Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals

The use of information and communication technologies in Latin American dentists: a cross-sectional study from Ecuador

BACKGROUND

The use of information and communication technologies (ICTs) provide the tools for enabling fast and reliable real-time communications, as well as the transfer of information between dental professionals and their patients. However, little is known about the frequency and preference of ICTs among Latin-American dentists. Our study aims to fill this gap by assessing different aspects related to ICTs, mainly the frequency of use, perceptions, and barriers among Ecuadorian dentists.

METHODS

An anonymous, cross-sectional survey-based study was conducted among 342 Ecuadorian dentists. The final questionnaire included 13 items related to the frequency of use, perceptions, and barriers of ICTs. Bivariate analysis was performed by using chi-squared testing to explore the association between the independent variables and the intended use of ICTs, as well as to characterize the perceptions and barriers related to ICTs.

RESULTS

In general, most participants reported the use of ICTs to communicate with colleagues (99.7%), and patients (96.2%), while only 63.5% reported using ICTs to obtain academic information in their daily practice. WhatsApp was rated as the most used ICT for communicating with colleagues and patients. A majority of participants considered that ICTs can be useful for facilitating continuing dental education (92.1%), searching new work opportunities (91.5%), promoting health (90.1%), working with colleagues and other health professionals (91.2%), promoting their professional services (90.6%), and for resolving clinical cases (87.7%). On the subject of barriers, privacy and security concerns about personal and/or patient information was the biggest concern among dentists (65%), followed by lack of time to learn how to use and/or use ICTs (48%), lack of mobile internet access (28.1%), and lack of internet access at work (24.9%).

CONCLUSION

In our study, we found that Ecuadorian dentists had a high usage rate of ICTs, mainly for communicating with other colleagues and patients, while the academic use of technology remains a comparatively underused application. Most of the participants surveyed had a positive perception towards ICTs, while privacy and security concerns were identified as the main barrier. Older age was associated with a less favourable perception toward ICTs, as well as an increased likelihood of reporting barriers related to the use of technology.

The association between social media use for health related information and compliance with breast and cervical cancer screenings

There is a need to investigate the impact of social media use on patient compliance with important health screenings due to the inconsistency of research findings on the effect of using social media on cervical cancer screenings. This study assessed associations between social media use and adherence in women at risk for breast and cervical cancer to mammograms and Pap smear screenings. A total of 6695 respondents from the Health Information National Trends Survey (HINTS) 5 Cycle 1 and 2 datasets were used for data analysis. Chi-square tests were used to explore social network activities and cancer screening compliance, and multivariate logistic regressions were used to identify factors associated with cancer screening compliance. Among respondents, 68% of women and 84% of women complied with mammograms and Pap smears, respectively. Women who used the Internet during last 12 months to visit a social networking site, participate in a forum support group for medical issue, or watch a health-related video on YouTube complied with Pap smears more significantly than women who did not use the Internet (p <.05, p <.0001, and p <.001, respectively). Variables associated with mammogram and Pap smear screening compliance were age, health insurance, regular provider, marital status, and internet use. There was no significant association between social network activities and compliance with mammogram screenings. It is critical to use the same and up-to-date guidelines when reporting cancer screening rates to effectively promote adherence to cancer prevention programs and make valid and reliable comparisons across studies.

Harnessing the power of social media: how can it help in axial spondyloarthritis research?

PURPOSE OF REVIEW

Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease that is relatively unknown among the general public. Most patients with axSpA are young or middle-aged adults and more likely to use some social media. This review highlights trends in the application of social media and different ways in which these tools do already or may benefit clinical research, delivery of care, and education in rheumatology, particularly in the field of axSpA.

RECENT FINDINGS

This article discusses four areas in the biomedical field that social media has infused with novel ideas: (i) the use of patient-generated health data from social media to learn about their disease experience, (ii) delivering health education and interventions, (iii) recruiting study participants, and (iv) reform, transfer, and disseminate medical education. We conclude with promising studies in rheumatology that have incorporated social media and suggestions for future directions.

SUMMARY

Rheumatologists now have the opportunity to use social media and innovate on many aspects of their practice. We propose further exploration of multiple ways in which social media might help with the identification, diagnosis, education, and research study enrollment of axSpA patients. However, standardization in study design, reporting, and managing ethical and regulatory aspects will be required to take full advantage of this opportunity.

Patients' Use of Social Media for Diabetes Self-Care: Systematic Review

BACKGROUND

Patient engagement with diabetes self-care is critical to reducing morbidity and mortality. Social media is one form of digital health that is available for diabetes self-care, although its use for peer-to-peer communication has not been systematically described, and its potential to support patient self-care is unclear.

OBJECTIVE

The primary aim of this systematic review was to describe the use of social media among patients (peer-to-peer) to manage diabetes and cardiovascular disease (CVD). The secondary aim was to assess patients' clinical outcomes, behavioral outcomes, quality of life, and self-efficacy resulting from peer-to-peer social media use.

METHODS

We conducted a literature search in the following databases: PubMed, EMBASE, Web of Science, CINAHL, and PsycINFO (January 2008 through April 2019). The inclusion criteria were quantitative studies that included peer-to-peer use of social media for self-care of diabetes mellitus (with all subtypes) and CVD, including stroke.

RESULTS

After an initial yield of 3066 citations, we selected 91 articles for a full-text review and identified 7 papers that met our inclusion criteria. Of these, 4 studies focused on type 1 diabetes, 1 study included both type 1 and 2 diabetes, and 2 studies included multiple chronic conditions (eg, CVD, diabetes, depression, etc). Our search did not yield any individual studies on CVD alone. Among the selected papers, 2 studies used commercial platforms (Facebook and I Seek You), 3 studies used discussion forums developed specifically for each study, and 2 surveyed patients through different platforms or blogs. There was significant heterogeneity in the study designs, methodologies, and outcomes applied, but all studies showed favorable results on either primary or secondary outcomes. The quality of studies was highly variable.

CONCLUSIONS

The future landscape of social media use for patient self-care is promising. However, current use is nascent. Our extensive search yielded only 7 studies, all of which included diabetes, indicating the most interest and demand for peer-to-peer interaction on diabetes self-care. Future research is needed to establish efficacy and safety in recommending social media use among peers for diabetes self-care and other conditions.

"Clicks, likes, shares and comments" a systematic review of breast cancer screening discourse in social media

BACKGROUND

Unsatisfactory participation rate at population based organised breast cancer screening is a long standing problem. Social media, with 3.2 billion users in 2019, is potentially an important site of breast cancer related discourse. Determining whether these platforms might be used as channels by screening providers to reach under-screened women may have considerable public health significance.

OBJECTIVES

By systematically reviewing original research studies on breast cancer related social media discourse, we had two aims: first, to assess the volume, participants and content of breast screening social media communication and second, to find out whether social media can be used by screening organisers as a channel of patient education.

METHODS

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). After searching PubMed, ScienceDirect, Web of Science, Springer and Ebsco, 17 studies were found that met our criteria. A systematic narrative framework was used for data synthesis. Owing to the high degree of heterogeneity in social media channels, outcomes and measurement included in this study, a meta-analytic approach was not appropriate.

RESULTS

The volume of breast cancer related social media discourse is considerable. The majority of participants are lay individuals as opposed to healthcare professionals or advocacy groups. The lay misunderstandings surrounding the harms and benefits of mammography is well mirrored in the content of social media discourse. Although there is criticism, breast cancer screening sentiment on the social media ranges from the neutral to the positive. Social media is suitable for offering peer emotional support for potential participants.

CONCLUSION

Dedicated breast screening websites operated by screening organisers would ensure much needed quality controlled information and also provide space for reliable question and answer forums, the sharing of personal experience and the provision of peer and professional support.

The Influence of Social Media on Intrapartum Decision Making: A Scoping Review

Social media has been influential in decision making regarding a number of health concerns. However, comparatively little has been examined with regard to its effects on pregnant women. The goal of this scoping review was to examine the literature and identify the role of social media in intrapartum decision making. A scoping review of the literature published between January 1990 and June 2018 was performed using PubMed, CINAHL, EMBASE, PsychINFO, Web of Science, and Cochrane databases. Of the initial 1951 records reviewed, 5 met inclusion criteria. Two of the 5 were quantitative in design, 1 was qualitative, and 2 used mixed methods. Internationally widespread, studies largely took place in developed nations including the United States, the United Kingdom, Canada, Australia, New Zealand, and Finland. Women are using the Internet, including social media, consistently as a source of pregnancy information, for example, 97% of 2400 participates in 1 exploratory study. This knowledge seeking was found to increase women's confidence and self-assurance in making decision during labor and birth. Studies identified issues surrounding women's ability to appraise available information. While it is clear that social media has an influence on women's intrapartum decision making, it is not clear exactly how. Further studies are needed to determine the content of the social media being appraised, the accuracy of the information, and the resulting decision as it affects the intrapartum experience. In addition, efforts should be made to open lines of communication between patients and care providers. This may foster a greater clinical understanding of social media consumption and its influences.

The Use of the Internet and Social Media by Individuals with Ménière's Disease: An Exploratory Survey of Finnish Ménière Federation Members

OBJECTIVES

The present study explored the use of the Internet and social media by individuals with Ménière's disease (MD).

MATERIALS AND METHODS

This study utilized a retrospective design and included the data of 465 individuals with MD from the Finnish Ménière Federation (FMF) database. Moreover, the participants included 346 females (i.e., approximately 75% of the sample), with roughly 95% of which middle-aged or older adults. An Internet-based survey was used to collect the demographic information and determine the use of the Internet and social media by individuals with MD in order to establish a computer-based peer support program.

RESULTS

Based on the findings, more than 90% of the respondents reported using the Internet, 70% used the Internet to gather information about MD, and 47% stated that they trusted the information on the Internet.

CONCLUSION

The Internet and social media are frequently used by individuals with MD to gather information about their health conditions. Therefore, it is essential to ensure that appropriate and accurate information is available via Internet websites and social media platforms.

Social media trends in dermatology, dermatopathology, and pathology publications: The social construction of medical subdisciplines

BACKGROUND

An increase in the number of publications on social media has paralleled the growth of social media use in the past decade. Our study examined the trends in these publications relating to the fields of dermatology, pathology, and dermatopathology.

METHODS

PubMed was searched for relevant literature from 2009 to present, using the following key terms: "social media", "dermatology", "dermatopathology", and "pathology." Topics of articles, years of publication, countries of origin, and contributing journals were compiled and analyzed.

RESULTS

A total of 99 publications was retrieved during the period between January 2009 and November 2019. Top publication years included 2019 (n = 21), 2018 (n = 24), 2017 (n = 20), and 2016 (n = 13). The most common topic areas noted were related to dissemination of information (n = 17; 17.2%), knowledge exchange for physicians (n = 16; 16.2%), and social networking (n = 15; 15.2%).

CONCLUSION

The number of published articles on social media in these specialties has increased since 2009, signifying the widespread use of social media for professional networking, knowledge exchange, real-time communication with patients and colleagues, and patient care. Social media in the areas of dermatology, dermatopathology, and pathology has undergone social construction during the past decade because of changes in technology and ideologies surrounding the use of social media within medicine.

Understanding Social Media Use and Engagement Among Dermatology Patients to Inform Dermatological Prevention and Care in Vietnam: Cross-sectional Study

Background

Social media has emerged as a common source of dermatological information. Monitoring the patterns of social media use and engagement is important to counteract the limitations of social media. However, evidence in Vietnamese dermatology patients is lacking.

Objective

This study aimed to explore social media use and engagement by dermatology patients and to identify factors associated with social media use and engagement.

Methods

A cross-sectional study was conducted with 519 participants at the Vietnam National Hospital of Dermatology and Venereology during September to November 2018. Data about sociodemographic characteristics, social media use, and social media engagement were collected. Multivariate logistic and tobit regression models were used to identify factors associated with social media use and engagement.

Results

Interest in information about “cosmetic, beauty, and skincare techniques” was the greatest (184/519, 46.2%). The mean engagement score was 8.4 points (SD 2.4 points). Female patients were more likely to use social media (odds ratio [OR] 2.23, 95% CI 1.23-4.06) and be interested dermatological information on social media (OR 3.09, 95% CI 1.35-7.09). Women also had higher social media engagement scores (coefficient=0.68, 95% CI 0.17-1.18). Higher social media engagement scores were related with Instagram use (coefficient=0.58, 95% CI 0.00-1.15) and higher credibility scores for “family members” (coefficient=0.15, 95% CI 0.03-0.26) and “dermatology companies” (coefficient=0.22, 95% CI 0.04-0.39).

Conclusions

This study discovered high social media usage among dermatology patients. However, only moderate utilization and credibility levels were reported regarding the use of social media as a source of dermatological information. More efforts should focus on involving dermatologists in the development of individualized information on social media targeting specific groups of dermatology patients.

Attitudes of Nurses Towards Searching Online for Medical Information for Personal Health Needs: Cross-Sectional Questionnaire Study

BACKGROUND

Use of online clinical health care information has become part of the skill set required by medical teams. Nurses believe that information quality and availability affect nursing care and methods. However, nurses tend not to exploit professional medical databases for evidence-based medical information for their personal needs. This phenomenon has received little research attention.

OBJECTIVE

This study aimed to address the knowledge gap around nurses' attitudes towards searching online for medical information for their personal needs (ie, for themselves and their families) by (1) evaluating the level of exposure to medical information and the effect on attitudes towards the use of online search options, (2) assessing the effect of the choice of a primary means of searching for medical information on the attitudes towards the use of online search options, and (3) gauging the influence of sociodemographic data and health status on nurses' attitudes towards searching online for medical information.

METHODS

Nurses employed in general departments in a general hospital (34/210, 16.2%), nursing home (42/200, 21.0%), and geriatric medical center (45/180, 25.0%) in Israel were invited to complete the eHealth Impact Questionnaire (alpha=.95). Questionnaires were distributed by nurses in charge of the general hospitalization wards. The data collection period was February to March 2018. The response rate was 40.3% (121/300).

RESULTS

Nurses tended to search for medical information for personal needs on social media (24/121, 19.8%) and TV (eg, health programs, health news; 23/121, 19.0%). Nurses who chose social media as their primary means of receiving general information had a positive attitude about using the online environment as a source for medical information compared to nurses who found information through other means (t119=4.44, P<.001). Nurses exposed to medical information via social media had a positive attitude towards the use of the internet to find medical information compared to nurses who were not exposed to social media (t119=3.04, P=.003). The attitudes of nurses towards the utility of online medical information for personal needs increased with better participant health status (F2,118=3.63, P=.03). However, the attitudes of participants with a chronic disease did not differ from those of healthy participants.

CONCLUSIONS

Nurses in Israel are less likely to use their professional skills and knowledge to search in professional databases for evidence-based medical information for their personal needs. Instead, they prefer medical information that is easy to access and not evidence-based, such as that on social media and TV. However, these search patterns for personal use may affect their clinical role, impair quality of care, and lead to incorrect medical decisions for their patients in the health care system. Therefore, during nursing education, training for searching skills, retrieval skills, and online search techniques for evidence-based medical information is vital for evidence-based practice.

Committed to Health: Key Factors to Improve Users' Online Engagement through Facebook

Health organizations, continuously exposed to public scrutiny due to the social relevance of the services provided, have adopted social media to disseminate information about health but also about themselves, and thus, reducing uncertainty and improving communication. In this context, users’ participation in social media has become one of the main indicators of their effectiveness, highlighting the importance of analyzing which factors enhance online engagement. This research extends the number of variables identified in prior studies and analyzes 19,817 Facebook posts from 126 health organizations. Using multivariate linear regression, explanatory results show that economic and organizational attributes, and factors related to the social media posts, both contribute significantly to explain the engagement reached in social media by those organizations. According to our findings, health organizations are not taking enough advantage of social media to engage with their current and potential users. The dissemination of relevant information using visually attractive formats could help draw the attention of consumers, both to reach a higher commitment with the organization and to create value for society.

Knowledge translation strategies for dissemination with a focus on healthcare recipients: an overview of systematic reviews

BACKGROUND

While there is an ample literature on the evaluation of knowledge translation interventions aimed at healthcare providers, managers, and policy-makers, there has been less focus on patients and their informal caregivers. Further, no overview of the literature on dissemination strategies aimed at healthcare users and their caregivers has been conducted. The overview has two specific research questions: (1) to determine the most effective strategies that have been used to disseminate knowledge to healthcare recipients, and (2) to determine the barriers (and facilitators) to dissemination of knowledge to this group.

METHODS

This overview used systematic review methods and was conducted according to a pre-defined protocol. A comprehensive search of ten databases and five websites was conducted. Both published and unpublished reviews in English, Spanish, or Portuguese were included. A methodological quality assessment was conducted; low-quality reviews were excluded. A narrative synthesis was undertaken, informed by a matrix of strategy by outcome measure. The Health System Evidence taxonomy for "consumer targeted strategies" was used to separate strategies into one of six categories.

RESULTS

We identified 44 systematic reviews that describe the effective strategies to disseminate health knowledge to the public, patients, and caregivers. Some of these reviews also describe the most important barriers to the uptake of these effective strategies. When analyzing those strategies with the greatest potential to achieve behavioral changes, the majority of strategies with sufficient evidence of effectiveness were combined, frequent, and/or intense over time. Further, strategies focused on the patient, with tailored interventions, and those that seek to acquire skills and competencies were more effective in achieving these changes. In relation to barriers and facilitators, while the lack of health literacy or e-literacy could increase inequities, the benefits of social media were also emphasized, for example by widening access to health information for ethnic minorities and lower socioeconomic groups.

CONCLUSIONS

Those interventions that have been shown to be effective in improving knowledge uptake or health behaviors should be implemented in practice, programs, and policies-if not already implemented. When implementing strategies, decision-makers should consider the barriers and facilitators identified by this overview to ensure maximum effectiveness.

PROTOCOL REGISTRATION

PROSPERO: CRD42018093245.

The influence of social media on acne treatment: A cross-sectional survey

BACKGROUND/OBJECTIVES

Social media use has been suggested to worsen psychiatric health among adolescents, especially those with visible skin lesions including acne. However, little is known about social media's impact on acne treatment. The purpose of the study sought to characterize the influence of social media use on acne treatment.

METHODS

We conducted a cross-sectional survey of West Virginia University ambulatory patients whose chief complaint was acne was conducted. The survey collected sociodemographics and queried whether individuals accessed social media for acne treatment advice or not, whether changes to acne care were made based on social media, and whether these changes aligned with the American Academy of Dermatology (AAD) clinical guidelines for acne management.

RESULTS

Of 130 respondents, 45% consulted social media for acne treatment advice (54% of women vs 31% of men). 41% of adolescents and 51% of adults consulted social media. The most used platforms were YouTube and Instagram (58% each). Social media users often tried an OTC treatment (81%) or dietary modification (40%). However, only 31% of participants consulting social media made changes fully aligned with AAD clinical guidelines.

CONCLUSIONS

Social media-influenced acne treatment advice is prevalent, especially among women, adolescents, and young adults. This treatment advice frequently does not align with AAD guidelines, with notably 40% of respondents choosing dietary modification for acne management. These results suggest that dermatologists should inquire about social media acne treatment advice and directly address misinformation.

Revision total hip arthroplasty: An analysis of the quality and readability of information on the internet

The demand for revision total hip arthroplasty (THA) is increasing. Information quality on the internet has been extensively analysed in relation to primary THA but no such analysis has ever been performed for revision THA. Our aim was to assess the quality and readability of this information. Three major internet search engines were searched for information on revision THA. All websites were assessed for quality of information using the DISCERN score, the Journal of the American Medical Association benchmark criteria and a novel scoring system specific to revision THA [Vancouver Revision Arthroplasty Information (VRAI) score]. Website readability was assessed, as was presence of the Health On the Net Foundation (HON) seal. The majority of websites (52%) were academic with a post-graduate reading level. Only 6.5% of websites had the HON seal. Twenty-eight percent of websites had a ‘good’ DISCERN score and only 28% had a ‘good’ score with the novel VRAI scoring system. Health information websites had significantly higher rates of ‘good’ VRAI scores (P = 0.008). Websites with the HON seal had significantly higher DISCERN scores (P = 0.01). All governmental websites were at a reading level suitable for patient review. Information on the internet relating to revision THA is of low quality, much lower than the quality of information on primary THA. We recommend governmental websites for their readability and health information websites for their quality of information specific to revision THA. Websites with the HON seal provide higher quality information and should be recommended to patients as reading material regarding revision THA.

Can Digitization of Health Care Help Low-Resourced Countries Provide Better Community-Based Rehabilitation Services?

In the wake of globalization, proliferation of digital technologies (DTs) is rapidly changing many activities across sectors, including influencing health to "go digital." Harnessing opportunities of DTs can be a pathway for delivery of health services, such as community-based rehabilitation (CBR) to the vulnerable groups of populations, particularly those in countries with low resources where health systems are weak and experiencing a deficit of trained health workers necessary to effectively deliver a full spectrum of health services. This perspective explored how some DTs can be leveraged in delivery of CBR services in rural and remote areas of countries with low resources. This is described based on information access and exchange, social satisfaction, shortages of rehabilitation workforce, professional development, and capacity building. However, since seizing advantages of DTs can inevitably be associated with spillovers and limitations, including needs prioritization, skills and language limitations, internet addiction and censorship issues, professionalism and ethical dilemmas, and sustainability, if proper measures are not taken, a caution is made. Moreover, as DTs are revolutionizing various activities across sectors, including health, this is not meant as a substitute for traditional health care activities, including those delivered through CBR, but rather to augment their delivery in settings with low resources and elsewhere.

Healthcare practitioners' views of social media as an educational resource

Social media is increasingly utilized as a resource in healthcare. We sought to identify perceptions of using social media as an educational tool among healthcare practitioners. An electronic survey was distributed to healthcare administrators, nurses, nurse practitioners, pharmacists, physicians, and physician assistants f hospital systems and affiliated health science schools in Georgia, Maryland, South Carolina, and Wisconsin. Survey questions evaluated respondents' use and views of social media for educational purposes and workplace accessibility using a Likert scale (1 = strongly disagree, 5 = strongly agree). Nurses (75%), pharmacists (11%), and administrators (7%) were the most frequent respondents. Facebook® (27%), Pinterest® (17%), and Instagram® (17%) were the most frequently accessed social media platforms. Nearly 85% agreed or strongly agreed that social media can be an effective tool for educational purposes. Among those who had social media platforms, 43.0% use them for educational purposes. Pinterest® (30%), Facebook® (22%), LinkedIn® (16%), and Twitter® (14%) were most frequently used for education. About 50% of respondents had limited or no access to social media at work. Administrators, those with unlimited and limited work access, and respondents aged 20-29 and 30-39 years were more likely to agree that social media is an educational tool (OR: 3.41 (95% CI 1.31 to 8.84), 4.18 (95% CI 2.30 to 7.60), 1.66 (95% CI 1.22 to 2.25), 4.40 (95% CI 2.80 to 6.92), 2.14 (95% CI 1.53 to 3.01) respectively). Residents, physicians, and those with unlimited access were less likely to agree with allowing social media access at work for educational purposes only. Healthcare practitioners frequently utilize social media, and many believe it can be an effective educational tool in healthcare.

A Co-Designed Social Media Intervention to Satisfy Information Needs and Improve Outcomes of Patients With Chronic Kidney Disease: Longitudinal Study

Background

The number of people living with a long-term condition is increasing worldwide. Social media offers opportunities for patients to exchange information and experiences with others with the same condition, potentially leading to better self-management and improved patient outcomes, at minimal costs to health service providers.

Objective

This paper describes how an online network with a range of social media platforms was created, with the help of a group of patients with chronic kidney disease and specialist professionals. The project considered whether information needs and health-related and social outcomes were met.

Methods

We performed a longitudinal in-depth evaluation of the creation of the moderated network, observation of the use of the platforms, self-efficacy surveys (at baseline and 6 months), and semistructured interviews (at baseline and 6 months).

Results

A total of 15 patients and professionals participated in the co-design of the network (hub), which was initially launched with 50 patients. Several platforms were needed to engage patients at different levels and encourage generation of information, with the support of moderators. In addition, 14 separate patients participated in the evaluation. Satisfaction of information needs through social engagement improved self-efficacy (n=13) with better self-care and management of illness. Social outcomes included seeking employment and an increase in social capital.

Conclusions

An online network (hub) with several social media platforms helped patients with chronic kidney disease manage their condition. Careful co-designing with users resulted in a sustainable network with wider applicability across health and social care.

A Strategic Imperative for Promoting Hospital Branding: Analysis of Outcome Indicators

Background

Optimizing the use of social media to promote hospital branding is important in the present digital era. In Taiwan, only 51.1% of hospitals have official Facebook fan pages. The numbers of likes for these hospitals are also relatively low.

Objective

Our objective was to establish a special branding team for social media operation, led by top administrators of our hospital. Here we present our strategic imperative for promoting hospital branding as well as an analysis of its effectiveness.

Methods

Led by top administrators, the branding team was formed by 11 divisions to create branding strategies. From 2016 to 2018, the team implemented action plans. All information unique to the hospital was posted on Facebook, as well as on the hospital’s official website. To determine the plans’ efficiencies, we obtained reference data from Google Analytics, and we compared Facebook Insights reports for 2016 with those for 2017 and 2018.

Results

One of the branding team’s main missions was to establish branding strategies and to integrate segmental branding messages. In each quarter we regularly monitored a total of 52 action plan indicators, including those for process and outcome, and discussed the results at team meetings. We selected 4 main performance outcome indicators to reflect the effectiveness of the branding efforts. Compared with 2016, the numbers of likes posted on the Facebook fan page increased by 61.2% in 2017 and 116.2% in 2018. Similarly, visits to the hospital website increased by 4.8% in 2017 and 33.1% in 2018. Most Facebook fan page and website viewers were in 2 age groups: 25 to 34 years, and 35 to 44 years. Women constituted 60.42% (14,160/23,436) of Facebook fans and 59.39% (778,992/1,311,605) of website viewers. According to the Facebook Insights reports, the number of likes and post sharing both increased in 2017 and 2018, relative to 2016. Comment messages also increased from 2016 to 2018 (P=.02 for the trend). The most common theme of posts varied over time, from media reports in 2016, to innovative services in both 2017 and 2018. Likes for innovative services posts increased from 2016 through 2018 (P=.045 for the trend). By the end of 2018, we recorded 23,436 cumulative likes for posts, the highest number among medical centers in Taiwan.

Conclusions

We achieved the largest number of Facebook fans among all medical centers in Taiwan. We would like to share our experience with other hospitals that might be interested in engaging in social media for future communications and interactions with their patients.

Social Influence in the Uptake and Use of Electronic Cigarettes: A Systematic Review

CONTEXT

E-cigarettes were introduced to support smoking cessation, but their popularity has increased among nonsmokers, challenging current perspectives on their safety and effectiveness as a public health intervention. The objective of this systematic review was to identify and synthesize current evidence on the influence of social factors on e-cigarette intentions and use.

EVIDENCE ACQUISITION

MEDLINE, CINAHL, PsycINFO, and Embase were searched for studies of the effects of social factors on e-cigarette intention or use in February 2019. Studies were included if they used experimental, longitudinal, qualitative, or mixed methods designs. Advertising, social interactions, and social norms were considered as social factors; social media was considered a conduit for other social factors. Two reviewers screened all studies; bias risk was evaluated for all RCTs using the Cochrane risk of bias tool.

EVIDENCE SYNTHESIS

This review included 43 studies: 9 experimental, 11 longitudinal, 22 qualitative, and 1 mixed method. All experimental studies examined advertising and consistently showed that exposure increased intentions to use e-cigarettes. Evidence of the influence of social interactions and social norms came from longitudinal and qualitative studies, suggesting that these factors could increase e-cigarette use. Most participants were nonsmokers (81%; 22,233 of 27,303). Studies rarely considered differences in the effects of social factors on smokers and nonsmokers.

CONCLUSIONS

Given the increased popularity among nonsmokers and the potential for advertising to increase e-cigarette use, closer public health monitoring of e-cigarette uptake by nonsmokers is warranted. Future primary research should be designed to measure how social factors affect smokers and nonsmokers differently.

Parental Perceptions of the Internet and Social Media as a Source of Pediatric Health Information

OBJECTIVE

1) To evaluate differences in how parents use the Internet and social media for health information by child age. 2) To examine parental perceptions of health information on social media.

METHODS

We conducted a cross-sectional survey of parents of children 0 to 18 years seen in clinics and an inpatient medical unit. Survey questions focused on: patterns of Internet and social media use, for what topics, and parental ratings of the accuracy, reliability, and appeal of information from social media. Parents' responses were categorized by age of their youngest child in years (0-4, 5-11, 12-18).

RESULTS

A total of 258 parents completed the survey. The mean age was 39.8 years, 83% were female, 59% were white. The most common topics parents read about online were: sleep, mental health, and car safety. Nearly all parents (96%) used social media, with 68% using social media for health information. There were no significant differences in the proportion of parents who reported using social media for health information by child age. Only half of parents discussed information from social media with their physician. Parents of children age ≥5 years rated health information on social media as significantly more accurate than parents of younger children. There were no significant differences in ratings of reliability and appeal by child age.

CONCLUSIONS

Parents of children of all ages use social media for a variety of important topics related to child health. As many parents do not discuss it with their physician, there are missed opportunities for pediatricians to provide high-quality information.

Gathering Structured Patient Insight to Drive the PRO Strategy in COPD: Patient-Centric Drug Development from Theory to Practice

We illustrate our experience of gathering patient insights on the most patient-relevant symptoms in chronic obstructive pulmonary disease (COPD) via a structured and systematic approach towards ‘patient-centric’ drug development, leveraging recent advances in digital technologies using online platforms. The four-step approach comprised the following: literature search, social media listening (SML) study, online bulletin board (OBB) exercise, and design of an online patient preference study (PPS). The initial online studies (SML and OBB) revealed that, besides dyspnoea and exacerbations, patients perceive cough and mucus production as equally important aspects of disease management for COPD. To further build and quantify patients’ understanding of the importance of these symptoms, an online patient preference survey is underway. Based on these findings, we have elected to include the Cough and Sputum Assessment Questionnaire or CASA-Q, a validated instrument to collect patient-reported outcomes (PRO), besides the use of the COPD assessment test or CAT to assess the severity and impact of COPD in drug development studies for COPD. Additionally, to capture movement and sleep disturbance, we consider the inclusion of actigraphy as a digital evidence-capture end point. Lastly, in a phase II trial, a survey questionnaire on incontinence will be administered to evaluate the importance of this issue among patients. We believe that integrating insights derived from “online” studies (SML, OBB, and PPS) into drug development offers an opportunity to truly listen to patients’ voices in early product design ensuring relevance of end points selected for the clinical trial program. This approach also has the potential to complement conventional qualitative and quantitative data collection requirements for PRO instrument development. While awaiting final guidance from the US Food and Drug Administration, or FDA, the recently released draft documents on collecting representative patients’ input reference social media as a tool to collect qualitative patient preference data and these developments suggest that patient preference data can influence future clinical trial design, end point selection, and regulatory reviews.

Funding: Novartis Pharma AG, Basel.

How Health Communication via Tik Tok Makes a Difference: A Content Analysis of Tik Tok Accounts Run by Chinese Provincial Health Committees

During the last two decades, social media has immersed itself into all facets of our personal and professional lives. The healthcare sector is no exception, with public health departments now capitalizing on the benefits that social media offers when delivering healthcare education and communication with citizens. Provincial Health Committees (PHCs) in China have begun to adopt the micro-video sharing platform, Tik Tok, to engage with local residents and communicate health-related information. This study investigates the status quo of official Tik Tok accounts managed by PHCs in mainland China. In total, 31 PHC accounts were analyzed during August 2019, while the top 100 most liked micro-videos were examined using content analysis. Coding included three major aspects: Quantified Impact, Video Content, and Video Form. 45.2% (n = 14) of PHCs had official Tik Tok accounts. A limited number of accounts (n = 2) were yet to upload a micro-video, while most (n = 9) had uploaded their first micro-video during 2019. For the top 100 most liked micro-videos, a sharp difference was observed in terms of number of Likes, Comments and Reposts. Videos containing cartoons or documentary-style content were most frequently watched by citizens. Similarly, content that promoted professional health or provided knowledge of diseases was frequently viewed. Content containing original music, formal mandarin language, subtitles, and which lasted less than 60 s, were most frequently followed. It is considered a missed opportunity that most PHCs struggle to take advantage of the Tik Tok platform, especially given its growing popularity and daily increase in account creation.

The social phenotype: Extracting a patient-centered perspective of diabetes from health-related blogs

MOTIVATIONS

It has recently been argued [1] that the effectiveness of a cure depends on the doctor-patient shared understanding of an illness and its treatment. Although a better communication between doctor and patient can be pursued through dedicated training programs, or by collecting patients' experiences and symptoms by means of questionnaires, the impact of these actions is limited by time and resources. In this paper we suggest that a patient-centered view of a disease - as well as potential misalignment between patient and doctor focuses - can be inferred at a larger scale through automated textual analysis of health-related forums. People are generating an enormous amount of social data to describe their health care experiences, and continuously search information about diseases, symptoms, diagnoses, doctors, treatment options and medicines. By automatically collecting, analyzing and exploiting this information, it is possible to obtain a more detailed and nuanced vision of patients' experience, that we call the "social phenotype" of diseases.

MATERIALS AND METHODS

As a use-case for our analysis, we consider diabetes, a widespread disease in most industrialized countries. We create a high quality data sample of diabetic patients' messages in Italy, extracted from popular medical forums during more than 10 years. Next, we use a state-of-the-art topic extraction technique based on generative statistical models improved with word embeddings, to identify the main complications, the frequently reported symptoms and the common concerns of these patients. Finally, in order to detect differences in focus, we compare the results of our analysis with available quality of life (QoL) assessments obtained with standard methodologies, such as questionnaires and survey studies.

RESULTS

We show that patients with diabetes, when accessing on-line forums, express a perception of their disease in a way that might be noticeably different from what is inferred from published QoL assessments on diabetes. In our study, we found that issues reported to have a daily impact on these patients are diet, glycemic control, drugs and clinical tests. These problems are not commonly considered in QoL assessments, since they are not perceived by doctors as representing severe limitations. Although limited to the case of Italian diabetic patients, we suggest that the methodology described in this paper, which is language and disease agnostic, could be applied to other diseases and countries, since misalignment between doctor and patients, and the importance of collecting unbiased patient perceptions, has been emphasized in many studies ([2,3]inter alia). Extracting the social phenotype of a disease might help acquiring patient-centered information on health care experiences on a much wider scale.

Factors Influencing Patient Selection of Urologists

OBJECTIVE

To describe the factors affecting patients' selection of a urologist, and the utilization of the Internet and social media.

MATERIALS AND METHODS

All new patients presenting to a single-institution for evaluation were invited to complete an anonymous 26-item questionnaire between April 2018 and October 2018, including demographic information, use of Internet and social media resources, and relative importance of factors when selecting a urologist. Descriptive statistics were reported, and a stratified analysis was performed for age, gender, and education.

RESULTS

A total of 238 patients responded. More than half (53%) of patients searched their medical condition prior to presentation. When stratified by age, younger patients were 3 times as likely to utilize Internet resources (Group 1 vs Group 2; OR 3.3, 95%CI 1.5-7.2, P <.01). Few patients utilized Facebook (7%) or Twitter (1%). The 3 most important surveyed urologist selection factors included hospital reputation (4.3 ± 1.0), in-network providers (4.0 ± 1.3), and appointment availability (3.9 ± 1.0). The 3 least important included medical school attended (2.7 ± 1.3), urologist on social media (1.9 ± 1.2), and TV, radio, and/or billboard advertisements (1.7 ± 1.3).

CONCLUSION

This study suggests a significant proportion of patients search the Internet regarding their medical condition prior to presenting to clinic. Further, younger patients utilize this methodology significantly more than the senior population. Important factors when selecting a urologist may be driven by a hospital's reputation, in addition to scheduling convenience.

Role of empowerment and sense of community on online social health support group

Purpose

Drawing on the taxonomy of patient empowerment and a sense of community (SoC), the purpose of this paper is to analyze the factors that impact the intention of the individual to continue using online social health support community for their chronic disease management.

Design/methodology/approach

A survey design was used to collect the data from multiple online social health support groups related to chronic disease management. The survey yielded a total of 246 usable responses.

Findings

The primary findings from this study indicate that the informational support – not the nurturant support such as emotional, network, and esteem support – are the major types of support people are seeking from an online social health support community. This research also found that patient empowerment and SoC would positively impact their intention to continue using the online health community.

Research limitations/implications

This study utilized a survey design method may limit precision and realism. Also, there is the self-selection bias as the respondents self-selected themselves to take the survey.

Practical implications

The findings can help the community managers or webmasters to design strategies for the promotion and diffusion of online social health group among patient of chronic disease. Those strategies should focus on patient’s empowerment through action facilitating and social support and through creating a SoC.

Originality/value

An innovative research model integrates patient empowerment and a SoC to study patient’s chronic disease management through online social health groups to fill the existing research gap.

Conflicting demands that dentists and dental care professionals experience when using social media: a scoping review

Introduction There are many conflicting demands for dentists and dental care professionals (DCPs) when using social media, for example between using social media for marketing and as professional provider of information. To gain a fuller understanding of how dentists/DCPs should optimally use social media, these conflicting demands need to be explored. The aim of this scoping review was to map out the current state of the literature describing the conflicting demands encountered by dentists and DCPs when using social media and the approaches used to manage these conflicting demands.Methods A scoping review was carried out. PubMed and Web of Science Core Collection were searched using inclusion and exclusion criteria. Data was extracted from the identified articles and analysed.Results The review identified 39 articles for inclusion. Conflicting demands were related to marketing and education with little information about how these conflicting demands can be managed.Conclusions The published literature on dentists'/DCPs' use of social media highlights that there are conflicting demands and little advice on management strategies. To gain an understanding of these conflicting demands, further research is required, including looking at the patient perspective, to inform future practice.

The role of social media in selective dorsal rhizotomy for children: information sharing and social support

PURPOSE

Selective dorsal rhizotomy (SDR) is a surgical treatment for spasticity, primarily in cerebral palsy (CP). There is a growing trend for patients to seek medical information from their peers on social media platforms. This study qualitatively and quantitatively assessed the use of social media as an information-sharing and support-seeking tool by patients and caregivers.

METHODS

A search was performed on Facebook, Twitter, and YouTube. Public information was quantitatively assessed by category, users, year of creation, and country of origin. Representative samples of comments and posts were then qualitatively assessed by thematic analysis.

RESULTS

One hundred eighty-five Facebook groups and pages, 97 YouTube videos, and 14 Twitter accounts were identified, based in 13 countries. SDR and CP groups had a mean membership of 3063 and 2339, respectively; SDR and CP pages had a mean number of "likes" of 1650 and 10,711, respectively. Total YouTube video views were 593,135 (mean 6115). Total Twitter followers were 62,609 (mean 2160). Qualitative analysis identified seven categories of comments: emotional support and forming connections (22.34%), sharing information and advice (15.96%), appreciation and successes (31.91%), challenges and difficulties (8.51%), advertising/offering services (4.79%), inequities and access (4.79%), and social media as a second opinion (11.7%).

CONCLUSIONS

This study outlines the use of social media platforms in the distribution of information regarding SDR. We highlight the importance placed by patients and caregivers on the advice of their peers. The current report should inform healthcare providers' interactions with patients with respect to information seeking and provision of support.

Popular Media and Cardiovascular Medicine: "with Great Power There Must Also Come Great Responsibility"

PURPOSE OF REVIEW

Media sources, such as the Internet, television, and social media, have become powerful communication tools that have transformed the way medical information is acquired across the world.

RECENT FINDINGS

Over 40% of today's patients report that social media affects their healthcare decisions, and approximately 65% of healthcare professionals report using social media for professional activities. These enhanced communication tools have made a substantial impact on the widespread dissemination of medical information. However, as a consequence, popular media platforms have also become purveyors of medical misinformation. In this review, we propose a framework for clinicians on how to effectively and appropriately integrate medical information available via online resources including social media platforms into modern healthcare practices.

Exploring patient empowerment

Purpose

The purpose of this paper is to develop a research framework for exploring and improving patient empowerment through the analysis of the effects produced by a satisfying physician relationship on patient involvement in the healthcare process.

Design/methodology/approach

The authors begin with a literature review of patient empowerment in healthcare, useful to highlight the importance of relational aspects. Then, the authors tested the hypotheses of the research through the analysis of 450 questionnaires. The results are analyzed through covariance-based structural equation modeling.

Findings

This paper highlights how empowerment is a more complex phenomenon, needing many dimensions to be investigated. The hypotheses were tested, and correlations computed, highlighting a medium-strong positive correlation between physician relationship and patient involvement determining satisfying patient empowerment.

Research limitations/implications

The considerations conducted in the paper are restricted to physician relationship and needs further research aimed to analyze and evaluate the changes in the patient behaviors influenced by empowerment.

Practical implications

The research points offer new insight into patient empowerment and allow the healthcare provider to create new opportunities for promoting patient empowerment through the development of quality relationship for effective patient involvement.

Originality/value

The study developed contributes new insight about patient empowerment in the healthcare management literature, proving the key role of satisfying physician relationship useful for future researches.

Impact of the Internet on Patient-Physician Communication

Data from the Health Information National Trends Survey (HINTS) show that the Internet is the first place people go to when they need information about health or medical topics. Searches for online health information have both benefits and challenges for patient-physician communication. To fully appreciate these issues, it is important to understand the following: (1) who is going online; (2) why are they going; (3) where are they going; (4) what needs are being met; and (5) how, if at all, do they discuss health information found online with their doctors. The objective of this mini-review is to highlight contemporary issues regarding the impact of the internet on patient-physician communication and to present directions for future research. PATIENT SUMMARY: The growing use of the Internet has implications for people seeking information on health matters. Our review shows that the Internet can be helpful for patient-physician communication, but this depends on the quality of health information found and whether the information is discussed during medical visits.

Use of social media in a national Tuberculosis Drug Resistance Survey: lessons from the first anti-tuberculosis drug resistance survey in Ghana

Background: The widespread use of social media applications on mobile phones indicate that smart phones have become more than just a simple medium for voice calling. Several studies have shown the potential benefit of these social media applications in discussing many health conditions. We report on tracking sample transport by public and private transport providers using WhatsApp during the first nationwide drug resistance tuberculosis (TB) survey in Ghana. Methods: The survey was conducted between February 2016 and June 2017, and involved 33 TB diagnostic sites selected on the basis of a two-stage cluster randomized sampling design on both anticipated yield and probability proportional to size method. We engaged the services of privately and publicly owned vehicles’ union to transport samples to the Bacteriology department at the Kumasi Centre for Collaborative Research in Tropical Medicine laboratories for further laboratory processing. We created a mobile social group platform (‘National TBDRS’) on WhatsApp consisting of two representatives from each site as well as other stakeholders. The purpose was to notify a laboratory team in Kumasi, on the following details of the sample: date and time of dispatch, driver’s name, car number, estimated time of arrival, and bus terminal name.  Results: A total 3077 WhatsApp messages were received during the survey period. Of these, 2879 (93.57%) messages were related to the survey. We observed a positive correlation between the total number of messages received and the total number of well-packaged sputum samples sent (r=0.89, p=0.02). There were no major transport delays (11:44±03:50) and all samples arrived within a 3-day window from the survey sites. Conclusions: Using WhatsApp as a platform of communication can aid in improving tracking of samples, enhance accountability of for example drivers handling the samples over at a road crossing and communication across health facilities.

Communicating Science in the Digital and Social Media Ecosystem: Scoping Review and Typology of Strategies Used by Health Scientists

BACKGROUND

The public's understanding of science can be influential in a wide range of areas related to public health, including policy making and self-care. Through the digital and social media ecosystem, health scientists play a growing role in public science communication (SC).

OBJECTIVE

This review aimed to (1) synthesize the literature on SC initiated by health scientists targeting the public in the digital and social media ecosystem and (2) describe the SC strategies and communication channels used.

METHODS

This scoping review was based on the Joanna Briggs Institute Methodological Framework. A systematic search was performed in 6 databases (January 2000 to April 2018). Title and abstract screening, full-text review, data charting, and critical appraisal were performed independently by two review authors. Data regarding included studies and communication channels were synthesized descriptively. A typology of SC strategies was developed using a qualitative and inductive method of data synthesis.

RESULTS

Among 960 unique publications identified, 18 met inclusion criteria. A third of publications scored good quality (6/18, 33%), half scored moderate quality (9/18, 50%), and less than a fifth scored low quality (3/18, 16%). Overall, 75 SC strategies used by health scientists were identified. These were grouped into 9 types: content, credibility, engagement, intention, linguistics, planification, presentation, social exchange, and statistics. A total of 5 types of communication channels were identified: social networking platforms (eg, Twitter), content-sharing platforms (eg, YouTube), digital research communities (eg, ResearchGate), personal blogs and websites (eg, WordPress), and social news aggregation and discussion platforms (eg, Reddit).

CONCLUSIONS

Evidence suggests that multiple types of SC strategies and communication channels are used by health scientists concurrently. Few empirical studies have been conducted on SC by health scientists in the digital and social media ecosystem. Future studies should examine the appropriateness and effectiveness of SC strategies for improving public health-related outcomes and identify the barriers, facilitators, and ethical considerations inherent to the involvement of health scientists in the digital and social media ecosystem.

Making an IMPACT: A priority setting consultation exercise to improve outcomes in patients with locally advanced, recurrent and metastatic colorectal cancer

AIM

The IMPACT (Improving the Management of Patients with Advanced Colorectal Tumours) initiative was established by the Association of Coloproctology of Great Britain and Ireland in 2017 as a consortium of surgeons (colorectal, hepatobiliary, thoracic), oncologists, radiologists, pathologists, palliative care physicians, patients, carers and charity stakeholders who will work together to improve outcomes in patients with advanced and metastatic colorectal cancer. To establish this initiative, better information is required to establish how further intervention is focused. This paper details the approaches used, and outcomes generated, from a priority setting exercise to inform the design of the IMPACT initiative.

METHODS

A mixed method approach was employed to set the priorities of patients, clinicians and other key stakeholders in the delivery of optimal care. This consisted of two patient centered consultation events and a questionnaire.

RESULTS

A total of 128 participants took part in the consultation exercise; 15 patients, 5 carers/family members, 5 charity representatives and 113 healthcare professionals. Nine key themes for focus were identified, these were: current service provision, specialist services, communication, education, access to care, definitions and standardisation, research and audit, outcome measures, and funding of specialist care.

CONCLUSION

These future priorities will be developed with collaborative engagement in a systematic manner to produce an overall cohesive programme which will deliver a sustainable and efficient clinical and academic service to improving the management of patients with advanced colorectal tumours.

Social Media Surveillance of Multiple Sclerosis Medications Used During Pregnancy and Breastfeeding: Content Analysis

Background

Multiple sclerosis (MS) is a chronic neurological disease occurring mostly in women of childbearing age. Pregnant women with MS are usually excluded from clinical trials; as users of the internet, however, they are actively engaged in threads and forums on social media. Social media provides the potential to explore real-world patient experiences and concerns about the use of medicinal products during pregnancy and breastfeeding.

Objective

This study aimed to analyze the content of posts concerning pregnancy and use of medicines in online forums; thus, the study aimed to gain a thorough understanding of patients’ experiences with MS medication.

Methods

Using the names of medicinal products as search terms, we collected posts from 21 publicly available pregnancy forums, which were accessed between March 2015 and March 2018. After the identification of relevant posts, we analyzed the content of each post using a content analysis technique and categorized the main topics that users discussed most frequently.

Results

We identified 6 main topics in 70 social media posts. These topics were as follows: (1) expressing personal experiences with MS medication use during the reproductive period (55/70, 80%), (2) seeking and sharing advice about the use of medicines (52/70, 74%), (3) progression of MS during and after pregnancy (35/70, 50%), (4) discussing concerns about MS medications during the reproductive period (35/70, 50%), (5) querying the possibility of breastfeeding while taking MS medications (30/70, 42%), and (6) commenting on communications with physicians (26/70, 37%).

Conclusions

Overall, many pregnant women or women considering pregnancy shared profound uncertainties and specific concerns about taking medicines during the reproductive period. There is a significant need to provide advice and guidance to MS patients concerning the use of medicines in pregnancy and postpartum as well as during breastfeeding. Advice must be tailored to the circumstances of each patient and, of course, to the individual medicine. Information must be provided by a trusted source with relevant expertise and made publicly available.

Not Just a Headache: Qualitative Study About Web-Based Self-Presentation and Social Media Use by People With Migraine

BACKGROUND

To help with a long-term but invisible medical condition such as migraine, many people seek information and support on social media. The effect of using social media for people with migraine is not fully understood and remains to be investigated.

OBJECTIVE

The aim of this study was to describe how people with migraine use social media and how social media use affects their identity and sense of self.

METHODS

A total of 20 participants who experienced migraine were recruited via migraine-specific charities. Semistructured interviews were conducted with questions based on a topic guide. Interviews were transcribed verbatim, and transcripts were analyzed using thematic analysis.

RESULTS

People with migraine are using social media to obtain information to better understand their condition and treatment options. Social media offers instant access to continuous information and social support. This exchange of social support and information was viewed as mutually beneficial. Participants viewed social media as an outlet to vent frustrations and validate the migraine experience. Several participants pointed out that the invisible and episodic nature of migraine can lead to societal misunderstanding of the impact and or severity of their condition. Some participants masked their online migraine-related behavior using different sites or closed online groups to control who saw their migraine-related content. Participating in closed social media groups sometimes changed Web-based behavior in other areas of the platform. This illustrates the complex relationship between migraine, social media, and identity.

CONCLUSIONS

How migraine is part of an individual's identity and how this is represented online can vary. Social media can provide people who experience migraine with instant and continuous access to support and information, from a group of empathic others with similar lived experiences. Social media is used to validate the illness experience, as well as provide reassurance and help reduce feelings of isolation.

Toward a maturity model for the application of social media in healthcare

Purpose

The advent of new technologies and change of patients’ behavioral patterns have triggered the provision of medical services through social media. Although the intersection between social media and health has received considerable research attention, there is little research on how health institutions implement social media strategy; thus a roadmap is required to navigate these technological initiatives. So, the purpose of this paper is to overcome this challenge by developing the Health 2.0 maturity model in the healthcare field.

Design/methodology/approach

To obtain this aim, the mixed method was applied in this research. In the first step, qualitative research method was used. In this step, along with comprehensive literature review, semi-structured interviews were conducted with the healthcare professionals to find the practices and capabilities of Health 2.0. In the second step, the proposed key dimensions (KD) were assessed and prioritized based on the views of the healthcare professionals using the quantitative survey method. Finally, by considering the architecture of Health 2.0 maturity model, the KDs were assigned to maturity levels based on their priority of implementation using a focus group.

Findings

The proposed maturity model is composed of six KDs and five maturity levels based on the Capability Maturity Model Integration architecture. The KDs, as well as their implementation order and weights in the proposed maturity model are presented as a roadmap for applying Health 2.0 effectively.

Practical implications

Employing the Health 2.0 maturity model enables health institutions to assess the current social media capabilities and guide them to select appropriate strategies for progress. Due to the descriptive nature of the proposed model, it allows managers to conduct process-based assessments regarding health 2.0 implementation.

Originality/value

Health 2.0 has been a recurring theme on the agenda of healthcare institutions, but no sensitive tool is available to measure its growth processes. This paper explores the much ignored but critically important subject of Health 2.0 maturity model and its implementation roadmap. The main contribution of this paper is to introduce an integrated roadmap containing the most important capabilities of Health 2.0. The proposed model is both descriptive and prescriptive in nature, and has a significant theoretical contribution to healthcare studies. This paper provides a mechanism to benchmark Health 2.0 efforts and to develop a progressive strategy that would improve its activities.

Perceived Patient-Provider Communication Quality and Sociodemographic Factors Associated With Watching Health-Related Videos on YouTube: A Cross-Sectional Analysis

BACKGROUND

Approximately 73% of US adults use YouTube, making it the most popular social media platform. Misinformation on social media is a growing concern; recent studies show a high proportion of misinformative health-related videos. Several studies on patient-provider communication and general health information seeking have been conducted. However, few studies to date have examined the potential association between patient-provider communication and health information seeking on specific social media platforms such as YouTube. A better understanding of this relationship may inform future health communication interventions.

OBJECTIVE

The aim was to use nationally representative cross-sectional data to describe the association between perceived patient-provider communication quality and sociodemographic factors on watching YouTube health-related videos.

METHODS

Data from the 2018 Health Information National Trends Survey were analyzed (N=3504). The primary outcome was whether participants watched a health-related video on YouTube over the past 12 months. A patient-provider communication composite score was created by summing responses about how often providers did the following: (1) gave you the chance to ask all the health-related questions you had, (2) gave attention to your feelings, (3) involved you in health care decisions as much as you wanted, (4) made sure that you understood the things you needed to do to take care of your health, (5) explained things in a way that you could understand, (6) spent enough time with you, and (7) helped you deal with feelings of uncertainty. Sociodemographic factors included age, gender, race/ethnicity, and education. Descriptive statistics and multivariable logistic regression were conducted.

RESULTS

Approximately 1067 (35% weighted prevalence) participants reported watching a health-related video on YouTube. Higher perceived quality of patient-provider communication on the composite score was significantly associated with lower odds of watching health-related videos on YouTube. Regarding sociodemographic factors, increasing age and being a high school graduate (compared with college graduate) were associated with lower odds of watching health-related videos on YouTube; whereas, Hispanic and non-Hispanic Asians were more likely to have watched a health-related video on YouTube. For individual aspects of patient-physician communication, two of seven patient-provider communication variables were significant. Those who reported that providers "sometimes" spent enough time with them had higher odds of watching a health-related video on YouTube, compared with those who said providers "always" spent enough time with them. Participants reporting that they "never" have a chance to ask all their health-related questions also had higher odds of watching health-related videos on YouTube compared with those who reported "always."

CONCLUSIONS

Higher perceived quality of patient-provider communication is associated with lower odds of watching health-related videos on YouTube. When providers do not spend enough time or give an opportunity to ask questions, patients are more likely to pursue health information on social media.

Status Quo of Professional⁻Patient Relations in the Internet Era: Bibliometric and Co-Word Analyses

Background: Incidents of violence against medical staff have increased in intensity, showing the deteriorating relationship between doctors and patients in China over the past few years. In addition, professional-patient relations have been significantly affected in the Internet era in China, which has attracted great attention from many scholars. This study aims to analyze the research status of professional-patient relations in the Internet era in China and further reveal its research pattern and trends. Methods: This study collected journal articles published during the past 21 years from the Wanfang Data Knowledge Service Platform. Then, bibliometric analysis was carried out, including publication growth, core author and collaborative degree, highly cited papers, journal distribution, and institution distribution analyses. We also analyzed the subject heading-source literature matrix and co-occurrence matrix of keywords through hierarchical cluster, social network, and strategic diagram analyses. Results: The number of articles has continually risen since 1998, which follows the growth law of literature. Furthermore, the distribution of these studies obeys Bradford's law of scattering, and mainly concentrates on the fields of medicine and health technology. The distribution of high-frequency keywords follows Zipf's law. Conclusions: We identified eight focal research directions, namely: website building (especially for professional-patient interaction), telemedicine, professional-patient communication and network public opinion, professional-patient contradiction and health education, new media, follow-up interaction platform, healthcare reform and computer network, and medical ethics.

Role of Social Media Promotion of Prescription Drugs on Patient Belief-system and Behaviour

In the current scenario, extremely little information exists on the uses, benefits, and limitations of social media for health communication among the patients and health professionals. Further, how it is affecting the patient belief system and behavior is even less studied, but it is emerging on the research horizon due to its growing significance in this digital age. This is a review article using a systematic approach. We performed a systematic literature search for papers that address social media–related challenges and opportunities for pharmaceutical drugs. It identifies the needs that propel patients to take recourse to SMPs; the benefits they derive from these and their limitations. This review article confirms that healthcare information provided by the social media sites has been found to be beneficial in many ways for the stakeholders and that it complements existing patient-physician interaction. However, it has limitations that need to be explored and understood to avoid ill consequences.

Social Media in Primary Care

Social media has become a standard part of the day for the majority of people in the United States, and reciprocally has become an effective platform and tool for patient engagement within health care. This review provides context for its place in patient education, communication, and treatment, combined with a review of general operational and ethical principles for social media platforms within a primary care practice.

What Are Diabetes Patients Versus Health Care Personnel Discussing on Social Media?

BACKGROUND

Use of social media is increasing rapidly, also in health care and diabetes. However, patients, health care personnel, and patient organizations discuss diabetes on social media very differently. This has led to a lack of common ground when these stakeholders communicate about diabetes and a gap in understanding one another's point of view. Social media have a potential for improved communication if each stakeholder group knows about, acknowledges, and accepts one another's perspective.

METHOD

We extracted and analyzed posts from three Norwegian Facebook groups representing patients, patients' organization, and health care personnel. Qualitative content analysis was done to find the distribution of main categories, followed by a thematic analysis of subcategories that were posted and discussed.

RESULTS

The patient organization's posts are the most equally distributed over the four main identified categories: scientific content, health care services, self-management, and diabetes awareness. The closed patient group's posts were dominated by self-management; the open diabetes nurses' group was dominated by diabetes awareness. The three social media groups differed substantially in what and how they posted and discussed within the main topics. The nurses' open group had percentage-wise both the most liked and commented post, and the posts on self-management had the highest average number of comments.

CONCLUSIONS

There is a big discrepancy in posted information and discussions on social media, between patient closed group, patient organization open group, and health care personnel open group. To reach the aim of using social media for better health, there is a need for more information of what is posted and discussed in the other groups, to harmonize and ensure safe and accurate dissemination of information.

Patients' perspectives on COPD: findings from a social media listening study

We utilised social media listening (SML) to obtain patients' perspectives on symptoms, diagnosis and comorbidities associated with chronic obstructive pulmonary disease (COPD) and its impact on patients' quality of life (QoL). A comprehensive search on social media platforms was performed for English language content posted between July 2016 and January 2018 using COPD-related terms. Social Studio, a social media data aggregator tool, was used to capture relevant records. The content was manually curated to analyse and map psychological aspects with descriptive statistics applied on aggregated findings. A total of 849 posts from patients or caregivers ("patient insights") were considered for the analysis, corresponding to postings of 695 unique individuals. Based on 734 mentions of symptoms from 849 posts by potential patients/caregivers, cough (27%), mucus (25%) and shortness of breath (21%) were the most frequent; analysis by perceived COPD severity indicated these to be common across all severities. Difficulty in mucus clearance (24% of 268 mentions) and sadness (40% of 129 mentions) were top among the aspects impacting physical and emotional QoL, respectively. SML from patients with COPD indicated that relief from cough, mucus production and shortness of breath would be the most desirable aspects of disease management from a patient's perspective.

Use of social media in a national Tuberculosis Drug Resistance Survey: lessons from the first anti-tuberculosis drug resistance survey in Ghana

Background: The widespread use of social media applications on mobile phones indicate that smart phones have become more than just a simple medium for voice calling. Several studies have shown the potential benefit of these social media applications in discussing many health conditions. We report on tracking sample transport by public and private transport providers using WhatsApp during the first nationwide drug resistance tuberculosis (TB) survey in Ghana. Methods: The survey was conducted between February 2016 and June 2017, and involved 33 TB diagnostic sites selected on the basis of a two-stage cluster randomized sampling design on both anticipated yield and probability proportional to size method. We engaged the services of privately and publicly owned vehicles’ union to transport samples to the central laboratories in Kumasi for further laboratory processing. We created a mobile social group platform (‘National TBDRS’) on WhatsApp consisting of two representatives from each site as well as other stakeholders. The purpose was to notify a laboratory team in Kumasi, on the following details of the sample: date and time of dispatch, driver’s name, car number, estimated time of arrival, and bus terminal name.  Results: A total 3077 WhatsApp messages were received during the survey period. Of these, 2879 (93.57%) messages were related to the survey. We observed a positive correlation between the total number of messages received and the total number of well-packaged sputum samples sent (r=0.89, p=0.02). There were no major transport delays (11:44±03:50) and all samples arrived within a 3-day window from the survey sites. Conclusions: Using WhatsApp as a platform of communication can significantly aid in improving tracking of samples, enhance accountability of for example drivers handling the samples over at a road crossing and communication across health facilities.