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Kamiński M, Wieczorek T, Kręgielska-Narożna M, Bogdański P. Tweeting about fatphobia and body shaming: A retrospective infodemiological study. Nutrition 2024; 125:112497. [PMID: 38901121 DOI: 10.1016/j.nut.2024.112497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND We aimed to analyze reactions to tweets that employed weight-based discrimination terms and to compare them to others posted by the same users on X (formerly Twitter). METHODS We collected tweets featuring weight-based discrimination terms (the study group) and created a control group by randomly selecting up to five tweets from each account that did not mention any such terms. Descriptive statistics, sentiment analysis, and logistic regression modeling were used to compare the numbers of likes and retweets of the study and control groups, and to understand the emotions associated with these tweets. RESULTS Our analysis included 22,075 study group tweets and 50,341 control group tweets. Sentiment analysis was conducted on 41,403 (57.2%) tweets, with 65.7% of the study group tweets being found to contain negative sentiments. The study group had a higher median of likes (1 [0-4]) and retweets (0 [0-0]) than the control group (1 [0-2] and 0 [0-0], respectively, with the study group obtaining higher mean ranks in both comparisons, P < 0.001). Multivariable logistic regression analysis revealed that tweets using weight-based discrimination terms gained more likes (OR = 1.22; 95% CI: 1.16-1.28) and retweets (OR = 1.61; 95% CI: 1.49-1.74), independent of, for example, verification status, follower count, year and season of the tweet, and emotional expression of the tweet. CONCLUSIONS Tweets concerning fatphobia, body shaming, and similar terms gain more reactions than others posted by the same accounts.
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Affiliation(s)
- Mikołaj Kamiński
- Department of the Treatment of Obesity and Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, Poznań, Poland
| | - Tobiasz Wieczorek
- Department of the Treatment of Obesity and Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, Poznań, Poland.
| | - Matylda Kręgielska-Narożna
- Department of the Treatment of Obesity and Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, Poznań, Poland
| | - Paweł Bogdański
- Department of the Treatment of Obesity and Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, Poznań, Poland
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2
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Jones HM, Orr J, Whelan ME, Oyebode O. An exploration of pregnancy and postpartum content on Instagram: A content analysis of health and exercise focused accounts. Women Birth 2024; 37:101632. [PMID: 38971136 DOI: 10.1016/j.wombi.2024.101632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 07/08/2024]
Abstract
PROBLEM Although social media can be an accessible option for women to receive support, there is increasing awareness of the negative mental health impacts of social media use during the postpartum period. Idealistic portrayals on social media have been shown to lead to body dissatisfaction and low mood. BACKGROUND The beginning of a child's life is a period of significant physical, mental and social adjustment for a mother. Women often resort to online sources of information to navigate this time period. AIM This study explored the content featured in prominent health and exercise Instagram account posts targeting pregnant and postpartum women. METHODS Popular individual health and exercise focused accounts targeting pregnant and post-partum women were identified on Instagram. Data about the account holder and content of posts were extracted. Data were analysed using inductive content analysis. FINDINGS Most included accounts belonged to American women aged 35-44 who were slim. Content analysis of 317 posts from 43 Instagram accounts unveiled six themes: reasons to exercise, weight management, guidance on doing exercise, eating well or not so well, fitting it all in, and comparison of body image. DISCUSSION /CONCLUSION Content analysed was not representative of the general population. Included posts could shape beliefs that may lead to intrapersonal weight stigma. Consideration must be given to actions that could promote individuals of all body sizes being represented in the media relating to pregnancy and the postpartum period.
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Affiliation(s)
| | - Jemma Orr
- School of Biosciences, University of Nottingham, UK
| | - Maxine E Whelan
- Centre for Healthcare and Communities, Coventry University, UK
| | - Oyinlola Oyebode
- Wolfson Institute of Population Health, Queen Mary University of London, UK
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3
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Vegt N, Visch V, Spooren W, van Rossum EFC, Evers AWM, van Boeijen A. Erasing stigmas through storytelling: why interactive storytelling environments could reduce health-related stigmas. DESIGN FOR HEALTH (ABINGDON, ENGLAND) 2024; 8:46-77. [PMID: 38746072 PMCID: PMC11093225 DOI: 10.1080/24735132.2024.2306771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/11/2024] [Indexed: 05/16/2024]
Abstract
In this article we describe how designers can apply storytelling to reduce health-related stigmas. Stigma is a pervasive problem for people with illnesses, such as obesity, and it can persistently hinder coping, treatment, recovery, and prevention. Reducing health-related stigma is complex because it is multi-layered and self-perpetuating, leading to intertwined vicious circles. Interactive storytelling environments can break these vicious circles by delimiting the narrative freedom of stigma actors. We theoretically explain the potential of interactive storytelling environments to reduce stigma through the following seven functions: 1) expose participants to other perspectives, 2) provide a protective frame, 3) intervene in daily conversations, 4) persuade all stigma actors, 5) exchange alternative understandings, 6) elicit understanding and support for stigma victims, and 7) support stigma victims to cope with stigmatization. We elaborate on these functions through a demonstration of an interactive storytelling environment against weight stigma. In conclusion, this article is a call on designers for health and wellbeing, scientists, and practitioners from various disciplines to be sensitive to the pervasiveness of stigma and to collaboratively create destigmatizing storytelling environments.
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Affiliation(s)
- Niko Vegt
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Valentijn Visch
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Wilbert Spooren
- Faculty of Arts, Radboud University, Nijmegen, The Netherlands
| | - Elisabeth F. C. van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Andrea W. M. Evers
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
- Faculty of Social and Behavioral Science Leiden University, Leiden, The Netherlands
- Faculty of ESHPM, Erasmus University, Rotterdam, the Netherlands
| | - Annemiek van Boeijen
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
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4
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Wang J, Cai Y, Ren X, Ma B, Chen O. The effect of body mass index on self-rated health in middle-aged and older adults: evidence from the China health and retirement longitudinal study. Aging Clin Exp Res 2023; 35:2929-2939. [PMID: 37848805 DOI: 10.1007/s40520-023-02585-7] [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: 04/07/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND AND AIMS Health promotion for middle-aged and older people has received a lot of attention recently in the context of healthy aging. Furthermore, it is unclear how body mass index (BMI) presently affects self-rated health (SRH), a reliable and representative indicator of health. METHODS This study used longitudinal follow-up data from the China Health and Retirement Longitudinal Study (CHARLS). Systematic collection of information on the socio-demographic, lifestyle, and health status of the subjects. Binary logistic regression was used to investigate the relationship between BMI and SRH, and gender-specific variations were examined. Subgroup analysis was used to examine interactions, and the results of the research stability were demonstrated. RESULTS After adjusting for age, gender, education level, marital status, place of residence, number of chronic diseases, alcohol consumption, smoking, depressive symptoms, and SRH at baseline, it was found that obesity grade 1 and obesity grade 2 were good contributors to SRH compared to normal weight individuals, and this association was different in males and females. According to the results of the subgroup analyses, those under 65 years old, with junior high school or less education, with a spouse, residing in a city, having one chronic disease, and not smoking or drinking, respectively, all had stable positive associations between obesity and SRH. CONCLUSIONS Our findings suggest that obesity may be associated with good SRH. Teams of healthcare professionals should revisit the potential impact of obesity among middle-aged and older adults and focus on developing prevention strategies for morbid obesity.
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Affiliation(s)
- Jingyi Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Yingying Cai
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Xiaohe Ren
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Bin Ma
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Ou Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
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5
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Mazonde N, Goldstein S. Online Health Communities' Portrayal of Obesity on Social Media Platforms in South Africa. JOURNAL OF HEALTH COMMUNICATION 2023; 28:15-24. [PMID: 38146160 DOI: 10.1080/10810730.2023.2231374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
The rapidly increasing prevalence of obesity in South Africa, intertwined with extensive changes in diet, life expectancy, and nutritional status has led to a complex framing of obesity on social media. This has prompted the prioritization of media-based social and behavior change communication interventions leveraging social media for obesity prevention. This study was conducted to understand how obesity is constructed and represented on social media in South Africa. A media review of Facebook and Twitter platforms in South Africa was conducted over a six-month period using Meltwater software for data collection. The search yielded 13 500 posts and tweets. Data were cleaned and coded in Microsoft Excel. Content and framing analysis were performed to add insight into the nature of obesity discourse on social media. Portrayals of obesity on social media were dominated by stigmatizing imagery blaming individuals for unhealthy lifestyles, poor diets, and lack of physical activity. Future media-based social and behavior change communication interventions for obesity prevention can leverage social media to reach the broader public and insights into media portrayals of obesity have the potential to influence the shape and development of these behavioral interventions.
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Affiliation(s)
- Natasha Mazonde
- SAMRC/Wits Centre for Health Economics & Decision Science- PRICELESS-SA, University of Witwatersrand, Faculty of Health Sciences, School of Public Health, Parktown Johannesburg, South Africa
| | - Susan Goldstein
- SAMRC/Wits Centre for Health Economics & Decision Science- PRICELESS-SA, University of Witwatersrand, Faculty of Health Sciences, School of Public Health, Parktown Johannesburg, South Africa
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6
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Chen S, Lan X, Yu H. A social network analysis: mental health scales used during the COVID-19 pandemic. Front Psychiatry 2023; 14:1199906. [PMID: 37706038 PMCID: PMC10495585 DOI: 10.3389/fpsyt.2023.1199906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/11/2023] [Indexed: 09/15/2023] Open
Abstract
Introduction The focus on psychological issues during COVID-19 has led to the development of large surveys that involve the use of mental health scales. Numerous mental health measurements are available; choosing the appropriate measurement is crucial. Methods A rule-based named entity recognition was used to recognize entities of mental health scales that occur in the articles from PubMed. The co-occurrence networks of mental health scales and Medical Subject Headings (MeSH) terms were constructed by Gephi. Results Five types of MeSH terms were filtered, including research objects, research topics, research methods, countries/regions, and factors. Seventy-eight mental health scales were discovered. Discussion The findings provide insights on the scales used most often during the pandemic, the key instruments used to measure healthcare workers' physical and mental health, the scales most often utilized for assessing maternal mental health, the tools used most commonly for assessing older adults' psychological resilience and loneliness, and new COVID-19 mental health scales. Future studies may use these findings as a guiding reference and compass.
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Affiliation(s)
| | - Xue Lan
- Department of Health Management, China Medical University, Shenyang, China
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7
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Busam B, Solomon-Moore E. Public Understanding of Childhood Obesity: Qualitative Analysis of News Articles and Comments on Facebook. HEALTH COMMUNICATION 2023; 38:967-980. [PMID: 34605342 DOI: 10.1080/10410236.2021.1985859] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Childhood obesity has become a major focus of public health and subject to increased news coverage. News can shape public understanding of childhood obesity by selective reporting (framing) which can affect policy support and weight stigma. As news is consumed on social media, comments on articles present a novel method to explore public understanding. This study examined how childhood obesity is framed by news articles on Facebook and how individuals commenting understand and react to these articles. This study used a qualitative research design. Facebook pages of 11 national UK news outlets were searched for news articles on childhood obesity published between May 2015 and May 2020. Of those, 30 articles were randomly selected. Framing analysis was used to determine whether childhood obesity was portrayed as a behavioral, societal or medical issue. Responding comments (N = 1,104) were grouped according to the dominant frame of the corresponding article and analyzed using qualitative content analysis. Of the 30 articles, 28 mentioned societal, 26 behavioral and 18 medical aspects of childhood obesity, highlighting that most articles included more than one frame. Three themes were generated from responding comments: Culprits and Remedies, Appraising Childhood Obesity and Making Sense of the News Article. Findings showed that comments related to Appraising Childhood Obesity differed between differently framed articles, while the other themes did not. This study highlights the need for improved communication on childhood obesity to address weight stigma and improve understanding of news articles.
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Affiliation(s)
- Betty Busam
- Department of Psychology, University of Bath
- Department of Psychology, University of Heidelberg
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Kelly NR, Kosty D, Williamson G, Guidinger C, Cotter EW. Social media and dating app use are differentially related to same- and next-day disordered eating pathology in young men with loss of control eating. Eat Behav 2023; 49:101735. [PMID: 37146410 DOI: 10.1016/j.eatbeh.2023.101735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/30/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To evaluate whether social networking site (SNS) and dating app use is associated with disordered eating in young men. METHODS 42 men (18-35y) who reported ≥4 loss of control (LOC) eating episodes in the prior month completed a 14-day ecological momentary assessment (EMA) protocol. Five times throughout the day, participants responded to prompts regarding their dietary restraint, body dissatisfaction, and LOC eating. Each night at ~10 pm, participants reported their total time spent on SNSs and dating apps/websites within the last day. RESULTS 39 out of 42 cisgender men (Mage = 25.1 ± 5.3 years; 47 % non-Hispanic White, 29 % Black or African American; 63 % non-students; 87 % heterosexual) reported using SNSs and/or dating apps. Neither SNS nor dating app use was associated with body dissatisfaction. Dating app use with associated with higher same- (r2 equivalent = 0.022, p = .003) and next-day dietary restraint (r2 equivalent = 0.016, p = .02); SNS use was not. More SNS use was associated with lower odds of same- (OR [95 % CI] = 0.86 [0.75, 0.99], p = .044) and next-day LOC eating (OR [95 % CI] = 0.82 [0.71, 0.96], p = .011); links with dating app use were non-significant. DISCUSSION Non-significant links for SNS and dating app use with body dissatisfaction, and inverse associations with LOC eating, are contrary to research conducted with girls and women. Research is needed to evaluate whether the quality of SNS and dating app engagement (e.g., specific sites) are more closely related to men's disordered eating, and this work should consider muscularity concerns.
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Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America.
| | - Derek Kosty
- The Prevention Science Institute, University of Oregon, United States of America
| | - Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America
| | - Elizabeth W Cotter
- Department of Health Studies, American University, United States of America
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9
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Razzak FA, Saab D, Haddad F, Antoun J. Content analysis of social media regarding obesity as a chronic disease. PeerJ Comput Sci 2023; 9:e1321. [PMID: 37346663 PMCID: PMC10280592 DOI: 10.7717/peerj-cs.1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/09/2023] [Indexed: 06/23/2023]
Abstract
Background Social media is an effective online communication channel. Obesity has been classified as a chronic disease; yet, social media rarely portrays it as such. This study aims to explore the perception of obesity as a chronic disease through content analysis of social media content of obesity-related health organizations and weight loss commercial applications. Methods Using a codebook adapted from the definition of chronic disease, content analysis was conducted to evaluate a set of posts sampled from 11 health-related organizations and 10 weight loss applications Facebook and Twitter accounts. Descriptive statistics were used to assess the extent obesity was portrayed as a chronic disease. Results A total of 8,106 posts were extracted: 3,019 posts by organizations and 5,087 by weight loss commercial applications. Only 401 (4.5%) posts/tweets were related to obesity as a chronic disease and were posted by obesity-related health organizations. Only 69 (2.0%) posts from all the organizations' posts directly addressed the idea that obesity is a chronic disease. Almost none of the weight loss commercial apps' social media accounts tackled any aspect of obesity as a disease. Commercial applications' posts revolved mainly around recipes, exercise regimens, and behavioral advice, whereas organizations tackled more complications, treatment, and obesity bias. Conclusion Using content analysis of social media content, obesity-related health organizations and weight loss applications did not emphasize obesity as a chronic disease on their social media platforms of Facebook and Twitter. Weight-loss commercial applications on social media should include more posts to modify the public's perception regarding obesity as a disease, contributing to health promotion. Further research should explore other social media platforms and posts with specific hashtags posted by the general population.
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Affiliation(s)
- Farah Abdul Razzak
- Department of Family Medicine, American University of Beirut, Beirut, Lebanon
| | - Diane Saab
- American University of Beirut, Beirut, Lebanon
| | | | - Jumana Antoun
- Department of Family Medicine, American University of Beirut, Beirut, Lebanon
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10
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Sanzari CM, Gorrell S, Anderson LM, Reilly EE, Niemiec MA, Orloff NC, Anderson DA, Hormes JM. The impact of social media use on body image and disordered eating behaviors: Content matters more than duration of exposure. Eat Behav 2023; 49:101722. [PMID: 37060807 PMCID: PMC10363994 DOI: 10.1016/j.eatbeh.2023.101722] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/31/2023] [Accepted: 03/29/2023] [Indexed: 04/17/2023]
Abstract
Social media use is rapidly expanding in terms of frequency, duration, and the diversity of platforms available. Given evidence for associations between social media use, body image disturbances, and disordered eating it is important to identify potentially harmful aspects of social media use that could serve as intervention targets. This study surveyed two demographically diverse undergraduate student cohorts in 2015 and 2022 to compare patterns in social media use, body image, and disordered eating behaviors between samples, including as a function of the COVID-19 pandemic, and to test the hypothesized moderating role of specific content consumed in the association between social media use and maladaptive outcomes. Participants in 2022 reported greater body image disturbances, more frequent vomiting and laxative use, and more time spent on a greater number of social media accounts, with significantly greater use of image-based platforms such as Snapchat, TikTok, and YouTube. Moderated regression analyses suggest that type of content consumed, but not the amount of time spent on social media or diversity of platforms utilized, is associated with body image disturbances and disordered eating behaviors after controlling for gender and body mass index. Specifically, exposure to weight loss content was associated with lower body appreciation, greater fears of negative appearance evaluation, and more frequent binge eating. Contrary to initial hypotheses, exposure to body positivity/neutrality content did not have protective effects. Findings suggest that interventions targeting negative consequences of social media use should focus on addressing content consumed, rather than time spent on social media platforms.
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Affiliation(s)
- Christina M Sanzari
- Department of Psychology, University at Albany, State University of New York, USA.
| | - Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lisa M Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, USA
| | - Erin E Reilly
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Drew A Anderson
- Department of Psychology, University at Albany, State University of New York, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, USA
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11
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Westbury S, Oyebode O, van Rens T, Barber TM. Obesity Stigma: Causes, Consequences, and Potential Solutions. Curr Obes Rep 2023; 12:10-23. [PMID: 36781624 PMCID: PMC9985585 DOI: 10.1007/s13679-023-00495-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 02/15/2023]
Abstract
PURPOSE OF REVIEW This review aims to examine (i) the aetiology of obesity; (ii) how and why a perception of personal responsibility for obesity so dominantly frames this condition and how this mindset leads to stigma; (iii) the consequences of obesity stigma for people living with obesity, and for the public support for interventions to prevent and manage this condition; and (iv) potential strategies to diminish our focus on personal responsibility for the development of obesity, to enable a reduction of obesity stigma, and to move towards effective interventions to prevent and manage obesity within the population. RECENT FINDINGS We summarise literature which shows that obesity stems from a complex interplay of genetic and environment factors most of which are outside an individual's control. Despite this, evidence of obesity stigmatisation remains abundant throughout areas of media, entertainment, social media and the internet, advertising, news outlets, and the political and public health landscape. This has damaging consequences including psychological, physical, and socioeconomic harm. Obesity stigma does not prevent obesity. A combined, concerted, and sustained effort from multiple stakeholders and key decision-makers within society is required to dispel myths around personal responsibility for body weight, and to foster more empathy for people living in larger bodies. This also sets the scene for more effective policies and interventions, targeting the social and environmental drivers of health, to ultimately improve population health.
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Affiliation(s)
- Susannah Westbury
- School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia.
| | - Oyinlola Oyebode
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Thijs van Rens
- Department of Economics, University of Warwick, Coventry, UK
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12
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Tylka TL, Rodgers RF, Calogero RM, Thompson JK, Harriger JA. Integrating social media variables as predictors, mediators, and moderators within body image frameworks: Potential mechanisms of action to consider in future research. Body Image 2023; 44:197-221. [PMID: 36709634 DOI: 10.1016/j.bodyim.2023.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 01/28/2023]
Abstract
In this article, we consider how social media variables may be integrated as predictors, mediators, and moderators within dominant theoretical frameworks of body image in order to identify potential mechanisms of action that can be empirically examined in future research and used to direct prevention and intervention efforts. To achieve this goal, we first articulate social media variables that have been investigated as predictors, mediators, and moderators in body image research. Next, we present the following critical and sociocultural theoretical frameworks: social comparison theory, tripartite influence model, objectification theory, developmental theory of embodiment, acceptance model of intuitive eating, cultivation theory, and uses and gratifications theory. Additionally, we present the theory of development of critical body awareness, a newly developed model that may provide further insight regarding the relationships between social media and body image-related outcomes. For each model, we articulate extant research that has explored social media variables within its context and explicate how social media variables could potentially be studied as predictors, mediators, and moderators within its structure. To conclude, we address pertinent limitations and gaps within this research space that could direct future research across the theoretical frameworks.
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Affiliation(s)
- Tracy L Tylka
- Department of Psychology, The Ohio State University, Columbus, OH 43210, USA.
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
| | - Rachel M Calogero
- Department of Psychology, Western University, London, ON N6K 5C2, USA
| | - J Kevin Thompson
- Department of Psychology, University of South Florida, Tampa, FL 33620, USA
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13
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Pollack CC, Emond JA, O'Malley AJ, Byrd A, Green P, Miller KE, Vosoughi S, Gilbert-Diamond D, Onega T. Characterizing the Prevalence of Obesity Misinformation, Factual Content, Stigma, and Positivity on the Social Media Platform Reddit Between 2011 and 2019: Infodemiology Study. J Med Internet Res 2022; 24:e36729. [PMID: 36583929 PMCID: PMC9840103 DOI: 10.2196/36729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/06/2022] [Accepted: 09/07/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Reddit is a popular social media platform that has faced scrutiny for inflammatory language against those with obesity, yet there has been no comprehensive analysis of its obesity-related content. OBJECTIVE We aimed to quantify the presence of 4 types of obesity-related content on Reddit (misinformation, facts, stigma, and positivity) and identify psycholinguistic features that may be enriched within each one. METHODS All sentences (N=764,179) containing "obese" or "obesity" from top-level comments (n=689,447) made on non-age-restricted subreddits (ie, smaller communities within Reddit) between 2011 and 2019 that contained one of a series of keywords were evaluated. Four types of common natural language processing features were extracted: bigram term frequency-inverse document frequency, word embeddings derived from Bidirectional Encoder Representations from Transformers, sentiment from the Valence Aware Dictionary for Sentiment Reasoning, and psycholinguistic features from the Linguistic Inquiry and Word Count Program. These features were used to train an Extreme Gradient Boosting machine learning classifier to label each sentence as 1 of the 4 content categories or other. Two-part hurdle models for semicontinuous data (which use logistic regression to assess the odds of a 0 result and linear regression for continuous data) were used to evaluate whether select psycholinguistic features presented differently in misinformation (compared with facts) or stigma (compared with positivity). RESULTS After removing ambiguous sentences, 0.47% (3610/764,179) of the sentences were labeled as misinformation, 1.88% (14,366/764,179) were labeled as stigma, 1.94% (14,799/764,179) were labeled as positivity, and 8.93% (68,276/764,179) were labeled as facts. Each category had markers that distinguished it from other categories within the data as well as an external corpus. For example, misinformation had a higher average percent of negations (β=3.71, 95% CI 3.53-3.90; P<.001) but a lower average number of words >6 letters (β=-1.47, 95% CI -1.85 to -1.10; P<.001) relative to facts. Stigma had a higher proportion of swear words (β=1.83, 95% CI 1.62-2.04; P<.001) but a lower proportion of first-person singular pronouns (β=-5.30, 95% CI -5.44 to -5.16; P<.001) relative to positivity. CONCLUSIONS There are distinct psycholinguistic properties between types of obesity-related content on Reddit that can be leveraged to rapidly identify deleterious content with minimal human intervention and provide insights into how the Reddit population perceives patients with obesity. Future work should assess whether these properties are shared across languages and other social media platforms.
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Affiliation(s)
- Catherine C Pollack
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Jennifer A Emond
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - A James O'Malley
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH, United States
| | - Anna Byrd
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Peter Green
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Katherine E Miller
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Soroush Vosoughi
- Department of Computer Science, Dartmouth College, Hanover, NH, United States
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Tracy Onega
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
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14
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Tokac U, Brysiewicz P, Chipps J. Public perceptions on Twitter of nurses during the COVID-19 pandemic. Contemp Nurse 2022; 58:414-423. [PMID: 36370034 DOI: 10.1080/10376178.2022.2147850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The use of social media platforms to convey public opinions and attitudes has exponentially increased over the last decade on topics related to health. In all these social media postings related to the pandemic, specific attention has been focused on healthcare professionals, specifically nurses. OBJECTIVE This study aimed to explore how the keyword 'nurse' is located in COVID-19 pandemic-related tweets during a selected period of the pandemic in order to assess public perception. METHODS Tweets related to COVID-19 were downloaded from Twitter for the period January 1st, 2020, to November 11th, 2021. Sentiment analysis was used to identify opinions, emotions, and approaches expressed in tweet which included 'nurse', 'COVID-19', and 'pandemic' as either keyword or hashtags. RESULTS A total of 2,440,696 most used unique words in the downloaded 582,399 tweets were included and the sentiment analysis indicated that 24.4% (n = 595,530) of the tweets demonstrated positive sentiment while 14.1% (n = 343,433) of the tweets demonstrated negative sentiment during COVID-19. Within these results, 17% (n = 416,366) of the tweets included positive basic emotion words of trust and 4.9% (n = 120,654) of joy. In terms of negative basic emotion words, 9.9% (n = 241,758) of the tweets included the word fear, 8.3% (n = 202,179) anticipation, 7.9% (n = 193,145) sadness, 5.7% (n = 139,791) anger, 4.2% (n = 103,936) disgust, and 3.6% (n = 88,338) of the tweets included the word surprised. CONCLUSIONS It is encouraging to note that with the advent of major health crises, public perceptions on social media, appears to portray an image of nurses which reflects the professionalism and values of the profession.
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Affiliation(s)
- Umit Tokac
- UMSL College of Nursing, University of Missouri, One University Boulevard, St Louis, MO 63131-4400, USA
| | - Petra Brysiewicz
- Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Glenwood, Durban, 4041, South Africa
| | - Jennifer Chipps
- School of Nursing, Faculty of Community Health Sciences, University of the Western Cape, 14 Blanckenberg Road, Belville, Capetown, South Africa
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15
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Biefeld SD, Brown CS. Fat, sexy, and human? Perceptions of plus-size sexualized women and dehumanization. Body Image 2022; 42:84-97. [PMID: 35671637 DOI: 10.1016/j.bodyim.2022.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 04/28/2022] [Accepted: 05/10/2022] [Indexed: 11/27/2022]
Abstract
Past research suggests that sexualized women are dehumanized and viewing sexualized images negatively impacts viewers' body image; however, plus-size women are mostly absent from this research. The current studies investigate how sexualization impacts dehumanization of plus-size women and participants' body image. In Study 1 (N = 277, Mage = 19.52, SD =1.77) men and women viewed images of plus-size and thin sexualized and non-sexualized women and rated the women on traits linked to dehumanization. Results indicated that sexualized thin targets were perceived as less human than plus-size sexualized and non-sexualized targets. Plus-size sexualized targets were also perceived as less human than plus-size non-sexualized targets. In Study 2 (N = 500, Mage = 18.98, SD = 1.51) we investigated the impact of viewing sexualized images on participants' feelings about their own body. Results indicated that sexualization, but not body size, impacted women's objectified body consciousness. Men's body esteem was impacted by the body size of the image. Perceived race of the image also impacted feelings of body control for both men and women. Taken together these results highlight that sexualization, at any body size, impacts women's views about themselves and sexualized women, at any body size, are dehumanized.
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16
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Freshwater M, Christensen S, Oshman L, Bays HE. Behavior, motivational interviewing, eating disorders, and obesity management technologies: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 2:100014. [PMID: 37990715 PMCID: PMC10661888 DOI: 10.1016/j.obpill.2022.100014] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 03/19/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) is intended to provide clinicians an overview of "Behavior, Motivational Interviewing, Eating Disorders, and Obesity Management Technologies." Methods The scientific information for this CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS outlines important components of behavior, motivational interviewing, eating disorders, and obesity management technologies as they relate to pre-obesity and obesity. Topics include eating behavior disorder evaluation, the motivations behind eating and physical activity behaviors (including underlying neurophysiology, eating disorders, environmental factors, and personal prioritization), motivational interviewing techniques, and technologies that may assist with pre-obesity/obesity management. Conclusions This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on "Behavior, Motivational Interviewing, Eating Disorders, and Obesity Management Technologies" is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of pre-obesity/obesity. Implementation of appropriate clinical practices in these areas may improve the health of patients, especially those with adverse fat mass and adiposopathic metabolic consequences.
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Affiliation(s)
- Michelle Freshwater
- Diplomate of American Board of Obesity Medicine, Idaho Weight Loss, 801 N Stilson Road, Boise, ID, 83703, USA
| | - Sandra Christensen
- Certificate of Advanced Education in Obesity Medicine, Integrative Medical Weight Management, 2611 NE 125th St, Suite 100B, Seattle, WA, 98125, USA
| | - Lauren Oshman
- Diplomate of American Board of Obesity Medicine, University of Michigan Medical School, 14700 E Old US Hwy 12, Chelsea, MI, 48118, USA
| | - Harold Edward Bays
- Diplomate of American Board of Obesity Medicine, Medical Director/President Louisville Metabolic and Atherosclerosis Research Center, Clinical Associate Professor/University of Louisville Medical School, 3288 Illinois Avenue, Louisville, KY, 40213, USA
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17
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Kite J, Huang BH, Laird Y, Grunseit A, McGill B, Williams K, Bellew B, Thomas M. Influence and effects of weight stigmatisation in media: A systematic. EClinicalMedicine 2022; 48:101464. [PMID: 35706492 PMCID: PMC9125650 DOI: 10.1016/j.eclinm.2022.101464] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 04/26/2022] [Accepted: 05/05/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The lack of a comprehensive understanding of the role of mass media in perpetuating weight stigma hinders policy formulation. We reviewed the influence of mass media on weight stigmatisation and the effectiveness of media-based interventions designed to prevent or reduce stigma. METHODS We conducted a systematic review across seven databases from inception to December 2021. Included studies assessed exposure to or impact of weight stigma in mass media or examined interventions to reduce stigma through media in populations 12+ years. We synthesised data narratively, categorising studies based on similarity in focus to produce a set of integrated findings. The systematic review is registered in PROSPERO (No. CRD42020176306). FINDINGS One-hundred-and-thirteen records were eligible for inclusion from 2402 identified; 95 examined the prevalence of stigmatising content in mass media and its impact on stigma. Weight stigma was prevalent across media types, with the dominant discourse viewing overweight and obesity as an individual responsibility and overlooking systemic factors. Exposure to stigmatising content was found to negatively influence attitudes towards people with overweight or obesity. Few studies considered methods of reducing stigma in the media, with only two testing media-based interventions; their results were promising but limited. INTERPRETATION Weight stigma in media content is prevalent and harmful, but there is little guidance on reducing it. Future research focus needs to shift from assessing prevalence and impacts to weight stigma interventions. FUNDING None.
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Affiliation(s)
- James Kite
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
- Corresponding author.
| | - Bo-Huei Huang
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Yvonne Laird
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Anne Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Bronwyn McGill
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Kathryn Williams
- Charles Perkins Centre, The University of Sydney, NSW, Australia
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Nepean Blue Mountains Local Health District, Kingswood, NSW, Australia
| | - Bill Bellew
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Margaret Thomas
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, NSW, Australia
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18
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Methodological Aspects in Study of Fat Stigma in Social Media Contexts: A Systematic Literature Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12105045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
With increased obesity rates worldwide and the rising popularity in social media usage, we have witnessed a growth in hate speech towards fat/obese people. The severity of hate content has prompted researchers to study public perceptions that give rise to fat stigma from social media discourses. This article presents a systematic literature review of recent literature published in this domain to gauge the current state of research and identify possible research gaps. We have examined existing research (i.e., peer-reviewed articles that were systematically included using the EBSCO discovery service) to study their methodological aspects by reviewing their context, domain, analytical methods, techniques, tools, features and limitations. Our findings reveal that while recent studies have explored fat stigma content in social media, these mostly acquired manual analytical methods regardless of the evolved machine learning, natural language processing and deep learning methods. Although fat stigma in social media has gained enormous attention in current socio-psychological research, there exists a gap between how such research is conducted and what technologies are being applied, which limits in-depth investigations of fat stigma discussions.
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19
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Fan J, Geng H, Liu X, Wang J. The Effects of Online Text Comments on Patients' Choices: The Mediating Roles of Comment Sentiment and Comment Content. Front Psychol 2022; 13:886077. [PMID: 35602747 PMCID: PMC9122346 DOI: 10.3389/fpsyg.2022.886077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
As an increasingly important application of mobile social media usage, online healthcare platforms provide a new avenue for patients to obtain and exchange information, referring not only to online doctor's advice but also to the patients' comments on a doctor. Extant literature has studied the patients' comments facilitated with the direct numeric information gathered in the web pages including the frequencies of "thanks letter," "flowers," and "recommendation scores." Adopting the text analysis method, we analyzed patients' comments on the healthcare platform, focusing on the comments from two aspects, namely, comment contents and content sentiment. Based on the analysis of the data collected from one of the most popular healthcare apps named "Haodaifu" in China, the results show that the vast majority of the comments are positive, which basically follows the L-shaped distribution. Meanwhile, comment sentiment covering sentiment tendency and proportion of positive comments demonstrates significant effects on recent 2-week consultation by a doctor. One of the comment contents "patience explanation" has significant effects both on the total consultation and recent 2-week consultation by a doctor. The research findings indicate that the online preferences for and evaluations on doctors provide strong support and guidance for improving doctor-patient relationships and offer implications for medical practices and healthcare platforms improvement.
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Affiliation(s)
- Jing Fan
- International Business School, Beijing Foreign Studies University, Beijing, China
| | - Huihui Geng
- International Business School, Beijing Foreign Studies University, Beijing, China
- School of Economic and Management, Beijing Polytechnic, Beijing, China
| | - Xuan Liu
- Business School, East China University of Science and Technology, Shanghai, China
| | - Jiachen Wang
- International Business School, Beijing Foreign Studies University, Beijing, China
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20
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Durowaye TD, Rice AR, Konkle ATM, Phillips KP. Public health perinatal promotion during COVID-19 pandemic: a social media analysis. BMC Public Health 2022; 22:895. [PMID: 35513864 PMCID: PMC9069960 DOI: 10.1186/s12889-022-13324-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Canadian public health agencies, both municipal/regional and provincial/territorial, are responsible for promoting population health during pregnancy and the early postnatal period. This study examines how these agencies use web-based and Facebook channels to communicate perinatal health promotion during the emergence of the COVID-19 pandemic. Methods Perinatal health promotion content of websites and Facebook posts from a multijurisdictional and geographically diverse sample of government and non-governmental organizations (NGO) were evaluated using thematic content analysis in 2020. Results Major Facebook perinatal health promotion themes included breastfeeding, infant care, labor/delivery, parenting support and healthy pregnancy. Facebook COVID-19-themed perinatal health promotion peaked in the second quarter of 2020. Websites emphasized COVID-19 transmission routes, disease severity and need for infection control during pregnancy/infant care, whereas Facebook posts focussed on changes to local health services including visitor restrictions. NGO perinatal health promotion reflected organizations’ individual mandates. Conclusions Canadian government use of Facebook to disseminate perinatal health promotion during the COVID-19 pandemic varied in terms of breadth of topics and frequency of posts. There were missed opportunities to nuance transmission/severity risks during pregnancy, thereby proactively countering the spread of misinformation.
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Affiliation(s)
- Toluwanimi D Durowaye
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Alexandra R Rice
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Anne T M Konkle
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada.,University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada
| | - Karen P Phillips
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada.
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21
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Schmid JC, Rose KL, Hadler NL, Amaro X, Frank A, Wilkie E, Chang T, Sonneville KR. Content analysis of the impact of COVID-19 on weight and shape control behaviors and social media content of U.S. adolescents and young adults. Eat Behav 2022; 45:101635. [PMID: 35567879 PMCID: PMC9074298 DOI: 10.1016/j.eatbeh.2022.101635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The current study examines impacts of the COVID-19 pandemic on weight/shape control behaviors among adolescents and young adults in the U.S., and perceived changes to related social media content. METHOD A sample of youth (14-24 years) from MyVoice, a national text-message-based cohort, provided open-ended responses to questions on changes in eating and exercise habits due to concern about weight/shape, and social media content related to weight/shape, during the pandemic. Responses were collected using a secure online platform and analyzed using content analysis. RESULTS Among respondents (n = 939/1153, response rate = 81%), 40.0% adopted behaviors for the purpose of weight/shape control during the pandemic. Nearly half (49.2%) reported seeing posts about weight/shape on social media during the pandemic. DISCUSSION Findings from this study indicate that weight/shape concerns among adolescents and young adults in the U.S. may have increased due to the COVID-19 pandemic, with social media content as a potentially contributing factor.
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Affiliation(s)
- Jane C Schmid
- University of Michigan, School of Public Health, United States of America
| | - Kelsey L Rose
- Boston Children's Hospital, United States of America
| | - Nicole L Hadler
- Department of Mental Health Services, Naval Medical Center San Diego, United States of America
| | - Xochitl Amaro
- University of Michigan, School of Public Health, United States of America
| | - Abby Frank
- Community High School, United States of America
| | - Erin Wilkie
- University of Michigan, School of Public Health, United States of America
| | - Tammy Chang
- Department of Family Medicine, Michigan Medicine, Institute for Healthcare Policy and Innovation, University of Michigan, United States of America
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22
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A comparative assessment of action plans on antimicrobial resistance from OECD and G20 countries using natural language processing. Health Policy 2022; 126:522-533. [DOI: 10.1016/j.healthpol.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/13/2022] [Accepted: 03/22/2022] [Indexed: 11/18/2022]
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23
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Bograd S, Chen B, Kavuluru R. Tracking sentiments toward fat acceptance over a decade on Twitter. Health Informatics J 2022; 28:14604582211065702. [PMID: 34986689 DOI: 10.1177/14604582211065702] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The fat acceptance (FA) movement aims to counteract weight stigma and discrimination against individuals who are overweight/obese. We developed a supervised neural network model to classify sentiment toward the FA movement in tweets and identify links between FA sentiment and various Twitter user characteristics. We collected any tweet containing either "fat acceptance" or "#fatacceptance" from 2010-2019 and obtained 48,974 unique tweets. We independently labeled 2000 of them and implemented/trained an Average stochastic gradient descent Weight-Dropped Long Short-Term Memory (AWD-LSTM) neural network that incorporates transfer learning from language modeling to automatically identify each tweet's stance toward the FA movement. Our model achieved nearly 80% average precision and recall in classifying "supporting" and "opposing" tweets. Applying this model to the complete dataset, we observed that the majority of tweets at the beginning of the last decade supported FA, but sentiment trended downward until 2016, when support was at its lowest. Overall, public sentiment is negative across Twitter. Users who tweet more about FA or use FA-related hashtags are more supportive than general users. Our findings reveal both challenges to and strengths of the modern FA movement, with implications for those who wish to reduce societal weight stigma.
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Affiliation(s)
- Sadie Bograd
- 326741Paul Laurence Dunbar High School, Lexington, KY USA
| | - Benjamin Chen
- 326741Paul Laurence Dunbar High School, Lexington, KY, USA
| | - Ramakanth Kavuluru
- Department of Internal Medicine, 4530University of Kentucky, Lexington, KY, USA
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24
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Wanniarachchi VU, Scogings C, Susnjak T, Mathrani A. Fat stigma and body objectification: A text analysis approach using social media content. Digit Health 2022; 8:20552076221117404. [PMID: 35990109 PMCID: PMC9386857 DOI: 10.1177/20552076221117404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/15/2022] [Indexed: 11/21/2022] Open
Abstract
This study investigates how female and male genders are positioned in fat stigmatising discourses that are being conducted over social media. Weight-based linguistic data corpus, extracted from three popular social media (SM) outlets, Twitter, YouTube and Reddit, was examined for fat stigmatising content. A mixed-method analysis comprising sentiment analysis, word co-occurrences and qualitative analysis, assisted our investigation of the corpus for body objectification themes and gender-based differences. Objectification theory provided the underlying framework to examine the experiential consequences of being fat across both genders. Five objectifying themes, namely, attractiveness, physical appearance, lifestyle choices, health and psychological well-being, emerged from the analysis. A deeper investigation into more facets of the social interaction data revealed overall positive and negative attitudes towards obesity, which informed on existing notions of gendered body objectification and weight/fat stigmatisation. Our findings have provided a holistic outlook on weight/fat stigmatising content that is posted online which can further inform policymakers in planning suitable props to facilitate more inclusive SM spaces. This study showcases how lexical analytics can be conducted by combining a variety of data mining methods to draw out insightful subject-related themes that add to the existing knowledge base; therefore, has both practical and theoretical implications.
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Affiliation(s)
| | - Chris Scogings
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
| | - Teo Susnjak
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
| | - Anuradha Mathrani
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
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25
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Chaturvedi J, Mascio A, Velupillai SU, Roberts A. Development of a Lexicon for Pain. Front Digit Health 2021; 3:778305. [PMID: 34966903 PMCID: PMC8710455 DOI: 10.3389/fdgth.2021.778305] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/24/2021] [Indexed: 11/15/2022] Open
Abstract
Pain has been an area of growing interest in the past decade and is known to be associated with mental health issues. Due to the ambiguous nature of how pain is described in text, it presents a unique natural language processing (NLP) challenge. Understanding how pain is described in text and utilizing this knowledge to improve NLP tasks would be of substantial clinical importance. Not much work has previously been done in this space. For this reason, and in order to develop an English lexicon for use in NLP applications, an exploration of pain concepts within free text was conducted. The exploratory text sources included two hospital databases, a social media platform (Twitter), and an online community (Reddit). This exploration helped select appropriate sources and inform the construction of a pain lexicon. The terms within the final lexicon were derived from three sources—literature, ontologies, and word embedding models. This lexicon was validated by two clinicians as well as compared to an existing 26-term pain sub-ontology and MeSH (Medical Subject Headings) terms. The final validated lexicon consists of 382 terms and will be used in downstream NLP tasks by helping select appropriate pain-related documents from electronic health record (EHR) databases, as well as pre-annotating these words to help in development of an NLP application for classification of mentions of pain within the documents. The lexicon and the code used to generate the embedding models have been made publicly available.
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Affiliation(s)
- Jaya Chaturvedi
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Aurelie Mascio
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Sumithra U Velupillai
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Angus Roberts
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom.,Health Data Research UK, London, United Kingdom
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Esthetic Dentistry on Twitter: Benefits and Dangers. Int J Dent 2021; 2021:5077886. [PMID: 34925512 PMCID: PMC8674081 DOI: 10.1155/2021/5077886] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/20/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives The demand for esthetic dentistry is growing, and social media constitute the main driving force behind this revolution. Twitter is a leading social media platform; however, there is a lack of research on the pattern of communications and the impact of Twitter on esthetic dentistry. The purpose of this study was to analyze the content of tweets related to esthetic dentistry and to investigate how Twitter has affected the perception of, and demand for, esthetic dentistry. Moreover, it aimed to assess the potential benefits and risks of esthetic dentistry advertising strategies on Twitter as a potential social media platform. Materials and Methods Using a specialized web scrapping tool made available by the Python programming language, a total of 54,000 public tweets were downloaded from Twitter at real-time by matching specific keywords. The downloaded tweets were manually filtered, and 13,787 tweets were included and categorized into four tweet sets by content. Results The main categories were tweets regarding specific cosmetic procedure, totaling 56.53% (43.2% for veneers, 13.3% for whitening), advertisements (36.72%), information (5.53%), and general cosmetic dentistry (1.22%). Negative opinions towards veneers and whitening were the most common themes (68.03% and 43.44%). For veneers, illegal use for kids was the most common negative theme (59.7%) and being destructive for whitening (86.3%). Positive opinions counted 6.26% of veneers and 4.3% of whitening tweets. Advertising for whitening products was the second most common between all tweets (16.6%), and advertising for dental practices was the third (14.7%). Presenting facilities/services was the most common marketing strategy for dental practices (49.7%). Twitter was weakly used to circulate educational content (5.5%) and to post reviews (0.75%). Conclusion Twitter was extensively used to share experiences/opinions towards dental cosmetic interventions. Advertising is another vital use of this platform. However, circulating information was the least common use of this social media. Additionally, tweeters were rarely to post online reviews and specific advices and recommendations regarding esthetic dentistry. Moreover, females tended to participate and tweet more significantly in cosmetic-related topics than males. This platform should be tailored efficiently to target users' priorities and to improve health literacy and self-care. Twitter was weakly used to circulate educational content according to this study and rarely used to share online reviews.
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Clark O, Lee MM, Jingree ML, O'Dwyer E, Yue Y, Marrero A, Tamez M, Bhupathiraju SN, Mattei J. Weight Stigma and Social Media: Evidence and Public Health Solutions. Front Nutr 2021; 8:739056. [PMID: 34869519 PMCID: PMC8632711 DOI: 10.3389/fnut.2021.739056] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/18/2021] [Indexed: 12/22/2022] Open
Abstract
Weight stigma is a pressing issue that affects individuals across the weight distribution. The role of social media in both alleviating and exacerbating weight bias has received growing attention. On one hand, biased algorithms on social media platforms may filter out posts from individuals in stigmatized groups and concentrate exposure to content that perpetuates problematic norms about weight. Individuals may also be more likely to engage in attacks due to increased anonymity and lack of substantive consequences online. The critical influence of social media in shaping beliefs may also lead to the internalization of weight stigma. However, social media could also be used as a positive agent of change. Movements such as Body Positivity, the Fatosphere, and Health at Every Size have helped counter negative stereotypes and provide more inclusive spaces. To support these efforts, governments should continue to explore legislative solutions to enact anti-weight discrimination policies, and platforms should invest in diverse content moderation teams with dedicated weight bias training while interrogating bias in existing algorithms. Public health practitioners and clinicians should leverage social media as a tool in weight management interventions and increase awareness of stigmatizing online content among their patients. Finally, researchers must explore how experiences of stigma differ across in-person and virtual settings and critically evaluate existing research methodologies and terminology. Addressing weight stigma on social media will take a concerted effort across an expansive set of stakeholders, but the benefits to population health are consequential and well-worth our collective attention.
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Affiliation(s)
- Olivia Clark
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Matthew M Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Muksha Luxmi Jingree
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Erin O'Dwyer
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Yiyang Yue
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Abrania Marrero
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Martha Tamez
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.,Brigham and Women's Hospital, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Alvarez-Mon MA, Llavero-Valero M, Asunsolo Del Barco A, Zaragozá C, Ortega MA, Lahera G, Quintero J, Alvarez-Mon M. Areas of Interest and Attitudes Toward Antiobesity Drugs: Thematic and Quantitative Analysis Using Twitter. J Med Internet Res 2021; 23:e24336. [PMID: 34698653 PMCID: PMC8579215 DOI: 10.2196/24336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/02/2020] [Accepted: 08/12/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Antiobesity drugs are prescribed for the treatment of obesity in conjunction with healthy eating, physical activity, and behavior modification. However, poor adherence rates have been reported. Attitudes or beliefs toward medications are important to ascertain because they may be associated with patient behavior. The analysis of tweets has become a tool for health research. OBJECTIVE The aim of this study is to investigate the content and key metrics of tweets referring to antiobesity drugs. METHODS In this observational quantitative and qualitative study, we focused on tweets containing hashtags related to antiobesity drugs between September 20, 2019, and October 31, 2019. Tweets were first classified according to whether they described medical issues or not. Tweets with medical content were classified according to the topic they referred to: side effects, efficacy, or adherence. We additionally rated it as positive or negative. Furthermore, we classified any links included within a tweet as either scientific or nonscientific. Finally, the number of retweets generated as well as the dissemination and sentiment score obtained by the antiobesity drugs analyzed were also measured. RESULTS We analyzed a total of 2045 tweets, 945 of which were excluded according to the criteria of the study. Finally, 320 out of the 1,100 remaining tweets were also excluded because their content, although related to drugs for obesity treatment, did not address the efficacy, side effects, or adherence to medication. Liraglutide and semaglutide accumulated the majority of tweets (682/780, 87.4%). Notably, the content that generated the highest frequency of tweets was related to treatment efficacy, with liraglutide-, semaglutide-, and lorcaserin-related tweets accumulating the highest proportion of positive consideration. We found the highest percentages of tweets with scientific links in those posts related to liraglutide and semaglutide. Semaglutide-related tweets obtained the highest probability of likes and were the most disseminated within the Twitter community. CONCLUSIONS This analysis of posted tweets related to antiobesity drugs shows that the interest, beliefs, and experiences regarding these pharmacological treatments are heterogeneous. The efficacy of the treatment accounts for the majority of interest among Twitter users.
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Affiliation(s)
- Miguel Angel Alvarez-Mon
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain.,Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain
| | - Maria Llavero-Valero
- Department of Endocrinology and Clinical Nutrition, Hospital Universitario Infanta Leonor, Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
| | - Angel Asunsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Madrid, Spain.,Ramón y Cajal Institute of Sanitary Research, Madrid, Spain
| | - Cristina Zaragozá
- Pharmacology Unit, Biomedical Sciences Department, University of Alcalá, Madrid, Spain
| | - Miguel A Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain.,Ramón y Cajal Institute of Sanitary Research, Madrid, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain.,Ramón y Cajal Institute of Sanitary Research, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.,Psychiatry Service, Hospital Universitario Principe de Asturias, Alcalá de Henares, Spain
| | - Javier Quintero
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain.,Department of Legal Medicine and Psychiatry, Complutense University, Madrid, Spain
| | - Melchor Alvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain.,Ramón y Cajal Institute of Sanitary Research, Madrid, Spain.,Internal Medicine and Autoimmunity/Rheumatology Service, Hospital Universitario Principe de Asturias, Madrid, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Madrid, Spain
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Lazarus JV, Kakalou C, Palayew A, Karamanidou C, Maramis C, Natsiavas P, Picchio CA, Villota-Rivas M, Zelber-Sagi S, Carrieri P. A Twitter discourse analysis of negative feelings and stigma related to NAFLD, NASH and obesity. Liver Int 2021; 41:2295-2307. [PMID: 34022107 DOI: 10.1111/liv.14969] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/27/2021] [Accepted: 05/18/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND People with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are stigmatized, partly since 'non-alcoholic' is in the name, but also because of obesity, which is a common condition in this group. Stigma is pervasive in social media and can contribute to poorer health outcomes. We examine how stigma and negative feelings concerning NAFLD/NASH and obesity manifest on Twitter. METHODS Using a self-developed search terms index, we collected NAFLD/NASH tweets from May to October 2019 (Phase I). Because stigmatizing NAFLD/NASH tweets were limited, Phase II focused on obesity (November-December 2019). Via sentiment analysis, >5000 tweets were annotated as positive, neutral or negative and used to train machine learning-based Natural Language Processing software, applied to 193 747 randomly sampled tweets. All tweets collected were analysed. RESULTS In Phase I, 16 835 tweets for NAFLD and 2376 for NASH were retrieved. Of the annotated NAFLD/NASH tweets, 97/1130 (8.6%) and 63/535 (11.8%), respectively, related to obesity and 13/1130 (1.2%) and 5/535 (0.9%), to stigma; they primarily focused on scientific discourse and unverified information. Of the 193 747 non-annotated obesity tweets (Phase II), the algorithm classified 40.0% as related to obesity, of which 85.2% were negative, 1.0% positive and 13.7% neutral. CONCLUSIONS NAFLD/NASH tweets mostly indicated an unmet information need and showed no clear signs of stigma. However, the negative content of obesity tweets was recurrent. As obesity-related stigma is associated with reduced care engagement and lifestyle modification, the main NAFLD/NASH treatment, stigma-reducing interventions in social media should be included in the liver health agenda.
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Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Christine Kakalou
- Institute of Applied Biosciences, Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - Adam Palayew
- McGill Department of Epidemiology, Biostatistics, and Occupational Health, Montreal, QC, Canada
| | - Christina Karamanidou
- Institute of Applied Biosciences, Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - Christos Maramis
- Institute of Applied Biosciences, Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - Pantelis Natsiavas
- Institute of Applied Biosciences, Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - Camila A Picchio
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Marcela Villota-Rivas
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Shira Zelber-Sagi
- School of Public Health, University of Haifa, Haifa, Israel.,Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
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Lessard LM, Puhl RM. Adolescents' Exposure to and Experiences of Weight Stigma During the COVID-19 Pandemic. J Pediatr Psychol 2021; 46:950-959. [PMID: 34313727 PMCID: PMC8344898 DOI: 10.1093/jpepsy/jsab071] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has increased attention to the proliferation of pediatric obesity amidst significant changes in weight-related health functioning (e.g., compromised physical activity, limited food access, increased stress). The present cross-sectional study investigated adolescents' feelings about their bodies and perceived changes in weight stigma from peers, parents, and social media during the pandemic. METHODS Four hundred fifty-two adolescents (11-17 years old) completed an online survey during the Fall of 2020. Measures assessed perceived changes in exposure to weight stigmatizing social media content (stress eating jokes, weight gain memes) and experiences of weight stigma (weight-based bullying, teasing, hurtful comments) by parents and peers, as well as body dissatisfaction, during the COVID-19 pandemic. Weight status and gender were examined as individual difference variables. RESULTS The majority (53%) of adolescents reported increased exposure to at least one form of weight stigmatizing social media content during the pandemic. Additionally, pandemic-related increases in body dissatisfaction were prevalent (41%), especially among girls with higher body mass index (≥85th percentile; 67%). On average, the extent to which adolescents experienced weight-based mistreatment from parents and peers remained consistent with their pre-pandemic experiences. CONCLUSIONS Overall, these findings highlight changes in the social messages that adolescents receive about their bodies, as well as their subjective body satisfaction, during the pandemic. Results underscore the need for healthcare providers and mental health professionals to be aware of the potential rise in weight stigma during the pandemic, and encourage families and schools to engage in supportive, rather than stigmatizing, weight-related communication with youth.
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Affiliation(s)
- Leah M Lessard
- Rudd Center for Food Policy and Obesity, University of Connecticut
| | - Rebecca M Puhl
- Rudd Center for Food Policy and Obesity, University of Connecticut
- Department of Human Development & Family Sciences, University of Connecticut
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31
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Klein WMP, O'Connell ME, Bloch MH, Czajkowski SM, Green PA, Han PKJ, Moser RP, Nebeling LC, Vanderpool RC. Behavioral Research in Cancer Prevention and Control: Emerging Challenges and Opportunities. J Natl Cancer Inst 2021; 114:179-186. [PMID: 34240206 PMCID: PMC8344826 DOI: 10.1093/jnci/djab139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/25/2021] [Accepted: 07/02/2021] [Indexed: 12/24/2022] Open
Abstract
It is estimated that behaviors such as poor diet, alcohol consumption, tobacco use, sedentary behavior, and excessive ultraviolet exposure account for nearly one-half of all cancer morbidity and mortality. Accordingly, the behavioral, social, and communication sciences have been important contributors to cancer prevention and control research, with methodological advances and implementation science helping to produce optimally effective interventions. To sustain these contributions, it is vital to adapt to the contemporary context. Efforts must consider ancillary effects of the 2019 coronavirus disease pandemic, profound changes in the information environment and public understanding of and trust in science, renewed attention to structural racism and social determinants of health, and the rapidly increasing population of cancer survivors. Within this context, it is essential to accelerate reductions in tobacco use across all population subgroups; consider new models of energy balance (diet, physical activity, sedentary behavior); increase awareness of alcohol as a risk factor for cancer; and identify better communication practices in the context of cancer-related decisions such as screening and genetic testing. Successful integration of behavioral research and cancer prevention depends on working globally and seamlessly across disciplines, taking a multilevel approach where possible. Methodological and analytic approaches should be emphasized in research training programs and should use new and underused data sources and technologies. As the leadership core of the National Cancer Institute’s Behavioral Research Program, we reflect on these challenges and opportunities and consider implications for the next phase of behavioral research in cancer prevention and control.
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Affiliation(s)
- William M P Klein
- Associate Director, Behavioral Research Program, National Cancer Institute
| | - Mary E O'Connell
- Scientific Program Manager, Behavioral Research Program, National Cancer Institute
| | - Michele H Bloch
- Chief, Tobacco Control Research Branch, National Cancer Institute
| | | | - Paige A Green
- Chief, Basic Biobehavioral/Psychological Sciences Research Branch, National Cancer Institute
| | - Paul K J Han
- Senior Scientist, Behavioral Research Program, National Cancer Institute
| | - Richard P Moser
- Training Director and Research Methods Coordinator, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Linda C Nebeling
- Deputy Associate Director, Behavioral Research Program, National Cancer Institute
| | - Robin C Vanderpool
- Chief, Health Communication and Informatics Research Branch, National Cancer Institute
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Chirumamilla S, Gulati M. Patient Education and Engagement through Social Media. Curr Cardiol Rev 2021; 17:137-143. [PMID: 31752656 PMCID: PMC8226210 DOI: 10.2174/1573403x15666191120115107] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/26/2019] [Accepted: 10/08/2019] [Indexed: 12/20/2022] Open
Abstract
This review addresses the demographics of social media users and their relative health literacy. Means of overcoming health inequities via social media and the role of social media in patient education and engagement are explored. This review discusses forms of appropriate patient engagement, including the pitfalls of social media use.
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Affiliation(s)
- Sravya Chirumamilla
- Huntsville Heart Center, 930 Franklin St SE, Huntsville, AL 35801, United States
| | - Martha Gulati
- Division of Cardiology, University of Arizona- Phoenix, 475 N. 5th Street, Phoenix, AZ 85004, United States
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Abstract
PURPOSE OF REVIEW This review explores potential sources of weight bias and stigma during the COVID-19 pandemic, including "quarantine-15" messages and discussion of obesity in media and public health campaigns. We examine evidence of the effects of weight bias on well-being during the pandemic and highlight unanswered questions to be addressed in future research. RECENT FINDINGS Studies that have investigated weight change during stay-at-home orders have yielded mixed findings and relied predominantly on self-reported retrospective recall, thus providing weak evidence of a widespread "quarantine-15" effect. No studies to date have evaluated the effects on weight stigma and health of obesity-focused COVID-19 media and public health messages. Individuals with a history of experiencing weight bias may be more vulnerable to binge eating and psychological distress during the pandemic. Weight bias and stigma during the COVID-19 pandemic, and their effects on health and well-being, warrant greater investigation and consideration in public health efforts.
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Affiliation(s)
- Rebecca L Pearl
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | - Erica M Schulte
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Ventura V, Cavaliere A, Iannò B. #Socialfood: Virtuous or vicious? A systematic review. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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35
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Batsis JA, Zagaria AB, Brooks E, Clark MM, Phelan S, Lopez-Jimenez F, Bartels SJ, Rotenberg S, Carpenter-Song E. The Use and Meaning of the Term Obesity in Rural Older Adults: A Qualitative Study. J Appl Gerontol 2021; 40:423-432. [PMID: 32065013 PMCID: PMC7429325 DOI: 10.1177/0733464820903253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The term "obesity" is associated with societal stigma and discrimination. Eight individual semi-structured interviews and five focus groups with 29 community-dwelling, rural older adults with obesity, seven primary care clinicians, and four rural community leaders were completed using purposive and snowball sampling. Clinicians perceived that older adults are less affected by obesity stigma than younger adults, yet this was not observed by community leaders; however, older participants with obesity reported that they often felt ashamed and/or stigmatized because of their weight. There was also a disconnect between clinician and older adult understanding of obesity. For older adults with obesity, the word "obesity" was associated with negative connotations. Just as physiological aspects of obesity persist into older adulthood, so do psychological aspects, such as perceptions of stigma. The use of the word "obesity" in medical settings may hinder communication between clinician and older participants. Heightened awareness may change the dialogue around obesity.
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Affiliation(s)
- John A. Batsis
- Geisel School of Medicine and The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
- Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
- Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, NH
- Health Promotion Research Center at Dartmouth, Lebanon, NH
| | - Alexandra B. Zagaria
- Geisel School of Medicine and The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
| | - Emma Brooks
- Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, NH
- Section of Weight & Wellness, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Matthew M. Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Sean Phelan
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN
| | | | | | - Sivan Rotenberg
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, NH
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Do caregivers who connect online have better outcomes? A systematic review of online peer-support interventions for caregivers of people with stroke, dementia, traumatic brain injury, Parkinson’s disease and multiple sclerosis. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
AbstractBackground and Objectives:This systematic review aimed to identify and appraise the evidence for online peer-support interventions for caregivers of stroke survivors (with and without aphasia), and people with dementia, traumatic brain injury (TBI), Parkinson’s disease and multiple sclerosis.Research Design and Methods:Systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases were systematically searched up until September 2020: EMBASE, PubMed, CINAHL, Scopus and Web of Science. Two reviewers independently screened titles, abstracts and full-text articles. The methodological quality of included studies was assessed using Physiotherapy Evidence Database (PEDro) and Mixed-Methods Appraisal Tool (MMAT) scales. Interventions were described using the Template for Intervention Description and Replication (TIDieR) checklist.Results:A total of 3026 records were identified from database searches. Following screening, 18 studies reporting 17 interventions were included in this review. Most studies (n = 13) reported interventions for caregivers of people with dementia. All studies incorporated an element of peer support as part of the intervention, however, most interventions (n = 15) comprised both psychosocial and educational elements. Statistically significant changes were reported for 11 interventions in one or more of the following domains: caregiver knowledge, mental health, stress, depression, distress, burden, self-efficacy, mastery, helplessness and perceived support. Qualitative outcomes included perceived reductions in stress and increased emotional and informational support.Discussion and Implications:Positive changes in caregiver outcomes were identified in response to multi-component online interventions (i.e., peer support in addition to education). Peer support was often poorly described, limiting the conclusions that could be drawn about the intervention components which result in better outcomes. Online interventions may provide an accessible and effective means of supporting caregivers.
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Fung XCC, Siu AMH, Potenza MN, O'Brien KS, Latner JD, Chen CY, Chen IH, Lin CY. Problematic Use of Internet-Related Activities and Perceived Weight Stigma in Schoolchildren: A Longitudinal Study Across Different Epidemic Periods of COVID-19 in China. Front Psychiatry 2021; 12:675839. [PMID: 34108898 PMCID: PMC8183469 DOI: 10.3389/fpsyt.2021.675839] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Social distancing and school suspension due to the coronavirus pandemic (COVID-19) may have a negative impact on children's behavior and well-being. Problematic smartphone use (PSU), problematic social media use (PSMU) and perceived weight stigma (PWS) are particularly important issues for children, yet we have a poor understanding of how these may have been affected by lockdowns and physical isolation resulting from COVID-19. This research aimed to understand how these psychosocial and behavioral variables may be associated with psychological distress, and how these associations may have changed during the COVID-19 pandemic. Methods: A total of 489 children completed a three-wave longitudinal study from January 2020 to June 2020. The first wave was conducted before the COVID-19 outbreak. The second wave was conducted during the outbreak. The third wave was conducted during post-COVID-19 lockdown. Questionnaires measured psychological distress, PSU, PSMU, and PWS. Results: PSU, PSMU, PWS and psychological distress were all significantly associated with each other. PSU was significantly higher during outbreak. PWS was significantly higher before outbreak. We found an increased association between PSMU and PWS across three waves in all three models. The association between PSU and depression/anxiety decreased across three waves; however, association between PSMU and depression/anxiety increased across three waves. Conclusions: COVID-19 initiated school suspension and associated lockdowns appear to have exacerbated PSU and depression among children. However, PWS was reduced during this period. Children should use smartphones and social media safely and cautiously, and be aware of the potential exposure to weight stigmatization.
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Affiliation(s)
- Xavier C C Fung
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Andrew M H Siu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, United States.,Connecticut Council on Problem Gambling, Wethersfield, CT, United States
| | - Kerry S O'Brien
- School of Social Sciences, Faculty of Arts, Monash University, Melbourne, VIC, Australia
| | - Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Chao-Ying Chen
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I-Hua Chen
- International College, Krirk University, Bangkok, Thailand.,School of Education Science, Minnan Normal University, Zhangzhou, China
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Earnshaw VA, Karpyn A. Understanding stigma and food inequity: a conceptual framework to inform research, intervention, and policy. Transl Behav Med 2020; 10:1350-1357. [PMID: 33421077 PMCID: PMC8218858 DOI: 10.1093/tbm/ibaa087] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
There is increasing understanding that stigma associated with poverty, race, nationality, gender, obesity, and other intersecting, socially devalued characteristics is a key social determinant of health that plays a role in food inequities; yet, the processes linking stigma with food inequities are poorly defined. Building on prior conceptual and empirical stigma research in public health, this paper introduces The Stigma and Food Inequity Framework. Supporting empirical evidence for the associations proposed by the framework is reviewed. The framework proposes that stigma is manifested at the structural (e.g., neighborhood infrastructure and targeted marketing) and individual (e.g., internalized stigma and stereotypes) levels. These stigma manifestations are associated with food inequities via a series of mediating mechanisms, including access to resources, the home food environment, and psychosocial and behavioral processes, which ultimately undermine healthy food consumption, contribute to food insecurity, and impact diet quality. The framework further proposes that processes linking stigma with food inequities are situated within contexts of history, culture, and human development. Future directions to address stigma and enhance food equity include the value of addressing the broad range of underlying structural stigma manifestations when creating policy to promote food equity.
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Affiliation(s)
- Valerie A Earnshaw
- Human Development and Family Sciences, University of Delaware, Newark, DE, USA
| | - Allison Karpyn
- Human Development and Family Sciences, University of Delaware, Newark, DE, USA
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Grannell A, le Roux CW, McGillicuddy D. "I am terrified of something happening to me" The lived experience of people with obesity during the COVID-19 pandemic. Clin Obes 2020; 10:e12406. [PMID: 32885595 DOI: 10.1111/cob.12406] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/22/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022]
Abstract
Obesity is emerging as a risk factor for COVID-19 disease severity. The impact of the pandemic and knowledge of obesity as a risk factor on the lived experience of people with obesity is not fully understood. The aim of this study was to investigate the impact of the COVID-19 pandemic on people living with severe obesity (BMI ≥35 kg/m2 ), currently engaged in multi-modal treatment. The primary objectives were to examine the impact of the pandemic on their lived experience from a treatment and psychosocial standpoint and additionally explore their awareness of obesity as a risk factor for COVID-19 disease severity. An in-depth qualitative study was adopted employing semi-structured interviews with open-ended questions. Interpretive thematic analysis was adopted to analyse the data and identify key themes taking a grounded approach. Themes that emerged from the perspective of impact on lived experience were (a) challenge sustaining treatment and (b) psychosocial impact. There was an even split regarding awareness and lack of awareness of obesity as risk factor which itself contributes towards a negative psychosocial impact in most patients. The COVID-19 pandemic is posing a diverse challenge to people with obesity. This has implications for their on-going treatment. From an ethical standpoint, there is a need to fully elucidate the link between obesity and COVID-19, disseminate this information using people friendly language and imagery in a manner that does not exacerbate a harmful psychosocial response or lead to stigmatization.
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Affiliation(s)
- Andrew Grannell
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
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40
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El-Awaisi A, O’Carroll V, Koraysh S, Koummich S, Huber M. Perceptions of who is in the healthcare team? A content analysis of social media posts during COVID-19 pandemic. J Interprof Care 2020; 34:622-632. [DOI: 10.1080/13561820.2020.1819779] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Alla El-Awaisi
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | | | - Somaya Koraysh
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Sarra Koummich
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Marion Huber
- ZHAW School of Health Professions, Zurich University of Applied Sciences, Zurich, Switzerland
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Walker T, Molenaar A, Palermo C. A qualitative study exploring what it means to be healthy for young Indigenous Australians and the role of social media in influencing health behaviour. Health Promot J Austr 2020; 32:532-540. [PMID: 32726490 DOI: 10.1002/hpja.391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 07/20/2020] [Indexed: 02/03/2023] Open
Abstract
ISSUE ADDRESSED This study explored what it means to young Indigenous people to be healthy and how social media influences health behaviours. METHODS Indigenous people (17-24 years) participated in face-to-face interviews or online Facebook conversations. Discussions were informed by the Integrated Model of Behaviour Change exploring perceptions of self, health and wellbeing, social media use, decision making around health and environmental influences on their health. Interviews and online conversations were analysed using thematic analysis. RESULTS Eighteen young Indigenous Australians participated. Three themes were identified (a) Family and community connection in constructing health beliefs; (b) Individual health-seeking behaviours, mental health status and the importance of physical activity; and (c) peers and others were key influencers of health behaviour on social media. CONCLUSIONS Social connection and social media may provide platforms for young Indigenous people to facilitate exchange of culturally relevant information and encourage behaviour change alongside family, peer and community support. SO WHAT?: Unless accompanied with environmental changes, young adults may struggle to assert their individual agency and realise healthful behaviours, therefore strategies to change the environment are urgently required.
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Affiliation(s)
- Troy Walker
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Annika Molenaar
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
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42
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Pearl RL. Weight Stigma and the "Quarantine-15". Obesity (Silver Spring) 2020; 28:1180-1181. [PMID: 32324954 PMCID: PMC7264559 DOI: 10.1002/oby.22850] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Rebecca L. Pearl
- Center for Weight and Eating DisordersDepartment of PsychiatryPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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43
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Pilozzi A, Huang X. Overcoming Alzheimer's Disease Stigma by Leveraging Artificial Intelligence and Blockchain Technologies. Brain Sci 2020; 10:E183. [PMID: 32210011 PMCID: PMC7139597 DOI: 10.3390/brainsci10030183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/11/2020] [Accepted: 03/20/2020] [Indexed: 01/19/2023] Open
Abstract
Alzheimer's disease (AD) imposes a considerable burden on those diagnosed. Faced with a neurodegenerative decline for which there is no effective cure or prevention method, sufferers of the disease are subject to judgement, both self-imposed and otherwise, that can have a great deal of effect on their lives. The burden of this stigma is more than just psychological, as reluctance to face an AD diagnosis can lead people to avoid early diagnosis, treatment, and research opportunities that may be beneficial to them, and that may help progress towards fighting AD and its progression. In this review, we discuss how recent advents in information technology may be employed to help fight this stigma. Using artificial intelligence (AI) technologies, specifically natural language processing (NLP), to classify the sentiment and tone of texts, such as those of online posts on various social media sites, has proven to be an effective tool for assessing the opinions of the general public on certain topics. These tools can be used to analyze the public stigma surrounding AD. Additionally, there is much concern among individuals that an AD diagnosis, or evidence of pre-clinical AD such as a biomarker or imaging test results, may wind up unintentionally disclosed to an entity that may discriminate against them. The lackluster security record of many medical institutions justifies this fear to an extent. Adopting more secure and decentralized methods of data transfer and storage, and giving patients enhanced ability to control their own data, such as a blockchain-based method, may help to alleviate some of these fears.
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Affiliation(s)
| | - Xudong Huang
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA;
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Garvey WT, Mechanick JI. Proposal for a Scientifically Correct and Medically Actionable Disease Classification System (ICD) for Obesity. Obesity (Silver Spring) 2020; 28:484-492. [PMID: 32090513 PMCID: PMC7045990 DOI: 10.1002/oby.22727] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/25/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Obesity is responsible for a huge burden of suffering and social costs, and yet many patients lack access to evidence-based therapies. The diagnostic term "obesity" and inadequate International Classification of Diseases(ICD) codes contribute to suboptimal efforts to prevent and treat obesity as a chronic disease. The goal of this review is to develop a medically actionable classification system based on the diagnostic term "adiposity-based chronic disease" (ABCD) that reflects disease pathophysiology and specific complications causing morbidity and mortality. METHODS A coding system based on the diagnosis of ABCD with four domains is proposed: A codes reflect pathophysiology, B codes indicate BMI classification, C codes specify specific biomechanical and cardiovascular complications remediable by weight loss, and D codes indicate the degree of the severity of complications. Supplemental codes identify aggravating factors that complicate care and that are relevant to a personalized therapeutic plan. RESULTS The coding system addresses pathophysiology and therapeutic goals and differential risk, presence, and severity of specific complications that are integral to ABCD as a chronic disease. CONCLUSIONS The scientifically correct and medically actionable approach to diagnosis and disease coding will lead to greater acknowledgement of ABCD as a disease and accessibility to evidence-based therapies on behalf of patients across the life cycle.
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Affiliation(s)
- W. Timothy Garvey
- Charles E. Butterworth, Jr. Professor, Department of Nutrition Sciences, University of Alabama at Birmingham, Director UAB Diabetes Research Center, Physician Scientist and GRECC Investigator, Birmingham VA Medical Center
| | - Jeffrey I. Mechanick
- Professor of Medicine, Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Medical Director, the Marie-Josée and Henry R. Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Director, Metabolic Support, Icahn School of Medicine at Mount Sinai
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45
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Emmer C, Bosnjak M, Mata J. The association between weight stigma and mental health: A meta-analysis. Obes Rev 2020; 21:e12935. [PMID: 31507062 DOI: 10.1111/obr.12935] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/26/2019] [Accepted: 07/14/2019] [Indexed: 10/26/2022]
Abstract
In recent years, there has been considerable research on the relation between weight stigma and mental health, but no quantitative synthesis of the empirical evidence is available to date. This meta-analysis (105 studies, 59 172 participants, and 497 effect sizes) fills this gap by quantifying the association between weight stigma and mental health. Age, gender, and factors presumed to exert a protective role (i.e., adaptive coping strategies and perceived social support) were tested as potential moderators. The three-level meta-analytic model estimated under a random effects assumption revealed a medium to large negative association between weight stigma and mental health (r = -0.35). The overall association remained significant when controlling for publication year, education, and body weight. There was substantial heterogeneity in effect sizes between studies (I2 = 43%) and within studies (I2 = 56%). Surprisingly, all moderator hypotheses had to be rejected. Body weight was a significant moderator, indicating a stronger association between weight stigma and diminished mental health with increasing body mass index. Future research might focus on explaining the heterogeneity of findings and on testing causality as well as potential underlying mechanisms.
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Affiliation(s)
- Christine Emmer
- Health Psychology, University of Mannheim, Mannheim, Germany
| | - Michael Bosnjak
- ZPID-Leibniz Institute for Psychology Information and University of Trier, Trier, Germany
| | - Jutta Mata
- Health Psychology, University of Mannheim, Mannheim, Germany
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46
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Myre M, Berry TR, Ball GDC, Hussey B. Motivated, Fit, and Strong-Using Counter-Stereotypical Images to Reduce Weight Stigma Internalisation in Women with Obesity. Appl Psychol Health Well Being 2019; 12:335-356. [PMID: 31714033 DOI: 10.1111/aphw.12187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/30/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aimed to use implicit retraining to change automatic associations between body size and physical activity (PA) in women with obesity to reduce weight bias internalisation (WBI). METHODS A Solomon-square experimental design was used to determine the effect of a four-week online implicit retraining intervention on WBI (primary measure) and PA attitudes, self-efficacy, and self-reported behaviour (secondary measures). The intervention was a visual probe task pairing counter-stereotypical images of active individuals with obesity with positive PA-related words. In qualitative telephone interviews, a sub-sample of participants provided feedback and recommendations for using counter-stereotypical images in PA promotion. RESULTS Women completed the intervention (n = 48) or a control task (n = 55). Results of a RM-ANOVA showed no interaction or main effect of group on WBI. A main effect of time demonstrated that both groups had reduced WBI between pre-test and post-test, through to one-week follow-up. There were no differences between groups or over time for PA attitudes, self-efficacy, or behaviour. Women who completed interviews (n = 16) discussed several benefits and drawbacks of using counter-stereotypical images. CONCLUSION Implicit retraining did not reduce WBI but qualitative findings support the use of counter-stereotypical PA images.
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47
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Craig H, le Roux C, Keogh F, Finucane FM. How Ethical Is Our Current Delivery of Care to Patients with Severe and Complicated Obesity? Obes Surg 2019; 28:2078-2082. [PMID: 29766353 PMCID: PMC6018590 DOI: 10.1007/s11695-018-3301-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Despite overwhelming evidence that bariatric interventions reduce morbidity and mortality and are cost-effective, access for affected patients is limited. We sought to describe the extent to which health policy makers and publically funded health services have an ethical obligation to provide bariatric care. We conducted a narrative review of the literature pertaining to the efficacy, safety, and cost-effectiveness of bariatric surgical interventions, in the context of the core principles of medical ethics. We found that in relation to autonomy (i.e., the right to self-determination), beneficence, non-maleficence, and justice (i.e., the obligation to provide fair and equitable treatment to all patients), the current provision of bariatric surgical care fell short of meeting internationally recognized medical ethical standards. These findings have important implications for government policy and healthcare resource allocation. Respecting the individual’s right of self-determination, to do good, prevent harm, and provide equity in access to services is paramount, even when that individual is obese.
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Affiliation(s)
- Hilary Craig
- Department of Surgery, St. James's Hospital, Dublin, Ireland
| | - Carel le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Fiona Keogh
- Centre for Economic and Social Research in Dementia, National University of Ireland, Galway, Ireland
| | - Francis M Finucane
- Bariatric Medicine Service and HRB Clinical Research Facility, Galway University Hospital and National University of Ireland, Galway, Ireland.
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Assessment of public and patient online comments in social media and food and drug administration archival data. Res Social Adm Pharm 2019; 16:967-973. [PMID: 31668550 DOI: 10.1016/j.sapharm.2019.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/30/2019] [Accepted: 10/09/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To refine a method of collecting the data from various patient generated data sources to explore themes with high repeatability. FDA will acquire new insight into understanding the perspectives of patients and caregivers through analyses of multiple sources. DESIGN Qualitative analysis of FDA archival data and social media data. SETTING Two pilot studies assessing methodologies on differing unstructured data sources. Study 1: Opioid Use Disorder (OUD), analyzing OUD public docket comments and social media data. STUDY 2: Pulmonary Arterial Hypertension (PAH), utilizing FDA's PAH PFDD meeting transcripts and 1813 Online User Generated Content (UGC) posts. RESULTS Through triangulation of data, FDA identified data overlaps (thus increasing confidence of data) and located information found only in certain sources. CONCLUSIONS and Relevance: For research to be patient centric, leveraging technological advances and multiple patient experience data sources captures the patient perspective beyond clinical delivery and provides additional information and aids in understanding the picture of medical product functioning beyond controlled randomized clinical trials.
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49
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Cesare N, Nguyen QC, Grant C, Nsoesie EO. Social media captures demographic and regional physical activity. BMJ Open Sport Exerc Med 2019; 5:e000567. [PMID: 31423323 PMCID: PMC6678033 DOI: 10.1136/bmjsem-2019-000567] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2019] [Indexed: 12/04/2022] Open
Abstract
Objectives We examined the use of data from social media for surveillance of physical activity prevalence in the USA. Methods We obtained data from the social media site Twitter from April 2015 to March 2016. The data consisted of 1 382 284 geotagged physical activity tweets from 481 146 users (55.7% men and 44.3% women) in more than 2900 counties. We applied machine learning and statistical modelling to demonstrate sex and regional variations in preferred exercises, and assessed the association between reports of physical activity on Twitter and population-level inactivity prevalence from the US Centers for Disease Control and Prevention. Results The association between physical inactivity tweet patterns and physical activity prevalence varied by sex and region. Walking was the most popular physical activity for both men and women across all regions (15.94% (95% CI 15.85% to 16.02%) and 18.74% (95% CI 18.64% to 18.88%) of tweets, respectively). Men and women mentioned performing gym-based activities at approximately the same rates (4.68% (95% CI 4.63% to 4.72%) and 4.13% (95% CI 4.08% to 4.18%) of tweets, respectively). CrossFit was most popular among men (14.91% (95% CI 14.52% to 15.31%)) among gym-based tweets, whereas yoga was most popular among women (26.66% (95% CI 26.03% to 27.19%)). Men mentioned engaging in higher intensity activities than women. Overall, counties with higher physical activity tweets also had lower leisure-time physical inactivity prevalence for both sexes. Conclusions The regional-specific and sex-specific activity patterns captured on Twitter may allow public health officials to identify changes in health behaviours at small geographical scales and to design interventions best suited for specific populations.
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Affiliation(s)
- Nina Cesare
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Quynh C Nguyen
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Christan Grant
- School of Computer Science, University of Oklahoma, Norman, Oklahoma, USA
| | - Elaine O Nsoesie
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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50
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Foufi V, Timakum T, Gaudet-Blavignac C, Lovis C, Song M. Mining of Textual Health Information from Reddit: Analysis of Chronic Diseases With Extracted Entities and Their Relations. J Med Internet Res 2019; 21:e12876. [PMID: 31199327 PMCID: PMC6595941 DOI: 10.2196/12876] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 05/06/2019] [Accepted: 05/21/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social media platforms constitute a rich data source for natural language processing tasks such as named entity recognition, relation extraction, and sentiment analysis. In particular, social media platforms about health provide a different insight into patient's experiences with diseases and treatment than those found in the scientific literature. OBJECTIVE This paper aimed to report a study of entities related to chronic diseases and their relation in user-generated text posts. The major focus of our research is the study of biomedical entities found in health social media platforms and their relations and the way people suffering from chronic diseases express themselves. METHODS We collected a corpus of 17,624 text posts from disease-specific subreddits of the social news and discussion website Reddit. For entity and relation extraction from this corpus, we employed the PKDE4J tool developed by Song et al (2015). PKDE4J is a text mining system that integrates dictionary-based entity extraction and rule-based relation extraction in a highly flexible and extensible framework. RESULTS Using PKDE4J, we extracted 2 types of entities and relations: biomedical entities and relations and subject-predicate-object entity relations. In total, 82,138 entities and 30,341 relation pairs were extracted from the Reddit dataset. The most highly mentioned entities were those related to oncological disease (2884 occurrences of cancer) and asthma (2180 occurrences). The relation pair anatomy-disease was the most frequent (5550 occurrences), the highest frequent entities in this pair being cancer and lymph. The manual validation of the extracted entities showed a very good performance of the system at the entity extraction task (3682/5151, 71.48% extracted entities were correctly labeled). CONCLUSIONS This study showed that people are eager to share their personal experience with chronic diseases on social media platforms despite possible privacy and security issues. The results reported in this paper are promising and demonstrate the need for more in-depth studies on the way patients with chronic diseases express themselves on social media platforms.
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Affiliation(s)
- Vasiliki Foufi
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Tatsawan Timakum
- Department of Library and Information Science, Yonsei University, Seoul, Republic of Korea
| | - Christophe Gaudet-Blavignac
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christian Lovis
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Min Song
- Department of Library and Information Science, Yonsei University, Seoul, Republic of Korea
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