What Do Patients Tweet About Their Mammography Experience?

The Role of Social Media in Breast Cancer Care and Survivorship: A Narrative Review

Background

Female breast cancer (BC) is the most diagnosed cancer and the leading cause of malignancy-related death worldwide. With the widespread utilisation of the Internet, social media has presented an invaluable yet underemployed tool in the context of BC medical information dissemination, support hub formation, and patient empowerment.

Summary

In this narrative review, we explore the untapped potential of social media in this context, caveats, and future directions that may aid in formulating a new era of patient led, in addition to patient-centred care.

Key Messages

Social media represents a powerful tool with significant potential to enable the seeking and sharing of BC-related information, and enhance patient education, communication, engagement, and empowerment. However, its use is associated with a number of limitations, including confidentiality and addiction issues, excessive and inaccurate information, and a possibility of jeopardising the patient-doctor relationship. Further research is needed to shed more light on this topic.

Patient Experience Scores for Radiologists: Comparison With Nonradiologist Physicians and Changes After Public Posting in an Institutional Online Provider Directory

BACKGROUND. Patients are increasingly using online information regarding patient experiences to guide care decisions. OBJECTIVE. The purpose of our study was to compare patient experience scores between radiologists and nonradiologist physicians and to assess changes in scores after their public posting in an online physician directory. METHODS. This retrospective study included data collected from May 1, 2017, to November 30, 2018, at a single large academic medical center. After all institutional outpatient visits, patients were e-mailed the Press Ganey Medical Practice Survey, which included 10 questions (answered using a Likert scale and converted to 100-point range) relating to the patient's experience with the specific provider for the encounter. Surveys were distributed to patients after radiology encounters if involving an image-guided invasive procedure. Mean scores for each question and the mean weighted overall score were displayed on each physician's publicly available profile on the hospital's online physician directory and were updated monthly. Scores were compared between radiologists and nonradiologist physicians; temporal changes were assessed. RESULTS. The response rate was 18.0% (96,057/533,983). After exclusions (23,989 surveys completed without provider ratings; 183 surveys evaluating physician assistants), 71,885 physician surveys were evaluated: 2703 surveys for 65 radiologists, 49,403 surveys for 916 physicians in 17 nonsurgical specialties, and 19,779 surveys for 262 physicians in 13 surgical specialties. Over the study period, the mean overall score was 95.6 for radiologists and 95.9 for nonradiologists (94.6 for surgical specialties, 96.4 for nonsurgical specialties). For the 10 individual questions, scores ranged for radiologists from 94.6 (time spent with patient) to 96.8 (friendliness/courtesy) and for nonradiologists from 94.6 (time spent with patient) to 97.0 (friendliness/courtesy). The mean overall score increased from the first month to the final month for radiologists from 94.2 to 97.1 and for nonradiologists from 95.7 to 96.3. For radiologists, the largest improvement was for instructions regarding postprocedure follow-up care (increased from 91.4 to 97.4). CONCLUSION. Radiologists received high scores on patient experience surveys when evaluated on encounters involving invasive procedures, achieving scores similar to those for other physicians. Scores improved over time, possibly related to online posting of survey results. CLINICAL IMPACT. The findings support the utility of implementing patient experience surveys in radiology.

Radiology on Instagram: Analysis of Public Accounts and Identified Areas for Content Creation

RATIONALE AND OBJECTIVES

Radiology social media research has focused on Twitter, Facebook, and YouTube, with minimal attention to Instagram, which may be a natural platform for engagement. We evaluated features of public radiology-related Instagram accounts.

MATERIALS AND METHODS

Instagram accounts were searched using the term "radiology." Two independent raters used a coding system developed through initial content review to categorize account user types and post aims over the study month (October 2019). Multivariate linear regressions were performed.

RESULTS

49 Instagram accounts and their 459 posts were retrieved. Users had median 117 total posts (interquartile range 43-203), 9 posts during the study month (1-16), 3079 followers (695-19,600), and 106 followed users (50-351). Most users were radiologists (41%, most commonly academic), radiology practices (12%, most commonly academic) and 10% radiology professional societies. The 459 posts had median 178 likes (interquartile range 51-353) and 2 comments (0-5); single videos had median 4693 views (2183-6080). 75% of posts were radiology images or videos (of these, 29% MRI, 28% CT). 65% of posts were clinical imaging cases (most commonly neuroradiology). Seven posts violated HIPAA regulations, all originating outside the U.S. When controlling for number of account followers, posts by radiology society (β = -130.6, p = 0.017) and practice accounts (β = -90.6, p = 0.049) had fewer post likes. An artwork post was the only significant predictor of greater post likes (β = +866.2, p < 0.001) and comments (β = +14.3, p < 0.001).

CONCLUSION

Instagram is commonly used by academic radiologists to present clinical imaging cases. Radiologists should consider opportunities for greater application of this unique image-based social media platform.

Making it (net)work: a social network analysis of "fertility" in Twitter before and during the COVID-19 pandemic

Objective

To characterize activity, text sentiment, and online community characteristics regarding "fertility" on Twitter before and during the COVID-19 pandemic using social network analysis.

Design

Cross-sectional analysis.

Setting

Publicly available Twitter data.

Patients

Not applicable.

Interventions

Not applicable.

Main Outcome Measures

Number of users (vertices); edges (connections, defined as unique and total); self-loops (tweet without connection to another user); connected components (groups of users communicating back and forth frequently); maximum vertices in a connected component (largest group size); maximum and average geodesic distance (number of tweets to connect two users in the network); graph density; positive and negative sentiment tweets; and top 5 hashtags and top 5 word pairs.

Results

There were 1426 unique users and 401 groups in the pre-COVID-19 data compared to 1492 unique users and 453 groups in the during COVID-19 data. There was no difference in the number of total connections (96.8% [1381/1426] vs. 96.0% [1433/1492]) or self-loops (20.0% [286/1426] vs. 22.1% [329/1492]) before and during the COVID-19 pandemic. The percentage of unique connections per user decreased during COVID-19 (91.6% [1381/1508] pre-COVID-19 vs. 83.3% [1433/1720] during COVID-19). The average and maximum distance between users in the community increased during COVID-19 (maximum: 5 pre-COVID-19, 8 during COVID-19; average 1.95 pre-COVID-19, 2.43 during COVID-19). The percentage of positive sentiments per total number of tweets increased during COVID-19 (58.1% pre-COVID-19 [773/1331] vs. 64.3% [1198/1863] during COVID-19). The top 5 hashtags changed during COVID-19 to include COVID-19. The top word pairs changed from "family, hereditary; parents, children" to "fertility, treatment; healthcare, decisions."

Conclusions

Despite the challenge to the fertility community amidst the COVID-19 pandemic, the overall Twitter sentiment regarding fertility was more positive during than before the pandemic. Top hashtags and word pairs changed to reflect the emergence of COVID-19 and the unique healthcare decision-making challenges faced. While the character, the number of users, and the total connections remained constant, the number of unique connections and the distance between users changed to reflect more self-broadcasting and less tight connections.

Role of social and non-social online media: how to properly leverage your internet presence for professional development and research

The internet has become an integral component of daily life, with its content broadly grouped into social media and non-social online content. The use of social media, comprising interactive information sharing and networking tools, has proliferated in radiology, with as many as 85% of radiologists utilizing social media and adoption by both private and academic practices. In radiology, social media has been used to increase patient and public awareness of the specialty, establish a professional brand, share scholarly activity, aid in professional development and recruitment, improve communication, and increase engagement during scientific meetings. Organizations like the Society of Abdominal Radiology have increased the visibility of abdominal and pelvic radiology through their activity on social media; however, individual radiologists are integral to this function as well. In this article, we outline a stepwise approach to the individual use of social media, with practical tips for radiologists interested in effectively engaging the plethora of social media and non-social online content available. We also briefly discuss an approach to performing research using publicly available online media.

Expressed Symptoms and Attitudes Toward Using Twitter for Health Care Engagement Among Patients With Lupus on Social Media: Protocol for a Mixed Methods Study

BACKGROUND

Lupus is a complex autoimmune disease that is difficult to diagnose and treat. It is estimated that at least 5 million Americans have lupus, with more than 16,000 new cases of lupus being reported annually in the United States. Social media provides a platform for patients to find rheumatologists and peers and build awareness of the condition. Researchers have suggested that the social network Twitter may serve as a rich avenue for exploring how patients communicate about their health issues. However, there is a lack of research about the characteristics of lupus patients on Twitter and their attitudes toward using Twitter for engaging them with their health care.

OBJECTIVE

This study has two objectives: (1) to conduct a content analysis of Twitter data published by users (in English) in the United States between September 1, 2017 and October 31, 2018 to identify patients who publicly discuss their lupus condition and to assess their expressed health themes and (2) to conduct a cross-sectional survey among these lupus patients on Twitter to study their attitudes toward using Twitter for engaging them with their health care.

METHODS

This is a mixed methods study that analyzes retrospective Twitter data and conducts a cross-sectional survey among lupus patients on Twitter. We used Symplur Signals, a health care social media analytics platform, to access the Twitter data and analyze user-generated posts that include keywords related to lupus. We will use descriptive statistics to analyze the data and identify the most prevalent topics in the Twitter content among lupus patients. We will further conduct self-report surveys via Twitter by inviting all identified lupus patients who discuss their lupus condition on Twitter. The goal of the survey is to collect data about the characteristics of lupus patients (eg, gender, race/ethnicity, educational level) and their attitudes toward using Twitter for engaging them with their health care.

RESULTS

This study has been funded by the National Center for Advancing Translational Science through a Clinical and Translational Science Award. The institutional review board at the University of Southern California (HS-19-00048) approved the study. Data extraction and cleaning are complete. We obtained 47,715 Twitter posts containing terms related to "lupus" from users in the United States published in English between September 1, 2017 and October 31, 2018. We included 40,885 posts in the analysis. Data analysis was completed in Fall 2020.

CONCLUSIONS

The data obtained in this pilot study will shed light on whether Twitter provides a promising data source for garnering health-related attitudes among lupus patients. The data will also help to determine whether Twitter might serve as a potential outreach platform for raising awareness of lupus among patients and implementing related health education interventions.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/15716.

Discussions of miscarriage and preterm births on Twitter

BACKGROUND

Experiences typically considered private, such as, miscarriages and preterm births are being discussed publicly on social media and Internet discussion websites. These data can provide timely illustrations of how individuals discuss miscarriages and preterm births, as well as insights into the wellbeing of women who have experienced a miscarriage.

OBJECTIVES

To characterise how users discuss the topic of miscarriage and preterm births on Twitter, analyse trends and drivers, and describe the perceived emotional state of women who have experienced a miscarriage.

METHODS

We obtained 291 443 Twitter postings on miscarriages and preterm births from January 2017 through December 2018. Latent Dirichlet Allocation (LDA) was used to identify major topics of discussion. We applied time series decomposition methods to assess temporal trends and identify major drivers of discussion. Furthermore, four coders labelled the emotional content of 7282 personal miscarriage disclosure tweets into the following non-mutually exclusive categories: grief/sadness/depression, anger, relief, isolation, annoyance, and neutral.

RESULTS

Topics in our data fell into eight groups: celebrity disclosures, Michelle Obama's disclosure, politics, healthcare, preterm births, loss and anxiety, flu vaccine and ectopic pregnancies. Political discussions around miscarriages were largely due to a misunderstanding between abortions and miscarriages. Grief and annoyance were the most commonly expressed emotions within the miscarriage self-disclosures; 50.6% (95% confidence interval [CI] 49.1, 52.2) and 16.2% (95% CI 15.2, 17.3). Postings increased with celebrity disclosures, pharmacists' refusal of prescribed medications and outrage over the high rate of preterm births in the United States. Miscarriage disclosures by celebrities also led to disclosures by women who had similar experiences.

CONCLUSIONS

This study suggests that increase in discussions of miscarriage on social media are associated with several factors, including celebrity disclosures. Additionally, there is a misunderstanding of the potential physical, emotional and psychological impacts on individuals who lose a pregnancy due to a miscarriage.

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

“Less is more”

Purpose

This work studies automated user classification on Twitter in the public health domain, a task that is essential to many public health-related research works on social media but has not been addressed. The purpose of this paper is to obtain empirical knowledge on how to optimise the classifier performance on this task.

Design/methodology/approach

A sample of 3,100 Twitter users who tweeted about different health conditions were manually coded into six most common stakeholders. The authors propose new, simple features extracted from the short Twitter profiles of these users, and compare a large set of classification models (including state-of-the-art) that use more complex features and with different algorithms on this data set.

Findings

The authors show that user classification in the public health domain is a very challenging task, as the best result the authors can obtain on this data set is only 59 per cent in terms of F1 score. Compared to state-of-the-art, the methods can obtain significantly better (10 percentage points in F1 on a “best-against-best” basis) results when using only a small set of 40 features extracted from the short Twitter user profile texts.

Originality/value

The work is the first to study the different types of users that engage in health-related communication on social media, applicable to a broad range of health conditions rather than specific ones studied in the previous work. The methods are implemented as open source tools, and together with data, are the first of this kind. The authors believe these will encourage future research to further improve this important task.

Advances in Retrieval and Dissemination of Medical Information

In recent years, there has been a dramatic change in how information can be disseminated in the scientific world. This is especially true for health care in general, and exotic pet practice hardly makes an exception. From the constant growth of online repositories that archives scholarly articles such as PubMed, to the creation of hashtags specific for health care that can be followed by millions of persons, we need to understand that communication is changing and that the proper use of modern technologies may result in an unprecedented era for knowledge retrieval and dissemination.

A comparison of information sharing behaviours across 379 health conditions on Twitter

Objectives

To compare information sharing of over 379 health conditions on Twitter to uncover trends and patterns of online user activities.

Methods

We collected 1.5 million tweets generated by over 450,000 Twitter users for 379 health conditions, each of which was quantified using a multivariate model describing engagement, user and content aspects of the data and compared using correlation and network analysis to discover patterns of user activities in these online communities.

Results

We found a significant imbalance in terms of the size of communities interested in different health conditions, regardless of the seriousness of these conditions. Improving the informativeness of tweets by using, for example, URLs, multimedia and mentions can be important factors in promoting health conditions on Twitter. Using hashtags on the contrary is less effective. Social network analysis revealed similar structures of the discussion found across different health conditions.

Conclusions

Our study found variance in activity between different health communities on Twitter, and our results are likely to be of interest to public health authorities and officials interested in the potential of Twitter to raise awareness of public health.

Electronic supplementary material

The online version of this article (10.1007/s00038-018-1192-5) contains supplementary material, which is available to authorized users.

Using Facebook to communicate mammography messages to rural audiences

OBJECTIVE

The purpose of this scholarly project was to answer the following question: What is the highest level of engagement achieved with a mammography campaign on Facebook?

DESIGN AND SAMPLE

An Idaho public health department implemented a tailored message mammography campaign on Facebook during Breast Cancer Awareness Month. Target sample for the Facebook campaign were women and men over the age of 40 in rural Idaho.

MEASURES

Data collected from Facebook were used to measure and stratify engagement into a hierarchy of six levels, with intent to get a mammogram representing the highest level of engagement. A survey measuring women's intent to a get a mammogram was distributed via an online link.

RESULTS

The posts reached 48,503 Facebook users-11,147 of the total reach were unique users. Intent to get a mammogram, the highest level of engagement, was stated both in Facebook comments and on the online survey. Forty-nine women completed the survey, and 82% of women expressed intent to get a mammogram in the next year.

CONCLUSION

This project conducted as a program evaluation demonstrates how public health nurses can develop, implement, and evaluate Facebook mammography campaigns in the future.

Breast compression techniques in screening mammography - A Maltese evaluation project

INTRODUCTION

In screening mammography, the radiographer should be responsible for providing mammograms of high diagnostic value, possibly without subjecting clients to a painful experience. This skill is demonstrated via the technique of breast compression and is explored in this study by analysing insights about methods and underlying principles in regards to this procedure.

METHODS

One-to-one semi-structured interviews were conducted with radiographers who perform screening mammography in Malta. For data analysis, a descriptive phenomenological approach following a simplified version of Hycner's (1985) method was adopted.

RESULTS

Five general themes were extracted from the data; meeting the client, preparing the client, the mammography procedure, pain from compression and client turnout. It was determined that the participants alter their breast compression technique according to the client rather than following a rigid step-by-step process and that explanation and requesting client feedback are essential to obtain cooperation. Additionally, mammography positioning and compression application are tailored in a way that encourage compliance, however not at the expense of degrading image quality. Ultimately, it is also believed that a proper breast compression technique positively influences client turnout.

CONCLUSION

The results of this study demonstrate that radiographers should be flexible in their approach in order to carry out a successful breast compression technique. However, it has also been shown that such effectiveness in practice is gained from experience rather than initial training. If exposed to this study's findings, new mammographers would be able to form a robust core of knowledge before embarking on the challenging specialisation of mammography.

Monitoring Twitter Conversations for Targeted Recruitment in Cancer Trials in Los Angeles County: Protocol for a Mixed-Methods Pilot Study

BACKGROUND

Insufficient recruitment of participants remains a critical roadblock to successful clinical research, particularly clinical trials. Social media provide new ways for connecting potential participants with research opportunities. Researchers suggest that the social network Twitter may serve as a rich avenue for exploring how patients communicate about their health issues and increasing enrollment in cancer clinical trials. However, there is a lack of evidence that Twitter offers practical utility and impact.

OBJECTIVE

This pilot study aimed to examine the feasibility and impact of using Twitter monitoring data (ie, user activity and their conversations about cancer-related conditions and concerns expressed by Twitter users in Los Angeles County) as a tool for enhancing clinical trial recruitment at a comprehensive cancer center.

METHODS

We will conduct a mixed-methods interrupted time series study design with a before-and-after social media recruitment intervention. On the basis of a preliminary analysis of eligible trials, we plan to onboard at least 84 clinical trials across 6 disease categories: breast cancer, colon cancer, kidney cancer, lymphoma, non-small cell lung cancer, and prostate cancer that are open to accrual at the University of Southern California (USC) Norris Comprehensive Cancer Center. We will monitor messages about these 6 cancer conditions posted by Twitter users in Los Angeles County. Recruitment for the trials will occur through the Twitter account (@USCTrials). Primary study outcomes-feasibility and acceptance of the social media intervention among targeted Twitter users and the study teams of the onboarded trials-will be assessed using qualitative interviews and the 4-point Likert scale and by calculating the proportion of targeted Twitter users who engaged with outreach messages. Second, impact of the social media intervention will be measured by calculating the proportion of enrollees in trials. The enrollment rate will be compared between the active intervention period and the prior 10 months as historical control for each disease trial group. This study has been funded by the National Center for Advancing Translational Science through a Clinical and Translational Science Award. Study approval was obtained from the clinical investigations committee at USC Norris and the institutional review board at USC.

RESULTS

Recruitment on Twitter started in February 2018. Data collection will be completed in November 2018.

CONCLUSIONS

This pilot project will provide preliminary data and practical insight into the application of publicly available Twitter data to identify and recruit clinical trial participants across 6 cancer disease types. We will shed light on the acceptance of the social media intervention among Twitter users and study team members of the onboarded trials. If successful, the findings will inform a multisite randomized controlled trial to determine the efficacy of the social media intervention across different locations and populations.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03408561; https://clinicaltrials.gov/ct2/show/NCT03408561 (Archived by WebCite at http://www.webcitation.org/72LihauzW).

REGISTERED REPORT IDENTIFIER

RR1-10.2196/9762.

Artificial Intelligence and Radiology: A Social Media Perspective

OBJECTIVE

To use Twitter to characterize public perspectives regarding artificial intelligence (AI) and radiology.

METHODS AND MATERIALS

Twitter was searched for all tweets containing the terms "artificial intelligence" and "radiology" from November 2016 to October 2017. Users posting the tweets, tweet content, and linked websites were categorized.

RESULTS

Six hundred and five tweets were identified. These were from 407 unique users (most commonly industry-related individuals [22.6%]; radiologists only 9.3%) and linked to 216 unique websites. 42.5% of users were from the United States. The tweets mentioned machine/deep learning in 17.2%, industry in 14.0%, a medical society/conference in 13.4%, and a university in 9.8%. 6.3% mentioned a specific clinical application, most commonly oncology and lung/tuberculosis. 24.6% of tweets had a favorable stance regarding the impact of AI on radiology, 75.4% neutral, and none were unfavorable. 88.0% of linked websites leaned toward AI being positive for the field of radiology; none leaned toward AI being negative for the field. 51.9% of linked websites specifically mentioned improved efficiency for radiology with AI. 35.2% of websites described challenges for implementing AI in radiology. Of the 47.2% of websites that mentioned the issue of AI replacing radiologists, 77.5% leaned against AI replacing radiologists, 13.7% had a neutral view, and 8.8% leaned toward AI replacing radiologists.

CONCLUSION

These observations provide an overview of the social media discussions regarding AI in radiology. While noting challenges, the discussions were overwhelmingly positive toward the transformative impact of AI on radiology and leaned against AI replacing radiologists. Greater radiologist engagement in this online social media dialog is encouraged.

Is social media the way to empower patients to share their experiences of dental care?

BACKGROUND

Social media present opportunities to understand patient experience and information needs. In this study, the authors use hypodontia as an example to explore social media use by dental patients and how this provides for understanding patient experience.

METHODS

The cross-sectional survey design involved systematic search of 6 social media online environments with hypodontia-related terms. The authors categorized records by using a coding system for user, type and theme of post, and target audience. The authors used a thematic framework approach to analyze qualitatively the word content of posts from people affected by hypodontia (nondentists).

RESULTS

The authors searched and identified 571 records and included 467 of them in their study. The authors analyzed the content of records from people affected by hypodontia (n = 176). Themes emerged about the experience of untreated hypodontia, treatment experience and outcomes, and decision making. Content analysis provided evidence about peer-to-peer communication, areas of information need, and desire for peer support.

CONCLUSIONS

Social media communities have responded to the need for information exchange and peer support by the public. Analysis of communications helped identify a need for dissemination of understandable information to patients and improved dentist awareness of patient needs.

PRACTICAL IMPLICATIONS

Clinicians should reassess understanding and information needs actively throughout treatment and identify support needs. Clinicians should refer patients to quality information sources and peer support groups.

Lung Cancer Messages on Twitter: Content Analysis and Evaluation

PURPOSE

The aim of this project was to describe and evaluate the levels of lung cancer communication across the cancer prevention and control continuum for content posted to Twitter during a 10-day period (September 30 to October 9) in 2016.

METHODS

Descriptive and inferential statistics were used to identify relationships between tweet characteristics in lung cancer communication on Twitter and user-level data. Overall, 3,000 tweets published between September 30 and October 9 were assessed by a team of three coders. Lung cancer-specific tweets by user type (individuals, media, and organizations) were examined to identify content and structural message features. The study also assessed differences by user type in the use of hashtags, directed messages, health topic focus, and lung cancer-specific focus across the cancer control continuum.

RESULTS

Across the universe of lung cancer tweets, the majority of tweets focused on treatment and the use of pharmaceutical and research interventions, followed by awareness and prevention and risk topics. Among all lung cancer tweets, messages were most consistently tweeted by individual users, and personal behavioral mobilizing cues to action were rare.

CONCLUSIONS

Lung cancer advocates, as well as patient and medical advocacy organizations, with an interest in expanding the reach and effectiveness of social media efforts should monitor the topical nature of public tweets across the cancer continuum and consider integrating cues to action as a strategy to increase engagement and behavioral activation pertaining to lung cancer reduction efforts.

Risk Factors for Late Screening Mammography

BACKGROUND

Breast cancer has the highest incidence of cancers in women in the United States. Previous research has shown that screening mammography contributes to reduced breast cancer mortality. This study aimed to clarify why late screening might occur in an at-risk population.

MATERIALS AND METHODS

This study was a prospective cross-sectional study including 758 patients presenting to our radiology department for routine screening mammography who completed a 30-question survey regarding personal characteristics and mammography history. Univariate and multivariate logistic regression were performed to determine whether survey responses correlated with late screening.

RESULTS

Of the 758 patients, 184 (24%) were noncompliant with screening mammography guidelines. Risk factors for late screening included younger age (P = 0.001), white race/ethnicity (P = 0.03), self-reported lack of financial means or health insurance (P = 0.005), lack of satisfaction with a previous mammogram experience (P = 0.001), inadequate mammography education by a physician (P = 0.001), and lack of awareness/comprehension of screening mammography guidelines (P = 0.002).

CONCLUSION

Many factors contribute to late screening mammography. Although some are outside physician control, others can be influenced: patient education regarding screening mammography guidelines, and patient satisfaction with the mammography experience. This study highlights the importance of communication with and education of patients.

The Bigger Picture: Picking the Right Soap Box-Is it Possible to Connect with Different Audience Targets (Practitioners and Patients) from the Same Platform?

The use of Internet and social media has skyrocketed in the past decade. It did not take long until physicians realized that they could use social media as a tool for communication with patients and colleagues. Since then use of social media has exploded and the information that has become available for physicians and their patients is remarkable. In addition, because of the immediacy of the platform, messages that are incorrect or not desired can be rapidly promoted, whether deliberately or accidentally. To obtain the best use of social media, the right platform should be chosen, and this varies depending on the group one is trying to reach, and the message or visibility desired. In this article, we review the variety of options available to users.

Frequencies of Private Mentions and Sharing of Mammography and Breast Cancer Terms on Facebook: A Pilot Study

BACKGROUND

The most popular social networking site in the United States is Facebook, an online forum where circles of friends create, share, and interact with each other's content in a nonpublic way.

OBJECTIVE

Our objectives were to understand (1) the most commonly used terms and phrases relating to breast cancer screening, (2) the most commonly shared website links that other women interacted with, and (3) the most commonly shared website links, by age groups.

METHODS

We used a novel proprietary tool from Facebook to analyze all of the more than 1.7 million unique interactions (comments on stories, reshares, and emoji reactions) and stories associated with breast cancer screening keywords that were generated by more than 1.1 million unique female Facebook users over the 1 month between November 15 and December 15, 2016. We report frequency distributions of the most popular shared Web content by age group and keywords.

RESULTS

On average, each of 59,000 unique stories during the month was reshared 1.5 times, commented on nearly 8 times, and reacted to more than 20 times by other users. Posted stories were most often authored by women aged 45-54 years. Users shared, reshared, commented on, and reacted to website links predominantly to e-commerce sites (12,200/1.7 million, 36% of all the most popular links), celebrity news (n=8800, 26%), and major advocacy organizations (n=4900, 15%; almost all accounted for by the American Cancer Society breast cancer site).

CONCLUSIONS

On Facebook, women shared and reacted to links to commercial and informative websites regarding breast cancer and screening. This information could inform patient outreach regarding breast cancer screening, indirectly through better understanding of key issues, and directly through understanding avenues for paid messaging to women authoring and reacting to content in this space.