YouTube as a New Medium for Dementia Education Among Chinese Americans

A Model of Social Media Effects in Public Health Communication Campaigns: Systematic Review

BACKGROUND

Social media platforms are frequently used in health communication campaigns. Common understandings of campaign effects posit a sequential and linear series of steps from exposure to behavior change, commonly known as the hierarchy of effects model (HOE). These concepts need to be reevaluated in the age of social media, which are interactional and communal.

OBJECTIVE

This review aims to update the traditional HOE for health communication campaigns in the context of social media, including identifying indicators of effectiveness and how these are conceptualized to lead to health-related outcomes.

METHODS

We conducted a systematic review of studies following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines reporting on the use of social media as part of health communication campaigns, extracting campaign information such as objectives, platforms used, and measures of campaign performance. We used these data, combined with our understanding of the HOE, to develop an updated conceptual model of social media campaign effects.

RESULTS

We identified 99 eligible studies reporting on 93 campaigns, published between 2012 and 2022. The campaigns were conducted in over 20 countries, but nearly half (n=42) were conducted in the United States. Campaigns targeted a variety of health issues and predominantly used Facebook, Twitter, Instagram, and YouTube. Most campaigns (n=81) set objectives targeting awareness or individual behavior change. Process measures (n=68; eg, reach and impressions) and engagement measures (n=73; eg, likes and retweets) were reported most frequently, while two-fifths (n=42) did not report any outcomes beyond engagement, such as changes in knowledge, behavior, or social norms. Most campaigns (n=55) collected measures that did not allow them to determine if the campaign objective had been met; that is, they were process evaluations only. Based on our review, our updated model suggests that campaign exposure can lead to individual behavior change and improved health outcomes, either through a direct or indirect pathway. Indirect pathways include exposure through social and policy changes. "Engagement" is positioned as critical to success, replacing awareness in the traditional HOE, and all types of engagement are treated as equal and good. No consideration is being given to potential negative engagement, such as the distribution of misinformation. Additionally, the process is no longer linear and sequential, with circular pathways evident, such as engagement not only influencing behavior change but also generating additional exposure to campaign messages.

CONCLUSIONS

Our review has highlighted a change in conventional understandings of how campaigns can influence health outcomes in the age of social media. The updated model we propose provides social media campaigners with a starting point to develop and tailor campaign messages and allows evaluators to identify critical assumptions to test, including the role and value of "engagement."

TRIAL REGISTRATION

PROSPERO CRD42021287257; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=287257.

Dementia education and training for the general public: A scoping review

The lack of public awareness and understanding of dementia affects the experiences of people living with dementia and their families. Dementia education and training for the general public have been gradually disseminated. We conducted a systematic scoping review guided by PRISMA-ScR to map existing evidence and identify dementia education and training available to the general public. From the four electronic databases, 41 articles were identified. Dementia education has three main purposes: dementia friendliness (n = 25), early diagnosis/help-seeking (n = 10), and prevention (n = 6). Education aimed at dementia friendliness was delivered in the community (n = 6), schools/universities (n =14), workplaces (n = 2), and online (n = 3). Interventions aimed at early diagnosis and prevention were often conducted in communities with middle-aged and older people or specific ethnic groups. Eleven dementia-friendliness studies reported on the interaction with people living with dementia to reduce stigma. Dementia knowledge, attitudes, and preventive behaviors were assessed as outcomes. Though randomized controlled trials were conducted in early diagnosis and prevention studies via e-learning, they were not performed in dementia-friendliness studies. Therefore, there is a need to further accumulate evidence of dementia education for each of these purposes.

Barriers to Online Dementia Information and Mitigation

There is growing interest in HCI to study ways to support access to accurate, accessible, relevant online health information for different populations. Yet, there remains a need to understand the barriers that are posed by the way our platforms are designed as well as how we might overcome these barriers for people with dementia. To address this, we conducted sixteen interviews and observation sessions with people with mild to moderate dementia. Our analysis uncovered four barriers to online health information and corresponding mitigation strategies that participants employed. We discuss how HCI researchers may apply these findings towards new technical approaches and standards concerning information accessibility and credibility for neurodiverse populations. Finally, we broaden the scope of HCI research to include investigations of the accessibility and credibility of online information for people with age-related cognitive impairment independent of proxies.

Consumer Wearables and the Integration of New Objective Measures in Oncology: Patient and Provider Perspectives

With one in five adults in the United States owning a smartwatch or fitness tracker, these devices are poised to impact all aspects of medicine by offering a more objective approach to replace self-reported data. Oncology has proved to be a prototypical example, and wearables offer immediate benefits to patients and oncologists with the ability to track symptoms and health metrics in real time. We aimed to review the recent literature on consumer-grade wearables and its current applications in cancer from the perspective of both the patient and the provider. The relevant studies suggested that these devices offer benefits, such as improved medication adherence and accuracy of symptom tracking over self-reported data, as well as insights that increase patient empowerment. Physical activity is consistently correlated with stronger patient outcomes, and a patient's real-time metrics were found to be capable of tracking medication side effects and toxicity. Studies have made associations between wearable data and telomere shortening, cardiovascular disease, alcohol consumption, sleep apnea, and other conditions. The objective data obtained by the wearable presents a more complete picture of an individual's health than the snapshot of a 15-minute office visit and a single set of vital signs. Real-time metrics can be translated into a digital phenotype that identifies risk factors specific to each patient, and shared risk factors across one's social network may uncover common environmental exposures detrimental to one's health. Wearable data and its upcoming integration with social media will be the foundation for the next generation of personalized medicine.

Use of technology and social media in dementia care: Current and future directions

As the population across the globe continues to dramatically increase, the prevalence of cognitive impairment and dementia will inevitably increase as well, placing increasing burden on families and health care systems. Technological advancements over the past decade provide potential benefit in not only relieving caregiver burden of caring for a loved one with dementia, but also enables individuals with dementia to age in place. Technological devices have served to improve functioning, tracking and mobility. Similarly, smartphones, tablets and the ubiquitous world wide web have facilitated the dissemination of health information to previously hard to reach populations largely through use of various social media platforms. In this review, we discuss the current and future uses of technology via devices and social media to promote healthy aging in individuals with dementia, and also limitations and challenges to consider in the future.

Information about COVID-19 for deaf people: an analysis of Youtube videos in Brazilian sign language

OBJECTIVE

to analyze YouTube videos with information about COVID-19 in Brazilian sign language.

METHODS

a cross-sectional study conducted with 402 videos from the YouTube sharing platform. Chi-square, Fisher's exact, Mann-Whitney and Spearman's correlation tests were used.

RESULTS

the videos mainly covered COVID-19 prevention (20.6%). There was a positive correlation between video length and number of views (p<0.001). The length of more than 20 minutes was associated with narration only in BSL (p=0.37) and in BSL with audio (p<0.001), while videos with less than 20 minutes were associated with simultaneous narration in BSL, audio and subtitles. Those with narration only in BSL had a similar number of views to those narrated with subtitles and/or audio (p=0.998).

CONCLUSION

the videos were mostly short and included COVID-19 prevention. The longer the video, the greater the number of views. Regardless the presentation of narrations, the videos had a similar number of views.

Assessing YouTube as an Educational Tool for Shingles: Cross-Sectional Study

Background

YouTube is a popular platform with many videos, which have potential educational value for medical students. Due to the lack of peer review, other surrogates are necessary to determine the content quality of such educational videos. Few studies have analyzed the research background or academic affiliation of the physicians associated with the production of YouTube videos for medical education. The research background or academic affiliations of those physicians may be a reflection of the content quality of these educational videos.

Objective

This study identifies physicians associated with the production of educational YouTube videos about shingles and analyzes those physicians based on their research background or academic affiliation, which may be good surrogates for video content quality.

Methods

Using the YouTube search engine with default settings, the term “shingles” was searched on May 8, 2020. A cross-sectional study was performed using the first 50 search results. A search on Scopus for each identified physician was performed, and data regarding their research background and academic affiliation were recorded.

Results

Of the 50 YouTube videos, 35 (70%) were categorized as academic. Of the 35 academic videos, 24 (71%) videos featured physicians, totaling 25 physicians overall. Out of these 25 physicians, 5 (20%) had at least 1 shingles-related publication and 8 (32%) had an h-index >10. A total of 21 (84%) physicians held an academic affiliation.

Conclusions

These results ensure to a certain degree the quality of the content in academic videos on YouTube for medical education. However, further evaluation is needed for this growing platform.

Digital Media as a Proponent for Healthy Aging in the Older Chinese American Population: Longitudinal Analysis

Background

Ensuring health literacy among underserved populations is essential amid an aging population. Accessible and appropriate (both culturally and linguistically) information is important when considering digital media education for older Chinese Americans.

Objective

This study aims to investigate how social media fare over time in disseminating health information and how we may most effectively educate this population.

Methods

For this study, 5 geriatric-themed educational videos about Parkinson disease, fall prevention, gastrointestinal health, oral health, and pulmonary disease were uploaded to YouTube. Data were collected over a 40-month period. Descriptive statistics and chi-square analysis were used to compare results from the first and second 20-month periods.

Results

In 40 months, the 5 videos in aggregate accrued 1171.1 hours of watch time, 7299 views, and an average view duration of 9.6 minutes. Comparing the first and second 20-month periods, there was a significant increase in mobile device usage, from 79.4% (3541/4458) to 83.3% (2367/2841). There was no significant difference in the usage of various external traffic sources and methods of sharing, with WhatsApp accounting for the majority of sharing in both 20-month periods.

Conclusions

Our study provides insight into where to focus future strategies to optimize digital media content, and how to best recruit, direct, and disseminate health education to an older adult Chinese American population. Combining the success of YouTube, social media, and messaging platforms such as WhatsApp can help to transcend cultural and linguistic barriers to promote healthy aging.

Using Consumer Perceptions of a Voice-Activated Speaker Device as an Educational Tool

Voice-activated smart speakers, with their ease of setup, low cost, and versatility, could be an affordable and accessible way to improve health and mental health outcomes. In 2018, there were a total of 320 comments generated from verified purchases of a voice-activated smart speaker. These comments revealed there could be potential benefits of reducing loneliness and social isolation for adult users, especially for the older population. However, further research is warranted to determine whether using such devices would be harmful to children's physical or mental development.

The Roles of YouTube and WhatsApp in Dementia Education for the Older Chinese American Population: Longitudinal Analysis

Background

Dementia remains a stigmatized topic in the Chinese community.

Objective

This study aims to analyze and compare the usage of dementia educational YouTube videos and the modalities of video sharing over a 6-year period.

Methods

Dementia educational videos were uploaded to YouTube. Data was collected over a 6-year period. Results from the first 3 years were compared to those from the second 3 years using descriptive statistics and chi-square analysis.

Results

Over 6 years, the dementia educational videos generated a total watch time of 269,388 minutes, 37,690 views, and an average view duration of 7.1 minutes. Comparing the first and second 3-year periods of video performance data, there was a longer watch time (59,262 vs 210,126 minutes), more total views (9387 vs 28,303 views), and a longer average view duration (6.3 vs 7.4 minutes). Furthermore, WhatsApp has become a leading external traffic source and top sharing service, accounting for 43.5% (929/2137) and 67.0% (677/1011), respectively.

Conclusions

Over 6 years, YouTube has become an increasingly popular tool to deliver culturally sensitive dementia education to Chinese Americans. WhatsApp continues to be the preferred method of sharing dementia education and has become a top external traffic source to dementia educational videos. Taken together, these social media platforms are promising means of reducing the disparity in dementia knowledge in linguistically and culturally isolated populations.

Dementia-Related Products on an e-Commerce Platform

Dementia is a neurocognitive disorder, which affects older adults. There are currently no medication treatments available to cure dementia, but a number of biomedical technologies could be useful in assisting patients with dementia. With the continued growth of electronic commerce (e-commerce), online shopping for aging and health-related products will only continue to increase. Using the Tmall marketplace as an example, the purpose of this viewpoint is to describe the current trends of dementia-related products and devices available on an e-commerce platform. Feedback and critiques in the form of consumer reviews should be used to improve the design of dementia-related products. Online medical product consumers, however, must be vigilant about the effectiveness and risks of these biomedical devices.