach.

Results

Our findings indicated that migrant workers’ health literacy and health information behavior could be improved through technology when facing a health crisis. We found that participants sought health information proactively to reduce their perceived risks. However, there is still space for design to support the ability to process jargon information and apply local policy, such as providing easy-to-understand, accurate, and timely information. The findings of this study provide some insights for the authority and technological design to respond to migrant workers’ health information needs.

Conclusions

This study acknowledges and understands the needs of vulnerable migrant workers in society. The findings of this study provide insights for the authority and technological design to respond to migrant workers’ health information needs. We also outline the areas worth further investigation, such as the communication between information seekers and providers, and the navigation of the healthcare system for migrants in the host country.

Social media and sociodemographic characteristics associated with general health in breast cancer patients: a cross-sectional study

Introduction

little is known about social media (SM) use among breast cancer (BC) patients and their general health (GH). This study aimed to evaluate the impact of SM and sociodemographic characteristics associated with GH in BC patients during the treatment phases.

Methods

a retrospective cross-sectional study was conducted on BC patients at Shiraz University from December 2017 to August 2020. Data on clinical, epidemiological, and GH information were collected using a general health questionnaire (GHQ-28). Univariate analysis was performed to determine the impact of SM on GH. Additionally, multivariate logistic regression models [odds ratio (OR)] were performed to identify sociodemographic factors that affect the GH of BC patients.

Results

amongst the 353 individuals with BC, 339 (96%) were female. Their mean age was 48.98 ± 11.57 years. Two hundred and thirty (65.2%) patients used SM; the most frequent SM application was WhatsApp by 209 participants (59.2%). Univariate analysis showed a significant social dysfunction among SM nonusers compared to their users (6.68 ± 2.87 vs. 7.87 ± 3.22) and the difference was statistically significant (p < 0.0001). The use of SM for 3 hours or less was associated with less social dysfunction. However, the difference was not statistically significant (22.80± 12.48 vs. 25.21 ± 10.17, p =0.415). Multivariate logistic regression showed that using SM and working outdoors was positively associated with GH (OR = 0.68, 95% CI =0.29-1.59) and (OR =0.92, 95% CI = 0.54-1.57), respectively. However, female gender and use of chemotherapy were negatively associated with GH (OR = 2.96, 95% CI = 0.74-11.72, and OR =1.47, 95% CI = 0.83-2.57), respectively. Age, marital status, educational level, and disease duration were not statistically associated with GH.

Conclusion

using SM and working outdoors directly and positively impact the behavior of people who have BC, while the female gender and those under chemotherapy were negatively associated with GH in BC patients.

Is the information about orthodontics on Youtube and TikTok reliable for the oral health of the public? A cross sectional comparative study

PURPOSE

The aim of this study was to evaluate and compare orthodontic videos uploaded to YouTube and TikTok, the two most popular video sharing platforms, and to determine which of these platforms has more reliable and higher quality videos.

MATERIALS AND METHOD

YouTube (www.YouTube.com) and Tiktok (www.tiktok.com) was searched for two search-terms: "Orthodontics" and "Orthodontic Treatment". Reliability and quality of the first 120 videos for each search-term was evaluated by social media video content evaluation tools: Global Quality Score (GQS) and Reliability Score (modified DISCERN tool).

RESULTS

While YouTube videos were more informative or sharing patient experiences, TikTok videos were almost purely entertainment oriented. Tiktok videos had lower reliability. YouTube videos were rated of higher quality than Tiktok videos. GQS mean values for Youtube and TikTok were 2.90 ± 1.35 and 2.23 ± 1.08 respectively; and reliability (DISCERN) values were 2.42 ± 1.70 and 1.27 ± 1.48 respectively. GQS median values for Youtube and TikTok were 3 and 2 respectively; and reliability (DISCERN) values were 2 and 1 respectively. Most of the uploaders in both platforms were professionals.

CONCLUSION

Neither YouTube videos nor Tiktok videos were found to be reliable or of good quality. Videos on YouTube were higher quality and more reliable than videos on TikTok. However, YouTube videos also contained unreliable information.

In Urticarial Vasculitis, Long Disease Duration, High Symptom Burden, and High Need for Therapy Are Linked to Low Patient-Reported Quality of Life

BACKGROUND

Urticarial vasculitis (UV) is a rare and difficult-to-treat chronic skin disease defined by long-lasting urticarial lesions and the histopathologic finding of leukocytoclastic vasculitis. As of yet, little is known about UV patients' perspective on the disease.

OBJECTIVE

To assess UV patients' perspective on the clinical course, treatment response, greatest challenges, and quality-of-life (QOL) impairment.

METHODS

A web-based questionnaire was disseminated in a Facebook group of patients with UV. Patients with UV confirmed by skin biopsy were included.

RESULTS

Patients with UV had a mean age of 47.3 ± 12.3 years and were mostly female (94.3%; n = 82 of 87). The median delay in diagnosis was 8.1 months (interquartile range, 2.0-46.3). Normocomplementemia and hypocomplementemia were present in 54.0% (n = 27) and 46.0% (n = 23) of 50 patients, respectively. Most patients with UV (51.8%; n = 43 of 83) reported severely decreased QOL due to their disease. Low QOL was also the most frequently reported greatest challenge for patients with UV (40.7%), followed by the long-standing course of UV with frequent relapses (14.8%). Low QOL correlated with long disease duration (r = 0.298; P = .02) and high numbers of clinical symptoms (r = 0.294; P = .007). Patients with UV with allergies, lung diseases, and chronic infections reported lower QOL. Patients with UV with low QOL were treated with analgesics, dapsone, montelukast, omalizumab, and colchicine more often than patients with UV with higher QOL (P < .05 for all).

CONCLUSIONS

Our results show a considerable impairment in QOL in patients with UV associated with long disease duration, high symptom burden, and a high need for therapy. Improvement of the management of UV by further research is necessary.

Perceived Effects of Socio-Economics and Social Media Variables on Body Mass Index in Saudi Young Adults

This study aimed to measure the extent to which Saudi young adults used social media as a source for nutrition information and assess the perception of those networks on their dietary behaviors. The study also investigated the association between participants' socio-economic variables, social media variables, and body mass index. A cross-sectional survey was used and distributed via social media. This study included 228 participants (20-24 years old) who lived in AL-Ahssa Province. Over 50% of the participants were single females with bachelor's degrees. Among the participants, 70% were interested in increasing their nutrition knowledge, and 95% agreed that they obtained their nutrition information through social media. The participants surfed social media for at least one hour per day. Over 70% responded that exposure to social media had influenced their dietary behaviors (adopting new positive dietary behaviors, including selecting healthy foods and reading nutrition labels). Instagram was the most used application of all social media networks, with over 50% of the participants following 2-4 Instagram accounts related to nutrition. A majority of participants (78%) preferred obtaining nutrition information through visual methods, such as videos (49.1%) and infographic images (28.9%). Challenges to using nutrition information on social media were unproven or misleading topics and provided by non-nutrition experts. Social media may therefore be an effective tool to increase nutrition awareness and assist in disseminating nutrition intervention programs by nutrition educators and experts.

Does the medium matter? Comparing the effectiveness of videos, podcasts and online articles in nutrition communication

Videos and podcasts have become popular in nutrition communication. However, it is unclear whether they are more effective than online texts in conveying knowledge and promoting behavioural intentions. Based on the Cognitive Theory of Multimedia Learning, it was hypothesised that videos are more effective than podcasts or texts in communicating nutrition-related information. In addition, differences in behaviour change intentions were explored. The pre-registered online experiment used a 3 (medium: video, podcast and text) × 3 (topic: diet and climate change, sugar content, and nudging) between-subjects design with 320 participants who were randomly assigned to the conditions. After receiving the respective content, the participants' intention to change their behaviour accordingly and their knowledge about all topics were assessed. A mixed Analysis of Variance revealed a significant interaction of topic and knowledge, indicating that knowledge was higher for the topic that participants were assigned to, compared to the two topics they received no information about. There were no differences in knowledge or intention for the three media. Videos, podcasts and texts are equally suitable for conveying nutrition knowledge and may also be equally beneficial for promoting intention. Communicators may thus base their choice of medium on considerations like available resources and preferences of the target group.

Identifying key challenges and needs in digital mental health moderation practices supporting users exhibiting risk behaviours to develop responsible AI tools: the case study of Kooth

Digital platforms for mental health and wellbeing purposes have become increasingly common to help users exhibiting risk behaviours (e.g. self-harming, eating-related disorders) across all ages, opening new frontiers in supporting vulnerable users. This study stems from a larger project, which explores how responsible AI solutions can up-scale existing manual moderation approaches and better target interventions for young people who ask for help or engage in risk behaviours online. This research aims to better understand the challenges and needs of moderators and digital counsellors, i.e. the ‘behind the scenes’. Through this case study, the authors intend to contribute to the development of responsible AI tools that are fit for purpose and better understand the challenges. The key focus lies on Kooth.com, the UK’s leading free online confidential service offering counselling and emotional wellbeing support to young people in the UK through its online web-based and pseudo-anonymous digital platform.

Content Analysis of #Postpartumbody Images Posted to Instagram

Understanding the imagery on social media targeting postpartum women is an important step in determining the utility of Instagram as a potential avenue for targeting public health messages to this group. This study (1) describes the content of images on Instagram tagged with #postpartumbody and; (2) compares images from ‘Top’ posts (‘trending’ or ‘popular’) with ‘Recent’ posts. 600 images tagged with #postpartumbody (300 ‘Top’ and 300 ‘Recent’) were systematically captured from Instagram and coded using a predefined framework. Images of women were coded for adiposity, muscularity, pose and attire. Chi-square tests were used to compare ‘Top’ and ‘Recent’ posts. Most (n = 409) images were of a woman who generally had low/average adiposity (91%) and little-to-none/some visible muscle definition (93%). Most women (52%) were posing in a non-specific manner, 5% were posing to accentuate a postpartum body feature and 40% were wearing fitness attire. Compared with ‘Recent’, ‘Top’ posts were less likely to be text-focused (p < 0.001), photos of food (p < 0.001) or linked to a product/program (p < 0.001). Women of lower adiposity are more likely to post images of themselves on Instagram tagged with #postpartumbody than women of higher adiposity, which may reflect increased body pride in this group, but could reduce body satisfaction for some viewers. Conveying health information on Instagram may be necessary to interrupt potentially harmful content.

Detecting the research structure and topic trends of social media using static and dynamic probabilistic topic models

Purpose

A huge volume of published research articles is available on social media which evolves because of the rapid scientific advances and this paper aims to investigate the research structure of social media.

Design/methodology/approach

This study employs an integrated topic modeling and text mining-based approach on 30381 Scopus index titles, abstracts, and keywords published between 2006 and 2021. It combines analytical analysis of top-cited reviews with topic modeling as means of semantic validation. The output sequences of the dynamic model are further analyzed using the statistical techniques that facilitate the extraction of topic clusters, communities, and potential inter-topic research directions.

Findings

This paper brings into vision the research structure of social media in terms of topics, temporal topic evolutions, topic trends, emerging, fading, and consistent topics of this domain. It also traces various shifts in topic themes. The hot research topics are the application of the machine or deep learning towards social media in general, alcohol consumption in different regions and its impact, Social engagement and media platforms. Moreover, the consistent topics in both models include food management in disaster, health study of diverse age groups, and emerging topics include drug violence, analysis of social media news for misinformation, and problems of Internet addiction.

Originality/value

This study extends the existing topic modeling-based studies that analyze the social media literature from a specific disciplinary viewpoint. It focuses on semantic validations of topic-modeling output and correlations among the topics and also provides a two-stage cluster analysis of the topics.

The usefulness of YouTube videos on lung cancer

BACKGROUND

The use of social media as a source of health information is increasing, and the usefulness of the content may vary depending on the specific disease. Thus, this study was designed to assess the content, viewer engagement and usefulness of the most viewed YouTube videos on lung cancer.

METHODS

167 videos were reviewed, and 143 met the eligibility criteria. Two authors evaluated the videos separately, and data on views, likes, dislikes and comments were extracted, and data on the source of uploader, duration and content quality were recorded.

RESULTS

89 videos (62%) were classified as useful, 8 (6%) as misleading and 46 (32%) as neither. The misleading videos were significantly more popular in terms of views and likes compared with the useful videos: 845 643 versus 81 700, P = 0.003 and 12 170 versus 415, P < 0.001, respectively.

CONCLUSIONS

This study shows that YouTube videos on lung cancer are popular and that around two-thirds of the videos are useful in terms of patient education. However, the misleading videos are currently attracting higher viewer interaction and might compose a future challenge in terms of the spread of misinformation as the algorithms will prioritize popular videos rather than videos with evidence-based information.

Development of Principles for Health-Related Information on Social Media: Delphi Study

Background

Health-related misinformation can be propagated via social media and is a threat to public health. Several quality assessment tools and principles to evaluate health-related information in the public domain exist; however, these were not designed specifically for social media.

Objective

This study aims to develop Principles for Health-related Information on Social Media (PRHISM), which can be used to evaluate the quality of health-related social media content.

Methods

A modified Delphi approach was used to obtain expert consensus on the principles and functions of PRHISM. Health and social media experts were recruited via Twitter, email, and snowballing. A total of 3 surveys were administered between February 2021 and May 2021. The first survey was informed by a literature review and included open-ended questions and items from existing quality assessment tools. Subsequent surveys were informed by the results of the proceeding survey. Consensus was deemed if ≥80% agreement was reached, and items with consensus were considered relevant to include in PRHISM. After the third survey, principles were finalized, and an instruction manual and scoring tool for PRHISM were developed and circulated to expert participants for final feedback.

Results

A total of 34 experts consented to participate, of whom 18 (53%) responded to all 3 Delphi surveys. In total, 13 principles were considered relevant and were included in PRHISM. When the instructions and PRHISM scoring tool were circulated, no objections to the wording of the final principles were received.

Conclusions

A total of 13 quality principles were included in the PRHISM tool, along with a scoring system and implementation tool. The principles promote accessibility, transparency, provision of authoritative and evidence-based information and support for consumers’ relationships with health care providers. PRHISM can be used to evaluate the quality of health-related information provided on social media. These principles may also be useful to content creators for developing high-quality health-related social media content and assist consumers in discerning high- and low-quality information.

Motivational Influences Affecting Middle-Aged and Elderly Users' Participation Intention in Health-Related Social Media

Social media provide users with multi-directional dialogue for creating and sharing health information that can effectively promote the self-management of health. In regard to the 'greying' trend in social media, most researchers have studied the health-related social media (HRSM) acceptance status and use behavior of middle-aged and elderly people, and have explored the role of HRSM in this group. However, the continuous participation of users is the key to the successful operation of HRSM, and is an essential prerequisite for the subsequent HRSM behavior habits of middle-aged and elderly people. Therefore, we aimed to explore what motivations drive the first use of HRSM among middle-aged and older adults, and the impact of their perception of HRSM, after personal use, on their intention to use it continually. In the study, we used the partial least squares structural equation model (PLS-SEM) to analyze data collected from online questionnaires. The results showed that a self-protection motivation and a social motivation promoted the initial participation of middle-aged and elderly individuals. In addition, these people experienced deeper levels of perceived usefulness and perceived entertainment after their initial participation. The results also revealed that these two perceptions could positively influence middle-aged and elderly individuals' intention to continue with their participation. Our findings should help service platforms to better understand the needs of middle-aged and elderly users. This would help researchers and practitioners to gain a more complete understanding of the motivation of middle-aged and elderly people for participating in HRSM, and the related impacts this may have.

Factors influencing schizotypal personality trait-dependent immersion and digital media usage: Adaptation and maladaptation

Immersion in the digital environment has been widely researched; however, the effects of adaptive and maladaptive schizotypal personality traits on immersion have received relatively little attention up till now. This study investigates the factors of personal immersion while using entertainment and digital communication applications and other variables such as problematic internet usage, and Facebook addiction. The Immersive Tendency Questionnaire was applied to measure participants' tendency to experience artistic and life-like scenarios in traditional settings (reading a book and watching a movie) and digital environments (playing computer games and using the internet). The study was conducted with 717 college students and graduate persons including, 186 males (mean age: 28.49) and 531 females (mean age: 28.4). The results show that lowered focusing abilities are directly linked with deficiencies in self-coherence, and maladaptive behavior that manifests in problematic internet and Facebook usage. Furthermore, the attention/focusing ability during immersion is accompanied by coherent self-structure and psychological well-being. Therefore, for people who have adequate focusing skills and coherent self-structure, the usage of social media and computer gaming can be considered adequate digital tools for developing their cognitive and social skills.

#Healthpromotion: A qualitative exploration of how dietitians can use social media to positively influence women aged 18-35 years

Aims

To understand how young adult women use social media, including which nutrition and health‐related content they prefer to view and why. Findings are intended to support dietitians to use social media more effectively for health promotion to reach, educate and positively influence young adult women.

Methods

Qualitative research was conducted through semi‐structured interviews involving 10 women aged 18–35 years via Zoom videoconferencing. The interviews were recorded, transcribed verbatim and analysed using an interpretative phenomenological approach.

Results

Young adult women use social media daily to view a wide variety of content, including nutrition and health‐related content. Three themes were identified: authenticity, engaging content, and affecting trust through selling products.

Conclusion

To effectively use social media for health promotion, dietitians need to share their authentic voice while maintaining professional standards. Recommendations for effective social media engagement include using engaging content, infographics, and videos with closed captions. More research is needed to assess whether health promotion deployed via social media is effective at increasing nutrition knowledge, improving health literacy, and producing behaviour change.

Searching for Certainty During a Pandemic: A Longitudinal Investigation of the Moderating Role of Media Consumption on the Development of Posttraumatic Stress Symptoms During COVID-19

ABSTRACT

The current study longitudinally examined the moderating effects of consuming different types of media ( i.e. , formal [news] and informal [social media, WhatsApp]) in the association among COVID-19-related worries, intolerance of uncertainty (IU), and posttraumatic stress symptoms (PTSSs). Data were collected at two time points during July and September 2020, with approximately 60 days between measurements. Results showed that both COVID-19-related worries and IU were found to be positively associated with PTSSs. An interaction with formal media consumption was found, so that when one's formal media consumption was high, he or she were most vulnerable to the aforementioned effects on the development of PTSSs. Our findings point to the interactive effects of both COVID-19 worries and IU with media consumption on the development of PTSSs. Although media consumption might provide information during uncertainty, it may also intensify PTSSs during times of crisis. Implications and limitations are discussed.

Social media mining under the COVID-19 context: Progress, challenges, and opportunities

Social media platforms allow users worldwide to create and share information, forging vast sensing networks that allow information on certain topics to be collected, stored, mined, and analyzed in a rapid manner. During the COVID-19 pandemic, extensive social media mining efforts have been undertaken to tackle COVID-19 challenges from various perspectives. This review summarizes the progress of social media data mining studies in the COVID-19 contexts and categorizes them into six major domains, including early warning and detection, human mobility monitoring, communication and information conveying, public attitudes and emotions, infodemic and misinformation, and hatred and violence. We further document essential features of publicly available COVID-19 related social media data archives that will benefit research communities in conducting replicable and reproducible studies. In addition, we discuss seven challenges in social media analytics associated with their potential impacts on derived COVID-19 findings, followed by our visions for the possible paths forward in regard to social media-based COVID-19 investigations. This review serves as a valuable reference that recaps social media mining efforts in COVID-19 related studies and provides future directions along which the information harnessed from social media can be used to address public health emergencies.

Using a social media based intervention to enhance eye health awareness of members of a deprived community in India

Deprived communities in India experience a range of health challenges as the result of a mixture of lack of access to information technologies, and difficulties in accessing health information and provision. This article reports on an intervention centred on the use of the social media platform, WhatsApp, in order to promote eye health communication. The case study based research was conducted in the village of Chowbaga, close to Kolkata, in West Bengal, with women participants who had low levels of education and high levels of unemployment. The women were invited to participate in a WhatsApp intervention that comprised five educational sessions. Participants were recruited through the local school that their children attended. Shortly after the conclusion of the intervention, focus groups were conducted with the participants in order to develop an understanding of participants views of the beneficial characteristics of such a social media based intervention, and, more specifically, the benefits of WhatsApp in increasing awareness of eye problems within their community. This research demonstrates and summarises the benefits of WhatsApp as a communications medium for deprived communities, as well as its potential for increasing awareness of eye problems. In particular, participants were of the view that future access to WhatsApp and other mobile-based platforms empowered them to take better care of their own and their family’s health.

Social Media Use in Hearing Loss, Tinnitus, and Vestibular Disorders: A Systematic Review

Background:

People are increasingly using social media outlets for gathering health-related information. There has also been considerable interest from researchers and clinicians in understanding how social media is used by the general public, patients, and health professionals to gather health-related information. Interest in the use of social media for audiovestibular disorders has also received attention, although published evidence synthesis of this use is lacking. The objective of this review article was to synthesize existing research studies related to social media use concerning hearing loss, tinnitus, and vestibular disorders.

Method:

Comprehensive searches were performed in multiple databases between October and November 2020 and again in June 2021 and March 2022, with additional reports identified from article citations and unpublished literature. This review article was presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results:

A total of 1,512 articles were identified. Of these, 16 publications met the inclusion criteria. Overall, social media offered people the platform to learn about hearing loss, tinnitus, and vestibular disorders via advice and support seeking, personal experience sharing, general information sharing, and relationship building. Research studies were more common on information and user activities seen on Facebook Pages, Twitter, and YouTube videos. Misinformation was identified across all social media platforms for each of these conditions.

Conclusions:

Online discussions about audiovestibular disorders are evident, although inconsistencies in study procedures make it difficult to compare these discussion groups. Misinformation is a concern needing to be addressed during clinical consultations as well as via other public health means. Uniform guidelines are needed for research regarding the use of social media so that outcomes are comparable. Moreover, clinical studies examining how exposure to and engagement with social media information may impact outcomes (e.g., help seeking, rehabilitation uptake, rehabilitation use, and satisfaction) require exploration.

Supplemental Material:

https://doi.org/10.23641/asha.20667672

Integrated entitymetrics analysis for health information on bipolar disorder using social media data and scientific literature

Purpose

This study aimed to examine the mental health information entities and associations between the biomedical, psychological and social domains of bipolar disorder (BD) by analyzing social media data and scientific literature.

Design/methodology/approach

Reddit posts and full-text papers from PubMed Central (PMC) were collected. The text analysis was used to create a psychological dictionary. The text mining tools were applied to extract BD entities and their relationships in the datasets using a dictionary- and rule-based approach. Lastly, social network analysis and visualization were employed to view the associations.

Findings

Mental health information on the drug side effects entity was detected frequently in both datasets. In the affective category, the most frequent entities were “depressed” and “severe” in the social media and PMC data, respectively. The social and personal concerns entities that related to friends, family, self-attitude and economy were found repeatedly in the Reddit data. The relationships between the biomedical and psychological processes, “afraid” and “Lithium” and “schizophrenia” and “suicidal,” were identified often in the social media and PMC data, respectively.

Originality/value

Mental health information has been increasingly sought-after, and BD is a mental illness with complicated factors in the clinical picture. This paper has made an original contribution to comprehending the biological, psychological and social factors of BD. Importantly, these results have highlighted the benefit of mental health informatics that can be analyzed in the laboratory and social media domains.

Differences of Search Engine Digital Footprints Between Podiatrists and Foot and Ankle Orthopaedic Surgeons: A Need to Join the Digital Era

BACKGROUND

Search engines generate lists of the most relevant websites using a keyword or phrase query and are integral in guiding consumer preferences. Digital information is important in the field of medicine, influencing what patients learn about their conditions and who they choose as providers. When two types of healthcare providers, such as podiatry and foot and ankle orthopaedic surgeons (FAOSs), share an overlapping consumer market, whichever group has a larger digital footprint receives increased digital engagement.

METHODS

The Google search engine was used to query nine common foot and ankle-associated terms using a "search term + zip code" format for 150 zip codes divided into urban, suburban, and rural population densities. The first 10 results of each search were classified into one of five categories. Site content was classified as podiatry-oriented, other MD/DO-oriented, or FAOS-oriented. Separately, a ratio between podiatrists and FAOSs was calculated for each population density group. Data were then normalized using this ratio and reanalyzed with the Wilcoxon signed-rank test with significance at P < 0.05.

RESULTS

Of 13,500 total search results, 4,992 (36.9%) were podiatry-oriented, 2,109 (15.6%) were other MD/DO-oriented, and 436 (3.2%) were FAOS-oriented. All geographic areas featured a higher number of podiatry than FAOS-oriented sites. FAOSs have more results per provider in urban areas (P < 0.001), although podiatrists had more in suburban and rural areas (P < 0.001, P < 0.001). Podiatrists have greater digital engagement in descriptive search terms. "Ankle replacement" has greater FAOS engagement in all three geographic areas.

DISCUSSION

Foot and ankle-related Internet search terms results are overwhelmingly composed of podiatry-oriented sites. Per provider, regional differences are demonstrated, with FAOS having more sites in urban areas only. FAOS scope-of-practice terms such as "ankle replacement" still retain greater engagement by FAOSs. Search engine optimization and saturation strategies should be considered.

LEVEL OF EVIDENCE

Level 3 (observational study).

Quasi-experimental design for using an interactive social media intervention program to improve truck drivers' health beliefs and eating behaviors

Background

Truck drivers have difficulties participating in health education programs delivered at a fixed time and place due to the mobility of their workplace. Interventions conducted via social media can overcome these limitations of time and place. This study aimed to investigate the effect of a nutrition education intervention program delivered via a social media platform on the healthy eating behaviors of truck drivers.

Methods

This study adopted a quasi-experimental design. A 12-week intervention program was conducted for a social-media group (n = 125) and a conventional-teaching group (n = 117) from February to May 2020. The social-media group participated in a social-media-based health intervention on the LINE application. The intervention involved the provision of online messages, online instant responses, a picture-based food log, an audio e-book, and a loyalty e-card. The conventional-teaching group participated in a healthy diet course and a hygiene education manual. The generalized estimation equation (GEE) was applied to evaluate the intervention effects on the outcome measures derived from the Health Belief Model.

Results

The results of the GEE showed the social-media-based intervention strategies significantly decreased perceived barriers of consuming a healthy diet (p =  < 0.001), increased willingness to follow cues of action (p = 0.036), improved the self-efficacy of healthy eating behaviors (p = 0.001), and increased the score of healthy eating behaviors (p < 0.001) compared with the conventional teaching strategies. For the social-media and conventional-teaching groups, no significant changes occurred in self-perceived health status, self-perceived susceptibility, or self-perceived severity after the intervention. More than 90% of the participants in the social-media group believed the social-media-based intervention strategies could help implement and maintain healthy eating behaviors.

Conclusions

The results indicate social-media-based intervention strategies can facilitate approaching a population without a fixed workplace, such as truck drivers. Health promoters and planners focusing on occupational health can consider developing social-media-based intervention strategies for improving truck drivers' health status.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13883-6.

Social Media for the Dissemination of Educational Videos About Inflammatory Bowel Diseases

INTRODUCTION

To broadly disseminate 5 user-centered educational videos for patients with inflammatory bowel disease and their family and friends on social media.

METHODS

Relevant social media users were iteratively identified based on their online behavior. For each video, 2 different accompanying texts were tested.

RESULTS

We reached 4.2 million social media users of whom 320,302 watched at least 50% of the video. A short description resulted in higher view rates than posing an open-ended question.

DISCUSSION

We showed the feasibility of large-scale dissemination of health-related educational videos through social media. Our findings can inform future online dissemination approaches of educational content.

#TheUglyTruth? A Qualitative Evaluation of Outcomes Photography on Instagram: Introducing the SEPIA Scoring System

Photographs of cosmetic treatment outcomes on social media are prone to bias and misrepresentation from nonadherence to established photographic standards. However, there is currently insufficient information regarding which norms are most-commonly violated, precluding quality improvement efforts.

Methods

A qualitative study of cosmetic treatment photographs published on Instagram was undertaken in accordance with the Guidelines for Reporting Reliability and Agreement Studies using a newly proposed Standards for the Evaluation of Photographs In Aesthetics (SEPIA) nine-point photograph scoring system and grading scale.

Results

A total of 510 posts encompassing 2020 clinical photographs published by 102 practitioner accounts on Instagram were audited for photographic quality. The average score was 4 out of 9 (medium quality), with approximately 40% of posts scoring in the low-quality range. Zoom, lighting, timing, and presentation of multiple views were the standards most-commonly disregarded. Plastic and Reconstructive Surgery specialty and subspecialty (PRSS) practitioners scored higher (4.5/9 versus 3.1/9, P = 0.002) and had fewer low-quality posts (22% versus 54%, P = 0.001) than non-PRSS providers. Low-quality photographs were most often seen with rhinoplasty (30% versus 7%, P < 0.00001) and lip filler (60% versus 33%, P = 0.0001) compared with surgical and nonsurgical treatments, respectively, due to a higher incidence of immediate photographs and selfies.

Conclusions

Before and after photographs of surgical and nonsurgical cosmetic treatment outcomes on social media are frequently of substandard quality. This study outlines specific items frequently neglected in outcomes photography to assist practitioners in maximizing adherence to established standards of photography online.

The Relationship Between Information Sources, Health Literacy, and COVID-19 Knowledge in the COVID-19 Infodemic: Cross-sectional Online Study in Japan

BACKGROUND

The COVID-19 pandemic has caused not only a disease epidemic but also an infodemic. Due to the increased use of the internet and social media, along with the development of communication technology, information has spread faster and farther during the COVID-19 infodemic. Moreover, the increased choice of information sources has made it more difficult to make sound decisions regarding information. Although social media is the most common source of misinformation, other forms of media can also spread misinformation. However, the media sources used by people with high health literacy and COVID-19 knowledge to obtain information are unclear. Furthermore, the association between the use of multiple information sources and health literacy or COVID-19 knowledge is ill-defined.

OBJECTIVE

This study aims to examine the following 3 aspects regarding the COVID-19 infodemic: (1) the relationship between health literacy, COVID-19 knowledge, and the number of information sources used; (2) the impact of media use on health literacy; and (3) the impact of media use on COVID-19 knowledge.

METHODS

An online cross-sectional study was conducted in November 2021. Participants were 477 individuals aged 20-69 years. After obtaining consent to participate in the study, participants were asked about sociodemographic indicators, sources of health-related information, health literacy, and COVID-19 knowledge. Sources of health-related information were categorized into 4 types: mass media, digital media, social media, and face-to-face communication. The Spearman rank correlation test was conducted to determine the relationship between health literacy, the number of correct answers to COVID-19 knowledge, and the number of information sources used. Multiple regression analysis was conducted with health literacy and the number of correct answers as dependent variables, the 4 media types as independent variables, and age and sex as adjustment variables.

RESULTS

Mass media was the most frequently used source of information, followed by digital media, face-to-face communication, and social media. Social media use was significantly higher among individuals aged 20-29 years than among other age groups. Significant positive correlations were found between health literacy, the number of positive responses to COVID-19 knowledge, and the number of information sources used. Multiple linear regression analysis showed that health literacy is associated with access to information from digital media and face-to-face communication. Additionally, COVID-19 knowledge was associated with access to information from mass media, digital media, and face-to-face communication.

CONCLUSIONS

Health literacy and COVID-19 knowledge could be improved using diverse information sources, especially by providing opportunities to use digital media and face-to-face communication. Furthermore, it may be important to improve health literacy and provide accurate knowledge about COVID-19 to young adults.

Impact of a digital manual for guidance on malignant hyperthermia: patient education

Background

Malignant hyperthermia (MH) is a rare, hereditary disease with a hypermetabolic response to volatile anesthetics/succinylcholine. Susceptible patients face difficulties due to a lack of knowledge about MH. As informational materials could increase knowledge and adherence to prevention/therapy, digital information about rare diseases validated for patients is needed. Our objective was to evaluate the following: (1) the impact of digital manuals on the knowledge/quality of life of MH patients and (2) access to MH services.

Materials and methods

Fifty MH-susceptible patients filled out a virtual questionnaire twice (demographic/economic/clinical data, MH knowledge and impact on daily life, and SF-36 quality of life). Test groups 1 (n = 17) and 2 (n = 16) were evaluated 30 and 180 days after receiving a digital manual, and the control group (n = 17; without manual) was evaluated after 180 days. We collected the MH service data about the number of contacts.

Results

Twenty-four (48%) patients reported problems in personal/professional life, sports, clinical/surgical/dental treatments, and military service, in addition to concerns about emergency care and complaints of sequelae. The percentage of correct answers in the second MH knowledge questionnaire increased for test group 2 (62% vs. 74.1%; unpaired t test, p < 0.01), was significantly greater in test groups 1 (68.1%) and 2 (74.1%) than in the control group (56.5%; Kruskal–Wallis, p < 0.05), and correlated with more time studying the manual and reports of MH-related problems (multiple regression, p < 0.05).

Conclusions

The digital manual improved patients’ MH knowledge. Online contacts with the MH service increased, allowing greater information dissemination. As informational materials could increase knowledge/adherence to prevention/therapy, digital information about MH validated for patients should be implemented.

It's safe to move! A protocol for a randomised controlled trial investigating the effect of a video designed to increase people's confidence becoming more active despite back pain

INTRODUCTION

Social media provide promising contemporary platforms for sharing public health information with a broad audience. Before implementation, testing social media campaigns that are intended to engage audiences and initiate behaviour change is necessary. This trial aims to investigate the effectiveness of a public health campaign to increase people's confidence in becoming more active despite low back pain in comparison with no intervention.

METHODS AND ANALYSIS

This is an online randomised controlled trial with two intervention groups and one control group in a 1:1:1 allocation. People over 18 years of age and fluent in English will be recruited via social media advertising. We developed a social media-based public health campaign to support recommendations for managing low back pain. The interventions are two videos. Participants in the control group will be asked questions about low back pain but will not view either video intervention. The primary outcome will be item 10 of the Pain Self-Efficacy Questionnaire, which asks participants to rate how confident they would feel to gradually become more active despite pain ranging from 0 (not at all confident) to 6 (completely confident). This outcome will be measured immediately in all participant groups. We will compare group mean of the three arms of the trial using univariate analyses of variance.

ETHICS AND DISSEMINATION

This trial has been prospectively registered with the Australian New Zealand Clinical Trials Registry. We obtained ethical approval from our institutions Human Research Ethics Committee before data collection. We will publish the results in a peer-reviewed medical journal and on institution websites.

TRIAL REGISTRATION NUMBER

Australian New Zealand Clinical Trials Registry (ACTRN12622000466741).

Assessment of Indonesian-Language Orthodontics-Related YouTube Video as a Source of Information

OBJECTIVES

 Health-seeking behavior through social media including orthodontics treatment has become popular among community in Indonesia. However, the characteristics of uploaded video in term of quality, reliability, and usefulness are unknown. This study aims to analyze the characteristics of Indonesian-language orthodontic-related YouTube videos uploaded.

MATERIALS AND METHODS

 This study adopted cross-sectional design and analyzed 300 videos as the sample. A final 100 related videos were included for analysis of the quality, usefulness, and reliability of the video uploaded as well as viewers' interaction in term of popularity and visibility. Mann-Whitney's test was used for the statistical analysis.

RESULTS

 The majority of the videos were uploaded by individual users (60%) with moderate quality, usefulness, and reliability. Statistical analysis showed that orthodontics-related YouTube videos uploaded by individuals have lower popularity and reliability compared with health professional (p < 0.05).

CONCLUSION

 Most of the Indonesian-language orthodontic-related YouTube videos have moderate quality, usefulness, and reliability. There is a need from health professional to contribute more related video as main source of health information for the general to make healthy health-seeking behavior.

The Association of Internet Use Intensity and Lifestyle Behaviors During the COVID-19 Pandemic: A Cross-Sectional Study in Chinese Adults

The COVID-19 pandemic substantially increased the intensity of internet use in humans, which has made public opinion around health and public perceptions of it more vital, and this phenomenon has had a significant impact on human lifestyle behavior. This study used cross-sectional data during the COVID-19 pandemic to explore how internet use intensity influenced lifestyle behaviors among adults, and compared the differences between samples of different ages. The findings showed that the internet use intensity among adults increased the probability of physical activity, staying up late, and high-quality eating behaviors, and that they had a statistically significant positive association. Such associations were also found in independent younger, middle-aged, and older samples. However, the internet use intensity elevated the probability of body weight gain only in the independent samples of younger, middle-aged, and older adults. Besides, internet use intensity was able to increase the probability of smoking & drinking only among the younger sample. Notably, the effect of internet use intensity on lifestyle behaviors, including body weight gain, physical activity, staying up late, and a high-quality diet, was strongest among the elderly, followed by the middle-aged, and weakest among the younger. In the process of rural and urban governance regarding citizens' health, public health agencies should remind citizens to spend a reasonable amount of time on internet use to reduce the probability of unhealthy lifestyle behaviors and improve their physical health.

A Qualitative Research on Usage Intention and Platform Swinging Behavior of Anonymous Social Applications “Soul”

By iheriting online natural properties, anonymous social media (ASM) applications have become popular and have attracted large amounts of mobile users (e.g., the youth) who can construct new identities for role-play and show themselves in anonymous ways. In order to investigate the influencing factors toward usage intention (UI) and platform swinging (PS) behavior among anonymous social applications, we choose one of the most active ASM App “Soul” as the example in China and then conducte a semi-structured interview with 23 valid Soul users using qualitative methods. The results show that the factors, i.e., perceived usefulness, perceived ease of use, perceived privacy riskiness, perceived anonymity, subjective norms, emotional attachments, and perceived interactivity, indeed affect UI among Soul users via online communication. Moreover, we find that PS behavior is ubiquitous among interviewees and mainly depends on diversified needs, which consist of nine dimensions including different position and function among apps, usage comparison, friend migration, etc. Nearly 80% of interviewees believe that there exists a relationship between UI and PS, which can be described as a inverted U-shaped curve, i.e., the higher or lower UI, the less probability of PS. For the individuals’ social media usage behavior, a closed loop “Attitude–Intention–Behavior” is summarized. By conducting qualitative research, we intend to provide some insights and deepen the understanding of UI among ASM users in daily life.

Professional benefits and challenges of health information documentation on Instagram for Iranian physicians

Social media are new tools that can be used for facilitating health information management. However, social media’s benefits and challenges for information documentation have not been identified well. This study sought to identify the benefits and challenges of Instagram to information documentation based on Iranian physicians’ viewpoints. In this qualitative study, a semi-structure interview was administered to 28 Iranian physicians, and data were collected using purposive and snowball sampling method. The data analysis was done using the thematic analysis method by MAXQDA 10. Based on the findings of this study, six benefits for information documentation over Instagram were identified include sharing lessons learned, developing incidental learning, empowering communications, supporting decision-making, managing personal brand and translating knowledge. Also, based on Iranian physicians’ viewpoints, three challenges were found for information documentation in Instagram include ethical and privacy challenges, poor information quality and damaging professional image. Iranian physicians have different attitudes towards using Instagram for information documentation. For control challenges, regulatory and security issues must be addressed to protect physicians’ privacy and more education is required for the health professionals to make them more aware of the nature of using social media.

Experiences, Motivations, and Perceived Impact of Participation in a Facebook-Based Support Group for Caregivers of Children and Youth With Complex Care Needs: Qualitative Descriptive Study

BACKGROUND

Caregivers of children and youth with complex care needs (CCNs) often require considerable support to ensure the well-being of their families. Social media present an opportunity to better support caregivers through computer-mediated communication for social support. Peer-to-peer (P2P) support groups are a way in which caregivers are accessing needed support; however, the experiences of caregivers who use these groups and the perceived impact that participation has on caregivers of children and youth with CCNs are not known.

OBJECTIVE

This study aimed to explore the experiences of caregivers of children and youth with CCNs who use a Facebook-based P2P support group to communicate, understand their motivations to use the group, and investigate its perceived impact on knowledge of programs and services and sense of community belonging among caregivers.

METHODS

A qualitative descriptive design was used to explore the experiences and perceived impact of a Facebook-based (Meta Platforms) P2P support group for caregivers of children and youth with CCNs in New Brunswick, Canada. The group was launched on the web in October 2020, during the COVID-19 pandemic, and resulted in 108 caregivers joining the group. A web-based survey was distributed, and semistructured interviews were conducted in February 2021 with a subsample of members. Thematic analysis was used to identify and report patterns related to caregivers' experiences and perceived impacts of participation.

RESULTS

A subsample of members in the Facebook group completed the web-based survey (39/108, 36.1%) and interviews (14/108, 12.9%). A total of 5 themes emerged from the interviews: safe space, informational support and direction, web-based connection with peers, impact on knowledge of programs and services, and degree of community belonging. Participants reported joining the group to obtain geography-specific information support and connect with peers. Many participants reported an improvement in their knowledge of programs and services and felt connected to the community; however, the short observation period and diversity among the caregiver population were cited as barriers to community belonging.

CONCLUSIONS

Social media present an important opportunity to facilitate the exchange of support between patients and caregivers in an accessible and curated environment. Findings from this study suggest that involvement in web-based, geography-specific P2P support groups can influence perceived knowledge of services and resources and sense of community belonging among caregivers of children and youth with CCNs. Furthermore, this study provides insight into the experiences and motivations of caregivers of children and youth with CCNs who participate in a private social media environment.

Epidemiological challenges in pandemic coronavirus disease (COVID-19): Role of artificial intelligence

World is now experiencing a major health calamity due to the coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus clade 2. The foremost challenge facing the scientific community is to explore the growth and transmission capability of the virus. Use of artificial intelligence (AI), such as deep learning, in (i) rapid disease detection from x-ray or computed tomography (CT) or high-resolution CT (HRCT) images, (ii) accurate prediction of the epidemic patterns and their saturation throughout the globe, (iii) forecasting the disease and psychological impact on the population from social networking data, and (iv) prediction of drug-protein interactions for repurposing the drugs, has attracted much attention. In the present study, we describe the role of various AI-based technologies for rapid and efficient detection from CT images complementing quantitative real-time polymerase chain reaction and immunodiagnostic assays. AI-based technologies to anticipate the current pandemic pattern, prevent the spread of disease, and face mask detection are also discussed. We inspect how the virus transmits depending on different factors. We investigate the deep learning technique to assess the affinity of the most probable drugs to treat COVID-19. This article is categorized under:Application Areas > Health CareAlgorithmic Development > Biological Data MiningTechnologies > Machine Learning.

Characterizing the content, messaging, and tone of trichotillomania on YouTube: A content analysis

BACKGROUND

Trichotillomania is associated with secrecy and reluctance to seek help due to shame and lack of knowledge. Social media can connect people with similar lived experience. However, there is no literature regarding online communities related to trichotillomania. This study is a content analysis of depictions of trichotillomania on YouTube to identify the potential role of social media in this disorder.

METHODS

We used a cross-sectional observational study to examine the 100 most-viewed YouTube videos for trichotillomania content until June 2018. Up to 96 variables were abstracted from each video including demographics, characteristics of the videos, and depictions of trichotillomania.

RESULTS

View counts ranged from 9,186 to 15,597,149. Uploaders had a mean age of 20.1 years, were mostly female (85%) and appearing Caucasian (63%). Nearly half of the videos were self-filmed stories (48%). Most had a neutral message (44%), provided strategies to stop hair-pulling (31%), or focused on stimulating discussion (17%). Approximately half had a factual tone (51%) and many were hopeful (44%). Videos accurately described hair-pulling and associated characteristics.

LIMITATIONS

This study was limited to an analysis of video content. Future research should examine the comments on the videos as well as other social media platforms. It may also be important to assess the socioeconomic status of video uploaders and ensure the broader accessibility of positive messages on trichotillomania.

CONCLUSIONS

People with trichotillomania may find positive messages, information, and helpful recommendations on YouTube. This may represent an under-leveraged venue to improve clinical outcomes for people with trichotillomania.

Inflammatory Bowel Disease Self-Management: Exploring Adolescent Use of an Online Instagram Support Community

The purpose of this qualitative study was to explore the challenges adolescents with inflammatory bowel disease (IBD) experience with disease self-management as expressed in an online Instagram social support community. Public Instagram posts between January and December 2019 were manually collected from an online IBD support community. To focus on adolescent self-management needs, only posts from Instagram users who (1) indicated they had inflammatory bowel disease, (2) were 13-24 years old, or were in middle school, high school, or college were collected. Using thematic analysis, authors independently coded and identified emerging themes about self-management. Of 2,700 Instagram posts assessed for eligibility, 83 posts met inclusion criteria. Six major themes about inflammatory bowel disease self-management emerged: Desire for Normalcy, Dietary Changes, Education and Career, Healthcare System, Relationships With Others, and Symptoms and Complications. As the first thematic analysis of Instagram posts in an online inflammatory bowel disease community, results provide a crucial perspective of the concerns of adolescents with inflammatory bowel disease. Self-management challenges were wide-ranging and complex, underscoring the importance of IBD self-management in the adolescent population. Nurses should take a holistic approach to assess self-management challenges and tailor care to the specific needs of adolescents living with inflammatory bowel disease.

The Information Sharing Behaviors of Dietitians and Twitter Users in the Nutrition and COVID-19 Infodemic: Content Analysis Study of Tweets

Background

The COVID-19 pandemic has generated an infodemic, an overabundance of online and offline information. In this context, accurate information as well as misinformation and disinformation about the links between nutrition and COVID-19 have circulated on Twitter since the onset of the pandemic.

Objective

The purpose of this study was to compare tweets on nutrition in times of COVID-19 published by 2 groups, namely, a preidentified group of dietitians and a group of general users of Twitter, in terms of themes, content accuracy, use of behavior change factors, and user engagement, in order to contrast their information sharing behaviors during the pandemic.

Methods

Public English-language tweets published between December 31, 2019, and December 31, 2020, by 625 dietitians from Canada and the United States, and Twitter users were collected using hashtags and keywords related to nutrition and COVID-19. After filtration, tweets were coded against an original codebook of themes and the Theoretical Domains Framework (TDF) for identifying behavior change factors, and were compared to reliable nutritional recommendations pertaining to COVID-19. The numbers of likes, replies, and retweets per tweet were also collected to determine user engagement.

Results

In total, 2886 tweets (dietitians, n=1417; public, n=1469) were included in the analyses. Differences in frequency between groups were found in 11 out of 15 themes. Grocery (271/1417, 19.1%), and diets and dietary patterns (n=507, 34.5%) were the most frequently addressed themes by dietitians and the public, respectively. For 9 out of 14 TDF domains, there were differences in the frequency of usage between groups. "Skills" was the most used domain by both groups, although they used it in different proportions (dietitians: 612/1417, 43.2% vs public: 529/1469, 36.0%; P<.001). A higher proportion of dietitians' tweets were accurate compared with the public's tweets (532/575, 92.5% vs 250/382, 65.5%; P<.001). The results for user engagement were mixed. While engagement by likes varied between groups according to the theme, engagement by replies and retweets was similar across themes but varied according to the group.

Conclusions

Differences in tweets between groups, notably ones related to content accuracy, themes, and engagement in the form of likes, shed light on potentially useful and relevant elements to include in timely social media interventions aiming at fighting the COVID-19-related infodemic or future infodemics.

Usage of social media in epidemic intelligence activities in the WHO, Regional Office for the Eastern Mediterranean

Social media platforms are a massive source of information being used for monitoring and detecting various actual events such as natural disasters and disease outbreaks. This paper aims to present the experience of WHO, Regional Office for the Eastern Mediterranean in using social media for the detection and monitoring of COVD-19 pandemic alongside the other event-based surveillance tools. Over the period of 29 January 2020 to 31 May 2021, information was collected from social media and other media outlets (web news) as being the source of health information for early detecting and monitoring the situation of COVID-19 events. Signals were categorised into new events and event updates; where event updates captured from social media were categorised into official and unofficial. A total of 10 160 COVID-19 information were captured, out of which 95.8% (n=9732) were detected through social media. None of the information captured were discarded. 50.0% (n=11) of the COVID-19 events in the Eastern Mediterranean Region (EMR) were primarily captured from social media compared with 4.5% (n=1) primarily captured from other media outlets. Almost all (99.4%) of the event updates captured from social media were official updates. Real-time, transparent and relevant information posted on different social media platforms, especially the governmental official social media accounts, strengthened the early detection and follow-up of public health events in the EMR, especially during the current COVID-19 pandemic.

Users' passivity in accessing digested scientific evidence through social media: cross-sectional insights

OBJECTIVES

This manuscript provides novel insights about the potential use of social media (a Facebook page, the first strategic attempt by EviDent initiative) to share evidence-based dentistry content and empowerment strategies for professionals, using quantifiable usage metrics, besides exposing the strengths and weaknesses of this knowledge translation strategy. One year-long gathered metrics were analyzed to understand information about usage patterns.

RESULTS

Publications were potentially exposed to 4784 users, and subsequent interaction with the page occurred in 18% of cases. Users' involvement with page content was associated with the number of page visitors (P = .005). However, users' interaction with the page was not associated with the potential number of users that could have seen the page (P = .25). Even considering the users that approved the posts, only 7%, on average, interacted with the post's links. Although social media has effectively disseminated scientific content, our experience revealed the user's passivity in interacting with the content. We expect to overcome these barriers by developing a mobile app to offer a more interactive and dynamic interface associated with a more attractive format for posting, including images and infographics.