The emerging use of social media for health-related purposes in low and middle-income countries: A scoping review

Instagram for audience engagement: an evaluation of CERC framework in the GCC nations for digital public health during the Covid-19 pandemic

BACKGROUND

In this study, we investigate the utilization of Instagram by public health ministries across the Gulf Cooperation Council (GCC) nations to disseminate health-related information during the COVID-19 pandemic. With Instagram's visual-centric approach and high user engagement, the research aims to investigate its critical yet complex role in information dissemination amid a health crisis.

METHODS

To examine how Instagram communication strategies align with the CDC's Crisis and Emergency Risk Communication (CERC) framework, we employ the content analysis method. This approach helps to evaluate the effectiveness and challenges of employing Instagram for health communication within a region known for its significant social media usage.

RESULTS

Findings indicate that Instagram serves as a vital platform for the rapid dissemination of health information in the GCC, leveraging its visual capabilities and wide reach. The GCC ministries of health utilized Instagram to demonstrate a consistent and strategic approach to communicate essential COVID-19 related information. Kuwait and Bahrain were the most active of all the assessed ministries with respect to the number of engagement metrics (likes and comments). Most of the posts, as per the CERC framework, were informational and related to vaccine infection and death cases. The second most salient theme in line with the CERC framework was about promoting actions, followed by Instagram posts about activities, events, and campaigns.

CONCLUSIONS

The research underscores Instagram's potential as a powerful tool in enhancing public health resilience and responsiveness during health emergencies in the GCC. It suggests that leveraging social media, with careful consideration of its affordances, can contribute significantly to effective health communication strategies in times of crisis.

Utilization of Social Media for the Prevention and Control of HIV/AIDS: A Scoping Review

Social media has been used widely in public health for understanding health risks and intervening to improve health. However, the utilization of social media for HIV prevention and control interventions has not been clearly characterized. We conducted a scoping review on the utilization of social media for HIV prevention and control to identify gaps in the literature and highlight opportunities for future research and intervention. A comprehensive search of seven databases was performed: PubMed, Embase, CINAHL Complete (EBSCO), PsycInfo (EBSCO), Scopus, and WOS (Science Citation Index Expanded (SCI-EXPANDED). The Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used as a framework. A total of 790 articles were screened at the title and abstract level, and 78 were screened at the full-text level. Twenty-three articles met the eligibility criteria for review. We found that Facebook was still the most common social media service used to reach target populations. Lesbian, gay, bisexual and transgender (LGBT) individuals were the primary groups and were the most common targets of social media-based HIV prevention interventions. Outcomes of social media-based interventions, such as increased HIV testing, social networking and social support, condom use attitudes, behavioral skills, and research participation, were reported. Most social media-based interventions have emphasized HIV prevention, with fewer interventions focused on improving linkage to care and adherence to treatment among people living with HIV. Future studies may benefit from using social media for interventions to improve HIV-related outcomes in high-risk populations. This review highlights the potential and challenges of social media approaches for HIV/AIDS prevention and control.

A Study on Communication Practices in Reducing Non-Communicable Diseases in Bahir Dar City, Ethiopia

Background

Non-communicable diseases (NCDs) pose special challenges in developing countries In Ethiopia, the growing NCD burden has raised a public health concern with significant social, economic, and developmental effects. Thus, the study sought to examine health communication practices in addressing the NCDs in Bahir Dar City of the Amhara Region of Ethiopia.

Methods

A qualitative case study was conducted from January to April 2023. The study employed in-depth interviews, focus group discussions, and observations to gather data from health extension workers, NCD experts, and NCD focal persons about their experiences and perspectives regarding NCD prevention and control. The participants were purposively selected, and a thematic analysis technique was employed to analyze the data.

Results

The study found that several health communication strategies, such as health promotion, training and creating model households, screening, referrals, follow-ups, rehabilitation services, and activities reporting were employed. Nevertheless, there was a lack of consistent, reliable, and long-lasting and professional health communication regarding NCD prevention and management. Some of the challenges contributing to such deficient practices were overloading HEWs with various tasks, allocating many households to a single HEW, shortage of screening tools, shortage of financial and human resources, weak interdisciplinary collaboration, COVID-19, and recurrent conflicts in the city and the region. Above all, lack of health communication skills affected the health interventions. Concerning communication methods, one-to-one communication was frequently employed, while mass media and social media were rare. Generally, NCD communication, in particular, and health communication, in general, did not receive priority as other health-related activities in the city.

Conclusion

The study found that there were poor health communication practices in preventing and controlling NCDs. Thus, professional practice of health communication about NCDs must be prioritized, and emphasis should be given to inter-sectoral collaborations. Prioritizing financial and human resources is also essential for effective NCD communication.

Exploring How People Interact With Dental Misinformation on Social Media: A Cross-Sectional Study

BACKGROUND

Social media has been widely utilized to spread health-related information, which has led to the possibility of spreading medical misinformation. The extent of the issue is unknown, even though policymakers, researchers, and medical professionals agree that health misinformation must be controlled and combated.

OBJECTIVE

A cross-sectional study was conducted by the faculty of dentistry at Damascus University.

METHODS

This quantitative cross-sectional study used a voluntary questionnaire distributed online in social media groups. Participants were of different ages, genders, and educational levels.

RESULTS

Of the 301 questionnaires collected, 291 were analyzed. The study sample comprised secondary education certificates, university students, and postgraduate students. 96.6% of the study sample used two or more SM applications. 71.5% of the study sample uses Facebook more than other applications for dental information research, followed by Instagram (14.8%), Telegram (8.2%), and finally WhatsApp (5.5%). There was a significant difference between the age of the respondents and the SM application they used most (p = 0.027). 46.4% of the study sample were neutral in their answer about what they believed in the trust of information on SM sites, followed by 42.3% who did not agree with the trust of information on SM sites and 11.3 who agreed. 89.7% of the study sample visit the dentist when facing a medical problem, while 10.3% follow advice on SM sites. There was a significant difference between the age of respondents and the source they relied on when facing a medical problem (p = 0.019). 50.2% of the study sample sometimes feels that the advice on SM sites is marketing for a company or product or advertising for doctors and not others.

CONCLUSION

In particular, understanding the methods and prevalence of health misinformation, as well as the current gaps in knowledge in this area, will help us to guide future research and, more specifically, to develop evidence-based digital policy action plans targeted at addressing this public health issue through various social media platforms.

Fake news research trends, linkages to generative artificial intelligence and sustainable development goals

In the digital age, where information is a cornerstone for decision-making, social media's not-so-regulated environment has intensified the prevalence of fake news, with significant implications for both individuals and societies. This study employs a bibliometric analysis of a large corpus of 9678 publications spanning 2013-2022 to scrutinize the evolution of fake news research, identifying leading authors, institutions, and nations. Three thematic clusters emerge: Disinformation in social media, COVID-19-induced infodemics, and techno-scientific advancements in auto-detection. This work introduces three novel contributions: 1) a pioneering mapping of fake news research to Sustainable Development Goals (SDGs), indicating its influence on areas like health (SDG 3), peace (SDG 16), and industry (SDG 9); 2) the utilization of Prominence percentile metrics to discern critical and economically prioritized research areas, such as misinformation and object detection in deep learning; and 3) an evaluation of generative AI's role in the propagation and realism of fake news, raising pressing ethical concerns. These contributions collectively provide a comprehensive overview of the current state and future trajectories of fake news research, offering valuable insights for academia, policymakers, and industry.

Marketing yourself in social media as a global health organization: lessons to be learned

PURPOSE

To evaluate whether X, formerly known as Twitter, is being used effectively to advance the goals of International Volunteers in Urology (IVUmed). How is X activity associated with end-user engagement?

METHODS

Monthly analytics of the X account @IVUmed were reviewed between September 2014 and November 2022 using https://analytics.twitter.com/ . Outcomes included tweets, mentions, impressions, engagements, interactions, followers, and profile visits. Statistical analysis using Mann-Whitney U test and Spearman's rank-order correlation was performed. Top tweet content between December 2020 and November 2022 was also analyzed and assigned one of seven different categories: research, workshops, mission statement, educational materials, fundraising, individual spotlight, and other.

RESULTS

Of @IVUmed's 1668 followers, 1334 (80.0%) were individuals. One thousand one hundred twenty-six (84.4%) individuals listed their locations with the majority (79.8%) residing in high-income countries. Tweet impressions have increased over time; they were significantly higher (p < 0.01) on average after the onset of COVID-19 in March 2020. From December 2020 to November 2022, new followers were positively correlated with tweet impressions (p < 0.01), total mentions (p < 0.01), and profile visits (p < 0.01). Profile visits were positively correlated with total tweets (p < 0.01). The content categories for monthly top tweets that proportionally garnered the most engagements were workshops (50%) and individual spotlight (29%), despite not being the most tweeted about content categories.

CONCLUSION

Non-profit organizations wishing to increase their web-based outreach can benefit from increased primary X activity. While not evaluated in this study, it may also improve fundraising capabilities. Nevertheless, periodic review of account activity is important to ensure engagement of the targeted audience.

The Use of Social Media by Clinical Nurse Specialists at a Tertiary Hospital: Mixed Methods Study

BACKGROUND

Recently, many health care professionals, who use social media to communicate with patients and colleagues, share information about medical research and promote public health campaigns.

OBJECTIVE

This study aimed to examine the motives, barriers, and implementation of social media use among clinical nurse specialists in Oman.

METHODS

A mixed methods study was conducted among 47 clinical nurse specialists at Sultan Qaboos University Hospital between November and December 2020. Qualitative data were collected using an open-ended questionnaire and analyzed using thematic analysis, and quantitative data were collected with a questionnaire and analyzed using SPSS (version 21.0; IBM Corp).

RESULTS

Of the 47 clinical nurse specialists surveyed, 43 (91.5%) responded. All respondents reported using social media applications, with WhatsApp being the most commonly used platform. Most respondents (n=18, 41.9%) spent 1-2 hours per day on social media. The main motives for using social media were increasing knowledge, communication, reaching patients easily, and reducing the number of hospital visits. The main barriers to social media use were privacy concerns, time constraints, and a lack of awareness of legal guidelines for social media use in the workplace. All participants requested clear rules and regulations regarding the use of social media among health care providers in the future.

CONCLUSIONS

Social media has the option to be a powerful institutional communication and health education tool for clinical nurse specialists in Oman. However, several obstacles must be addressed, including privacy concerns and the need for clear guidelines on social media use in the workplace. Our findings suggest that health care institutions and clinical nurse specialists must work together to overcome these impediments and leverage the benefits of social media for health care.Bottom of Form.

Public health agencies' use of social media for communication during pandemics: a scoping review of the literature

Public health agencies (PHAs) have increasingly incorporated social media into their communication mix during successive pandemics in the 21st century. However, the quality, timing, and accuracy of their health messages have varied significantly, resulting in mixed outcomes for communication, audience engagement, and pandemic management. This study aimed to identify factors influencing the effectiveness of pandemic-related health messages shared by PHAs on social media and to report their impact on public engagement as documented in the literature. A scoping literature review was conducted following a predefined protocol. An electronic search of 7 relevant databases and 5 grey literature repositories yielded 9,714 papers published between January 2003 and November 2022. Seventy-three papers were deemed eligible and selected for review. The results underscored the insufficiency of social media guidance policies for PHAs. Six themes were identified: message source, message topic, message style, message timing, content credibility and reliability, and message recipient profile. These themes encompassed 20 variables that could inform PHAs' social media public health communication during pandemics. Additionally, the findings revealed potential interconnectedness among the variables, and this study concluded by proposing a conceptual model that expands upon existing theoretical foundations for developing and evaluating pandemic-related health messaging.

Using a Design Thinking Approach to Develop a Social Media-Based Parenting Program for Parents of Children With Attention-Deficit/Hyperactivity Disorder: Mixed Methods Study

Background: Parenting programs have proven effective in improving the behavior of children with attention-deficit/hyperactivity disorder (ADHD). However, barriers such as job and transportation constraints hinder parents from attending face-to-face therapy appointments. The COVID-19 pandemic has further exacerbated these challenges. Objective: This study aimed to develop and test the feasibility of a social media-based parenting program for parents of children with ADHD, considering both the pre-existing challenges faced by parents and the additional barriers imposed by the COVID-19 pandemic. Methods: This study used a 5-stage design thinking process, encompassing empathizing with parents, defining their needs, ideating innovative solutions, prototyping the program, and testing the program with parents. Qualitative interviews were conducted with 18 parents of children with ADHD to understand their unique needs and values. Brainstorming techniques were used to generate creative ideas, leading to the creation of a prototype that was tested with 32 parents. Participants' engagement with the program was measured, and posttraining feedback was collected to assess the program's effectiveness. Results: Parents of children with ADHD encounter specific challenges, including managing impulsive behavior and difficulties in emotion regulation. The social media-based parenting program was delivered through the LINE app (Line Corporation) and consisted of 7 modules addressing topics related to ADHD management and effective parenting strategies. The program exhibited a high completion rate, with 84% (27/32) of participants successfully finishing it. Program provider-participant interaction peaked during the first week and gradually decreased over time. Qualitative feedback indicated that the program was feasible, accessible, and well received by participants. The LINE app was found to be convenient and helpful, and participants preferred content delivery once or twice per week, expressing acceptance for various content formats. Conclusions: This study emphasizes the significance of adopting a human-centered design thinking approach to develop parenting programs that cater to the unique needs and values of parents. By leveraging social media platforms, such as LINE, a parenting program can overcome the challenges posed by the COVID-19 pandemic and other constraints faced by parents. LINE offers a viable and feasible option for supporting parents of children with ADHD, with the potential for customization and widespread dissemination beyond the pandemic context.

A narrative review of course evaluation methods for continuing professional development: The case of paediatric and neonatal acute-care in-service courses in low and lower-middle income countries: BEME Guide No. 76

BACKGROUND

Training a skilled healthcare workforce is an essential part in reaching the United Nations Sustainable Development Goal to end preventable deaths in children and neonates. The greatest burden of mortality lies in low and lower-middle income countries (LLMIC). Short term, in-service courses have been implemented in many LLMIC to improve the quality of care delivered, but the evaluation methods of these courses are inconsistent.

METHOD

Studies describing evaluations of course and outcome measures were included if the course lasted seven days or less with postgraduate participants, included paediatric or neonatal acute or emergency training and was based in a LLMIC. This narrative review provides a detailed description of evaluation methods of course content, delivery and outcome measures based on 'Context, Input, Process and Product' (CIPP) and Kirkpatrick models.

RESULTS

5265 titles were screened with 93 articles included after full-text review and quality assessment. Evaluation methods are described: context, input, process, participant satisfaction, change in learning, behaviour, health system infrastructure and patient outcomes.

CONCLUSIONS

Outcomes, including mortality and morbidity, are rightly considered the fundamental aim of acute-care courses in LLMIC. Course evaluation can be difficult, especially with low resources, but this review outlines what can be done to guide future course organisers in providing well-conducted courses with consistent outcome measures for maximum sustainable impact.

Social media information and its association with the adoption of COVID-19 preventive measures in four Latin American countries

Objective

The study aimed to assess the association between adherence to COVID-19 preventive measures and access to media information related to COVID-19.

Methods

A multi-country, cross-sectional study using an online survey was conducted from June to December 2020. The sample included 1,457 participants from Argentina, Brazil, Chile, and Mexico. The outcome variable was self-reported adherence to preventive measures (handwashing, social distancing, self-isolation, use of face masks, and working from home). The explanatory variable was self-report of following media information related to COVID-19 (watching or reading the news, following social media coverage). Multivariable logistic regression analyses were conducted to determine the associations.

Results

Following information on social media was positively associated with higher odds of practicing social distancing (AOR=5.39; 95%CI: 3.93-7.30), self-isolation (AOR=1.44; 95%CI: 1.08-1.92), use of face masks (AOR=16.84; 95%CI: 10.03-28.27), handwashing (AOR=6.95; CI 95%: 4.98-9.71), and working from home (AOR=1.85; 95% CI: 1.43-2.41). Differences in the use of social media for COVID-19 information were observed among the four countries.

Conclusion

Following social media was positively associated with adherence to COVID-19 preventive measures in Latin America. Social media may be effectively used for COVID-19 behaviour modification in Latin America.

Editorial: The health informatics series: Evolving with a new discipline

A brief history of the book series launched by Springer-Verlag in 1988 as Computers in Healthcare stands as a case study of its role in the development of informatics in medicine. Renamed Health Informatics in 1998, the series grew to include 121 titles as of September 2022, covering topics from dental informatics to ethics, from human factors to mobile health. An analysis of three titles now in their fifth editions reveals the evolution of content in the core disciplines of nursing informatics and health information management. Shifts in topics in the second editions of two landmark titles chart the history of the field and provide a map to the development of the computer-based health record. Metrics on the publisher's website document the reach of the series, available as e-books or chapters. The growth of the series mirrors the evolution of health informatics as a discipline, and the contributions of authors and editors from around the world are evidence of international scope.

Social Media and the Influence of Fake News on Global Health Interventions: Implications for a Study on Dengue in Brazil

Social media usage is growing globally, with an exponential increase in low- and middle-income countries. Social media changes the ways in which information-sharing occurs, intensifying the population's exposure to misinformation, including fake news. This has important repercussions for global health. The spread of fake news can undermine the implementation of evidence-based interventions and weaken the credibility of scientific expertise. This is particularly worrisome in countries, such as Brazil, in a sociopolitical context characterized by a lack of popular trust in public institutions. In this project report, we describe our experience with the spread of fake news through the social media platform WhatsApp during the implementation of a cluster randomized controlled trial aimed at reducing dengue incidence in children in Fortaleza (Brazil). During initial visits to selected clusters, the research team was met with resistance. Then, soon after data collection started, fake news began circulating about the study. As a result, the research team developed strategies to dispel suspicion and further promote the study. However, the climate of violence and mistrust, coupled with the COVID-19 pandemic, forced the interruption of the study in 2019. The lessons learned from our experience in Fortaleza can be useful to other researchers and practitioners implementing large-scale interventions in this era of health-related misinformation.

Exploring the Role of Infodemics in People’s Incompliance with Preventive Measures during the COVID-19 in Conflict Settings (Mixed Method Study)

The evolving availability of health information on social media, regardless of its credibility, raises several questions about its impact on our health decisions and social behaviors, especially during health crises and in conflict settings where compliance with preventive measures and health guidelines is already a challenge due to socioeconomic factors. For these reasons, we assessed compliance with preventive measures and investigated the role of infodemic in people’s non-compliance with COVID-19 containment measures in Yemen. To this purpose and to triangulate our data collection, we executed a mixed method approach in which raw aggregated data were taken and analyzed from multiple sources (COVID-19 Government Response Tracker and Google COVID-19 Community Mobility Reports), then complemented and verified with In-depth interviews. Our results showed that the population in Yemen had relatively complied with the governmental containment measures at the beginning of the pandemic. However, containment measures were not supported by daily COVID-19 reports due to low transparency, which, together with misinformation and lack of access to reliable sources, has caused the population not to believe in COVID-19 and even practice social pressure on those who showed some compliance with the WHO guidelines. Those results indicate the importance of adopting an infodemic management approach in response to future outbreaks, particularly in conflict settings.

Antidepressants: A content analysis of healthcare providers' tweets

Background

Antidepressants are the primary treatment for depression, and social support from social media may offer another support route. Whilst Twitter has become an interactive platform for healthcare providers and their patients, previous studies found low engagement of healthcare providers when discussing antidepressants on Twitter. This study aims to analyse the Twitter posts of healthcare providers related to antidepressants and to explore the healthcare providers' engagement and their areas of interest.

Method

Tweets within a 10-day period were collected through multiple searches with a list of keywords within Twitter. The results were filtered against several inclusion criteria, including a manual screening to identify healthcare providers. A content analysis was conducted on eligible tweets where correlative themes and subthemes were identified.

Key findings

Healthcare providers contributed 5.9% of the antidepressant-related tweets (n = 770/13,005). The major clinical topics referred to in the tweets were side effects, antidepressants for the treatment of COVID-19, and antidepressant studies of psychedelics. Nurses posted more tweets sharing personal experiences with commonly negative attitudes, in contrast to physicians. Links to external webpages were commonly used among healthcare providers, especially users representing healthcare organisations.

Conclusions

A relatively low proportion of healthcare providers' engagement on Twitter regarding antidepressants (5.9%) was identified, with a minimal increase throughout the COVID-19 pandemic when compared to previous studies. The major clinical topics referred to in the tweets were side effects, antidepressants for the treatment of COVID-19 and antidepressant studies of psychedelics, which have been made publicly available. In general, the findings confirmed that social media platforms are a mechanism by which healthcare providers, organisations and students support patients, share information about adverse drug effects, communicate personal experiences, and share research. It is plausible that this could impact the belief and behaviours of people with lived experience of depression who may see these tweets.

A systematic review of the available literature on the use of social media in brain tumor

Purpose

The use of social media is one of the new technological options that has been recommended as a potential new strategy for delivering high-quality, high-value cancer prevention and management services. Despite the increasing use of social media, little research has been done on the use of social media in brain tumors. Therefore, this systematic review aims to provide a comprehensive review of the use of social media in brain tumor research.

Design/methodology/approach

A systematic search was performed in PubMed, Scopus and Web of Science from inception to August 1, 2022. English full-text articles evaluating social media use, benefit or content in brain tumor were considered.

Findings

Sixteen documents satisfied the inclusion criteria and were included in the final analysis. Most of the included studies (n = 11/16) were conducted and published by researchers in the USA. In terms of social media platform, most studies focused on Twitter (8/16, 50%) and YouTube (8/16, 50%), followed by Facebook (6/16, 37.5%) and Instagram (4/16, 25%). Most studies (n = 7/12) analyzed the content of brain tumor information provided on social media, followed by patients’ use of social media (n = 3/12) and the quality of information on social media (n = 3/12). The other three articles also examined patient recruitment, crowdfunding and caregiver use of social media.

Practical implications

By identifying the use, benefits and content of social media platforms in different settings, patients, clinicians and policymakers can better benefit from harnessing the power of social media in different ways, leading to improved health-care services.

Originality/value

To the authors knowledge, this is the first study to systematically examine social media use, benefits and content status in brain tumors.

Impact of #PsychTwitter in promoting global psychiatry: A hashtag analysis study

Introduction

Multiple studies have shown how valuable Twitter hashtags can be for promoting content related to different themes in the online community. This arena has grown into a rich data source for public health observation and understanding key trends in healthcare on a global scale. In the field of mental health in particular, it would be of benefit to understand and report the key stakeholders' (individual mental health professionals, academic organizations and their countries) trends and patterns of psychiatric knowledge and information dissemination using #PsychTwitter.

Objective

In this study, we aim to evaluate the achieved outreach of psychiatry-related tweets using the hashtag #PsychTwitter.

Methods

We utilized the Symplur Signals research analytics tool to characterize tweets containing #PsychTwitter from the 20th of August, 2019, to the 20th of August, 2022.

Results

The #PsychTwitter movement resulted in 125,297 tweets that were shared by 40,058 Twitter users and generated a total of 492,565,230 impressions (views). The three largest identified groups of contributors were Doctors (13.8% of all tweets), Org. Advocacy (6.2% of all tweets), and Researcher/Academic (4% of all tweets) stakeholders. The top influential accounts consisted of 55 psychiatrists and 16 institutional or organizational accounts. The top 5 countries from where most of the tweets containing #PsychTwitter were shared include the United States (54.3% of all users), the United Kingdom (10.4% of all users), Canada (4.9% of all users), India (2% of all users), and Australia (1.8% of all users).

Conclusion

This is the first of its kind study featuring the influence and usage of #PsychTwitter and covering its global impact in the field of psychiatry using the Twitter platform. Our results indicate that Twitter represents a broadly used platform for mental health-related discussions.

Zika virus knowledge and vaccine acceptance among undergraduate students in Guayaquil, Ecuador

Purpose

Zika virus (ZIKV) was declared a Public Health Emergency of International Concern (PHEIC) in 2016. Concerns surrounding the effects of ZIKV persist today and several vaccine candidates are currently in various stages of development worldwide. There is limited research on ZIKV vaccine acceptability worldwide, and little research specific to Latin American countries. This research aims to identify the general beliefs and acceptance of a potential ZIKV vaccine in the undergraduate population at Escuela Superior Politécnica del Litoral (ESPOL) in Guayaquil, Ecuador.

Methods

Between January and November 2019, 429 undergraduate students at ESPOL responded anonymously to a ZIKV vaccine survey. Frequencies, percentages, simple correspondence analysis, and bivariate inferential analyses were conducted using Kendall's tau-b test. Tests explored associations between likelihood of receiving a ZIKV vaccine and demographic, ZIKV information seeking, ZIKV psychosocial variables, and ZIKV information source variables.

Results

Among the eligible participants, 241 (56.2%) were willing to receive a ZIKV vaccine if one was made commercially available. Most students were male (61.5%), age 20-25 (63.3%), and of mixed (Mestizo) race (95.3%). Results provided insight into student's knowledge on ZIKV, revealed television as the most common information source, and found most students were willing to receive a ZIKV vaccine were one to become available. Bivariate results revealed most respondents reported feeling neutral or likely to receive a ZIKV vaccine regardless of their agreeability with ZIKV information seeking behavior and psychosocial variables.

Conclusions

This study provides insight into ZIKV knowledge among ESPOL university students and reveals most respondents obtained ZIKV related information from television. The most common reason for not wanting to receive a hypothetical ZIKV vaccine was vaccine hesitancy. Likelihood of receiving a ZIKV vaccine was associated with several information seeking behavior and psychosocial variables. Public health campaigns should focus on comprehensive ZIKV education efforts in this population.

The Use of 2 e-Learning Modalities for Diabetes Education Using Facebook in 2 Cities of Argentina During the COVID-19 Pandemic: Qualitative Study

Background

The COVID-19 pandemic and the confinement that was implemented in Argentina generated a need to implement innovative tools for the strengthening of diabetes care. Diabetes self-management education (DSME) is a core element of diabetes care; however, because of COVID-19 restrictions, in-person diabetes educational activities were suspended. Social networks have played an instrumental role in this context to provide DSME in 2 cities of Argentina and help persons with diabetes in their daily self-management.

Objective

The aim of this study is to evaluate 2 diabetes education modalities (synchronous and asynchronous) using the social media platform Facebook through the content of posts on diabetes educational sessions in 2 cities of Argentina during the COVID-19 pandemic.

Methods

In this qualitative study, we explored 2 modalities of e-learning (synchronous and asynchronous) for diabetes education that used the Facebook pages of public health institutions in Chaco and La Rioja, Argentina, in the context of confinement. Social media metrics and the content of the messages posted by users were analyzed.

Results

A total of 332 messages were analyzed. We found that in the asynchronous modality, there was a higher number of visualizations, while in the synchronous modality, there were more posts and interactions between educators and users. We also observed that the number of views increased when primary care clinics were incorporated as disseminators, sharing educational videos from the sessions via social media. Positive aspects were observed in the posts, consisting of messages of thanks and, to a lesser extent, reaffirmations, reflections or personal experiences, and consultations related to the subject treated. Another relevant finding was that the educator/moderator role had a greater presence in the synchronous modality, where posts were based on motivation for participation, help to resolve connectivity problems, and answers to specific user queries.

Conclusions

Our findings show positive contributions of an educational intervention for diabetes care using the social media platform Facebook in the context of the COVID-19 pandemic. Although each modality (synchronous vs asynchronous) could have differential and particular advantages, we believe that these strategies have potential to be replicated and adapted to other contexts. However, more documented experiences are needed to explore their sustainability and long-term impact from the users' perspective.

Strengthening the Merci Mon Héros Campaign Through Adaptive Management: Application of Social Listening Methodology

Background

Between 2014 and 2018, the penetration of smartphones in sub-Saharan Africa increased from 10% to 30%, enabling increased access to the internet, Facebook, Twitter, Pinterest, and YouTube. These platforms engage users in multidirectional communication and provide public health programs with the tools to inform and engage diverse audiences on a range of public health issues, as well as monitor opinions and behaviors on health topics.

Objective

This paper details the process used by the U.S. Agency for International Development–funded Breakthrough RESEARCH to apply social media monitoring and social listening techniques in Burkina Faso, Côte d’Ivoire, Niger, and Togo for the adaptive management of the Merci Mon Héros campaign. We documented how these approaches were applied and how the lessons learned can be used to support future public health communication campaigns.

Methods

The process involved 6 steps: (1) ensure there is a sufficient volume of topic-specific web-based conversation in the target countries; (2) develop measures to monitor the campaign’s social media strategy; (3) identify search terms to assess campaign and related conversations; (4) quantitatively assess campaign audience demographics, campaign reach, and engagement through social media monitoring; (5) qualitatively assess audience attitudes, opinions, and behaviors and understand conversation context through social media listening; and (6) adapt campaign content and approach based on the analysis of social media data.

Results

We analyzed posts across social media platforms from November 2019 to October 2020 based on identified key search terms related to family planning, reproductive health, menstruation, sexual activity, and gender. Based on the quantitative and qualitative assessments in steps 4 and 5, there were several adaptive shifts in the campaign’s content and approach, of which the following 3 shifts are highlighted. (1) Social media monitoring identified that the Facebook campaign fans were primarily male, which prompted the campaign to target calls to action to the male audience already following the campaign and shift marketing approaches to increase the proportion of female followers. (2) Shorter videos had a higher chance of being viewed in their entirety. In response to this, the campaign shortened video lengths and created screenshot teasers to promote videos. (3) The most negative sentiment related to the campaign videos was associated with beliefs against premarital sex. In response to this finding, the campaign included videos and Facebook Live sessions with religious leaders who promoted talking openly with young people to support intergenerational discussion about reproductive health.

Conclusions

Prior to launching health campaigns, programs should test the most relevant social media platforms and their limitations. Inherent biases to internet and social media access are important challenges, and ethical considerations around data privacy must continue to guide the advances in this technology’s use for research. However, social listening and social media monitoring can be powerful monitoring and evaluation tools that can be used to aid the adaptive management of health campaigns that engage populations who have a digital presence.

Exploring the Antimicrobial Stewardship Educational Needs of Healthcare Students and the Potential of an Antimicrobial Prescribing App as an Educational Tool in Selected African Countries

Antimicrobial resistance (AMR) is a global health threat and one of the top 10 global public health threats facing humanity. AMR contributes to 700,000 deaths annually and more deaths, as many as 10 million are projected to happen by 2050. Antimicrobial stewardship (AMS) activities have been important in combating the ripple effects of AMR and several concerted efforts have been taken to address the issues of antimicrobial resistance. The Commonwealth Pharmacists Association through the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme has been enhancing the capacity of health institutions in Low-Middle-Income Countries (LMIC) to combat AMR. Through such efforts, an antimicrobial prescribing app (CwPAMS app) was launched and delivered to support antimicrobial prescribing and improve AMS practice in four African countries; Ghana, Uganda, Zambia, and Tanzania. The app provides easy access to infection management resources to improve appropriate use of antimicrobials in line with national and international guidelines. This study aimed to identify and explore the potential for the usability of the CwPAMS app among healthcare students across selected African countries that are part of the Commonwealth. The study equally evaluated the healthcare students’ understanding and attitudes towards antimicrobial resistance and stewardship. Despite 70% of the respondents indicating that they had been taught about prudent use of antibiotics, diagnosis of infections and their management using antibiotics in their universities, notable knowledge gaps were discovered: 52.2% of the respondents had no prior information on the term AMS, 50.6% of them reported a lack of resources for accessing up-to-date information on drugs, for instance only 36% had had an opportunity to access an app as a learning resource even when 70% of the respondents thought that a mobile app would support in increasing their knowledge. Those challenges reveal an opportunity for the CwPAMS App as a potential option to address AMR and AMS gaps among healthcare students.

How Advanced Technological Approaches Are Reshaping Sustainable Social Media Crisis Management and Communication: A Systematic Review

The end goal of technological advancement used in crisis response and recovery is to prevent, reduce or mitigate the impact of a crisis, thereby enhancing sustainable recovery. Advanced technological approaches such as social media, machine learning (ML), social network analysis (SNA), and big data are vital to a sustainable crisis management decisions and communication. This study selects 28 articles via a systematic process that focuses on ML, SNA, and related technological tools to understand how these tools are shaping crisis management and decision making. The analysis shows the significance of these tools in advancing sustainable crisis management to support decision making, information management, communication, collaboration and cooperation, location-based services, community resilience, situational awareness, and social position. Moreover, the findings noted that managing diverse outreach information and communication is increasingly essential. In addition, the study indicates why big data and language, cross-platform support, and dataset lacking are emerging concerns for sustainable crisis management. Finally, the study contributes to how advanced technological solutions effectively affect crisis response, communication, decision making, and overall crisis management.

Social media’s potential to promote conservation at the local level: an assessment in eleven primate range countries

Historically, Internet access has been linked to a country’s wealth. However, starting a decade ago, this situation changed dramatically and Internet access became increasingly available in primate range countries. The rapid growth of smartphone use in developing nations has created new avenues to communicate conservation. Here we assess the potential of social media to promote primate conservation at the local level within primate range countries. We interviewed 381 people in communities associated with 18 conservation projects from 11 countries to assess their use of social media. We found that 91% of the people had at least one social media account and 95% of these people checked their accounts daily. The median number of contacts per person across all platforms was 453 and 300 considering only each person’s most used platform. We also documented that local conservation projects had a diversity of information they wanted to relay to the local community through social media. Our research highlights the potential for social media to be an extremely useful communication tool for tropical conservation scientists. Thus, we encourage more conservation groups to explore using social media to communicate to local communities and to report on the impact it has on conservation.

Does social media provide adequate health education for prevention of COVID-19? A case study of YouTube videos on social distancing and hand-washing

Social media offers an opportune platform for educating the public about the recommended interventions during global health emergencies. This case study evaluated information in the popular social media platform YouTube about two key interventions (namely, 'social distancing' and 'hand washing') recommended during coronavirus disease-2019. Using the keywords 'social distancing' and 'hand washing', 77 and 78 videos, respectively, were selected from YouTube through pre-defined criteria. The understandability, actionability and quality of information in these videos were assessed. Cumulatively, the social distancing videos received >9 million views and the hand-washing videos received >37 million views. Thirteen social distancing videos (16.9%) and 46 hand-washing videos (58.9%) provided understandable, actionable and good-quality information. The non-understandable, non-actionable or poor-quality videos had paradoxically more viewer engagements than the understandable, actionable or good-quality videos, respectively. Most social distancing videos came from news agencies (68.8%). Hand-washing videos were mostly uploaded by health agencies or academic institutes (52.6%). The videos were less likely to be understandable and actionable and to be of good quality when uploaded by sources other than health agencies or academic institutes. The paucity of adequate information and the limited representation of 'authoritative' sources were concerning. Strategies for harnessing social media as an effective medium for public health education are necessary during pandemics.

Food choice in transition: adolescent autonomy, agency, and the food environment

Dietary intake during adolescence sets the foundation for a healthy life, but adolescents are diverse in their dietary patterns and in factors that influence food choice. More evidence to understand the key diet-related issues and the meaning and context of food choices for adolescents is needed to increase the potential for impactful actions. The aim of this second Series paper is to elevate the importance given to adolescent dietary intake and food choice, bringing a developmental perspective to inform policy and programmatic actions to improve diets. We describe patterns of dietary intake, then draw on existing literature to map how food choice can be influenced by unique features of adolescent development. Pooled qualitative data is then combined with evidence from the literature to explore ways in which adolescent development can interact with sociocultural context and the food environment to influence food choice. Irrespective of context, adolescents have a lot to say about why they eat what they eat, and insights into factors that might motivate them to change. Adolescents must be active partners in shaping local and global actions that support healthy eating patterns. Efforts to improve food environments and ultimately adolescent food choice should harness widely shared adolescent values beyond nutrition or health.

Medical and Health-related Misinformation on Social Media: Analysis of the Scientific Literature

Background

Social media has been extensively used for the communication of health-related information and consecutively for the potential spread of medical misinformation. Conventional systematic reviews have been published on this topic to identify original articles and to summarize their methodological approaches and themes. A bibliometric study could complement their findings, for instance, by evaluating the geographical distribution of the publications and determining if they were well cited and disseminated in high-impact journals.

Objective

The aim of this study was to perform a bibliometric analysis of the current literature to discover the prevalent trends and topics related to medical misinformation on social media.

Methods

The Web of Science Core Collection electronic database was accessed to identify relevant papers with the following search string: ALL=(misinformati* OR “wrong informati*” OR disinformati* OR “misleading informati*” OR “fake news*”) AND ALL=(medic* OR illness* OR disease* OR health* OR pharma* OR drug* OR therap*) AND ALL=(“social media*” OR Facebook* OR Twitter* OR Instagram* OR YouTube* OR Weibo* OR Whatsapp* OR Reddit* OR TikTok* OR WeChat*). Full records were exported to a bibliometric software, VOSviewer, to link bibliographic information with citation data. Term and keyword maps were created to illustrate recurring terms and keywords.

Results

Based on an analysis of 529 papers on medical and health-related misinformation on social media, we found that the most popularly investigated social media platforms were Twitter (n=90), YouTube (n=67), and Facebook (n=57). Articles targeting these 3 platforms had higher citations per paper (>13.7) than articles covering other social media platforms (Instagram, Weibo, WhatsApp, Reddit, and WeChat; citations per paper <8.7). Moreover, social media platform–specific papers accounted for 44.1% (233/529) of all identified publications. Investigations on these platforms had different foci. Twitter-based research explored cyberchondria and hypochondriasis, YouTube-based research explored tobacco smoking, and Facebook-based research studied vaccine hesitancy related to autism. COVID-19 was a common topic investigated across all platforms. Overall, the United States contributed to half of all identified papers, and 80% of the top 10 most productive institutions were based in this country. The identified papers were mostly published in journals of the categories public environmental and occupational health, communication, health care sciences services, medical informatics, and medicine general internal, with the top journal being the Journal of Medical Internet Research.

Conclusions

There is a significant platform-specific topic preference for social media investigations on medical misinformation. With a large population of internet users from China, it may be reasonably expected that Weibo, WeChat, and TikTok (and its Chinese version Douyin) would be more investigated in future studies. Currently, these platforms present research gaps that leave their usage and information dissemination warranting further evaluation. Future studies should also include social platforms targeting non-English users to provide a wider global perspective.

Demographic profiling of Caribbean and United Kingdom student nurses' use of social media for professional development

BACKGROUND

Most students are adept in using technology and have developed skills and confidence utilising SoMe for professional purposes. SoMe is used by both registered nurses and student nurses.

PURPOSE

The purpose of this study was to investigate the professional use of SoMe by student nurses in Trinidad and Tobago, Jamaica and the UK to guide, support and develop implementation of effective and appropriate use of SoMe for professional development.

METHODS

An online cross-sectional survey was completed by student nurses from the three countries. Data were analysed using descriptive statistics.

RESULTS

The main reason for using social media among Caribbean participants was to watch videos or short clips whereas in UK it was downloading articles. Over 75% participants of all ages believed that social media was likely to help their career. There is no social media guidance for student nurses in Trinidad and Tobago and Jamaica.

CONCLUSION

Our study demonstrated that social media is embedded in student nurses' professional development throughout their education, with some variation in their use by country. Despite the fundamental place that social media plays in student nurses' professional development, there is no national or international guidance on how student nurses should use social media for professional development.

Analyzing Patient Stories on Social Media Using Text Analytics

Patients can use social media to describe their healthcare experiences. Several social media platforms, such as the Care Opinion platform, host large volumes of patient stories. However, the large number of these stories and the healthcare system's workload make exploring these stories a difficult task for healthcare providers and administrators. This study uses text mining for analyzing patient stories on the Care Opinion platform and exploring healthcare experiences described in these stories. We collected 367,573 stories, which were posted between September 2005 and September 2019. Topic modeling (Latent Dirichlet Allocation) and sentiment analysis were used to analyze the stories. Sixteen topics were identified representing five aspects of the healthcare experience: communication between patients and providers, quality of clinical services, quality of non-clinical services, human aspects of healthcare experiences, and patient satisfaction. There was also a clear sentiment in 99% of the stories. More than 55% of the stories that describe the patient's request for information, the patient's description of treatment, or the patient's making of an appointment had a negative sentiment, which represents patient dissatisfaction. The study provides insights into the content of patient stories and demonstrates how topic modeling and sentiment analysis can be used to analyze large volumes of patient stories and provide insights into these stories. The findings suggest that these stories are not general social media posts; instead, they describe elements of healthcare experiences that can be helpful for quality improvement.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41666-021-00097-5.

Benefits and harms of patient stories on social media from the perspective of healthcare providers and administrators in Ontario

There has been a growing use of social media by patients to share their healthcare experiences and produce information that can be helpful to other patients seeking healthcare services. These stories can reveal issues in healthcare quality. However, faced with the inherent risks of social media, healthcare providers have been skeptical about the value of these stories, and many healthcare systems have adopted restrictive and protective policies to control the use of social media by healthcare providers. This study explores healthcare providers' and administrators' perspectives on patient stories on social media and whether they can use the stories to evaluate healthcare experiences. Semi-structured interviews (n = 21) were conducted with healthcare providers and administrators, including physicians, nurses, and quality managers in Ontario, Canada, between April 2018 and May 2019. Inductive and data-driven thematic analysis was used to analyze the data. Several barriers prevent healthcare providers from realizing the benefits of social media, including concerns about the quality of patients' feedback, the professional codes of conduct, and the time and effort required to process these stories. The study findings suggest that cultural changes in the healthcare system might be required to foster the use of social media for healthcare quality improvement and enable the development of a safe patient-provider communication environment that facilitates the exchange of constructive feedback between the two parties without the fear of legal consequences, breaches of patient privacy, or violation of professional codes of conduct.

Health-care provision and policy for non-alcoholic fatty liver disease in sub-Saharan Africa

Sub-Saharan Africa, which has a population of more than 1 billion people, carries 24% of the global burden of disease and spends the least on health care of any region, relying heavily on international development assistance to deliver health care for HIV, tuberculosis, and malaria. The demographic and epidemiological transitions occurring in sub-Saharan Africa, with rising prevalences of obesity and diabetes, enhance the risk of non-alcoholic fatty liver disease (NAFLD), yet this remains an unrecognised complication of metabolic syndrome. There are no guidance documents on NAFLD from sub-Saharan Africa, and non-communicable disease (NCD) guidance documents do not include the associated burden of fatty liver disease. Combating the health and socioeconomic burden of NAFLD requires an integrated liver health approach, with task-shifting to primary health care. Using clear guidance documents to link education and management of HIV, viral hepatitis, NAFLD, and associated NCDs is also crucial to an integrated approach to infectious diseases and NCDs, which requires targeted funding from both governments and international development agencies.

Social Media and mHealth Technology for Cancer Screening: Systematic Review and Meta-analysis

Background

Cancer is a leading cause of death, and although screening can reduce cancer morbidity and mortality, participation in screening remains suboptimal.

Objective

This systematic review and meta-analysis aims to evaluate the effectiveness of social media and mobile health (mHealth) interventions for cancer screening.

Methods

We searched for randomized controlled trials and quasi-experimental studies of social media and mHealth interventions promoting cancer screening (breast, cervical, colorectal, lung, and prostate cancers) in adults in MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, and Communication & Mass Media Complete from January 1, 2000, to July 17, 2020. Two independent reviewers screened the titles, abstracts, and full-text articles and completed the risk of bias assessments. We pooled odds ratios for screening participation using the Mantel-Haenszel method in a random-effects model.

Results

We screened 18,008 records identifying 39 studies (35 mHealth and 4 social media). The types of interventions included peer support (n=1), education or awareness (n=6), reminders (n=13), or mixed (n=19). The overall pooled odds ratio was 1.49 (95% CI 1.31-1.70), with similar effect sizes across cancer types.

Conclusions

Screening programs should consider mHealth interventions because of their promising role in promoting cancer screening participation. Given the limited number of studies identified, further research is needed for social media interventions.

Trial Registration

PROSPERO International Prospective Register of Systematic Reviews CRD42019139615; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=139615

International Registered Report Identifier (IRRID)

RR2-10.1136/bmjopen-2019-035411

Does Online Community Participation Contribute to Medication Adherence? An Empirical Study of Patients with Chronic Diseases

Effectively improving the medication adherence of patients is crucial. Past studies focused on treatment-related factors, but little attention has been paid to factors concerning human beliefs such as trust or self-efficacy. The purpose of this study is to explore the following aspects of patients with chronic diseases: (1) The relationship between emotional support, informational support, self-efficacy, and trust; (2) the relationship between self-efficacy, trust, and medication adherence; and, (3) whether chronic patients’ participation in different types of online communities brings about significant statistical differences in the relationships between the abovementioned variables. A questionnaire survey was conducted in this study, with 452 valid questionnaires collected from chronic patients previously participating in online community activities. Partial Least Squares-Structural Equation Modeling analysis showed that emotional support and informational support positively predict self-efficacy and trust, respectively, and consequently, self-efficacy and trust positively predict medication adherence. In addition, three relationships including the influence of emotional support on trust, the influence of trust on medication adherence, and the influence of self-efficacy on medication adherence, the types of online communities result in significant statistical differences. Based on the findings, this research suggests healthcare professionals can enhance patients’ self-efficacy in self-care by providing necessary health information via face-to-face or online communities, and assuring patients of demonstrable support. As such, patients’ levels of trust in healthcare professionals can be established, which in turn improves their medication adherence.

Demystifying media sources of information and levels of knowledge about COVID-19: a rapid mini-review of cross-sectional studies in Africa

COVID-19 control is highly affected by knowledge levels which are also affected by receipt of information on the disease. Therefore, this review examined knowledge levels and media sources of information findings of the studies on knowledge, attitudes, perceptions, and practices towards COVID-19 done in low- and middle-income countries in Africa to shed light on the interplay of the use of different media platforms and populations’ knowledge about the COVID-19 pandemic and identify shorter- and longer-term priorities for COVID-19 research to improve the continent’s capacity to not only deal with COVID-19 but also future pandemics. Searches were conducted in PubMed and CINAHL databases/sites with major terms being “knowledge”, “attitudes”, “perceptions”, “practices”, “COVID-19 “, and “Africa”. 319 were where identified and subjected to the exclusion and inclusion criteria retaining only 10 free, full-text research articles related to knowledge, attitudes, perceptions, and practices towards COVID-19. This review summarized the levels of knowledge and media information sources among African populations. The review indicated a largely higher level of knowledge towards COVID-19 among populations who received information through various media platforms and alluded to the different media platforms that could be appropriate to spread COVID-19 related information to African populations.

Implementation and use of the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG): A review of the grey literature

Background

The World Health Organization (WHO)’s Mental Health Gap Action Programme (mhGAP)-Intervention Guide (IG) aims to integrate mental health into primary care/community-based settings by equipping non-specialists with tools, training, and support to deliver evidence-based interventions. With the growing popularity of the mhGAP-IG, a systematic review was conducted by Keynejad and colleagues (2018) to identify articles reporting on evidence generated from the implementation and evaluation of the mhGAP-IG in low- and middle-income countries (LMICs). Their review identified peer-reviewed articles and one thesis. In this current review, we report on the implementation and use of mhGAP-IG documented in the grey literature, an important and accessible channel to share information for LMICs.

Methods

We searched grey literature databases for documents that reported on the implementation and/or use of the mhGAP-IG or its training modules: ProQuest Dissertations & Theses Global, the Mental Health Innovation Network (MHIN) database, the WHO website, the mhGAP Newsletter, and the first 10 pages of Google search results. Authors developed and adapted search strategies according to database characteristics. Database searches were completed by November 12, 2019.

Results

One hundred and fifty-one (n = 151) documents were included in our review. We report on where the mhGAP-IG has been implemented and/or used worldwide. Many types of personnel were trained in the mhGAP-IG and/or used it in clinical practice. Contextual barriers and facilitators may influence the implementation and/or use of the mhGAP-IG, and we organized these according to structural, organizational, provider, patient, and innovation characteristics. Some information on evaluating the mhGAP-IG was documented in the grey literature. Outcomes included: feasibility of implementing and/or using the mhGAP-IG, its coverage, its impact on the capacities of personnel, patient outcomes, and policies, as well as program costs.

Conclusions

This review of the grey literature provides rich experiential knowledge that can complement information documented in the peer-reviewed literature. It is important for researchers conducting reviews on global health/global mental health topics to consider incorporating grey literature search strategies in their reviews. This may not only help to acknowledge the research/dissemination realities of many LMICs, but also to generate findings that reinforce and/or expand those documented in peer-reviewed articles.

Hashtag, like or tweet: a qualitative study on the use of social media among dentists in London

Aim To explore dentists' perceptions and use of social media generally and in relation to their professional careers, together with its implications for professionalism.Methods Semi-structured interviews were conducted with dentists in their early, mid- and late careers working in a range of settings based in London. Participants were purposively sampled via gatekeeper organisations, supported by snowball sampling. Interviews were audio-recorded, transcribed verbatim and data were analysed using thematic analysis.Results Eighteen dentists working across a range of career stages and care settings were interviewed. Participants were aware of the risks and benefits of using social media and expressed ways of balancing them. A typology of social media user types in the dental profession emerged from the data, comprising avoiders, secondary users, occasional users, observers, seekers, active and cautious, limited, engaged users and deleters. Participants reported an awareness of the impact of maintaining professionalism when using social media.Conclusion Among the participant population sampled, the risks and benefits of general and professional social media were discussed and, in some cases, these overlapped. The findings suggest that dentists are aware of the risks and benefits and employ techniques to balance risk. There were a range of social media user types that varied by characteristics, use in learning and the influences that change their use. It was evident that social media plays an important role in communication between those dentists engaging with available platforms. This area requires further research into professionalism and social media in dentistry.

Scoping reviews in health professions education: challenges, considerations and lessons learned about epistemology and methodology

Scoping reviews are increasingly used in health professions education to synthesize research and scholarship, and to report on the depth and breadth of the literature on a given topic. In this Perspective, we argue that the philosophical stance scholars adopt during the execution of a scoping review, including the meaning they attribute to fundamental concepts such as knowledge and evidence, influences how they gather, analyze, and interpret information obtained from a heterogeneous body of literature. We highlight the principles informing scoping reviews and outline how epistemology-the aspect of philosophy that "deals with questions involving the nature of knowledge, the justification of beliefs, and rationality"-should guide methodological considerations, toward the aim of ensuring the production of a high-quality review with defensible and appropriate conclusions. To contextualize our claims, we illustrate some of the methodological challenges we have personally encountered while executing a scoping review on clinical reasoning and reflect on how these challenges could have been reconciled through a broader understanding of the methodology's philosophical foundation. We conclude with a description of lessons we have learned that might usefully inform other scholars who are considering undertaking a scoping review in their own domains of inquiry.

How 3D printing and social media tackles the PPE shortage during Covid - 19 pandemic

During the recent Covid-19 pandemic, additive Technology and Social Media were used to tackle the shortage of Personal Protective Equipment. A literature review and a social media listening software were employed to explore the number of the users referring to specific keywords related to 3D printing and PPE. Additionally, the QALY model was recruited to highlight the importance of the PPE usage. More than 7 billion users used the keyword covid or similar in the web while mainly Twitter and Facebook were used as a world platform for PPE designs distribution through individuals and more than 100 different 3D printable PPE designs were developed.

How 3D printing and social media tackles the PPE shortage during Covid - 19 pandemic

During the recent Covid-19 pandemic, additive Technology and Social Media were used to tackle the shortage of Personal Protective Equipment. A literature review and a social media listening software were employed to explore the number of the users referring to specific keywords related to 3D printing and PPE. Additionally, the QALY model was recruited to highlight the importance of the PPE usage. More than 7 billion users used the keyword covid or similar in the web while mainly Twitter and Facebook were used as a world platform for PPE designs distribution through individuals and more than 100 different 3D printable PPE designs were developed.

Social Media Perceptions of Surgical Cancer Care in the Era of COVID-19: A Global Cross-Sectional Study

PURPOSE

The rapid dissemination of information through social media renders a profound lens to evaluate perceptions of emerging topics, especially in the context of a global pandemic. The primary objective of this cross-sectional study was to elucidate trends on social media in the setting of surgical cancer care affected by the COVID-19 pandemic across the globe.

METHODS

A public search of Twitter from April 1 to 30, 2020, was conducted, which yielded 996 posts related to COVID-19 and cancer. Two authors (E.J.K. and H.S.) individually reviewed all posts and recorded the post category, engagement, author category, and geographic location. Data were then analyzed through descriptive analyses. Only English-language posts were included, and any noncancer- or non-COVID–related posts were excluded from the analysis.

RESULTS

A total of 734 unique authors from 26 different countries wrote 996 relevant posts that averaged 12.0 likes, 4.7 retweets, and 0.5 hashtags per post. Only 2.3% (23 of 996) of posts included a video. Authors of the included tweets most frequently were friends and families of patients (183; 18.4%), academic institutions or organizations (182; 18.3%), and physicians (138; 13.9%). Topics of importance were cancellations of surgeries (299; 40.1%), COVID-19 education (211; 121.2%), and research studies (93; 9.3%). The United Kingdom and the United States made up 81.5% of the cohort, followed by Canada (6.6%) and India (2.4%). Of posts where a specific type of surgery was identified (196), the most common type mentioned was breast cancer (50; 25.5%), followed by lung cancer (37; 18.9%) and urologic cancer (22; 11.2%).

CONCLUSION

This analysis provides insight into the resulting impacts of COVID-19 on the global discussion of surgical cancer care.

The Use of Fitness Influencers' Websites by Young Adult Women: A Cross-Sectional Study

The growth of the fitness industry observed in the last decade has been accompanied by the emergence of an occupation as a social media fitness influencer. The most popular are able to accumulate millions of followers. The marketing potential of fitness influencers is a subject of interest, not only for the fitness industry but also for other sectors offering products related to health, wellness, or healthy nutrition. However, the activities of fitness influencers related to the promotion of physical activity and healthy lifestyle converge with the aims of those promoting public health. The main objective of this study was to make an assessment of the determinants of regular access to fitness influencers' sites (FIS) and their relationship with the health behaviors of young adult women. It was based on the data originating from an online survey on a representative sample of Polish women aged 18-35 years. Chi2 test, univariate, and multiply logistic regression models were used to determine the relationships between FIS and the variables related to the respondents' characteristics of and their health behaviors. FIS were accessed by 29.3% of respondents (n = 1030) at least once a week. It was found that those living in cities with a population ranging from 20,000 to 100,000 were more likely to access FIS than those living in rural areas. Similarly, greater access was made by those in a high-income household rather than those with the lowest income, by those with inadequate rather than those with problematic health literacy and by those with high rather than low e-health literacy. The use of FIS was significantly associated with the consumptions of fruit and vegetables (OR, 95%CI: 2.77, 2.01-3.82), physical activity (1.74, 1.27-2.38), breast self-examination (1.54, 1.11-2.13), and also with the greater use of e-cigarettes (1.63, 1.09-2.43) and increased consumption of alcohol (1.37, 1.01-1.88). In conclusion, as access to Internet resources run by fitness influencers was a prevailing predictor of young adult Polish women's health behaviors, FIS may play a potentially important role in promoting a healthy lifestyle in this population. However, it should be remembered that there are complex patterns of associations with specific behaviors, e.g., the use of e-cigarettes or alcohol consumption.

The role of e-health in improving control and management of COVID 19 outbreak: current perspectives

E-health could play an important role in the global response to Coronavirus disease 2019 (COVID-19). This paper aims to outline the roles of using e-health in the control and management of COVID-19 based on current perspectives. Many databases and health organizations were searched. The results indicated that there are significant roles of e-health in strengthening the efforts to control and manage this COVID-19 pandemic through improving safe coordination and communication, affording an alternative for education and training, analyzing the data, and providing safe care. Further studies are recommended to evaluate the role of e-health in the control and management of COVID-19.

Social media based surveillance systems for healthcare using machine learning: A systematic review

BACKGROUND

Real-time surveillance in the field of health informatics has emerged as a growing domain of interest among worldwide researchers. Evolution in this field has helped in the introduction of various initiatives related to public health informatics. Surveillance systems in the area of health informatics utilizing social media information have been developed for early prediction of disease outbreaks and to monitor diseases. In the past few years, the availability of social media data, particularly Twitter data, enabled real-time syndromic surveillance that provides immediate analysis and instant feedback to those who are charged with follow-ups and investigation of potential outbreaks. In this paper, we review the recent work, trends, and machine learning(ML) text classification approaches used by surveillance systems seeking social media data in the healthcare domain. We also highlight the limitations and challenges followed by possible future directions that can be taken further in this domain.

METHODS

To study the landscape of research in health informatics performing surveillance of the various health-related data posted on social media or web-based platforms, we present a bibliometric analysis of the 1240 publications indexed in multiple scientific databases (IEEE, ACM Digital Library, ScienceDirect, PubMed) from the year 2010-2018. The papers were further reviewed based on the various machine learning algorithms used for analyzing health-related text posted on social media platforms.

FINDINGS

Based on the corpus of 148 selected articles, the study finds the types of social media or web-based platforms used for surveillance in the healthcare domain, along with the health topic(s) studied by them. In the corpus of selected articles, we found 26 articles were using machine learning technique. These articles were studied to find commonly used ML techniques. The majority of studies (24%) focused on the surveillance of flu or influenza-like illness (ILI). Twitter (64%) is the most popular data source to perform surveillance research using social media text data, and Support Vector Machine (SVM) (33%) being the most used ML algorithm for text classification.

CONCLUSIONS

The inclusion of online data in surveillance systems has improved the disease prediction ability over traditional syndromic surveillance systems. However, social media based surveillance systems have many limitations and challenges, including noise, demographic bias, privacy issues, etc. Our paper mentions future directions, which can be useful for researchers working in the area. Researchers can use this paper as a library for social media based surveillance systems in the healthcare domain and can expand such systems by incorporating the future works discussed in our paper.

Examining algorithmic biases in YouTube's recommendations of vaccine videos

OBJECTIVE

This research examines how YouTube recommends vaccination-related videos.

MATERIALS AND METHODS

We used a social network analysis to evaluate how YouTube recommends vaccination related videos to its users.

RESULTS

More pro-vaccine videos (64.75%) than anti-vaccine (19.98%) videos are on YouTube, with 15.27% of videos being neutral in sentiment. YouTube was more likely to recommend neutral and pro-vaccine videos than anti-vaccine videos. There is a homophily effect in which pro-vaccine videos were more likely to recommend other pro-vaccine videos than anti-vaccine ones, and vice versa.

DISCUSSION

Compared to our prior study, the number of recommendations for pro-vaccine videos has significantly increased, suggesting that YouTube's demonization policy of harmful content and other changes to their recommender algorithm might have been effective in reducing the visibility of anti-vaccine videos. However, there are concerns that anti-vaccine videos are less likely to lead users to pro-vaccine videos due to the homophily effect observed in the recommendation network.

CONCLUSION

The study demonstrates the influence of YouTube's recommender systems on the types of vaccine information users discover on YouTube. We conclude with a general discussion of the importance of algorithmic transparency in how social media platforms like YouTube decide what content to feature and recommend to its users.