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Suzuki Y, Iwamoto T, Uno M, Hatono M, Kajiwara Y, Takahashi Y, Kochi M, Shien T, Kikawa Y, Uemura Y, Hagiwara Y, Yamamoto S, Taira N, Doihara H, Toyooka S. Development and validation of a symptom illustration scale from the patient-reported outcome common terminology criteria for adverse events for patients with breast cancer. Breast Cancer 2023; 30:856-868. [PMID: 37422608 DOI: 10.1007/s12282-023-01480-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/25/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE Emojis are commonly used for daily communication and may be useful in assessing patient-reported outcomes (PROs) in breast cancer. The purpose of this study is to develop and validate a Symptom Illustration Scale (SIS) as a new PRO measurement. METHODS Eighteen original SIS items were developed from the PRO-CTCAE. In cohort one, the SIS validity and reliability were examined in patients with breast cancer, using a semi-structured five-question survey to investigate content validity. PROs with PRO-CTCAE and SIS were examined twice to determine criteria validity and test-retest reliability. In cohort two, the responsiveness of the scales were examined in patients treated with anthracycline, docetaxel, paclitaxel, and endocrine therapy. PROs with PRO-CTCAE and SIS were investigated two or three times, depending on the therapy. RESULTS Patients were enrolled from August 2019 to October 2020. In cohort one (n = 70), most patients had no difficulties with the SIS, but 16 patients indicated that it was difficult to understand severities in the SIS. For criterion validity, Spearman rank correlation coefficients (rs) between PRO-CTCAE and SIS items were ≥ 0.41, except for "Decreased appetite." For test-retest reliability, κ coefficients of the SIS were ≥ 0.41 for 16/18 items (88.9%). Response time was significantly shorter for the SIS than for PRO-CTCAE (p < 0.001). In cohort two (n = 106), score changes between PRO-CTCAE and SIS for relevant symptoms all had correlations with rs ≥ 0.41. CONCLUSION An original SIS from the PRO-CTCAE for patients with breast cancer were verified the validity, reliability, and responsiveness. Further studies to improve and validate the SIS are needed.
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Affiliation(s)
- Yoko Suzuki
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
- Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University, Okayama, Japan
| | - Takayuki Iwamoto
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
| | - Maya Uno
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
- Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University, Okayama, Japan
| | - Minami Hatono
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Yukiko Kajiwara
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Yuko Takahashi
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Mariko Kochi
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Tadahiko Shien
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Yuichiro Kikawa
- Breast Surgery, Kansai Medical University Hospital, Osaka, Japan
| | - Yukari Uemura
- Biosciences, Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuhiro Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | | | - Naruto Taira
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Hiroyoshi Doihara
- Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
- Department of Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Shinichi Toyooka
- Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University, Okayama, Japan
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Jones NW, Song SL, Thomasian N, Samuels EA, Ranney ML. Behavioral Health Decision Support Systems and User Interface Design in the Emergency Department. Appl Clin Inform 2023; 14:705-713. [PMID: 37673096 PMCID: PMC10482498 DOI: 10.1055/s-0043-1771395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/06/2023] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE The objective of this qualitative study is to gauge physician sentiment about an emergency department (ED) clinical decision support (CDS) system implemented in multiple adult EDs within a university hospital system. This CDS system focuses on predicting patients' likelihood of ED recidivism and/or adverse opioid-related events. METHODS The study was conducted among adult emergency physicians working in three EDs of a single academic health system in Rhode Island. Qualitative, semistructured interviews were conducted with ED physicians. Interviews assessed physicians' prior experience with predictive analytics, thoughts on the alert's placement, design, and content, the alert's overall impact, and potential areas for improvement. Responses were aggregated and common themes identified. RESULTS Twenty-three interviews were conducted (11 preimplementation and 12 postimplementation). Themes were identified regarding each physician familiarity with predictive analytics, alert rollout, alert appearance and content, and on alert sentiments. Most physicians viewed these alerts as a neutral or positive EHR addition, with responses ranging from neutral to positive. The alert placement was noted to be largely intuitive and nonintrusive. The design of the alert was generally viewed positively. The alert's content was believed to be accurate, although the decision to respond to the alert's call-to-action was physician dependent. Those who tended to ignore the alert did so for a few reasons, including already knowing the information the alert contains, the alert offering information that is not relevant to this particular patient, and the alert not containing enough information to be useful. CONCLUSION Ultimately, this alert appears to have a marginally positive effect on ED physician workflow. At its most beneficial, the alert reminded physicians to deeply consider the care provided to high-risk populations and to potentially adjust their care and referrals. At its least beneficial, the alert did not affect physician decision-making but was not intrusive to the point of negatively impacting workflow.
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Affiliation(s)
- Nicholas W. Jones
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, United States
| | - Sophia L. Song
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | - Nicole Thomasian
- Department of Anesthesiology, New York Presbyterian-Weill Cornell Medical Center, New York, New York, United States
| | - Elizabeth A. Samuels
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | - Megan L. Ranney
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
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3
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King M, Patterson ED. The FACES of the Future: Emojis in Perioperative Medicine. Anesth Analg 2023; 137:466-467. [PMID: 37450910 DOI: 10.1213/ane.0000000000006279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Affiliation(s)
- Morgan King
- From the School of Medicine, Queen's University, Kingston, Ontario, Canada
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4
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Carroll E, Giles J, Lewis A. An evaluation of surrogate decision maker health literacy in the neurology ward and neuroscience ICU. J Neurol Sci 2023; 444:120525. [PMID: 36525907 DOI: 10.1016/j.jns.2022.120525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/14/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE There has been little investigation into surrogate comprehension of education provided by the neuroscience healthcare team. We sought to evaluate 1) surrogate understanding about a patient's clinical condition and 2) the relationship between how surrogates and the neuroscience team perceive surrogate comprehension of a patient's condition. METHODS We prospectively surveyed surrogates of patients who lacked decision making capacity while admitted to the neurology ward or neuroscience ICU for >48 h from 10/2018-05/2021. The survey investigated the surrogate's communication with the neuroscience team and understanding of the hospitalization. A member of the neuroscience team was asked to provide clinical data about the patient and indicate how well they perceived the surrogate understood the situation. RESULTS We surveyed 50 surrogates at a median of 10 (IQR 5-17) days after hospitalization. There were 38 (76%) surrogates who correctly identified the reason for admission, and 21 (42%) who correctly identified all the assessments/interventions performed. Nearly all surrogates rated their understanding of the patient's medical condition as excellent (47%) or good (49%). There was no to slight agreement (kappa = 0.133) between surrogate self-perception of understanding and neuroscience team perception of the surrogate's understanding. Although only 20% of surrogates used institutional electronic education materials, 74% discussed the hospitalization with friends/family who work in healthcare. CONCLUSION Objective and subjective assessments of surrogate comprehension demonstrate that there is a need to improve communication with the surrogates of patients with neurological conditions. Neuroscience healthcare teams must be taught how to educate surrogates and assess their understanding.
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Affiliation(s)
- Elizabeth Carroll
- Department of Neurology, NYU Langone Medical Center, New York, NY, United States of America.
| | - Julie Giles
- Department of Neurology, NYU Langone Medical Center, New York, NY, United States of America
| | - Ariane Lewis
- Department of Neurology, NYU Langone Medical Center, New York, NY, United States of America; Department of Neurosurgery, NYU Langone Medical Center, New York, NY, United States of America
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5
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O'Hara DV, Yi TW, Lee VW, Jardine M, Dawson J. Digital health technologies to support medication adherence in chronic kidney disease. Nephrology (Carlton) 2022; 27:917-924. [PMID: 36176176 PMCID: PMC9828762 DOI: 10.1111/nep.14113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/24/2022] [Accepted: 09/17/2022] [Indexed: 01/12/2023]
Abstract
Non-adherence to medications is a critical challenge in the management of people with chronic kidney disease (CKD). This review explores the complexities of adherence in this population, the unique barriers and enablers of good adherence behaviours, and the role of emerging digital health technologies in bridging the gap between evidence-based treatment plans and the real-world standard of care. We present the current evidence supporting the use of digital health interventions among CKD populations, identifying the key research questions that remain unanswered, and providing practical strategies for clinicians to support medication adherence in a digital age.
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Affiliation(s)
- Daniel V. O'Hara
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,Department of Renal MedicineRoyal North Shore HospitalSydneyNew South WalesAustralia
| | - Tae Won Yi
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia,Department of Medicine, Clinician Investigator ProgramUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Vincent W. Lee
- Department of Renal MedicineWestmead HospitalSydneyNew South WalesAustralia,Westmead Applied Research Centre, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Meg Jardine
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,Department of Renal MedicineConcord Repatriation General HospitalSydneyNew South WalesAustralia
| | - Jessica Dawson
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,Department of Nutrition and DieteticsSt George HospitalSydneyNew South WalesAustralia
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Marzouk S, He S, Lee J. Emoji Education: How Students Can Help Increase Health Awareness by Making Emojis. JMIR MEDICAL EDUCATION 2022; 8:e39059. [PMID: 36367758 PMCID: PMC9700240 DOI: 10.2196/39059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 09/08/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Emojis can improve health communication, especially when incorporating emojis into traditionally word-only texts. Beyond improving communication, emojis also offer greater access to health care, especially for vulnerable and marginalized populations with limited health literacy. A recent study found that 94% of patients with limited health literacy preferred health reports with emojis. Moreover, health officials are considering adding emojis to cardiopulmonary resuscitation guidelines and public health guidelines for handwashing. As the world evolves with new technology and new methods of communication, we must also evolve the language and method we use to communicate health information to patients. In this viewpoint, we aim to discuss the methods health care professionals can use to develop novel communication methods using emojis and the benefits of their incorporation into health care communication.
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Affiliation(s)
- Sammer Marzouk
- Department of Chemistry and Chemical Biology, Harvard College, Cambridge, MA, United States
| | - Shuhan He
- Massachusetts General Hospital, Boston, MA, United States
| | - Jarone Lee
- Massachusetts General Hospital, Boston, MA, United States
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Seethapathy H, Beach J, Gillcrist M, Conway PT, Teakell J, Lee J, Vlasschaert C, He S, Lerma E. The Case for a Kidney Emoji. Am J Kidney Dis 2022; 80:155-157. [PMID: 35513182 DOI: 10.1053/j.ajkd.2022.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/01/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Harish Seethapathy
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
| | - Jeffrey Beach
- Rocky Vista University College of Osteopathic Medicine, Parker, Colorado
| | | | - Paul T Conway
- American Association of Kidney Patients, Tampa, Florida
| | - Jade Teakell
- Division of Renal Diseases and Hypertension, UTHealth McGovern Medical School, Houston, Texas
| | - Jarone Lee
- Departments of Surgery and Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Shuhan He
- Center for Innovation in Digital HealthCare, Lab of Computer Science, Massachusetts General Hospital, Boston, Massachusetts
| | - Edgar Lerma
- Section of Nephrology, University of Illinois at Chicago, Chicago, Illinois
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He S, Renne A, Argandykov D, Convissar D, Lee J. Comparison of an Emoji-Based Visual Analog Scale With a Numeric Rating Scale for Pain Assessment. JAMA 2022; 328:208-209. [PMID: 35819433 PMCID: PMC9277495 DOI: 10.1001/jama.2022.7489] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study surveyed patients admitted to the emergency department or surgical units at a single hospital to compare an emoji-based pain scale with a conventional numeric rating scale.
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Affiliation(s)
- Shuhan He
- Lab of Computer Science, Harvard Medical School, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Angela Renne
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston
| | - Dias Argandykov
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston
| | - David Convissar
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston
| | - Jarone Lee
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
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Szeto MD, Barber C, Ranpariya VK, Anderson J, Hatch J, Ward J, Aguilera MN, Hassan S, Hamp A, Coolman T, Dellavalle RP. Emojis and Emoticons in Health Care and Dermatology Communication: Narrative Review. JMIR DERMATOLOGY 2022; 5:e33851. [PMID: 36405493 PMCID: PMC9642845 DOI: 10.2196/33851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 05/24/2022] [Accepted: 06/21/2022] [Indexed: 12/19/2022] Open
Abstract
Background Emoticons and emojis have become staple additions to modern-day communication. These graphical icons are now embedded in daily society through the various forms of popular social media and through users' personal electronic conversations. With ever-increasing use and inclusivity, exploration of the possible health care and dermatology applications of these tools is imperative. Objective The goal of this narrative review was to provide and evaluate an up-to-date literature survey examining the utility of emoticons and emojis in medicine. Special attention was paid to their existing and potential uses in the field of dermatology, especially during the COVID-19 pandemic. Methods A PubMed search of peer-reviewed publications was performed in mid-2021 to collect articles with emoticon or emoji keywords in combination with other health care-relevant or dermatology-relevant keywords. Screening of publications and described studies was performed by the authors with education and research experience in health care, dermatology, social media, and electronic communication trends. Selected articles were grouped based on common subjects for qualitative analysis and presentation for in-depth discussion. Results From this extensive search, researchers were able to identify a wide variety of publications detailing the use of emoticons and emojis in general health care, pediatric health care, public health, and dermatology. Key subject areas that emerged from the investigation included the ability of emoticons and emojis to improve communication within pediatric health care, enhance mood and psychological assessment or mental health screening in adults, develop interventions to improve patient medication adherence, complement novel means of public health and COVID-19 surveillance, and bolster dermatology-specific applications. Conclusions This review illuminated the repurposing of emojis and emoticons for a myriad of advantageous functions in health care and public health, with applications studied in many populations and situations. Dermatology-specific uses were relatively sparse in the literature, highlighting potential opportunities for growth in future studies and practices. The importance of diversity and inclusivity has extended to emojis, with the recent introduction of skin color customization and new emojis better representing the comprehensive spectrum of users' experiences. A continuously evolving and technology-driven population creates a unique niche for emoticons and emojis to ease worldwide communication and understanding, transcending the barriers of age, language, and background. We encourage future studies and innovations to better understand and expand their utility.
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Affiliation(s)
- Mindy D Szeto
- Department of Dermatology University of Colorado Aurora, CO United States
| | - Cara Barber
- Department of Dermatology Good Samaritan Regional Medical Center/Silver Falls Dermatology Salem, OR United States
| | - Varun K Ranpariya
- Robert Wood Johnson Medical School Rutgers University Piscataway, NJ United States
| | | | - Jonny Hatch
- Texas College of Osteopathic Medicine University of North Texas Health Science Center Fort Worth, TX United States
| | - Jordan Ward
- Paul L Foster School of Medicine Texas Tech University Health Sciences Center El Paso El Paso, TX United States
| | - Megan N Aguilera
- School of Medicine University of Colorado Anschutz Medical Campus Aurora, CO United States
| | - Shahzeb Hassan
- Feinberg School of Medicine Northwestern University Chicago, IL United States
| | - Austin Hamp
- Abrazo Health Network Goodyear, AZ United States
| | - Tyler Coolman
- Department of Dermatology Case Western Reserve University Hospitals Cleveland, OH United States
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10
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Balk A, Lee J, Renne C, He S. The liver emoji. Hepatology 2022; 75:1073-1074. [PMID: 34860429 DOI: 10.1002/hep.32261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 12/08/2022]
Affiliation(s)
- Adi Balk
- Faculty of Health SciencesBen Gurion University of the NegevBeershevaIsrael
| | - Jarone Lee
- Department of SurgeryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA.,Department of Emergency MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA.,Department of Trauma, Emergency Surgery, & Surgical Critical CareMassachusetts General HospitalBostonMassachusettsUSA
| | - Christian Renne
- Department of Trauma, Emergency Surgery, & Surgical Critical CareMassachusetts General HospitalBostonMassachusettsUSA
| | - Shuhan He
- Department of Emergency MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA.,Department of Trauma, Emergency Surgery, & Surgical Critical CareMassachusetts General HospitalBostonMassachusettsUSA.,Center for Innovation in Digital HealthCareLab of Computer ScienceMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
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Boender TS, Louis-Ferdinand N, Duschek G. Digital visual communication for public health: a design proposal for a vaccinated emoji (Preprint). J Med Internet Res 2021; 24:e35786. [PMID: 35389363 PMCID: PMC8993141 DOI: 10.2196/35786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/11/2022] [Accepted: 03/06/2022] [Indexed: 01/22/2023] Open
Abstract
In the 21st century, the internet and particularly social media have become essential platforms for the spread of health information (including misinformation and disinformation). One of the distinguishing features of communication on these platforms is the widespread use of emojis. Though seemingly trivial emojis are now used by many if not most public health figures and organizations alongside important health updates. Much of that information has had to do with vaccination. Vaccines are a critical public health tool but one surrounded by falsehoods, phobias, and misinformation fueling vaccine hesitancy. Part of that has to do with their lack of positive representation on social media (eg, the syringe emoji is a plain needle, which for many people is an uncomfortable image). We thus argue that vaccination deserves an entirely new emoji to communicate vaccine confidence and discuss a design proposal for a vaccinated emoji that has gained traction in the global public health community.
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Affiliation(s)
- Tamara Sonia Boender
- Surveillance Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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