How patients' use of social media impacts their interactions with healthcare professionals

Comparative Analysis of Knee Osteoarthritis Treatment Information on Popular Social Media Platforms

INTRODUCTION

With the rise of social media as a source for health information, there is concern about the spread of unregulated, potentially misleading content. This study aimed to evaluate the quality of knee osteoarthritis (OA) treatment information on TikTok, YouTube, and Instagram platforms where patients often seek medical advice.

METHODS

TikTok videos, Instagram posts, and YouTube videos focusing on knee OA treatment and meeting specific engagement thresholds were identified using a standardized search. Six reviewers, including orthopaedic faculty and residents, assessed the content's accuracy and reliability using a 10-question Social Media Outreach Content Assessment & Review Tool (SOCART), adapted from the DISCERN instrument. Data were analyzed using analysis of variance, linear regression, and mixed methods.

RESULTS

The study reviewed 130 social media posts (YouTube: 30, TikTok: 50, Instagram: 50). YouTube had the highest median number of followers/subscribers, whereas TikTok had the most likes/day and comments/day. Most TikTok (66.7%) and Instagram (92.0%) content creators were from private practices, whereas YouTube creators were mainly affiliated with academic institutions (40.0%). YouTube scored the highest in SOCART assessments (32.86 ± 0.89/50), markedly outperforming Instagram (21.30 ± 0.69/50) and TikTok (20.34 ± 0.87/50; P < 0.001). Content from academic institutions scored higher than that from nonacademic sources (28.04 ± 1.05 vs. 21.77 ± 0.859, P = 0.014).

CONCLUSION

YouTube's high ratings in all SOCART instrument categories suggest that it presents higher-quality information about knee OA treatments relative to Instagram and TikTok. However, YouTube content was still found to be inaccurate and unreliable, making it unsatisfactory for dissemination of important health information. In addition, despite having the lowest SOCART scores, TikTok received the most engagement. This study highlights two important findings: social media presents a risk for patient misinformation when seeking medical advice, and it creates opportunities for physicians to connect with patients using platforms with higher user engagement. Physicians and medical societies can use this information during educational content creation to inform platform choice and dissemination strategies.

Shared decision-making in severe asthma therapy: qualitative study of physician-patient communication

RATIONALE

Biologics are indicated for severe asthma, but little is known about the factors driving patient and physician decisions surrounding their use.

OBJECTIVES

To understand decision drivers for biologic use and conversational dynamics between patients with severe asthma and physicians.

METHODS

This retrospective database study used anonymized physician-patient conversations (recorded September 2018-August 2020) from routine clinical visits, captured in Verilogue's physician-patient syndicated database. Eligible conversations included those of patients with severe asthma, who were considering biologic therapy (Topic 1), had initiated biologic within 7 months of clinical visit (Topic 2), or were discontinuing/considering switching biologic treatment (Topic 3). Conversations were analyzed quantitatively and descriptively by topic.

RESULTS

Overall, 50 conversations between 14 physicians and 50 patients were included (considering biologic, n = 10; recent biologic initiation, n = 20; switched/discontinued biologic, n = 20). Physicians had 68-73% share of the conversation. When considering biologic treatment, the presence of symptoms (including coughing, wheezing, shortness of breath and chest tightness) drove the decision, with 3/10 patients providing additional symptom impact/severity details, and 2/10 describing adjustments to accommodate symptoms. Physicians set unspecified treatment goals and modest expectations for biologic efficacy, framing any symptom control as success (13/20 conversations). Patient symptom assessment drove the decision to continue, discontinue, or switch biologic treatment: in 5/20 cases, physicians asked patients if they were "better" or the medication is "helping".

CONCLUSIONS

This study suggests that patients relied on physicians to shape patient-physician interactions and treatment expectations. This suggests that shared decision-making may improve physicians' understanding of the impact severe asthma has on patients and facilitate the setting of treatment expectations.

The needs of informal caregivers of people experiencing dementia as identified on social media

OBJECTIVES

The aims of this study were to 1) categorize and quantify the most frequent concerns of informal caregivers, 2) conduct a thematic analysis on a sample of the posts, and 3) examine a subset of 100 post responses to determine if they are supportive and evidence- based.

METHOD

For Aims 1 and 2, we used a qualitative descriptive design using content analysis. To address Aim 3, we used a Delphi method in a subset sample of responses to posts to determine if they were supportive or not and evidence-based or not.

RESULTS

The most frequent issues were: 1) information seeking about the problem behaviors of dementia, 2) grieving/loneliness/isolation, 3) caregiver stress/venting, 4) a need for celebration, and 5) financial/legal concerns. Seventy-three percent of the responses were supportive and accurate.

CONCLUSION

These findings highlight multifaceted concerns and areas of support needed for dementia caregivers. They may help inform future strategies that can be delivered in an interactive question and answering tool that provides supportive evidence-based information to dementia caregivers.

Endometriosis Influencers on Instagram: Who are They and What are They Posting?

STUDY OBJECTIVE

To examine endometriosis-related content on Instagram, a platform increasingly used for health communication, to understand: 1) the identity of Instagram content creators; 2) themes, tones, and emotions evoked from posts; and 3) accuracy of educational information. The relevance of this study lies in its potential to inform healthcare providers on how to better engage with social media to support individuals with endometriosis.

DESIGN

This mixed methods cross-sectional observational study was performed on June 6, 2021. Instagram content was collected via two approaches: 1) searching hashtags related to endometriosis from a list of 30 hashtags and analyzing the top 20 and 10 most recent posts and 2) searching endometriosis-related terms under accounts to examine the first 30 accounts retrieved. Posts were categorized into themes and evaluated for tone and emotion, with educational posts also evaluated for accuracy.

SETTING

Publicly available data on Instagram.

PARTICIPANTS

None.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The study analyzed 768 Instagram posts and 228 accounts. Of these, 59.9% of posts and 92.1% of accounts contained endometriosis-related content. Most posts (55.4%) and accounts (59.0%) were authored by people with endometriosis. Accounts owned by people with endometriosis were significantly more active and had more followers compared to those who identified as healthcare providers (mean difference of total # of posts = 714.4, p < .001, mean difference of total # of followers = 27,194.7, p < .001, respectively). Social support was the most common theme (67.2%). Many posts had a negative tone (43.7%) and evoked sadness (57.6%). Objective educational posts contained 85.0% accurate information. Allied healthcare providers were most likely to post accurate educational information compared to all other content creators (p < .001).

CONCLUSION

Instagram is widely used by people with endometriosis, with posts predominantly centered around social support and personal narratives. Healthcare providers can use this information better understand the experiences of people with endometriosis, and to engage more effectively on Instagram.

Examining healthcare workers' engagement with social media-based health education: Influencing factors, challenges, and future directions

BACKGROUND

Social Media-based Health Education (SMHE) provides an effective way to address health disparities and improve public health literacy. Despite its inherent advantages, Healthcare Workers (HCWs) in China have showed limited and transient interest in engaging with SMHE initiatives.

OBJECTIVE

This study aims to examine healthcare workers' perceptions of SMHE, identifying current influencing factors, challenges, and proposing future directions for development.

METHODS

A descriptive qualitative study was conducted from October 2021 to January 2022, involving healthcare workers (i.e., physicians, nurses, and hospital administrators) engaged in SMHE. Semi-structured in-depth interviews were undertaken with 30 HCWs, which were subsequently analyzed thematically.

RESULTS

Thematic analysis yielded 165 initial codes, organized into 12 subcategories spanning three main themes: (1) HCWs' perceptions of SMHE, (2) drivers and barriers to HCWs' engagement with SMHE, and (3) strategies to overcome current challenges.

CONCLUSION

This study yielded three main conclusions. First, HCWs in China exhibit a noticeable optimism toward SMHE, but most of them still have certain concerns. Second, HCWs engagement with SMHE is motivated or requested by their organizations, rather than their own initiatives. The main barriers for HCWs engagement with SMHE include: lack of time, risk of reputational loss, conflicts of interest, patient welfare, and concerns about legal issues. Third, healthcare organizations, social media platforms, and governmental bodies, must collaboratively address these issues to ensure protection for health workers engaged with SMHE.

PRACTICAL VALUE

This study finds that Chinese HCWs are willing to engage in SMHE provided they are moderately rewarded and assured of a secure environment.

Patient-Generated Data as Interventions in Doctor-Patient Relationships? Negotiating (Un)Invited Participation in Medical Consultations

Health data generated by apps and devices are increasingly popular and expected to affect various aspects of doctor-patient relationships. No longer confined to medically authorised and certified health technologies, a range of biomedical data-from heart rate to blood pressure or oxygen saturation-are captured and processed by consumer health devices. This article outlines different responses of physicians to patients collecting data with popular consumer devices and considers how the data may challenge or reify medical authority. Based on semi-structured interviews with doctors and chronically ill patients in Germany from 2021 to 2023, we compare cases from diabetes, sleep disorders, cardiovascular conditions, obesity and ME/CFS and explore when, how and for what reasons different medical specialists consider patient-generated data (PGD) from consumer devices in outpatient settings. Their response registers vary: whereas some physicians reject PGD that seem to compete with their diagnostic activities, others tolerate the data (collection), whereas still others more readily include them into their diagnostic practices. This suggests nuanced strategies for navigating the demarcation between accepting or rejecting 'uninvited' participation through PGD from consumer apps and devices.

What's on the agenda? Examining public health communication about opioids

The way media portray public health problems influences the public's perception of problems and related solutions. Social media allows users to engage with news and to collectively construct meaning. This paper examined news in comparison to user-generated content related to opioids to understand the role of second-level agenda-setting in public health. We analyzed 162,760 tweets about the opioid crisis, and compared the main topics and their sentiments with 2998 opioid stories from The New York Times online. Evidence from this study suggests that second-level agenda setting on social media is different from the news; public communication about opioids on X/Twitter highlights attributes that are different from the ones highlighted in news. The findings suggest that public health communication should strategically utilize social media data, including obtaining consumer insight from personal tweets, listening to diverse views and warning signs from issue tweets, and tuning to the media for policy trends.

Faster and better than a physician?: Assessing diagnostic proficiency of ChatGPT in misdiagnosed individuals with neuromyelitis optica spectrum disorder

BACKGROUND

Neuromyelitis optica spectrum disorder (NMOSD) is a commonly misdiagnosed condition. Driven by cost-consciousness and technological fluency, distinct generations may gravitate towards healthcare alternatives, including artificial intelligence (AI) models, such as ChatGPT (Generative Pre-trained Transformer). Our objective was to evaluate the speed and accuracy of ChatGPT-3.5 (GPT-3.5) in the diagnosis of people with NMOSD (PwNMOSD) initially misdiagnosed.

METHODS

Misdiagnosed PwNMOSD were retrospectively identified with clinical symptoms and time line of medically related events processed through GPT-3.5. For each subject, seven digital derivatives representing different races, ethnicities, and sexes were created and processed identically to evaluate the impact of these variables on accuracy. Scoresheets were used to track diagnostic success and time to diagnosis. Diagnostic speed of GPT-3.5 was evaluated against physicians using a Cox proportional hazards model, clustered by subject. Logistical regression was used to estimate the diagnostic accuracy of GPT-3.5 compared with the estimated accuracy of physicians.

RESULTS

Clinical time lines for 68 individuals (59 female, 42 Black/African American, 13 White, 11 Hispanic, 2 Asian; mean age at first symptoms 34.4 years (y) (standard deviation = 15.5y)) were analyzed and 476 digital simulations created, yielding 544 conversations for analysis. The instantaneous probability of correct diagnosis was 70.65% less for physicians relative to GPT-3.5 within 240 days of symptom onset (p < 0.0001). The estimated probability of correct diagnosis for GPT-3.5 was 80.88% [95% CI = (76.35%, 99.81%)].

CONCLUSION

GPT-3.5 may be of value in recognizing NMOSD. However, the manner in which medical information is conveyed, combined with the potential for inaccuracies may result in unnecessary psychological stress.

Social Media Potential and Impact on Changing Behaviors and Actions in Skin Health Promotion: Systematic Review

BACKGROUND

Social media is used as a tool for information exchange, entertainment, education, and intervention. Intervention efforts attempt to engage users in skin health.

OBJECTIVE

This review aimed to collect and summarize research assessing the impact of social media on skin health promotion activities undertaken by social media users.

METHODS

In accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, the following scientific databases were searched: Scopus, Web of Science, PubMed, Academic Search Ultimate (via EBSCO), Academic Research Source eJournals (via EBSCO), ERIC (via EBSCO), Health Source: Consumer Edition (via EBSCO), and Health Source: Nursing/Academic Edition (via EBSCO). Using ProQuest Dissertations and Theses, OpenGrey, Grey Literature Report, and MedNar, the search was supplemented with gray literature. Articles on skin care, skin health, skin diseases, skin protection, and educational activities promoting healthy skin on social media were selected for review (search date: February 6, 2023). The following qualification criteria were used: original research; research conducted on social media; and research topics regarding educational activities in skin health promotion, skin care, skin health, skin diseases, and skin protection. To assess the risk of bias, the following tools were used: the Cochrane Collaboration tool for risk-of-bias assessment (randomized controlled trials and quasi-experimental studies) and the Centre for Evidence-Based Medicine checklist (cross-sectional studies).

RESULTS

Altogether, 1558 works were considered, of which 23 (1.48%) qualified, with 3 (13%) studies on acne and 20 (87%) on skin cancer, sunscreen, and tanning. Social media interventions were dealt with in 65% (15/23) of the studies. The review made it possible to investigate cognitive and cognitive-behavioral interventions. In both observational and interventional studies, the most frequently discussed topics were skin exposure and protection against UV radiation and skin cancer. The analyzed research showed that social media is a source of information. Visualization has a strong impact on users. The involvement of social media users is measured through the amount of content shared and contributes to changing attitudes and behaviors regarding skin health.

CONCLUSIONS

This review outlined the impact of social media, despite its heterogeneity, on users' skin health behaviors, attitudes, and actions. It identified strategies for digital interventions to promote skin health. In health sciences, a standardized tool is needed to assess the quality of social media digital interventions. This review has several limitations: only articles written in English were considered; ongoing studies were omitted; and there was a small number of interventional studies on acne and a lack of research on daily skin care, education, and antiaging activities on social media. Another limitation, resulting from the topic being too broad, was a failure to perform quantitative data analysis, resulting in the studies that qualified for the review being heterogeneous.

Right Information, Right Care, Right Patient, Right Time: Community Preferences to Inform a Self-Management Support Tool for Upper Respiratory Symptoms

OBJECTIVES

 During and since the coronavirus disease 2019 (COVID-19) pandemic, communities have needed to cope with several conditions that cause similar upper respiratory symptoms but are managed differently. We describe community reactions to a self-management toolkit for patients with upper respiratory symptoms to inform mobile e-health app development. The toolkit is based on the "4R" (Right Information, Right Care, Right Patient, Right Time) care planning and management model.

METHODS

 The 4R Cold, Flu, and COVID-19 Information Tool (4R-Toolkit) along with a brief evaluation survey were distributed in three ways: through a Bronx NY Allergy/Asthma clinic, through the Bronx Borough President's Office listserv, and through peer recruitment. The survey assessed respondents' perceptions of the 4R-Toolkit's accessibility, preferences for sharing symptoms with clinicians, social media use, and e-health literacy.

RESULTS

 We obtained a diverse sample of 106 Bronx residents, with 83% reporting personal or a social contact with symptoms suggestive of COVID-19. Respondents varied in the information sources they preferred: computer (39%), smartphone (28%), paper (11%), and no preference (22%). Most (67%) reported that social media had at least some impact on their health care decisions. Regardless of media preferences, respondents were positive about the 4R-Toolkit. Out of 106 respondents, 91% believed the 4R-Toolkit would help people self-manage upper respiratory symptoms and 85% found it easy to understand. Respondents strongly endorsed retention of all 4R-Toolkit content domains with 81% indicating that they would be willing to share symptoms with providers using a 4R-Toolkit smartphone app.

CONCLUSION

 The 4R-Toolkit can offer patients and community members accurate and up-to-date information on COVID-19, the common cold, and the flu. The user-friendly tool is accessible to diverse individuals, including those with limited e-health literacy. It has potential to support self-management of upper respiratory symptoms and promote patient engagement with providers.

Emerging Use of Social Media in Clinical Urology Practice in the 21st Century: Survey Study

Background

Social media (So-Me) platforms are valuable resources for health care professionals and academics to discover, discuss, and distribute current advances in research and clinical practices, including technology trends.

Objective

This study aims to assess the role of So-Me in urological practice in Saudi Arabia. It explores the influence of digital platforms on patient interaction, professional communication, decision-making, and education.

Methods

The survey was conducted among 145 urologists from July 2021 to July 2022 following institutional review board approval. A questionnaire designed using the SurveyMonkey platform examined urologists' knowledge of So-Me. The survey was conducted using the CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines and was open for 17 weeks. Data analysis was performed using SPSS 21.0.

Results

Of the 145 participants, 70% (n=102) were Saudi Arabians. The most common age groups were 30-40 (n=68, 46.8%) and 41-50 (n=61, 42.2%) years, with a gender distribution of 44.8% (n=65) women and 55.2% (n=80) men. A total of 61.5% (n=89) of urologists reported using So-Me accounts for professional purposes, with 54.9% (n=80) sharing health-related information. Social media enhanced patient connections beyond clinic visits for 55.8% (n=81) of respondents, while 57.2% (n=83) used it to provide educational resources. Additionally, 56.5% (n=82) believed So-Me facilitated patient feedback and improved their practice. In terms of professional communication, 60.6% (n=88) of urologists agreed that So-Me facilitated collaboration with colleagues, while 63.3% (n=92) used it to stay updated on the latest advances in urology. Furthermore, 62% (n=90) followed professional societies or journals on So-Me, and 63.3% (n=92) used it for continuing medical education. A majority (n=94, 64.7%) reported that So-Me influenced treatment decisions based on new research findings, and 85.3% (n=124) learned about novel technologies and treatment options through these platforms. Regression analysis showed a significant positive correlation between gender and social media usage patterns (R=0.653, R2=0.426), indicating that approximately 42.6% of the differences in usage patterns can be attributed to gender. However, the Pearson χ2 analysis showed that gender did not significantly affect most aspects of social media use, except information sharing and participating in online discussions (both P<.05).

Conclusions

This study highlights the widespread use of So-Me among urologists in Saudi Arabia, underscoring its role in enhancing patient interaction, professional development, and clinical decision-making. Strategically designed health care programs using social media could improve and modernize professional and patient-centered care in Saudi Arabia through legislative assistance and guidelines.

Trust of social media content and risk of making misinformed decisions: Survey of people affected by cancer and their caregivers

Background

This study explores social media (SM) usage and trust in information among cancer patients and their caregivers. We compare socio-demographic characteristics to identify groups more likely to rely on social media for treatment decisions and those less inclined to validate social media information with their provider.

Methods

A national survey of people diagnosed with cancer and those who were caregivers to people diagnosed with cancer was conducted via online survey in November-December 2021. Socio-demographic factors associated with respondents' use of SM and comfort disclosing SM use were assessed using logistic regression.

Findings

Out of 262 respondents, 65% were likely to use SM to make decisions about lifestyle changes, cancer screening, vaccination, cancer treatment, medical testing, or choosing a provider. SM users were younger (ORadj = 0.11, p < 0.01), identified as Black (ORadj = 10.19, p < 0.01), and had less education (ORadj = 0.86, p = 0.02). Those with less education reported not being comfortable discussing SM with their providers (ORadj = 1.25, padj = 0.01).

Discussion

Results contribute new understanding of the digital divide, highlighting the need for not only improving access to digital information but also the need for a supportive environment that provides patients with dependable methods to verify the authenticity of the information they encounter.

Using Natural Language Processing and Social Media Data to Understand the Lived Experience of People with Fibromyalgia

BACKGROUND AND OBJECTIVES

Fibromyalgia has many unmet needs relating to treatment, and the delivery of effective and evidence-based healthcare is lacking. We analyzed social media conversations to understand the patients' perspectives on the lived experience of fibromyalgia, factors reported to trigger flares of pain, and the treatments being discussed, identifying barriers and opportunities to improve healthcare delivery.

METHODS

A non-interventional retrospective analysis accessed detail-rich conversations about fibromyalgia patients' experiences with 714,000 documents, including a fibromyalgia language tag, which were curated between May 2019 and April 2021. Data were analyzed via qualitative and quantitative analyses.

RESULTS

Fibromyalgia conversations were found the most on Twitter and Reddit, and conversation trends remained stable over time. There were numerous environmental and modifiable triggers, ranging from the most frequent trigger of stress and anxiety to various foods. Arthritis and irritable bowel syndrome (IBS) were the most frequently associated comorbidities. Patients with fibromyalgia reported a wide range of symptoms, with pain being a cardinal feature. The massage, meditation and acupuncture domains were the most reported treatment modalities. Opportunities to improve healthcare delivered by medical providers were identified with current frustration relating to a lack of acknowledgement of their disease, minimization of symptoms and inadequately meeting their care needs.

CONCLUSIONS

We developed a comprehensive, large-scale study which emphasizes advanced natural language processing algorithm application in real-world research design. Through the extensive encapsulation of patient perspectives, we outlined the habitual symptoms, triggers and treatment modalities which provide a durable foundation for addressing gaps in healthcare provision.

Social Media Behavior Guidelines for Healthcare Professionals: An American Society of Pain and Neuroscience NEURON Project

Purpose

The American Society of Pain and Neuroscience (ASPN) identified a significant gap in resources and guidelines that aim to educate healthcare providers for best practices when engaging on social media. As part of the broader initiatives on Spine and Nerve practice, the executive board of ASPN has decided it would be beneficial to include comprehensive guidance for healthcare providers when engaging on social media.

Methods

A panel of experts was chosen based on expertise, publications, diversity, and their social media presence. Along with expert guidance, the committee conducted an extensive analysis of peer-reviewed literature in communication and medical journals to determine best practices for healthcare practitioners on social media.

Results

Social media messages significantly impact patients' and colleagues' perceptions and actions regarding medical issues. As such, providers and their teams must be aware of legal and ethical considerations in healthcare while maintaining a consistent, educational, and digestible persona online.

Conclusion

The advancement of communication and medical technologies and systems necessitates continued education and resources to adapt to our rapidly changing media and medical landscape.

Family medicine residents' perspectives on shared decision-making: A mixed methods study

OBJECTIVES

To 1) examine the willingness of residents to undertake shared decision-making and 2) explore whether the willingness to engage in shared decision-making is influenced by the perceived stakes of a clinical situation.

METHODS

Sequential mixed methods design. Phase One: Family Medicine residents completed IncorpoRATE, a seven-item measure of clinician willingness to engage in shared decision making. Mean IncorpoRATE scores were calculated. Phase Two: We interviewed residents from phase one to explore their perceptions of high versus low stakes situations. Transcripts were analyzed using qualitative content analysis.

RESULTS

IncorpoRATE scores indicated a greater willingness to engage in shared decision-making when the stakes of the decision were perceived as low (7.59 [2.0]) compared to high (4.38 [2.5]). Interviews revealed that residents held variable views of the stakes of similar clinical decisions.

CONCLUSION

Residents are more willing to engage in shared decision-making when the stakes of the situation are perceived to be low. However, the interpretation of the stakes of clinical situations varies.

PRACTICAL IMPLICATIONS

Further research is needed to explore how shared decision making is understood by residents in Family Medicine and when they view the process of shared decision-making to be most appropriate.

The experience of treatment for eating disorders as told by content creators on TikTok

TikTok, a social media platform with substantial youth engagement, has been used to examine eating disorder (ED) recovery; however, no studies have described the experience of ED treatment as told on TikTok. The purpose of this study was to describe content related to ED treatment using the hashtag #EDtreatment. The 100 most-viewed videos using #EDtreatment were downloaded, transcribed verbatim, and coded. Using qualitative thematic analysis, a coding framework was created; themes were generated and reviewed by coauthors until consensus was reached. Ultimately, 55 videos were included in the analysis. The videos included in the analysis had, in total, 15.6 million views, 3 million "likes", 36647 comments, and were shared by users 26,673 times. Themes generated included Aspects of Treatment, Interpersonal Relationships, Emotions and Psychiatric Comorbidities, and ED Experiences. Content ranged from uplifting and encouraging to negative and serious. Videos used dramatic reenactments, music, humor, and other entertainment methods, suggesting that creators attempted to generate high volume viewer consumption. When combined with TikTok's brief video format, users may consume large amounts of content rapidly. Individuals considering treatment may be influenced by viewing TikTok content. When clinically engaging individuals with EDs, the perceived significance of this content is a topic of consideration.

Endoscopic Spine Surgery on Instagram: Analysis of Content and Engagement

Introduction Social media platforms have changed the way society communicates and collaborates. Prior research in healthcare discusses how social media can empower patients, dispel health-related misinformation, and help maintain a patient-centered practice. The goal of this study was to evaluate the use of #endoscopicspinesurgery on Instagram and create a blueprint for creating engaging posts on the social media platform. Methodology Public Instagram posts (n = 171) that utilized #endoscopicspinesurgery were collected over three months in 2022. Each post was assessed for photo and caption content, likes, comments, number of followers, and hashtag information. Engagement rates were calculated for each post to assess the active interaction of post characteristics and content. Results The majority of posts were published by medical professionals (72/171, 42.1%) and industry-related user accounts (55/171, 32.2%). Content related to training, conferences, and the operating room garnered the highest average engagement. Post characteristics (number of hashtags and number of post photos) were significantly associated with engagement. Conclusions Results highlighted general trends in creating engaging social media posts, such as using hashtags intentionally to increase searchability and visibility, having higher numbers of photos in a post and using high-quality photos, and understanding the dynamic social media algorithms that may affect post viewership. When structuring social media posts, users should be aware of the audience they want to attract and construct their content accordingly.

Experiences and Views of Young People and Health Care Professionals of Using Social Media to Self-Manage Type 1 Diabetes Mellitus: Thematic Synthesis of Qualitative Studies

BACKGROUND

Social media have shown the potential to support type 1 diabetes self-management by providing informational, emotional, and peer-to-peer support. However, the perceptions of young people and health care professionals' (HCPs) toward the use of social media for type 1 diabetes self-management have not been systematically reviewed.

OBJECTIVE

The aim of this study is to explore and summarize the experiences and views of young people with type 1 diabetes and their HCPs on using social media for self-management across qualitative findings.

METHODS

We searched MEDLINE, Embase, PsycINFO, and CINAHL from 2012 to 2023 using Medical Subject Heading terms and text words related to type 1 diabetes and social media. We screened and selected the studies according to the inclusion and exclusion criteria. We quality appraised and characterized the included studies and conducted a thematic synthesis.

RESULTS

We included 11 studies in our synthesis. A total of 9 of them were qualitative and 2 were mixed methods studies. Ten focused on young people with type 1 diabetes and 1 on HCPs. All used content analysis and were of moderate to high quality. Thirteen descriptive themes were yielded by our thematic synthesis, contributing to five analytic themes: (1) differences in how young people interact with social media, (2) characteristics of social media platforms that influence their use and uptake for type 1 diabetes self-management, (3) social media as a source of information, (4) impact on young people's coping and emotional well-being, and (5) impact on support from and relationships with HCPs and services.

CONCLUSIONS

The synthesis suggests that we should consider leveraging social media's peer support capabilities to augment the traditional services for young people with type 1 diabetes. However, the patients may have privacy concerns about HCPs' involvement in their online activities. This warrants an update of existing guidelines to help young people use social media safely for self-managing their diabetes.

Social media influence on COVID-19 vaccine perceptions among University students: a Malawi case study

INTRODUCTION

The global fight against the COVID-19 pandemic relies significantly on vaccination. The collective international effort has been massive, but the pace of vaccination finds hindrance due to supply and vaccine hesitancy factors. Understanding public perceptions, especially through the lens of social media, is important. This study investigates the influence of social media on COVID-19 vaccine perceptions among university students in Malawi.

METHODS

The study utilized a quantitative methodology and employed a cross-sectional study design to explore the relationship between social media dynamics and COVID-19 vaccine perceptions among 382 randomly sampled students at MUBAS. Data, collected by use of a Likert-scale questionnaire, was analyzed using IBM SPSS 20 for descriptive statistics and Pearson correlation tests.

RESULTS

The findings reveal crucial correlations. Specifically, trust in online vaccine information shows a positive correlation (r = 0.296, p < 0.01) with active engagement in social media discussions. Conversely, a negative correlation surfaces concerning individuals' reactions to vaccine availability in Malawi (r = -0.026, p > 0.05). The demographic overview highlights the prevalence of the 16 to 30 age group, representing 92.9% of respondents.

CONCLUSIONS

The identified correlations emphasize the need for careful communication strategies tailored to combat misinformation and enhance vaccine acceptance among the younger demographic in Malawi. The positive correlation between trust in online vaccine information and social media engagement underscores digital platforms' potential for disseminating accurate information. Conversely, the negative correlation with vaccine availability reactions suggest the presence of complex factors shaping public perceptions.

Examining Healthcare Professionals' Communication Around Decision-Making with Internet-Informed Patients

In the last ten years the use of the internet as a health resource has transformed, and while patients increasingly consult online resources for health decision-making, less is known about how healthcare professionals (HCPs) currently discuss decision-making with internet informed patients (IIPs). In this paper we examine how HCPs perceive IIPs and specifically how bringing online information into appointments can prompt different communicative strategies around decision-making. Ten HCPs with experience working across different healthcare roles, took part in semi-structured interviews and discussed their interactions with IIPs around decision-making. Vignettes based on descriptions of real patients bringing online health information to their HCPs were used to prompt further discussion. The analysis identified two themes in relation to communication: (i) being honest about information sources and (ii) from compliance to co-construction: improving communication around decision-making. HCPs were overwhelmingly positive toward IIPs and encouraged patients to be transparent about their online searching to understand their motivations, priorities, and concerns. Although compliance remains part of the narrative, HCPs recognized practical ways in which discussing online health information could improve HCP-patient communication around shared decision-making. We discuss the findings in relation to early work on communicative strategies between HCP's and patients bringing resources to their consultations. We argue that for HCPs the concept of the internet as a provider of health information is no longer seen as inherently damaging or risky. There is growing acceptance of pre-consultation internet searching with the caveat that any information sourced online should inform rather than dictate decision-making with HCPs.

Patient experiences and perceptions of kidney stone surgery: what lessons can be learned from TikTok?

Introduction

The aim of this study was to perform an evaluation of patient experiences and perceptions regarding kidney stone surgery on the social media platform TikTok. An increasing number of the public use social media (SoMe) as a platform to share their views regarding their experiences related to surgical treatment.

Methods

Using the hashtag #kidneystonesurgery, the 100 most recent video posts as of 01.01.2024 on TikTok were included. As well as demographic data such as gender and location, thematic content was also collected. To achieve this, a previously published framework was used and adapted for application in the setting of kidney stone surgery. This was piloted on 20 sample videos to assess its feasibility before revision and establishment of the final framework. This included the following key areas: Pain, Complications, Anxiety, Recovery, Return to work, Finances, Treatment delays, Diet and Prevention and stent complaints.

Results

The majority of posts (95%) were from North America, 80% by females and the mean number of video views was 92,826 (range: 261-2,000,000). 76% of the videos discussed ureteroscopy (URS). 49% were filmed at the hospital, which was named in 9% of the videos. Top three topics discussed were: Recovery (65%), pain (62%) and stents (55%). This was followed by anxiety (39%) and complications (24%). 12% of these videos uploaded by lay people included basic medical information that was wholly incorrect. More than half of the posts (51%) were negative in tone. Treatment delays (5%) and a lack of sufficient preoperative information (4%) were also raised, that appeared to contribute to the negative reports. However, the main cause for negative tone owed to the 80% of the patients (n = 44) who discussed stents that focused their video on the pain suffered from the post operative stent.

Conclusion

There is a high level of usership and engagement on TikTok on the subject of kidney stone surgery. The proportion of negative videos is high and much of this is related to the bothersome stent symptoms and complications. This could easily lead to misperceptions among potential patients about the true burden of such adverse events.

An Analysis of Pediatric Ophthalmology Content on TikTok

PURPOSE

To assess pediatric ophthalmology-related information on TikTok (ByteDance).

METHODS

The 12 most commonly searched terms from the American Association for Pediatric Ophthalmology and Strabismus website were queried as TikTok hashtags. The top 20 videos for each hashtag were analyzed for views, likes, comments, saves, shares, author status and gender, content, and engagement level ratio (ELR). Subanalysis of the educational videos for quality, understandability and actionability, and medical accuracy using the modified DISCERN (mDISCERN), Patient Education Materials Assessment Tool (PEMAT), and modified Medical Information and Content Index (mMICI) was performed.

RESULTS

Analysis of 222 videos revealed a cumulative 191,337,973 views. Patients/families created the most videos (60.4%), followed by optometrists (14.4%), other (laypeople/unknown) (9.0%), ophthalmologists (7.7%), non-ophthalmology physicians (4.5%), and nurses (4.1%). Content was predominantly patient experience (56.8%), followed by educational (25.2%), humor (11.7%), self-promotional (3.6%), procedures (0.9%), other (0.9%), advertisements (0.5%), and career (0.5%). Educational videos had a lower ELR than humorous (3.3 vs 8.2, P < .001) and patient experience (3.3 vs 5.3, P < .001) videos, but more saves than patient experience videos (74 vs 25, P = .009). The mDISCERN scores were greater for videos authored by ophthalmologists (3, P < .001) and optometrists (2.5, P < .001) compared to lay-people (1.5). Ophthalmologist PEMAT understandability scores were greater than non-ophthalmology providers' (95.5% vs 67.4%, P = .002). There was no difference in PEMAT actionability (P = .743) or mMICI scores among the author subgroups (P = .206).

CONCLUSIONS

Pediatric ophthalmology content on Tik-Tok ranges in quality and understandability. Additional research is needed to help promote posts created by eyecare providers to ensure evidence-based medical content reaches pediatric patients and their families. [J Pediatr Ophthalmol Strabismus. 2024;61(2):90-97.].

What influences trust in and understanding of clinical trials? An analysis of information and communication technology use and online health behavior from the Health Information National Trends Survey

BACKGROUND

Using information and communication technologies to seek, discuss, and share health-related information influences people's trust and knowledge of several health practices. However, we know little about the associations between individuals' information and communication technology use and their perceptions of trust and knowledge of clinical trials. Examining these associations may lead to the identification of target audiences and channels for developing effective educational interventions and campaigns about clinical trials.

METHODS

In this study, we analyzed Health Information National Trends Survey data to document perceptions of clinical trial-related knowledge and trust that were recently added as questions in this annual national survey of US adults. We also examined correlates of these clinical trial perceptions that included sociodemographic factors and individuals' use of information and communication technologies to seek health information, discuss such information with their healthcare providers, and share the information in their network.

RESULTS

More than 90% of participants had no or limited perceived knowledge about clinical trials. Knowledge was higher among those who seek or discuss health-related information online. Differences in perceived knowledge and trust emerged for some racial/ethnic subgroups and other demographic factors. Providers were considered the most trusted source of information (73.6%), followed by health organizations (19.4%) and social support (7.1%). Trust in health organizations compared to health providers was higher among those who used online resources to share health information online with others. Trust in social support was significantly higher among those who used information and communication technologies to communicate about health.

CONCLUSION

Based on these findings, we recommend developing online resources about clinical trials to be distributed through social media. These resources should facilitate a dialogue and be targeted to several groups considering their information and communication technologies' use.

A Comparison of Lichen Sclerosus and Vulvodynia Content Across Social Media Platforms: What Is Trending Over Time

OBJECTIVES

Vulvovaginal diseases are common gynecologic complaints and patients often turn to social media (SM) for medical information. The objective of this study is to examine vulvovaginal content on SM and how it has changed over time.

MATERIALS AND METHODS

Four SM platforms were searched (i.e., Facebook, Instagram, Twitter, and YouTube) at 2 time points from March 30 to May 7, 2021, and again from November 24 to December 10, 2022. Newer SM platforms became popular during this time interval and thus TikTok and Reddit were included in the search in 2022. This study focused on 2 common vulvovaginal conditions: lichen sclerosus and vulvodynia. The SM platforms were searched for content on these conditions and the type of content, language, and country of origin were assessed.

RESULTS

A total of 1228 SM accounts, posts, and pages were assessed. Lichen sclerosus content on SM was mostly informational (32.6%), whereas vulvodynia content was mostly personal experience (30.5%). Patient support groups were significantly more popular in 2021 compared with 2022 and professional groups were more common in 2022 compared with 2021 ( p < .001). Overall, Facebook and Instagram consisted mostly of patient support groups, YouTube had both informational and professional videos, TikTok had mostly personal experiences and healthcare professional videos, and Reddit was mostly discussions about patient personal experiences.

CONCLUSIONS

The current study highlights the content and quantifies user engagement of lichen sclerosus and vulvodynia on SM.

Analysis of factors that promote the participation of patients with chronic diseases in shared decision making on medication: a cross-sectional survey in Hubei Province, China

BACKGROUND

Shared decision making (SDM) improves the health status of patients with chronic diseases, especially in the condition of poly-medicated patients. This study aims to find the factors associated with participation of patients with chronic diseases in SDM on medication.

METHODS

A total of 1,196 patients with chronic diseases were selected in Hubei Province of China using cluster sampling methods. The random forest method was applied to rank the importance of independent variables by Mean Decrease Gini and out-of- bag (OOB) curve. Multivariate logistic regression was used to explore the independent variables' effect direction and relative hazard.

RESULTS

In this study, 5.18% of patients used patient-directed decision making (PDM, a decision-making model led by patients), 37.79% of patients used SDM (a collaborative decision-making model by patients and doctors), and 57.02% of patients used doctor-directed decision making (DDM, or paternalistic decision making, a decision-making model led by doctors). The random forest analysis demonstrated that the top 5 important factors were age, education, exercise, disease course, and medication knowledge. The OOB curve showed that the error rate reached minimum when top 5 variables in importance ranking composed an optimal variable combination. In multivariate logistic regression, we chose SDM as a reference group, and identified medication knowledge (OR = 2.737, 95%CI = 1.524 ~ 4.916) as the influencing factor between PDM and SDM. Meanwhile, the influencing factors between DDM and SDM were age (OR = 0.636, 95%CI = 0.439 ~ 0.921), education (OR = 1.536, 95%CI = 1.122 ~ 2.103), exercise (OR = 1.443, 95%CI = 1.109 ~ 1.877), disease course (OR = 0.750, 95%CI = 0.584 ~ 0.964), and medication knowledge (OR = 1.446, 95%CI = 1.120 ~ 1.867).

CONCLUSION

Most Chinese patients with chronic diseases used DDM during their medication decision-making, and some patients used PDM and SDM. The participation in SDM should be taken seriously among elderly patients with lower education levels. The SDM promotion should focus on transformation of patients' traditional perception and enhance their medication knowledge.

Patient initiated radiology requests: proof of wellness through images

BACKGROUND

Traditionally, general practitioners (GPs) have initiated the need for, and ordered, radiological tests. With the emergence of consumer-centred care, patients have started to request scans from doctors on their own initiative. Consumeristic health care has shifted the patient-doctor dyadic relationship, with GPs trending towards accommodating patients' requests.

METHODS

A mixed method analysis was conducted using a survey instrument with open ended questions and concurrent interviews to explore participants' responses from their requests for radiological studies from GPs. Themes emerging from both qualitative and quantitative methodologies were mapped onto the Andersen Newman Model (ANM).

RESULTS

Data were analysed for 'predisposing,' 'need' and 'enabling' elements of the ANM model and were correspondingly mapped to patient's requests for radiological referrals according to the elements of the ANM. Participants expressed anxiety about their health, were confident in the types of radiological scans they desired and typically indicated the need for evidence of good health. Their desire for such requested scans was often enabled through prior exposure to health information and the experience of specific symptoms. Requests came with the expectation of validation, and if these requests were denied, participants indicated that they would seek another doctor who would oblige.

CONCLUSIONS

In our modest study of Australian patients, participants were well informed about their health. Exposure to information seems to create a sense of anxiousness prior to visiting the doctor. Individuals sought visual proof of wellness through imaging, and doctors in return often accommodated patient requests for radiological studies to appease patients' needs and to maintain workflow.

Decision-making in nursing research and practice-Application of the Cognitive Continuum Theory: A meta-aggregative systematic review

AIM

To explore how the Cognitive Continuum Theory has been used in qualitative nursing research and to what extent it has been integrated in the research process using the Qualitative Network for Theory Use and Methodology (QUANTUM).

BACKGROUND

Theory, research and nursing are intrinsically linked, as are decision-making and nursing practice. With increasing pressure on nurses to improve patient outcomes, systematic knowledge regarding decision-making is critical and urgent.

DESIGN

A meta-aggregative systematic review.

METHODS

DATABASES: CINAHL, Medline, PsycINFO, Embase and PubMed were searched from inception until May 2022 for peer-reviewed research published in English. Seven studies were included and assessed for methodological quality using the Joanna Briggs Institute checklist for qualitative research. A meta-aggregative synthesis was conducted using Joanna Briggs methodology. The QUANTUM typology was used to evaluate the visibility of the Cognitive Continuum Theory in the research process.

RESULTS

The review identified five synthesised findings, namely: 1. the decision-making capacity of the individual nurse, 2. nurses' level of experience, 3. availability of decision support tools, 4. the availability of resources and 5. access to senior staff and peers. Only two of seven studies rigorously applied the theory. The included studies were mainly descriptive-exploratory in nature.

CONCLUSION

The transferability of the Cognitive Continuum Theory was demonstrated; however, evolution or critique was absent. A gap in the provision of a patient-centric approach to decision-making was identified. Education, support and research is needed to assist decision-making. A new Person-Centred Nursing Model of the Cognitive Continuum Theory has been proposed to guide future research in clinical decision-making.

RELEVANCE TO CLINICAL PRACTICE

Nurses make numerous decisions every day that directly impact patient care, therefore development and testing of new theories, modification and revision of older theories to reflect advances in knowledge and technology in contemporary health care are essential.

Hope and Optimism in Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives

Introduction

Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.

Objective

This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.

Materials and Methods

Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, transcribed, and coded.

Results

Using thematic content analysis, four major themes from clinician interviews and five major themes from caregiver interviews related to hopes and expectations were identified. Clinicians expressed concerns about caregiver false hopes (86%, 25/29) and desperation (68.9%, 20/29) in light of DBS being a last resort. As a result, 68.9% of clinicians (20/29) expressed that they intentionally tried to lower caregiver expectations about DBS outcomes. Clinicians also expressed concern that, on the flip side, unrealistic pessimism drives away some patients who might otherwise benefit from DBS (34.5%, 10/29). Caregivers viewed DBS as the last option that they had to try (61.3%, 27/44), and 73% of caregivers (32/44) viewed themselves as having high hopes but reasonable expectations. Fewer than half (43%, 19/44) expressed that they struggled setting outcome expectations due to the uncertainty of DBS, and 50% of post-DBS caregivers (14/28) expressed some negative feelings post treatment due to unmet expectations. 43% of caregivers (19/44) had experiences with clinicians who tried to set low expectations about the potential benefits of DBS.

Conclusion

Thoughtful clinician-stakeholder discussion is needed to ensure realistic outcome expectations.

Surveying the Landscape of Social Media Usage for Health Care by Otolaryngology Patients

OBJECTIVE

To determine factors associated with social media usage for finding a doctor or seeking medical advice among otolaryngology patients.

METHODS

Cross-sectional study of 361 patients visiting our clinics. All participants were asked if they were aware social media may be used to find doctors and if they had ever done so, and also if they were aware social media could be used to get advice about a medical condition or its treatment and if they had ever done so. Demographic characteristics were examined for association with affirmative answers to these questions.

RESULTS

Facebook was the most used social media platform with 50.7% using Facebook daily. Over 50% of participants were aware social media could be used to find a doctor or seek medical advice. Daily use of Facebook was associated with using social media for finding a doctor (OR = 2.57, 95%CI: 1.41-4.67, p = 0.002) and seeking medical advice (OR = 1.72, 95%CI: 1.09-2.71, p = 0.020). Having Medicare was associated with using social media to find a doctor (OR = 2.20, 95%CI: 1.15-4.21, p = 0.017), whereas Medicaid was associated with using social media for medical advice (OR = 1.99, 95%CI: 1.08-3.67, p = 0.027).

CONCLUSION

A majority of otolaryngology patients may be aware of health care applications of social media, with Facebook being the dominant platform, and Medicare insurance identifying patients who may most use social media in this manner. There is also an indication that social determinants of health, as reflected by Medicaid insurance, may be associated with using social media to seek medical advice.

LEVEL OF EVIDENCE

NA Laryngoscope, 133:2116-2121, 2023.

Impacts of Symptom Checkers for Laypersons' Self-diagnosis on Physicians in Primary Care: Scoping Review

BACKGROUND

Symptom checkers (SCs) for laypersons' self-assessment and preliminary self-diagnosis are widely used by the public. Little is known about the impact of these tools on health care professionals (HCPs) in primary care and their work. This is relevant to understanding how technological changes might affect the working world and how this is linked to work-related psychosocial demands and resources for HCPs.

OBJECTIVE

This scoping review aimed to systematically explore the existing publications on the impacts of SCs on HCPs in primary care and to identify knowledge gaps.

METHODS

We used the Arksey and O'Malley framework. We based our search string on the participant, concept, and context scheme and searched PubMed (MEDLINE) and CINAHL in January and June 2021. We performed a reference search in August 2021 and a manual search in November 2021. We included publications of peer-reviewed journals that focused on artificial intelligence- or algorithm-based self-diagnosing apps and tools for laypersons and had primary care or nonclinical settings as a relevant context. The characteristics of these studies were described numerically. We used thematic analysis to identify core themes. We followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist to report the study.

RESULTS

Of the 2729 publications identified through initial and follow-up database searches, 43 full texts were screened for eligibility, of which 9 were included. Further 8 publications were included through manual search. Two publications were excluded after receiving feedback in the peer-review process. Fifteen publications were included in the final sample, which comprised 5 (33%) commentaries or nonresearch publications, 3 (20%) literature reviews, and 7 (47%) research publications. The earliest publications stemmed from 2015. We identified 5 themes. The theme finding prediagnosis comprised the comparison between SCs and physicians. We identified the performance of the diagnosis and the relevance of human factors as topics. In the theme layperson-technology relationship, we identified potentials for laypersons' empowerment and harm through SCs. Our analysis showed potential disruptions of the physician-patient relationship and uncontested roles of HCPs in the theme (impacts on) physician-patient relationship. In the theme impacts on HCPs' tasks, we described the reduction or increase in HCPs' workload. We identified potential transformations of HCPs' work and impacts on the health care system in the theme future role of SCs in health care.

CONCLUSIONS

The scoping review approach was suitable for this new field of research. The heterogeneity of technologies and wordings was challenging. We identified research gaps in the literature regarding the impact of artificial intelligence- or algorithm-based self-diagnosing apps or tools on the work of HCPs in primary care. Further empirical studies on HCPs' lived experiences are needed, as the current literature depicts expectations rather than empirical findings.

A case study of using natural language processing to extract consumer insights from tweets in American cities for public health crises

BACKGROUND

The COVID-19 pandemic was a "wake up" call for public health agencies. Often, these agencies are ill-prepared to communicate with target audiences clearly and effectively for community-level activations and safety operations. The obstacle is a lack of data-driven approaches to obtaining insights from local community stakeholders. Thus, this study suggests a focus on listening at local levels given the abundance of geo-marked data and presents a methodological solution to extracting consumer insights from unstructured text data for health communication.

METHODS

This study demonstrates how to combine human and Natural Language Processing (NLP) machine analyses to reliably extract meaningful consumer insights from tweets about COVID and the vaccine. This case study employed Latent Dirichlet Allocation (LDA) topic modeling, Bidirectional Encoder Representations from Transformers (BERT) emotion analysis, and human textual analysis and examined 180,128 tweets scraped by Twitter Application Programming Interface's (API) keyword function from January 2020 to June 2021. The samples came from four medium-sized American cities with larger populations of people of color.

RESULTS

The NLP method discovered four topic trends: "COVID Vaccines," "Politics," "Mitigation Measures," and "Community/Local Issues," and emotion changes over time. The human textual analysis profiled the discussions in the selected four markets to add some depth to our understanding of the uniqueness of the different challenges experienced.

CONCLUSIONS

This study ultimately demonstrates that our method used here could efficiently reduce a large amount of community feedback (e.g., tweets, social media data) by NLP and ensure contextualization and richness with human interpretation. Recommendations on communicating vaccination are offered based on the findings: (1) the strategic objective should be empowering the public; (2) the message should have local relevance; and, (3) communication needs to be timely.

The Effects of Patient-Centered Communication on Emotional Health: Examining the Roles of Self-Efficacy, Information Seeking Frustration, and Social Media Use

The existing literature on the direct association between patient-centered communication (PCC) and emotional well-being often demonstrates inconsistent results. To explain such inconsistency, it is important to explore the mediating and moderating mechanisms underlying this relationship. Built upon the communication pathways model, this study empirically analyzed the Health Information National Trends Survey 5 Cycle 3 dataset (N = 4,709) and tested a moderated mediation model that links PCC to emotional health via information-seeking self-efficacy, with an additional assessment of the moderating effects of information-seeking frustration and social media use. The findings showed that PCC was positively related to emotional health. Also, PCC was indirectly associated with emotional health through information-seeking self-efficacy. In addition, information-seeking frustration and social media use weakened the association between PCC and information-seeking self-efficacy. Furthermore, the indirect path from PCC to emotional health through information-seeking self-efficacy was conditional on both information-seeking frustration and social media use. Important theoretical and practical implications are also discussed.

From 'parallel world' to 'trading zone': How diabetes-related information from social media is (not) discussed in clinical consultations

In today's digital world, people with type 1 and 2 diabetes turn to peers on social media to access and share information. Some studies have addressed how such information is discussed in clinical consultations, but conceptual nuances are needed to account for the different ways information is discussed. In this article, we draw on semi-structured interviews with 19 clinicians and 25 people with diabetes to examine how diabetes-related information from social media is discussed in Danish outpatient clinical consultations. The data were collected from September 2020 to January 2021. We conceptualise how these discussions fall on a continuum of (dis)engagement with social media information represented by three metaphorical concepts: parallel world, border zone, and trading zone. On one end, social media resembles a parallel world disconnected from clinical consultations: people with diabetes do not bring up social media information and clinicians do not invite them to discuss it. The middle of the continuum is represented by a border zone in which people with diabetes present social media information and clinicians' reactions can either push back, maintaining social media as a parallel world, or support the formation of a trading zone. On the other end, clinical consultations resemble a trading zone: clinicians are open to social media information, invite people with diabetes to discuss it and acknowledge the value of social media. Furthermore, these discussions are often characterised by negotiation in which different perspectives are exchanged. We discuss the benefits and challenges of moving from the parallel world to the trading zone, arguing that discussions about social media information may help clinicians learn what people with diabetes gain from online peer interactions and enable them to offer their expertise to support people with diabetes as they navigate a complex world of online information.

Immunosuppression after pediatric liver transplant: The parents' perspective

BACKGROUND

For children with liver transplants (LT), achieving an "ideal outcome" is a balancing act: too little immunosuppression begets graft injury; too much begets systemic complications. We aimed to delineate the parental perspective on this tightrope.

METHODS

Parents of children with LT completed an internet-based survey about their child's immunosuppression.

RESULTS

Children of respondents (n = 82) were a median 4 years from primary LT (range 0-22); 73% were on immunosuppression monotherapy. Parents' top concerns were related to immunosuppression complications; 46% were more concerned about immunosuppression complications than rejection; only 17% were more concerned about rejection than immunosuppression complications. Among parents of children on immunosuppression monotherapy, 29% still worried more about immunosuppression complications than rejection, 48% expressed equal concern for both. Time since LT (0-4 vs. >4 years) was not associated with concern level for rejection or immunosuppression complications. Caregivers were significantly more certain that their child's immunosuppression regimen was correct to prevent rejection than to mitigate complications (p < .005).

CONCLUSION

Caregivers of children with LTs reported higher levels of concern and uncertainty about immunosuppression complications than rejection risk. Understanding parent and patient perspectives on IS, and incorporating them into immunosuppression counseling and decision-making, is critical to achieving truly "ideal" long-term outcomes.

Perceptions towards biologic and biosimilar therapy of patients with rheumatic and gastroenterological conditions

BACKGROUND

Biologic and targeted synthetic disease modifying agents (b/tsDMARDs) have broadened the treatment landscape for autoimmune diseases particularly in patients refractory to conventional DMARDs. More recently, the introduction of biosimilars has reduced the price of bDMARDs, potentially improving accessibility. Though efficacy and safety have been described, patient attitudes to b/tsDMARDs are not well-understood. We aim to investigate patients' beliefs about biologic and biosimilar therapy, and the factors influencing their perceptions.

METHODS

Patient consumer groups (Arthritis Australia, Crohn's and Colitis Australia) assisted in advertising an online questionnaire for people with a self-reported diagnosis of inflammatory arthritis (IA) or inflammatory bowel disease (IBD). The questionnaire incorporated the Belief about Medicines Questionnaire (BMQ) and the single-item literacy screener (SILS). Sources and favourability of biologic/biosimilar information were analysed, using the chi-square and a non-parametric trend test for unordered and ordered categorical variables respectively, comparing respondents with IA and IBD.

RESULTS

Eight hundred and thirty eight people (686-IA, 144-IBD, 8 both) responded. 658 (79%) used b/tsDMARDs. The BMQ demonstrated high necessity belief (median 4.2) with moderate concerns (median 2.8) about biologics. 95% of respondents obtained medication information from specialists though most used multiple sources (median 4). The most positive resources were specialists and specialist nurses. 73/141 (52%) respondents with IBD obtained information from specialist nurses compared with 202/685 (29%) with IA (p = 0.012). Respondents with limited reading ability on SILS were more likely to discuss information with a general practitioner or pharmacist. Younger respondents and those with higher BMQ concern scores more frequently consulted less reliable sources (e.g. social media). 502 respondents (60%) answered the biosimilar questions. Only 23 (4.6%) reported currently using a biosimilar and 336 (66.9%) were unsure if biosimilars were available in Australia. Specialist recommendation was the most frequent factor that would influence a patient to change from originator to biosimilar (352/495, 71.1%).

CONCLUSIONS

There is a high level of trust in specialists' recommendations about b/tsDMARDs, although most people also utilise additional information sources. Contextual factors influencing resource selection include age, reading ability and degree of concern about medicines. People with IA and IBD have similar attitudes though those with IBD more frequently access specialist nurse advice.

The Social Media Presence of Professional Sports Team Physicians Is High Among Major League Soccer, Major League Lacrosse, Major League Rugby, Winter Olympics, and Women's National Basketball Association, But Highest Among MLS Team Physicians

Purpose

To quantify the social media utilization of professional sports team physicians on popular platforms and analyze differences between physician users and physician non-users for smaller major professional sports: Major League Soccer (MLS), Major League Lacrosse (MLL), Major League Rugby (MLR), Winter Olympics (WO) and Women's National Basketball Association (WNBA).

Methods

Physicians for the MLS, MLL, MLR, WO, and WNBA were identified and characterized based on training background, practice setting, years of experience, and geographic location. Social media presence on Facebook, Twitter, LinkedIn, Instagram, and ResearchGate were determined. Differences between social media users and non-users were analyzed via chi-squared tests for nonparametric variables. Secondary analysis consisted of univariate logistic regression to identify associated factors.

Results

86 team physicians were identified. 73.3% of physicians had at least one social media profile. 80.2% of physicians were orthopedic surgeons. Specifically, 22.1% had a professional Facebook page, 24.4% had a professional Twitter page, 58.1% had a LinkedIn profile, 25.6% a ResearchGate profile, and 9.3% an Instagram account. All physicians with a social media presence were fellowship-trained.

Conclusions

Seventy-three percent of team physicians in the MLS, MLL, MLR, WO, or WNBA have social media presence, with over half using LinkedIn. Fellowship-trained physicians were significantly more likely to use social media, and 100% of physicians with social media presence were fellowship trained. MLS and WO team physicians were significantly more likely to use LinkedIn (P = .02). MLS team physicians were significantly more likely to use social media overall (P = .004). No other metric significantly impacted social media presence.

Clinical Relevance

The influence of social media is vast. It is important to explore the extent that sports team physicians utilize social media and how this use may influence patient care.

To be or not to be in the social media arena? The perspective of healthcare providers working within adolescent and young adult oncology in Switzerland

BACKGROUND

Given that social media is quickly penetrating clinical practice, it is essential to explore how these technologies can be used to improve patient-centered care. This is particularly important for healthcare professionals caring for adolescents and young adults (AYA), amid whom the use of social media is nearly universal and whose medical and psychosocial needs are often underestimated by the pediatric or adult oncology settings in which they are treated.

OBJECTIVES

To examine the perspectives of various medical professionals on the emerging role of social media in AYA oncology.

METHODS

Three focus groups were performed with Swiss healthcare professionals involved in the care of AYA patients with cancer. The focus groups were analyzed using thematic coding.

RESULTS

Healthcare professionals caring for AYA cancer patients in Switzerland are reluctant to step into the social media sphere because they find it difficult to navigate professional boundaries in an unfamiliar space where different contexts collapse. Nurses and younger healthcare professionals who tend to have a more intimate relationship with AYA, often lack virtual mentorship to know how to maintain online professionalism. Adolescents and young adults cancer-related social media presence was unknown to our participants which resulted in missed occasions to inform, educate and care for this often underserved population of cancer patients.

CONCLUSIONS

More practical guidance is needed to help healthcare professionals with how to integrate social media into clinical practice. Setting up fruitful collaborations between medical institutions and existing AYA support groups online might be the best way forward.

Online health communities and the patient-doctor relationship: An institutional logics perspective

Taking an institutional logics perspective, this study investigates how "internet-informed" patients manage tensions between the logic of personal choice and the logic of medical professionalism as they navigate treatment decisions and the patient-doctor relationship. Based on 44 semi-structured interviews with members of an online health community for people with diabetes, this study finds that patients exercise a great deal of agency in evaluating healthcare options not only by activating the logic of personal choice but also by appropriating the logic of medical professionalism. Furthermore, patients are strategic in deciding what community advice to share with their doctor or nurse depending on the healthcare professionals' reaction to the logic of personal choice. In contrast to many previous studies that emphasise patient consumerism fuelled by information on the Internet, this study provides a more nuanced picture of patient-doctor relationship engendered by patients' participation in online health communities.

Information needs of parents of children with congenital anomalies across Europe: a EUROlinkCAT survey

BACKGROUND

Parents of children who have a congenital anomaly can experience significant worry about their child's health. Access to clear, helpful, and trustworthy information can provide a valuable source of support. In this study the aim was to explore the information needs of parents/carers of children with congenital anomalies across Europe.

METHOD

A cross-sectional online survey was developed in nine languages to measure parents' information needs, including: (1) the 'helpfulness'/'trustworthiness' of information received from eight relevant sources, and (2) overall satisfaction with information received. Parents/carers of children (0-10 years) with cleft lip, spina bifida, congenital heart defect [CHD] requiring surgery, and/or Down syndrome were recruited online via relevant organisations in 10 European countries from March-July 2021. Quantitative analyses using multivariable logistic regressions were performed.

RESULTS

One thousand seventy parents/carers of children with a cleft lip (n = 247), spina bifida (n = 118), CHD (n = 366), Down syndrome (n = 281), and Down syndrome with CHD (n = 58) were recruited in Poland (n = 476), the UK (n = 120), Germany (n = 97), the Netherlands/Belgium (n = 74), Croatia (n = 68), Italy (n = 59), other European countries (n = 92), and not specified/non-European countries (n = 84). Most participants were mothers (92%) and aged 31-40 years (71%). Participants were most likely to rate support groups (63%), patient organisations (60%), specialist doctors/nurses (58%), and social media (57%) as 'very helpful' information sources. 'Very trustworthy' ratings remained high for specialist doctors/nurses (61%), however, they declined for support groups (47%), patient organisations (48%), and social media (35%). Germany had the highest proportion of participants who were 'very satisfied' (44%, 95% CI = 34%-54%) with information, whereas this percentage was lowest in Croatia (11%, 95% CI = 3%-19%) and Poland (15%, 95% CI = 11%-18%). Parents of children with Down syndrome had significantly lower satisfaction ratings than parents of children with CHD; 13% (95% CI = 8%-18%) reported being 'very satisfied' compared to 28% (95% CI = 23%-33%) in the CHD group.

CONCLUSIONS

Findings suggest that informal sources of information (e.g. support groups) are of value to parents, however, they are not deemed as trustworthy as specialist medical sources. Satisfaction ratings differed across countries and by anomaly, and were particularly low in Croatia and Poland, as well as for parents of children with Down syndrome, which warrants further investigation.

Resilience of political leaders and healthcare organizations during COVID-19

This study assesses the online societal association of leaders and healthcare organizations from the top-10 COVID-19 resilient nations through public engagement, sentiment strength, and inclusivity and diversity strength. After analyzing 173,071 Tweets authored by the leaders and health organizations, our findings indicate that United Arab Emirate's Prime Minister had the highest online societal association (normalized online societal association: 1.000) followed by the leaders of Canada and Turkey (normalized online societal association: 0.068 and 0.033, respectively); and among the healthcare organizations, the Public Health Agency of Canada was the most impactful (normalized online societal association: 1.000) followed by the healthcare agencies of Turkey and Spain (normalized online societal association: 0.632 and 0.094 respectively). In comparison to healthcare organizations, the leaders displayed a strong awareness of individual factors and generalized their Tweets to a broader audience. The findings also suggest that users prefer accessing social media platforms for information during health emergencies and that leaders and healthcare institutions should realize the potential to use them effectively.

Content Analysis of #Postpartumbody Images Posted to Instagram

Understanding the imagery on social media targeting postpartum women is an important step in determining the utility of Instagram as a potential avenue for targeting public health messages to this group. This study (1) describes the content of images on Instagram tagged with #postpartumbody and; (2) compares images from ‘Top’ posts (‘trending’ or ‘popular’) with ‘Recent’ posts. 600 images tagged with #postpartumbody (300 ‘Top’ and 300 ‘Recent’) were systematically captured from Instagram and coded using a predefined framework. Images of women were coded for adiposity, muscularity, pose and attire. Chi-square tests were used to compare ‘Top’ and ‘Recent’ posts. Most (n = 409) images were of a woman who generally had low/average adiposity (91%) and little-to-none/some visible muscle definition (93%). Most women (52%) were posing in a non-specific manner, 5% were posing to accentuate a postpartum body feature and 40% were wearing fitness attire. Compared with ‘Recent’, ‘Top’ posts were less likely to be text-focused (p < 0.001), photos of food (p < 0.001) or linked to a product/program (p < 0.001). Women of lower adiposity are more likely to post images of themselves on Instagram tagged with #postpartumbody than women of higher adiposity, which may reflect increased body pride in this group, but could reduce body satisfaction for some viewers. Conveying health information on Instagram may be necessary to interrupt potentially harmful content.

Day-to-Day Decision Making by Adolescents and Young Adults with Cancer

Background: Adolescents and young adults (AYAs) with cancer must negotiate the transition between childhood and adulthood while dealing with a life-threatening illness. AYA involvement in decision making varies depending on the type of decision and when decisions occur during treatment, and evidence suggests that AYAs want to be involved in decision making. Objective: To explore involvement of AYAs with cancer in day-to-day decisions affected by their cancer and treatment. Methods: This qualitative study used interpretive focused ethnography within the sociologic tradition, informed by symbolic interactionism. Semi-structured interviews and informal participant observation took place at two quaternary pediatric oncology programs. Results: Thirty-one interviews were conducted with 16 AYAs ages 15 to 20 years. Major day to day decision-making categories identified included: (1) mental mindset, (2) self-care practices, (3) self-advocacy, and (4) negotiating relationships. Participants described how they came to grips with their illness early on and decided to fight their cancer. They described decisions they made to protect their health, how they advocated for themselves and decisions they made about relationships with family and friends. Conclusions: Through day-to-day decisions, participants managed the impact of cancer and its treatment on their daily lives. Research should focus on developing and implementing interventions to empower AYAs to participate in day-to-day decisions that will affect how they manage their cancer, its treatment and ultimately their outcomes. Implications for Practice: Healthcare providers can facilitate AYA's participation in day-to-day decision making through encouraging autonomy and self-efficacy by providing support and through effective communication.

Synergy between Public and Private Healthcare Organizations during COVID-19 on Twitter

BACKGROUND

Social media platforms (SMPs) are frequently used by various pharmaceutical companies, public health agencies, and NGOs for communicating health concerns, new advancements, and potential outbreaks. While the benefits of using them as a tool have been extensively discussed, the online activity of various healthcare organizations on SMPs during COVID-19 in terms of engagement and sentiment forecasting has not been thoroughly investigated.

OBJECTIVE

The purpose of this research is to analyze the nature of information shared on Twitter, understand the public engagement generated on it, and forecast the sentiment score for various organizations.

METHODS

Data was collected from the Twitter handles of five pharmaceutical companies, ten U.S. and Canadian public health agencies, and World Health Organization (WHO) between January 01, 2017 - December 31, 2021. A total of 181,469 tweets were divided into two phases for the analysis: before COVID-19 and during COVID-19, based on the confirmation of the first COVID-19 community transmission case in North America on February 26, 2020. We conducted content analysis to generate health-related topics using Natural Language Processing (NLP) based topic modeling techniques, analyzed public engagement on Twitter, and performed sentiment forecasting using 16 univariate moving-average and machine learning (ML) models to understand the correlation between public opinion and tweet contents.

RESULTS

We utilized the topics modeled from the tweets authored by the health organizations chosen for our analysis using Non-Negative Matrix Factorization (NMF) ('c_umass' scores: -3.6530 and -3.7944, before COVID-19 and during COVID-19 respectively). The topics are - 'Chronic Diseases', 'Health Research', 'Community Healthcare', 'Medical Trials', 'COVID-19', 'Vaccination', 'Nutrition and Well-being', and 'Mental Health'. In terms of user impact, WHO (user impact: 4171.24) had the highest impact overall, followed by the public health agencies, CDC (user impact: 2895.87), and NIH (user impact: 891.06). Among pharmaceutical companies, Pfizer's user impact was the highest at 97.79. Furthermore, for sentiment forecasting, ARIMA and SARIMAX models performed best on the majority of the subsets of data (divided as per the health organization and time-period), with Mean Absolute Error (MAE) between 0.027 - 0.084, Mean Squared Error (MSE) between 0.001 - 0.011, and Root Mean Squared Error (RMSE) between 0.031 - 0.105.

CONCLUSIONS

Our findings indicate that people engage more on topics like 'COVID-19' than 'Medical Trials', 'Customer Experience'. Also, there are notable differences in the user engagement levels across organizations. Global organizations, like WHO, show wide variations in engagement levels over time. The sentiment forecasting method discussed presents a way for organizations to structure their future content to ensure maximum user engagement.

CLINICALTRIAL

Living in an online world: Social media experiences of adolescents and young adults with cancer

BACKGROUND

Despite widespread use, little is known about how adolescents and young adults (AYA) with cancer use social media (SM). This research characterized use and self-reported SM experiences among AYA with cancer.

PROCEDURE

AYA, aged 12-26 years, receiving cancer care completed a mixed-methods survey regarding SM experiences. Clinical information was obtained from the electronic medical record. Data were analyzed with descriptive statistics, t tests, and qualitative content analysis.

RESULTS

Thirty-nine AYA with average age 16 (SD = 3.2) years participated. Most were Caucasian (92%) males (54%). Participants had leukemia/lymphoma (56%), solid tumors (33%), and brain tumors (10%). Nearly all (97%) used SM, with YouTube, Snapchat, and Instagram being the most popular. AYA self-reported lower SM use than their smartphone data indicated (2.8 hours/day, SD = 1.2 vs 3.4 hours/day, SD = 1.3; P < 0.001). Participants used SM to obtain information about their cancer (45%), post about cancer (47%), and read about others' cancer experience (50%). One-third made a friend with cancer through SM (32%). Qualitative results indicated that AYA had positive cancer-related SM experiences, including feelings of support (54%), community (27%), distraction (8%), and inspiration (8%). Most denied negative experiences (78%); however, 17% reported cyberbullying related to cancer.

CONCLUSIONS

AYA with cancer avidly use SM, noting it provides a sense of support and community. However, one-sixth reported cancer-related cyberbullying. AYA oncology providers have an opportunity to enhance positive and blunt negative SM interactions by addressing and guiding SM use in AYA patients.

Word of Mouth and Online Reviews Are More Influential Than Social Media for Patients When Selecting a Sports Medicine Physician

Purpose

To (1) identify the percentage of patients seen in an orthopaedic sports medicine practice who use social media and (2) identify the role that social media has in physician selection as compared with other factors.

Methods

After institutional review board approval was received, new patients aged 18 years or older who attended a single orthopaedic sports medicine office from February 2020 to May 2021 were identified for inclusion. Sociodemographic information was recorded, and each patient was asked to fill out a questionnaire that assessed social media usage and online resources used to choose and formulate opinions regarding the patient’s provider.

Results

Two hundred patients met the inclusion criteria and completed the questionnaire. Of these, 96.5% reported social media use. The most common online method of searching for and identifying a physician was Google (50.5%). Social media outlets such as Facebook, Instagram, or LinkedIn were only used 15.5% of the time to search for and select a physician. Older patients were more likely to use recommendations from friends and family in their consideration when selecting a physician.

Conclusions

Despite almost all participants stating that they use social media, only 15.5% of patients reported that they used social media to search for and potentially select their physician. Our study suggests that although social media can be a helpful tool for patient education, other factors such as physician education and physician reputation through word-of-mouth referrals, online reviews, and online ratings seem to play a larger role in the patient’s selection of his or her physician.

Clinical Relevance

This information may be of value to orthopaedic surgeons looking for ways to build their patient base, online reputation, or other aspects of their practice on the Internet.

Trending Tubes: A Social Media Analysis of Tympanostomy Tubes in Children

Objective

To investigate the popular social media platforms Instagram and Facebook for public posts related to tympanostomy tubes in children, to discern attitudes and perceptions surrounding tympanostomy tubes, and to evaluate the content of social media posts related to tympanostomy tubes.

Study Design

Qualitative study.

Setting

Instagram and Facebook social media platforms.

Methods

Instagram and Facebook were searched for public posts from 2018 and 2019 including the search terms “ear tubes,”“ear tube surgery,”“tympanostomy,” and “myringotomy.” Posts were excluded if they were unrelated to pediatric tympanostomy tubes or written in a non-English language. Relevant posts underwent subgroup analysis based on 6 domains: media type, perspective, topic, timeframe, popularity, and overall tone.

Results

Of 1862 public social media posts, the majority (78.2%) were made by the patient’s parents/caregivers and the rest by physicians (6.0%), hospitals (8.2%), and chiropractors (6.1%), with a few posts by the patients themselves (0.4%). The majority (79.3%) of posts portrayed tympanostomy tubes positively. Most negative posts were made by chiropractors (50.8%) and the patient’s parents/caregivers (42.9%). The most common themes of posts were reassurance regarding surgery (74.9%), advertisements (12.5%), apprehension (12.4%), and education (10.3%).

Conclusion

Most social media posts were made by parents/caregivers in the perioperative period, and there was a low percentage of educational posts. This information could be used by otolaryngologists to optimize their interactions with patients and parents and to potentially increase physician involvement and educational material related to tympanostomy tubes on social media.

Social Media and Social Support: A Framework for Patient Satisfaction in Healthcare

Social media has been a powerful source of social support for health consumers. In the healthcare sector, social media has thrived, building on various dynamic platforms supporting the connection between social relationships, health, and wellbeing. While prior research has shown that social support exerts a positive impact on health outcomes, there is scant literature examining the implications of social support for patient satisfaction, which suggests that there is a profound gap in the extant literature. The objective of this study is to develop and test a theoretical model for understanding the relationship between different dimensions of social support and patient empowerment. The study further investigates the debated relationship between patient empowerment and patient satisfaction. The measurement model indicated an acceptable fit (χ2 = 260.226; df, 107, χ2/df = 2.432, RMSEA = 0.07, GFI = 0.90, IFI = 0.95, TLI = 0.94, and CFI = 0.95). Findings indicate that emotional support (p < 0.001), information support (p < 0.05), and network support (p < 0.001) positively influence the notion of patient empowerment. In turn, patient empowerment positively influences patient satisfaction (p < 0.001). The proposed framework contributes to the health communication literature by introducing a novel framework for patient satisfaction in the social media context, which provides important inputs for healthcare service providers in developing patient empowerment strategies.

Patient Influencers: The Next Frontier in Direct-to-Consumer Pharmaceutical Marketing

Social media influencers are becoming an increasingly popular strategic communication tactic used across industry verticals, including entertainment, fashion, and beauty, to engage directly with consumers. Pharmaceutical companies have also recently entered the social media marketing arena and—within the bounds of governmental regulations—have found ways to build relationships directly with patients using covert persuasion tactics like partnering with social media influencers. Due to consumers’ negative perceptions of pharmaceutical companies, it makes sense that new marketing tactics are being used to establish and improve relationships with consumers. Previous research well documents the ethical dilemmas of direct-to-consumer advertising, and there is recent burgeoning literature on online covert marketing tactics. The academic and medical literature, however, is behind in regard to social media influencers used in health and medicine. This paper highlights and defines terms used in industry practice, and also calls for more investigation and sets forward a research agenda. As consumers spend more time online and patients continue to consult social media for health information, it is important that this new marketing trend does not go unnoticed.

Feasibility and Efficacy of Online Strategies to Recruit Parents of Children With Rheumatic Diseases for Research

Objective

We aimed to determine the feasibility and efficacy of online strategies to recruit parents of children with pediatric rheumatic diseases (PRDs) for research and to evaluate the degree to which known features of various rheumatic disease groups were present in the online cohort.

Methods

We studied two cohorts; the first was composed of respondents from a cross‐sectional parental survey of children with PRDs contacted through patient support groups and social media platforms, and the second cohort was composed of participants from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) legacy clinical registry.

Results

In the social media cohort, 712 complete surveys were analyzed. Most (65.9%) were referred from Facebook. The most common rheumatic disease was juvenile idiopathic arthritis (JIA) (27.1%), followed by juvenile dermatomyositis (22.1%). In the CARRA registry cohort, 7985 records were included. JIA was the largest disease group (70.3%), followed by systemic lupus erythematosus (12.0%). The age at disease onset for most PRDs was similar between those in the social media and CARRA registry cohorts (mean difference = 1.3 years).

Conclusion

Recruitment through Facebook was the most fruitful. The clinical characteristics of the social media cohort were similar to those of patients recruited through a clinical registry, suggesting the utility of online recruitment for engaging disease‐relevant cohorts. Parents of children with rare PRDs were overrepresented in the social media cohort, perhaps reflecting the increased need of those parents to find online information and receive emotional support. Social media recruitment for research studies may help expand the number and diversity of participants in clinical research, especially by including those with rare diseases.

The Promises and Perils of Social Media for Pediatric Rheumatology

The advent of social media has revolutionized and empowered communities of people living with rare diseases. Social media has enabled families of children with similar pediatric rheumatic diseases (PRDs) to meet regardless of geographic distance, allowing them to support each other and join together to advocate on behalf of their children. Researchers have also leveraged social media to learn about the health of patients and their communities. This article reviews the promises and perils of social media related to health, focusing on its potential use to support research and care of children with PRD.