Coverage of the Ebola Virus Disease Epidemic on YouTube

Digital epidemiology: harnessing big data for early detection and monitoring of viral outbreaks

Digital epidemiology is the process of investigating the dynamics of disease-related patterns, both social and clinical, as well as the causes of these trends in epidemiology. Digital epidemiology, utilising big data from a variety of digital sources, has emerged as a viable method for early detection and monitoring of viral outbreaks. The present review gives an overview of digital epidemiology, emphasising its importance in the timely detection of infectious disease outbreaks. Researchers may discover and track outbreaks in real time using digital data sources such as search engine queries, social media trends, and digital health records. However, data quality, concerns about privacy, and data interoperability must be addressed to maximise the effectiveness of digital epidemiology. As the global landscape of infectious diseases evolves, integrating digital epidemiology becomes critical to improving pandemic preparedness and response efforts. Integrating digital epidemiology into routine monitoring systems has the potential to improve global health outcomes and save lives in the event of viral outbreaks.

Online Health Information-Seeking Behaviour among People of African Descent in the United Kingdom: A Qualitative Study

Effective public health interventions rely on understanding how individuals access, interpret, and utilise health information. Studying the health information-seeking behaviour (HISB) of a community can provide valuable insights to inform strategies that address community health needs and challenges. This study explored the online HISBs of People of African Descent (PoAD) in the United Kingdom (UK), a demographic that comprises four percent of the UK population and has a 92.8% active Internet usage rate. Data on the HISB were collected from 21 PoAD across various UK regions through online semi-structured interviews before being analysed using reflexive Thematic Analysis (TA). The participants ranged in age from 20 to 70 years and had a mean age of 42.8 (SD ± 11.4). Our analysis of the interview transcripts revealed five key themes: Internet usage and preferences, attitudes toward social media, barriers to seeking health information online, trust in online health information, and cultural influences on online HISB. Our findings indicate a proactive engagement among PoAD in seeking health information online that is underscored by a preference for professional sources over ethnic congruence. However, concerns about misinformation exist, and there are barriers to accessing health information online, including data privacy, unreliable information, and information relevance and overload. We also found that cultural factors and traditional beliefs impact the adoption of Internet-based interventions among PoAD, highlighting the need for culturally sensitive approaches. Preferences regarding the frequency and delivery of online health information varied among participants, with a majority preferring a weekly update. This study emphasises the critical need for accessible, culturally appropriate, secure, and reliable online health resources tailored to the needs and preferences of the PoAD.

Approaches to Research Ethics in Health Research on YouTube: Systematic Review

BACKGROUND

YouTube has become a popular source of health care information, reaching an estimated 81% of adults in 2021; approximately 35% of adults in the United States have used the internet to self-diagnose a condition. Public health researchers are therefore incorporating YouTube data into their research, but guidelines for best practices around research ethics using social media data, such as YouTube, are unclear.

OBJECTIVE

This study aims to describe approaches to research ethics for public health research implemented using YouTube data.

METHODS

We implemented a systematic review of articles found in PubMed, SocINDEX, Web of Science, and PsycINFO following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. To be eligible to be included, studies needed to be published in peer-reviewed journals in English between January 1, 2006, and October 31, 2019, and include analyses on publicly available YouTube data on health or public health topics; studies using primary data collection, such as using YouTube for study recruitment, interventions, or dissemination evaluations, were not included. We extracted data on the presence of user identifying information, institutional review board (IRB) review, and informed consent processes, as well as research topic and methodology.

RESULTS

This review includes 119 articles from 88 journals. The most common health and public health topics studied were in the categories of chronic diseases (44/119, 37%), mental health and substance use (26/119, 21.8%), and infectious diseases (20/119, 16.8%). The majority (82/119, 68.9%) of articles made no mention of ethical considerations or stated that the study did not meet the definition of human participant research (16/119, 13.4%). Of those that sought IRB review (15/119, 12.6%), 12 out of 15 (80%) were determined to not meet the definition of human participant research and were therefore exempt from IRB review, and 3 out of 15 (20%) received IRB approval. None of the 3 IRB-approved studies contained identifying information; one was explicitly told not to include identifying information by their ethics committee. Only 1 study sought informed consent from YouTube users. Of 119 articles, 33 (27.7%) contained identifying information about content creators or video commenters, one of which attempted to anonymize direct quotes by not including user information.

CONCLUSIONS

Given the variation in practice, concrete guidelines on research ethics for social media research are needed, especially around anonymizing and seeking consent when using identifying information.

TRIAL REGISTRATION

PROSPERO CRD42020148170; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=148170.

Analysis of YouTube© Videos Regarding Breastfeeding During the Coronavirus Disease (COVID-19) Pandemic

INTRODUCTION

During the coronavirus disease (COVID-19) pandemic, which has significantly impacted public health, it is crucial to raise awareness and access to accurate information about breastfeeding for healthy growth and development. This descriptive study aimed to evaluate the content, reliability, and quality of YouTube videos on COVID-19 and breastfeeding.

METHODS

The YouTube platform was searched for the English keywords "COVID-19" and "breastfeeding" in March 2021. A total of 325 videos were reached. Two independent researchers analyzed the content of 43 videos that met the inclusion criteria. The content quality of the videos was evaluated using the COVID-19 and Breastfeeding Score, which was prepared by researchers in line with international guidelines, the reliability of the videos was analyzed using the DISCERN, and the content quality was evaluated using the Global Quality Score (GQS).

RESULTS

The majority (72.1%) of the 43 videos included in the study were informative. In terms of the video origins, most had been uploaded in the U.S., and most had been created by news agencies or physicians. Using the DISCERN tool, 32.6% of videos scored 5 points, and 37.2% of videos scored five points using the GQS tool. Videos grouped as informative scored significantly higher than those grouped as misleading. The GQSs for the videos featuring parents were significantly lower than those for the videos featuring physicians or other healthcare professionals.

DISCUSSION

During the COVID-19 pandemic, YouTube videos served as an essential and easily accessible source of information about breastfeeding for mothers concerned about various aspects of the disease. This study showed that videos on breastfeeding and COVID-19 have high view rates but low quality and low reliability.

Favorite YouTubers as a source of health information during quarantine: viewers trust their favorite YouTubers with health information

During quarantine, between March and May 2020, YouTubers disseminated information about Covid-19 and the quarantine. The objectives of this study are (1) to explore whether YouTubers are considered as reliable sources of information regarding quarantine by French social media users, (2) to evaluate the link between the parasocial relationship with a favorite YouTuber and the level of trust in the information provided by this YouTuber and (3) to test the effectiveness of the favorite YouTuber as a source of information about the benefit of quarantine. Data from 596 participants were collected through an online survey, among whom, 251 had a favorite YouTuber. Wilcoxon signed-rank tests and ordered logistic regressions were used to explore two research questions and to test two hypotheses. Results show that (1) information about the benefit of quarantine from the favorite YouTuber is considered just as reliable as information from journalists, friends or family members, (2) the intensity of the parasocial relationship with the favorite YouTuber is positively and significantly associated with the level of trust in that favorite YouTuber, (3) having received trusted information about the benefit of quarantine from one’s favorite YouTubers is positively and significantly associated with the perception of the utility of quarantining. This study identifies YouTubers as important sources for health communication.

YouTube as a source of misinformation on COVID-19 vaccination: a systematic analysis

Introduction

Vaccines for SARS-CoV-2 have been accessible to the public since December 2020. However, only 58.3% of Americans are fully vaccinated as of 5 November 2021. Numerous studies have supported YouTube as a source of both reliable and misleading information during the COVID-19 pandemic. Misinformation regarding the safety and efficacy of COVID-19 vaccines has negatively impacted vaccination intent. To date, the literature lacks a systematic evaluation of YouTube’s content on COVID-19 vaccination using validated scoring tools. The objective of this study was to evaluate the accuracy, usability and quality of the most widely viewed YouTube videos on COVID-19 vaccination.

Methods

A search on YouTube was performed on 21 July 2021, using keywords ‘COVID-19 vaccine’ on a cleared-cache web browser. Search results were sorted by ‘views’, and the top 150 most-viewed videos were collected and analysed. Duplicate, non-English, non-audiovisual, exceeding 1-hour duration, or videos unrelated to COVID-19 vaccine were excluded. The primary outcome was usability and reliability of videos, analysed using the modified DISCERN (mDISCERN) score, the modified Journal of the American Medical Association (mJAMA) score and the COVID-19 Vaccine Score (CVS).

Results

Approximately 11% of YouTube’s most viewed videos on COVID-19 vaccines, accounting for 18 million views, contradicted information from the WHO or the Centers for Disease Control and Prevention. Videos containing non-factual information had significantly lower mDISCERN (p<0.001), mJAMA (p<0.01) and CVS (p<0.001) scores compared with videos with factual information. Videos from government sources had higher mJAMA and CVS scores, but averaged three times the ratio of dislikes to likes, while videos containing non-factual information averaged 14 times more likes than dislikes.

Conclusion

As the COVID-19 pandemic evolves, widespread adoption of vaccination is essential in reducing morbidity, mortality, and returning to some semblance of normalcy. Providing high-quality and engaging health information from reputable sources is essential in addressing vaccine hesitancy.

Epidemiology, Secondary School Curricula, and Preparing the Next Generation for Global Citizenship

Because COVID-19 and other emerging infectious diseases are likely to play an increasingly important role in shaping American and global society in years to come, there is a need to prepare young people to make informed decisions in this changing global context. One way to do so is teaching and learning about basic principles of epidemiology in secondary schools. Improved understanding about the agent of infection, mechanisms of transmission, factors that increase or decrease susceptibility, place variation and environmental factors that facilitate or hinder transmission, reservoirs of infection (where the agent lives and multiplies), and when the disease is more or less likely to occur comprise the main facts about an infectious disease relevant to prevention and control. Improved understanding of these basic concepts could help future generations make informed decisions in a changing global context with emerging infectious diseases and a plethora of widely disseminated misinformation and disinformation. This viewpoint considers why learning about epidemiology in secondary school would benefit population health using COVID-19 as an illustration.

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

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

Improving Google Flu Trends for COVID-19 estimates using Weibo posts

While incomplete non-medical data has been integrated into prediction models for epidemics, the accuracy and the generalizability of the data are difficult to guarantee. To comprehensively evaluate the ability and applicability of using social media data to predict the development of COVID-19, a new confirmed case prediction algorithm improving the Google Flu Trends algorithm is established, called Weibo COVID-19 Trends (WCT), based on the post dataset generated by all users in Wuhan on Sina Weibo. A genetic algorithm is designed to select the keyword set for filtering COVID-19 related posts. WCT can constantly outperform the highest average test score in the training set between daily new confirmed case counts and the prediction results. It remains to produce the best prediction results among other algorithms when the number of forecast days increases from one to eight days with the highest correlation score from 0.98 (P ​< 0.01) to 0.86 (P ​< 0.01) during all analysis period. Additionally, WCT effectively improves the Google Flu Trends algorithm's shortcoming of overestimating the epidemic peak value. This study offers a highly adaptive approach for feature engineering of third-party data in epidemic prediction, providing useful insights for the prediction of newly emerging infectious diseases at an early stage.

The information-seeking behavior and levels of knowledge, precaution, and fear of college students in Iloilo, Philippines amidst the COVID-19 pandemic

COVID-19 pandemic is devastating the health, social, and economic well-being of citizens worldwide. The high rates of morbidity and mortality and the absence of vaccines cause fear among the people regardless of age, gender, or social status. People's fear is heightened by misinformation spread across all media types, especially on social media. Filipino college students are one of the top Internet users worldwide and are very active in social media. Hence they are very prone to misinformation. This paper aims to ascertain the levels of knowledge, precaution, and fear of COVID-19 of the college students in Iloilo, Philippines, and determine the effects of their information-seeking behavior on the variables above. This paper is a cross-sectional survey that used a qualitative-quantitative method and snowball sampling technique. Data were gathered among 228 college students using an online survey instrument a few months after the pandemic began. College students were knowledgeable of the basic facts about the highly infectious COVID-19. However, the majority were inclined to believe the myths and misinformation regarding the pandemic. Television was the primary, most believable, and preferred source when seeking information. The Internet as a preferred source of information was significantly associated with a high level of knowledge. In contrast, the information sourced from interpersonal channels were found to make college students very cautious. The local presence of COVID-19 cases had caused college students to fear, likely exacerbated by the plethora of information about the pandemic, mostly from Facebook. This is the first study conducted on the effects of the information-seeking behavior on the levels of knowledge, precaution, and fear of COVID-19 of the college students in Iloilo, Philippines.

Determinants of Infodemics During Disease Outbreaks: A Systematic Review

Background: The widespread use of social media represents an unprecedented opportunity for health promotion. We have more information and evidence-based health related knowledge, for instance about healthy habits or possible risk behaviors. However, these tools also carry some disadvantages since they also open the door to new social and health risks, in particular during health emergencies. This systematic review aims to study the determinants of infodemics during disease outbreaks, drawing on both quantitative and qualitative methods. Methods: We searched research articles in PubMed, Scopus, Medline, Embase, CINAHL, Sociological abstracts, Cochrane Library, and Web of Science. Additional research works were included by searching bibliographies of electronically retrieved review articles. Results: Finally, 42 studies were included in the review. Five determinants of infodemics were identified: (1) information sources; (2) online communities' structure and consensus; (3) communication channels (i.e., mass media, social media, forums, and websites); (4) messages content (i.e., quality of information, sensationalism, etc.,); and (5) context (e.g., social consensus, health emergencies, public opinion, etc.). Studied selected in this systematic review identified different measures to combat misinformation during outbreaks. Conclusion: The clarity of the health promotion messages has been proven essential to prevent the spread of a particular disease and to avoid potential risks, but it is also fundamental to understand the network structure of social media platforms and the emergency context where misinformation might dynamically evolve. Therefore, in order to prevent future infodemics, special attention will need to be paid both to increase the visibility of evidence-based knowledge generated by health organizations and academia, and to detect the possible sources of mis/disinformation.

Public Opinions and Concerns Regarding the Canadian Prime Minister's Daily COVID-19 Briefing: Longitudinal Study of YouTube Comments Using Machine Learning Techniques

BACKGROUND

During the COVID-19 pandemic in Canada, Prime Minister Justin Trudeau provided updates on the novel coronavirus and the government's responses to the pandemic in his daily briefings from March 13 to May 22, 2020, delivered on the official Canadian Broadcasting Corporation (CBC) YouTube channel.

OBJECTIVE

The aim of this study was to examine comments on Canadian Prime Minister Trudeau's COVID-19 daily briefings by YouTube users and track these comments to extract the changing dynamics of the opinions and concerns of the public over time.

METHODS

We used machine learning techniques to longitudinally analyze a total of 46,732 English YouTube comments that were retrieved from 57 videos of Prime Minister Trudeau's COVID-19 daily briefings from March 13 to May 22, 2020. A natural language processing model, latent Dirichlet allocation, was used to choose salient topics among the sampled comments for each of the 57 videos. Thematic analysis was used to classify and summarize these salient topics into different prominent themes.

RESULTS

We found 11 prominent themes, including strict border measures, public responses to Prime Minister Trudeau's policies, essential work and frontline workers, individuals' financial challenges, rental and mortgage subsidies, quarantine, government financial aid for enterprises and individuals, personal protective equipment, Canada and China's relationship, vaccines, and reopening.

CONCLUSIONS

This study is the first to longitudinally investigate public discourse and concerns related to Prime Minister Trudeau's daily COVID-19 briefings in Canada. This study contributes to establishing a real-time feedback loop between the public and public health officials on social media. Hearing and reacting to real concerns from the public can enhance trust between the government and the public to prepare for future health emergencies.

Promoting Mask Use on TikTok: Descriptive, Cross-sectional Study

BACKGROUND

Over the past decade, there has been an increasing secular trend in the number of studies on social media and health.

OBJECTIVE

The purpose of this cross-sectional study was to examine the content and characteristics of TikTok videos that are related to an important aspect of community mitigation-the use of masks as a method for interrupting the transmission of SARS-CoV-2.

METHODS

In total, 100 trending videos with the hashtag #WearAMask (ie, a campaign on TikTok), along with 32 videos that were posted by the World Health Organization (WHO) and involved masks in any way (ie, all related WHO videos at the time of this study), were included in our sample. We collected the metadata of each post, and created content categories based on fact sheets that were provided by the WHO and the US Centers for Disease Control and Prevention. We used these fact sheets to code the characteristics of mask use.

RESULTS

Videos that were posted on TikTok and had the hashtag #WearAMask garnered almost 500 million views, and videos that were posted by the WHO garnered almost 57 million views. Although the ratio of the number of trending #WearAMask videos to the number of WHO videos was around 3:1, the #WearAMask videos received almost 10 times as many cumulative views as the WHO videos. In total, 68% (68/100) of the trending #WearAMask videos involved humor and garnered over 355 million cumulative views. However, only 9% (3/32) of the WHO videos involved humor. Furthermore, 27% (27/100) of the trending #WearAMask videos involved dance and garnered over 130 million cumulative views, whereas none of the WHO videos involved dance.

CONCLUSIONS

This study is one of the first to describe how TikTok is being used to mitigate the community spread of COVID-19 by promoting mask use. Due to the platform's incredible reach, TikTok has great potential in conveying important public health messages to various segments of the population.

Food Safety and Sanitation Implementation Impasse on Adolescents in Kenyan High Schools

The ability to combat food-borne illnesses in food facilities and institutional catering units require sufficient knowledge on food safety and sanitation standards by food producers and consumers. The aim of the study was to investigate the food safety and sanitation knowledge of food handlers in Kenyan high schools. A cross-sectional study was carried out among 204 food handlers in 50 schools. Questions about knowledge and practice toward food safety and sanitation were asked. Respondents were the most knowledgeable on food contamination (93%), while participants were the least knowledgeable on the importance of protective attire when distributing foods to learners (50%). One-way ANOVA revealed a significant difference between gender and food handlers' behavior and practice (F = 19.886, ρ = 0.00 < 0.05) as well as between job tenure and practice of food safety and sanitation (F = 17.874, ρ = 0.00 < 0.05). Multiple regression analysis established that knowledge contributed to 44.1% of the behavior and practice of the food handlers. It is concluded that food handlers have a fair knowledge despite lack of training, motivation, and facilities to maintain quality standards. It is recommended that the Kenyan Government develop and implement guidelines through school feeding policy that would ensure that food safety and sanitation practices are implemented and utilized by Kenyan high schools.

Coverage of Transmission of COVID-19 Information on Successive Samples of YouTube Videos

Mitigating transmission of SARS-Co-2 virus is critical to stopping the COVID-19 pandemic. Messages about the pandemic on YouTube reach millions of people and should be a part of a more comprehensive strategy for educating the public to reduce transmission. We examined successive samples of the 100 most widely viewed YouTube videos regarding COVID-19 at three time points between January and June 2020 and examined characteristics of videos that specifically mentioned COVID-19 transmission. We described the cumulative and mean number of views, video length, and video source and assessed differences across the samples. Historical events and confirmed worldwide cases are compared with cumulative views of videos mentioning disease transmission over time. Across the three successive samples, views for all videos increased from ~ 125 million to over 560 million views, and from ~ 63 million to more than 273 million for those videos specifically mentioning disease transmission, respectively. This increase coincided with the increase in the worldwide number of cases and the occurrence of COVID-19 transmission informational milestones. Despite its importance for community mitigation, the majority of the widely viewed videos we sampled did not specifically mention disease transmission. Because of its very widespread reach, YouTube can be an effective way to communicate with the public, especially to those who have lower levels of reading literacy and who may be inclined to search for information on YouTube. Greater efforts are needed to more fully realize the potential of YouTube for educating the public about COVID-19 transmission.

Evaluation of Korean-Language COVID-19-Related Medical Information on YouTube: Cross-Sectional Infodemiology Study

Background

In South Korea, the number of coronavirus disease (COVID-19) cases has declined rapidly and much sooner than in other countries. South Korea is one of the most digitalized countries in the world, and YouTube may have served as a rapid delivery mechanism for increasing public awareness of COVID-19. Thus, the platform may have helped the South Korean public fight the spread of the disease.

Objective

The aim of this study is to compare the reliability, overall quality, title–content consistency, and content coverage of Korean-language YouTube videos on COVID-19, which have been uploaded by different sources.

Methods

A total of 200 of the most viewed YouTube videos from January 1, 2020, to April 30, 2020, were screened, searching in Korean for the terms “Coronavirus,” “COVID,” “Corona,” “Wuhan virus,” and “Wuhan pneumonia.” Non-Korean videos and videos that were duplicated, irrelevant, or livestreamed were excluded. Source and video metrics were collected. The videos were scored based on the following criteria: modified DISCERN index, Journal of the American Medical Association Score (JAMAS) benchmark criteria, global quality score (GQS), title–content consistency index (TCCI), and medical information and content index (MICI).

Results

Of the 105 total videos, 37.14% (39/105) contained misleading information; independent user–generated videos showed the highest proportion of misleading information at 68.09% (32/47), while all of the government-generated videos were useful. Government agency–generated videos achieved the highest median score of DISCERN (5.0, IQR 5.0-5.0), JAMAS (4.0, IQR 4.0-4.0), GQS (4.0, IQR 3.0-4.5), and TCCI (5.0, IQR 5.0-5.0), while independent user–generated videos achieved the lowest median score of DISCERN (2.0, IQR 1.0-3.0), JAMAS (2.0, IQR 1.5-2.0), GQS (2.0, IQR 1.5-2.0), and TCCI (3.0, IQR 3.0-4.0). However, the total MICI was not significantly different among sources. “Transmission and precautionary measures” were the most commonly covered content by government agencies, news agencies, and independent users. In contrast, the most mentioned content by news agencies was “prevalence,” followed by “transmission and precautionary measures.”

Conclusions

Misleading videos had more likes, fewer comments, and longer running times than useful videos. Korean-language YouTube videos on COVID-19 uploaded by different sources varied significantly in terms of reliability, overall quality, and title–content consistency, but the content coverage was not significantly different. Government-generated videos had higher reliability, overall quality, and title–content consistency than independent user–generated videos.

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

BACKGROUND

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

METHODS

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

FINDINGS

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

CONCLUSIONS

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

Analysis of Dentistry YouTube Videos Related To COVID-19

Abstract This study aimed to analyze the videos available on YouTube related to dentistry and the novel coronavirus (COVID-19), as there is no such analysis in the existing literature. The terms “dental” and “COVID-19” were searched on YouTube on May 9, 2020. The top 116 English-language videos with at least 300 views were analyzed by two observers. Data was saved for each video, including target audience, source, country of origin, content, number of views, time watched, average views, duration, like/dislike ratio, and usefulness. Total video information and quality index (VIQI) scores were calculated, consisting of flow, information, accuracy, quality, and precision indices. Non-parametric tests were used for analysis. The analyzed videos were viewed 375,000 times and totaled 20 h of content. Most videos were uploaded by dentists (45.7%), originated from the United States (79.3%), and contained information targeted towards patients (48.3%). Nearly half of the videos (47.4%) were moderately useful. For the usefulness of the videos, statistically significant differences were found for all indices as well as total VIQI scores. A comparison of the indices according to the relevance of the videos showed statistically significant differences in the videos’ information and precision indices and total VIQI scores. The results of this study showed that dentistry YouTube videos related to COVID-19 had high view numbers; however, the videos were generally moderate in quality and usefulness.

YouTube coverage of COVID-19 vaccine development: implications for awareness and uptake

This study examined 100 widely viewed YouTube videos on COVID-19 vaccination. Information such as length, format, upload source, content, and cumulative views was coded. As of April 6, 2020, the videos were viewed >33 million times. Almost 75% were uploaded by news sources (garnering >20 million views). While only 16% were uploaded by consumers, these videos garnered over 25% of cumulative views (n = 8,581,186 views). The majority of videos mentioned the vaccine manufacturing process (61.0%) and 45.0% speculated on the amount of time needed to have a vaccine ready for use, which most often was thought to be 1-2 years. Even once the biological and technical aspects of vaccine development and manufacturing are accomplished, the benefits conferred on population health will also depend on public willingness to be vaccinated. Ongoing tracking of YouTube is needed to identify what is communicated about vaccines for COVID-19. To the extent that public health officials learn how to create videos about the safety and effectiveness of a COVID-19 vaccine, which attract viewers, this could help increase awareness and interest about vaccination and help individuals make an informed decision about vaccine uptake.

Coverage of the 2019 Eastern equine encephalitis virus outbreak on news media

Background: The media plays as an important role in delivering information about emergent issues, such as the Eastern equine encephalitis virus (EEEV) outbreak of 2019. As such, there has been an increase in news coverage of vector-borne disease coverage due to a rise in emerging or re-emerging arboviruses.

Methods: The purpose of this study was to describe the content of news clips related to the recent (2019) EEEV outbreak in the United States.

Results: Only 3 of the important topics identified were mentioned in a majority of the 110videos analyzed. These topics were, mosquito mentioned as transmitter, prevention by repellent/pesticide, and geography. Thus, many aspects of EEEV were lacking in coverage.

Conclusion: A priority for public health professionals should be to engage in discourse with newsmedia to assure that information disseminated via news channels is not vague or misleading.

Characteristics of YouTube Videos in Spanish on How to Prevent COVID-19

OBJECTIVE

To analyze the characteristics of YouTube videos in Spanish on the basic measures to prevent coronavirus disease 2019 (COVID-19).

METHODS

On 18 March 2020, a search was conducted on YouTube using the terms "Prevencion Coronavirus" and "Prevencion COVID-19". We studied the associations between the type of authorship and the country of publication with other variables (such as the number of likes and basic measures to prevent COVID-19 according to the World Health Organization, among others) with univariate analysis and a multiple logistic regression model.

RESULTS

A total of 129 videos were evaluated; 37.2% were produced in Mexico (25.6%) and Spain (11.6%), and 56.6% were produced by mass media, including television and newspapers. The most frequently reported basic preventive measure was hand washing (71.3%), and the least frequent was not touching the eyes, nose, and mouth (24.0%). Hoaxes (such as eating garlic or citrus to prevent COVID-19) were detected in 15 videos (10.9%). In terms of authorship, papers produced by health professionals had a higher probability of reporting hand hygiene (OR (95% CI) = 4.20 (1.17-15.09)) and respiratory hygiene (OR (95% CI) = 3.05 (1.22-7.62)) as preventive measures.

CONCLUSION

Information from YouTube in Spanish on basic measures to prevent COVID-19 is usually not very complete and differs according to the type of authorship. Our findings make it possible to guide Spanish-speaking users on the characteristics of the videos to be viewed in order to obtain reliable information.

YouTube as a source of information on COVID-19: a pandemic of misinformation?

Introduction

The COVID-19 pandemic is this century’s largest public health emergency and its successful management relies on the effective dissemination of factual information. As a social media platform with billions of daily views, YouTube has tremendous potential to both support and hinder public health efforts. However, the usefulness and accuracy of most viewed YouTube videos on COVID-19 have not been investigated.

Methods

A YouTube search was performed on 21 March 2020 using keywords ‘coronavirus’ and ‘COVID-19’, and the top 75 viewed videos from each search were analysed. Videos that were duplicates, non-English, non-audio and non-visual, exceeding 1 hour in duration, live and unrelated to COVID-19 were excluded. Two reviewers coded the source, content and characteristics of included videos. The primary outcome was usability and reliability of videos, analysed using the novel COVID-19 Specific Score (CSS), modified DISCERN (mDISCERN) and modified JAMA (mJAMA) scores.

Results

Of 150 videos screened, 69 (46%) were included, totalling 257 804 146 views. Nineteen (27.5%) videos contained non-factual information, totalling 62 042 609 views. Government and professional videos contained only factual information and had higher CSS than consumer videos (mean difference (MD) 2.21, 95% CI 0.10 to 4.32, p=0.037); mDISCERN scores than consumer videos (MD 2.46, 95% CI 0.50 to 4.42, p=0.008), internet news videos (MD 2.20, 95% CI 0.19 to 4.21, p=0.027) and entertainment news videos (MD 2.57, 95% CI 0.66 to 4.49, p=0.004); and mJAMA scores than entertainment news videos (MD 1.21, 95% CI 0.07 to 2.36, p=0.033) and consumer videos (MD 1.27, 95% CI 0.10 to 2.44, p=0.028). However, they only accounted for 11% of videos and 10% of views.

Conclusion

Over one-quarter of the most viewed YouTube videos on COVID-19 contained misleading information, reaching millions of viewers worldwide. As the current COVID-19 pandemic worsens, public health agencies must better use YouTube to deliver timely and accurate information and to minimise the spread of misinformation. This may play a significant role in successfully managing the COVID-19 pandemic.

YouTube as a source of medical information on the novel coronavirus 2019 disease (COVID-19) pandemic

Media coverage on coronavirus disease 2019 (COVID-19) has been extensive, yet large gaps remain in our understanding of the role of social media platforms during worldwide health crisis. The purpose of this study was to assess the most viewed YouTube videos on COVID-19 for medical content. We coded video characteristics, source, and medical content of the 113 most-widely viewed videos about COVID-19. Seventy-nine (69.9%) videos were classified as useful, and 10 (8.8%) videos were classified as misleading. Independent users were more likely to post misleading videos than useful videos (60.0% vs 21.5%, P = 0.009). News agencies were more likely to post useful videos than misleading videos (72.2% vs 40.0%, P = 0.039). Useful videos were more likely to present any information on prevalence or incidence (79.7% vs 20.0%, P < 0.001), as well as information on outcomes or prognosis (84.8% vs 30.0%, P < 0.001) compared to misleading videos. The World Health Organization contributed one useful video (1.3%), while no videos from the Center for Disease Control were included. Although YouTube generally is a useful source of medical information on the COVID-19 pandemic, increased efforts to disseminate accurate information from reputable sources is desired to help mitigate disease spread and decrease unnecessary panic in the general population.

The Role of YouTube and the Entertainment Industry in Saving Lives by Educating and Mobilizing the Public to Adopt Behaviors for Community Mitigation of COVID-19: Successive Sampling Design Study

Background

Effective community mitigation through voluntary behavior change is currently the best way to reduce mortality caused by coronavirus disease (COVID-19). This study builds on our prior study based on the scientific premise that YouTube is one of the most effective ways to communicate and mobilize the public in community mitigation to reduce exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Objective

Because of the rapidly changing nature of YouTube in the context of the COVID-19 pandemic, we conducted a follow-up study to document how coverage of preventive behaviors for effective community mitigation has changed.

Methods

A successive sampling design was used to compare coverage of behaviors to mitigate community transmission of COVID-19 in the 100 most widely viewed YouTube videos in January 2020 and March 2020.

Results

Videos in the January and March samples were viewed >125 million times and >355 million times, respectively. Fewer than half of the videos in either sample covered any of the prevention behaviors recommended by the US Centers for Disease Control and Prevention, but many covered key prevention behaviors and were very widely viewed. There were no videos uploaded by entertainment television in the January sample, but this source comprised the majority of videos and garnered the majority of cumulative views in the March sample.

Conclusions

This study demonstrates the incredible reach of YouTube and the potential value of partnership with the entertainment industry for communicating and mobilizing the public about community mitigation to reduce mortality from the COVID-19 viral pandemic.

Preventive Behaviors Conveyed on YouTube to Mitigate Transmission of COVID-19: Cross-Sectional Study

Background

Accurate information and guidance about personal behaviors that can reduce exposure to severe acute respiratory syndrome coronavirus 2 are among the most important elements in mitigating the spread of coronavirus disease 2019 (COVID-19). With over 2 billion users, YouTube is a media channel that millions turn to when seeking information.

Objective

At the time of this study, there were no published studies investigating the content of YouTube videos related to COVID-19. This study aims to address this gap in the current knowledge.

Methods

The 100 most widely viewed YouTube videos uploaded throughout the month of January 2020 were reviewed and the content covered was described. Collectively, these videos were viewed over 125 million times.

Results

Fewer than one-third of the videos covered any of the seven key prevention behaviors listed on the US Centers for Disease Control and Prevention website.

Conclusions

These results represent an important missed opportunity for disease prevention.

Ebola and Localized Blame on Social Media: Analysis of Twitter and Facebook Conversations During the 2014-2015 Ebola Epidemic

This study aimed to analyze main groups accused on social media of causing or spreading the 2014-2016 Ebola epidemic in West Africa. In this analysis, blame is construed as a vehicle of meaning through which the lay public makes sense of an epidemic, and through which certain classes of people become "figures of blame". Data was collected from Twitter and Facebook using key word extraction, then categorized thematically. Our findings indicate an overall proximate blame tendency: blame was typically cast on "near-by" figures, namely national governments, and less so on "distant" figures, such as generalized figures of otherness ("Africans", global health authorities, global elites). Our results also suggest an evolution of online blame. In the early stage of the epidemic, blame directed at the affected populations was more prominent. However, during the peak of the outbreak, the increasingly perceived threat of inter-continental spread was accompanied by a progressively proximal blame tendency, directed at figures with whom the social media users had pre-existing biopolitical frustrations. Our study proposes that pro-active and on-going analysis of blame circulating in social media can usefully help to guide communications strategies, making them more responsive to public perceptions.

Whose Risk? Why Did the U.S. Public Ignore Information About the Ebola Outbreak?

To test a possible boundary condition for the risk information seeking and processing (RISP) model, this study experimentally manipulates risk perception related to the 2014 Ebola outbreak in a nationally representative sample. Multiple-group structural equation modeling results indicate that psychological distance was negatively related to systematic processing in the high-risk condition. In the low-risk condition, psychological distance was positively related to heuristic processing; negative attitude toward media coverage dampened people's need for information, which subsequently influenced information processing. Risk perception elicited more fear, which led to greater information insufficiency and more heuristic processing in the low-risk condition. In contrast, sadness was consistently related to information processing in both conditions. Model fit statistics also show that the RISP model provides a better fit to data when risk perception is elevated. Further, this study contributes to our understanding of the role of discrete emotions in motivating information processing.

A content analysis of the UK press response to the diagnosis of Ebola in a British healthcare worker

Background

The Ebola epidemic led to considerable media attention, which may influence public risk perception. Therefore, this study analysed the UK press response following diagnosis of a British healthcare worker (HCW) with Ebola.

Methods

Using the Nexis database, the frequency of Ebola-related articles in UK national newspaper articles was mapped. This was followed by a content analysis of Ebola-related articles in the four newspapers with highest UK net readership from November 2014 to February 2015.

Results

During the 16-week study period, 1349 articles were found. The day with the highest number of Ebola-related articles was 31 December 2014, the day after the diagnosis of Ebola in a UK HCW. Seventy-seven articles were included in the content analysis. Content analysis demonstrated a shift from West African to UK-focused articles, increased discussion of border control, UK policy decisions and criticism, and an increased number of articles with a reassuring/threatening message.

Conclusions

UK press coverage of Ebola increased following a HCW's diagnosis, particularly regarding discussion of screening measures. This is likely to have increased risk perception of Ebola in the UK population and may have contributed to subsequent strengthening of UK screening policy beyond World Health Organisation requirements.

Precision Global Health - The case of Ebola: a scoping review

BACKGROUND

The 2014-2016 Ebola outbreak across West Africa was devastating, acting not only as a wake-up call for the global health community, but also as a catalyst for innovative change and global action. Improved infectious disease monitoring is the stepping-stone toward better disease prevention and control efforts, and recent research has revealed the potential of digital technologies to transform the field of global health. This scoping review aimed to identify which digital technologies may improve disease prevention and control, with regard to the 2014-2016 Ebola outbreak in West Africa.

METHODS

A search was conducted on PubMed, EBSCOhost and Web of Science, with search dates ranging from 2013 (01/01/2013) - 2017 (13/06/2017). Data was extracted into a summative table and data synthesized through grouping digital technology domains, using narrative and graphical methods.

FINDINGS

The scoping review identified 82 full-text articles, and revealed big data (48%, n = 39) and modeling (26%, n = 21) technologies to be the most utilized within the Ebola outbreak. Digital technologies were mainly used for surveillance purposes (90%, n = 74), and key challenges were related to scalability and misinformation from social media platforms.

INTERPRETATION

Digital technologies demonstrated their potential during the Ebola outbreak through: more rapid diagnostics, more precise predictions and estimations, increased knowledge transfer, and raising situational awareness through mHealth and social media platforms such as Twitter and Weibo. However, better integration into both citizen and health professionals' communities is necessary to maximise the potential of digital technologies.

Escherichia coli on the internet: The power of YouTube to educate and influence consumer behavior regarding pathogenic bacteria

BACKGROUND

Proper education about food safety and hand hygiene helps to reduce the risk of exposure to Escherichia coli associated disease. The purpose of this study was to describe the 100 most widely viewed YouTube videos on the subject of E. coli to determine what consumers are viewing related to the hazards of, and reducing risk of exposure to, bacteria such as E. coli.

METHODS

The search term was conducted using the keywords "E. coli." The 100 videos with the top view counts were included in this study. The sampling frame for this study included only videos that were in English. The source of the upload of each video was determined to be one of the following: (1) consumer, (2) professional (MD, RN)/government, (3) any news (television-based, internet-based, or print/radio). Content categories were created using a fact sheet from the Centers for Disease Control and Prevention.

RESULTS

Videos uploaded by a news source tended to have been uploaded more recently (2015-2018) compared to other sources (p < 0.001). Videos uploaded by consumers or news sources tended to have more views than professional/government-uploaded videos (p = 0.044). Videos uploaded by news sources were more likely to mention a specific outbreak (p < 0.001), statistics (p = 0.004), and transmission via raw meat (p = 0.036), feces (p = 0.006), vegetables or produce (p = 0.006), and processing techniques (p = 0.005).

CONCLUSIONS

YouTube videos on the topic were widely divergent, and varied in content, emphasizing different aspects of concern over hazards associated with E. coli. Consumer sources, rather than experts, were the most common source of upload of the most highly viewed videos. Government agencies, which collect and analyze public health data, do not appear to use YouTube effectively to disseminate information. This underscores the need for media to work with government agencies to provide accurate, timely information to the public.

Social media and outbreaks of emerging infectious diseases: A systematic review of literature

•

A systematic review of published articles on social media and emerging infectious disease.

•

Three major approaches are identified: assessment of public opinion, organization's social media use, and evaluation of information accuracy.

•

More theorization and methodologic rigor is needed.

Background

The public often turn to social media for information during emerging infectious diseases (EIDs) outbreaks. This study identified the major approaches and assessed the rigors in published research articles on EIDs and social media.

Methods

We searched 5 databases for published journal articles on EIDs and social media. We then evaluated these articles in terms of EIDs studied, social media examined, theoretical frameworks, methodologic approaches, and research findings.

Results

Thirty articles were included in the analysis (published between January 1, 2010, and March 1, 2016). EIDs that received most scholarly attention were H1N1 (or swine flu, n = 15), Ebola virus (n = 10), and H7N9 (or avian flu/bird flu, n = 2). Twitter was the most often studied social media (n = 17), followed by YouTube (n = 6), Facebook (n = 6), and blogs (n = 6). Three major approaches in this area of inquiry are identified: (1) assessment of the public's interest in and responses to EIDs, (2) examination of organizations' use of social media in communicating EIDs, and (3) evaluation of the accuracy of EID-related medical information on social media.

Conclusions

Although academic studies of EID communication on social media are on the rise, they still suffer from a lack of theorization and a need for more methodologic rigor.

Challenges of Vaccinations in the Era of New Media Communication

Active discussions are underway on whether or not the absence or insufficiency of communication is a decisive factor affecting hesitancy with regard to vaccines. Low-quality services such as insufficient communication can lead to an increase in the population postponing vaccinations in countries without deficiencies in vaccine procurement. This study examines the strategies and tasks of health communication in relation to vaccinations. Social networking services (SNSs) are major channels of health communication in responding to infectious diseases. New videos posted on the Internet attract considerable amounts of attention from SNS users and increase traffic to certain Web sites. However, most of these videos are produced and uploaded by nonexperts. Although medical institutions have striven to convey key messages concerning infectious diseases to the public, in the SNS space, contents differing from scientific evidence acknowledged as the established theory have been disseminated as well. Social networking services can also amplify any unnecessary anxiety about infectious diseases. In addition, as false information about vaccines is circulated or conflicting information surfaces, the confusion of the general public is aggravated and the phenomenon of vaccine hesitancy can be intensified. Therefore, it is necessary to improve vaccination acceptance through strategies that integrate new and old media. At the same time, we need to establish customized public health education for the public, vulnerable groups, and experts.

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

BACKGROUND

Social media allows for instant access to, and dissemination of, information around the globe. Access to social media in low- and middle-income countries has increased exponentially in recent years due to technological advances. Despite this growth, the use of social media in low- and middle-income countries is less well-researched than in high-income countries.

OBJECTIVE

To identify, explore and summarize the current state of the literature on the use of social media for health in low- and middle-income countries.

METHODS

A scoping review was conducted on literature available to December 2017. Six databases were searched, and grey literature was identified through the Google and Google Scholar search engines. Literature was considered for inclusion if it (1) was published in English, (2) was conducted in or in relation to a low or middle-income country, (3) reported on as least one type of social media or social media use generally for health purposes, and (4) reported on at least one aspect of human health. Content analysis was performed to identify themes.

RESULTS

Forty articles met the inclusion criteria. Thirty-one were research articles, and nine were review/discussion/descriptive and evaluative reports. Since 2010, when the first article was published, most of the literature has focused on Asian (n = 15) and African (n = 12) countries. Twitter (n = 11) and Facebook (n = 10) were the most frequently discussed individual social media platforms. Four themes were identified: (1) use for health education and influence (sub-themes were health behaviour and health education); (2) use within infectious disease and outbreak situations; (3) use within natural disaster, terrorism, crisis and emergency response situations; and (4) producers and consumers of social media for health (sub-themes were misinformation, organizational challenges, users' expectations, and challenges of unique sub-populations). Most studies addressed more than one theme.

CONCLUSION

Social media has the ability to facilitate disease surveillance, mass communication, health education, knowledge translation, and collaboration amongst health providers in low- and middle-income countries. Misinformation or poorly communicated information can contribute to negative health behaviours and adverse health outcomes amongst consumers, as well as hysteria and chaos. Organizations using social media should provide accurate and readable information. Promotion of credible social media sites by governments, health care professionals and researchers, as well as education on the appropriate use of social media, could help to lessen the effect of misinformation. This is a nascent body of literature and future research should investigate the relative effectiveness of various platforms for different users, other potential uses, and pursue a broader geographical focus.

Harnessing Big Data for Communicable Tropical and Sub-Tropical Disorders: Implications From a Systematic Review of the Literature

Aim

According to the World Health Organization (WHO), communicable tropical and sub-tropical diseases occur solely, or mainly in the tropics, thriving in hot, and humid conditions. Some of these disorders termed as neglected tropical diseases are particularly overlooked. Communicable tropical/sub-tropical diseases represent a diverse group of communicable disorders occurring in 149 countries, favored by tropical and sub-tropical conditions, affecting more than one billion people and imposing a dramatic societal and economic burden.

Methods

A systematic review of the extant scholarly literature was carried out, searching in PubMed/MEDLINE and Scopus. The search string used included proper keywords, like big data, nontraditional data sources, social media, social networks, infodemiology, infoveillance, novel data streams (NDS), digital epidemiology, digital behavior, Google Trends, Twitter, Facebook, YouTube, Instagram, Pinterest, Ebola, Zika, dengue, Chikungunya, Chagas, and the other neglected tropical diseases.

Results

47 original, observational studies were included in the current systematic review: 1 focused on Chikungunya, 6 on dengue, 19 on Ebola, 2 on Malaria, 1 on Mayaro virus, 2 on West Nile virus, and 16 on Zika. Fifteen were dedicated on developing and validating forecasting techniques for real-time monitoring of neglected tropical diseases, while the remaining studies investigated public reaction to infectious outbreaks. Most studies explored a single nontraditional data source, with Twitter being the most exploited tool (25 studies).

Conclusion

Even though some studies have shown the feasibility of utilizing NDS as an effective tool for predicting epidemic outbreaks and disseminating accurate, high-quality information concerning neglected tropical diseases, some gaps should be properly underlined. Out of the 47 articles included, only 7 were focusing on neglected tropical diseases, while all the other covered communicable tropical/sub-tropical diseases, and the main determinant of this unbalanced coverage seems to be the media impact and resonance. Furthermore, efforts in integrating diverse NDS should be made. As such, taking into account these limitations, further research in the field is needed.

Pre-Exposure Prophylaxis YouTube Videos: Content Evaluation

BACKGROUND

Antiretroviral (ARV) medicines reduce the risk of transmitting the HIV virus and are recommended as daily pre-exposure prophylaxis (PrEP) in combination with safer sex practices for HIV-negative individuals at a high risk for infection, but are underused in HIV prevention. Previous literature suggests that YouTube is extensively used to share health information. While pre-exposure prophylaxis (PrEP) is a novel and promising approach to HIV prevention, there is limited understanding of YouTube videos as a source of information on PrEP.

OBJECTIVE

The objective of this study was to describe the sources, characteristics, and content of the most widely viewed PrEP YouTube videos published up to October 1, 2016.

METHODS

The keywords "pre-exposure prophylaxis" and "Truvada" were used to find 217 videos with a view count >100. Videos were coded for source, view count, length, number of comments, and selected aspects of content. Videos were also assessed for the most likely target audience.

RESULTS

The total cumulative number of views was >2.3 million, however, a single Centers for Disease Control and Prevention video accounted for >1.2 million of the total cumulative views. A great majority (181/217, 83.4%) of the videos promoted the use of PrEP, whereas 60.8% (132/217) identified the specific target audience. In contrast, only 35.9% (78/217) of the videos mentioned how to obtain PrEP, whereas less than one third addressed the costs, side effects, and safety aspects relating to PrEP. Medical and academic institutions were the sources of the largest number of videos (66/217, 30.4%), followed by consumers (63/217, 29.0%), community-based organizations (CBO; 48/217, 22.1%), and media (40/217, 18.4%). Videos uploaded by the media sources were more likely to discuss the cost of PrEP (P<.001), whereas the use of PrEP was less likely to be promoted in videos uploaded by individual consumers (P=.002) and more likely to be promoted in videos originated by CBOs (P=.009). The most common target audience for the videos was gay and bisexual men.

CONCLUSIONS

YouTube videos can be used to share reliable PrEP information with individuals. Further research is needed to identify the best practices for using this medium to promote and increase PrEP uptake.

"We are survivors and not a virus:" Content analysis of media reporting on Ebola survivors in Liberia

BACKGROUND

The Ebola virus disease epidemic between 2013 and 2016 in West Africa was unprecedented. It resulted in approximately 28.000 cases and 10.000 Ebola survivors. Many survivors face social, economic and health-related predicaments and media reporting is crucially important in infectious disease outbreaks. However, there is little research on reporting of the social situation of Ebola survivors in Liberia.

METHODS

The study used a mixed methods approach and analysed media reports from the Liberian Daily Observer (DOL), a daily newspaper available online in English. We were interested to know how the situation of Ebola survivors was portrayed; in what way issues such as stigma and discrimination were addressed; and which stigma reduction interventions were covered and how. We included all articles on the situation of Ebola survivors in the quantitative and in-depth qualitative analysis published between April 2014 and March 2016.

RESULTS

The DOL published 148 articles that portrayed the social situation of Ebola survivors between the 24 months observation period. In these articles, Ebola survivors were often defined beyond biological terms, reflecting on a broader social definition of survivorship. Survivorship was associated with challenges such as suffering from after-effects, social and economic consequences and psychological distress. Almost 50% of the articles explicitly mentioned stigmatisation in their reporting on Ebola survivors. This was contextualised in untrustworthiness towards international responses and the local health care system and inconclusive knowledge on cures and transmission routes. In the majority of DOL articles stigma reduction and engaging survivors in the response was reported as crucially important.

DISCUSSION

Reporting in the DOL was educational-didactical and well-balanced in terms of disseminating available medical knowledge and reflecting the social situation of Ebola survivors. While the articles contextualised factors contributing to stigmatisation throughout the reporting, journalistic scrutiny regarding effectiveness of interventions by government and NGOs was missing.

Social Media's Initial Reaction to Information and Misinformation on Ebola, August 2014: Facts and Rumors

OBJECTIVE

We analyzed misinformation about Ebola circulating on Twitter and Sina Weibo, the leading Chinese microblog platform, at the outset of the global response to the 2014-2015 Ebola epidemic to help public health agencies develop their social media communication strategies.

METHODS

We retrieved Twitter and Sina Weibo data created within 24 hours of the World Health Organization announcement of a Public Health Emergency of International Concern (Batch 1 from August 8, 2014, 06:50:00 Greenwich Mean Time [GMT] to August 9, 2014, 06:49:59 GMT) and seven days later (Batch 2 from August 15, 2014, 06:50:00 GMT to August 16, 2014, 06:49:59 GMT). We obtained and analyzed a 1% random sample of tweets containing the keyword Ebola. We retrieved all Sina Weibo posts with Chinese keywords for Ebola for analysis. We analyzed changes in frequencies of keywords, hashtags, and Web links using relative risk (RR) and c(2) feature selection algorithm. We identified misinformation by manual coding and categorizing randomly selected sub-datasets.

RESULTS

We identified two speculative treatments (i.e., bathing in or drinking saltwater and ingestion of Nano Silver, an experimental drug) in our analysis of changes in frequencies of keywords and hashtags. Saltwater was speculated to be protective against Ebola in Batch 1 tweets but their mentions decreased in Batch 2 (RR=0.11 for "salt" and RR=0.14 for "water"). Nano Silver mentions were higher in Batch 2 than in Batch 1 (RR=10.5). In our manually coded samples, Ebola-related misinformation constituted about 2% of Twitter and Sina Weibo content. A range of 36%-58% of the posts were news about the Ebola outbreak and 19%-24% of the posts were health information and responses to misinformation in both batches. In Batch 2, 43% of Chinese microblogs focused on the Chinese government sending medical assistance to Guinea.

CONCLUSION

Misinformation about Ebola was circulated at a very low level globally in social media in either batch. Qualitative and quantitative analyses of social media posts can provide relevant information to public health agencies during emergency responses.

Zika Virus on YouTube: An Analysis of English-language Video Content by Source

OBJECTIVES

The purpose of this study was to describe the source, length, number of views, and content of the most widely viewed Zika virus (ZIKV)-related YouTube videos. We hypothesized that ZIKV-related videos uploaded by different sources contained different content.

METHODS

The 100 most viewed English ZIKV-related videos were manually coded and analyzed statistically.

RESULTS

Among the 100 videos, there were 43 consumer-generated videos, 38 Internet-based news videos, 15 TV-based news videos, and 4 professional videos. Internet news sources captured over two-thirds of the total of 8 894 505 views. Compared with consumer-generated videos, Internet-based news videos were more likely to mention the impact of ZIKV on babies (odds ratio [OR], 6.25; 95% confidence interval [CI], 1.64 to 23.76), the number of cases in Latin America (OR, 5.63; 95% CI, 1.47 to 21.52); and ZIKV in Africa (OR, 2.56; 95% CI, 1.04 to 6.31). Compared with consumer-generated videos, TV-based news videos were more likely to express anxiety or fear of catching ZIKV (OR, 6.67; 95% CI, 1.36 to 32.70); to highlight fear of ZIKV among members of the public (OR, 7.45; 95% CI, 1.20 to 46.16); and to discuss avoiding pregnancy (OR, 3.88; 95% CI, 1.13 to 13.25).

CONCLUSIONS

Public health agencies should establish a larger presence on YouTube to reach more people with evidence-based information about ZIKV.

Ebola virus disease and social media: A systematic review

OBJECTIVES

We systematically reviewed existing research pertinent to Ebola virus disease and social media, especially to identify the research questions and the methods used to collect and analyze social media.

METHODS

We searched 6 databases for research articles pertinent to Ebola virus disease and social media. We extracted the data using a standardized form. We evaluated the quality of the included articles.

RESULTS

Twelve articles were included in the main analysis: 7 from Twitter with 1 also including Weibo, 1 from Facebook, 3 from YouTube, and 1 from Instagram and Flickr. All the studies were cross-sectional. Eleven of the 12 articles studied ≥ 1of these 3 elements of social media and their relationships: themes or topics of social media contents, meta-data of social media posts (such as frequency of original posts and reposts, and impressions) and characteristics of the social media accounts that made these posts (such as whether they are individuals or institutions). One article studied how news videos influenced Twitter traffic. Twitter content analysis methods included text mining (n = 3) and manual coding (n = 1). Two studies involved mathematical modeling. All 3 YouTube studies and the Instagram/Flickr study used manual coding of videos and images, respectively.

CONCLUSIONS

Published Ebola virus disease-related social media research focused on Twitter and YouTube. The utility of social media research to public health practitioners is warranted.