Health Care Professionals' Social Media Behavior and the Underlying Factors of Social Media Adoption and Use: Quantitative Study

Clicks for credit: an analysis of healthcare professionals' social media use and potential for continuing professional development activities

BACKGROUND

Previous studies have examined social media habits and utilization patterns among various groups of healthcare professionals. However, very few studies have evaluated the use of social media to support continuing professional development activities. The goal of the 2023 Clinical Education Alliance social media survey was to explore how HCPs interact professionally with social media, describe utilization trends, and identify barriers to using social media to disseminate CPD content.

METHODS

We conducted an online anonymous, voluntary survey of healthcare professionals contained in the Clinical Education Alliance learner database from January to March 2023. The survey was distributed via email and all learners were invited to participate regardless of profession or specialty. This survey consisted of 16 questions and collected demographic information and social media utilization and habits of healthcare professionals.

RESULTS

Of the 2,615 healthcare professionals who completed the survey, 71.2% use social media. Most respondents were physicians (50.6%) practicing in an urban setting (59.6%) and have been practicing for more than 15 years (70.5%). The most widely used platform was Facebook (70.7%), but there were no significant differences among the different professions. Of the respondents who use social media, 44.5% used social media to access continuing professional development-certified activities. Surveyed learners preferred passive participation with social media content. Participant-reported concerns include issues with legitimacy of the information, privacy, time constraints, and institutional barriers.

DISCUSSION

As the continuing professional development community continues to evolve and seek new innovative strategies to reach healthcare professionals, the findings of this survey highlight the need to identify and enact social media-based strategies aimed to engage healthcare professionals and provide them with unbiased evidence-based education.

Relationships among health-related social media use, knowledge, worry, and cervical cancer screening: A cross-sectional study of US females

OBJECTIVE

This study aimed to explore the relationship between health-related social media use and HPV-related health knowledge, attitudes, and practices (KAP).

METHOD

Data were derived from a subset of the national cohort from the 2022 Health Information National Trends Survey (HINTS 6), including only women aged 21 to 65 years old (n = 2013). Ordinary least squares regression and structural equation modeling were used to answer the research question and test hypotheses.

RESULTS

Participants with a family history of cancer, higher education, and White showed more HPV knowledge. Older females were associated with lower HPV knowledge, less worry and fewer timely cervical cancer screening. Additionally, HPV knowledge positively predicted worry and cervical cancer screening. Health-related social media use positively predicted HPV knowledge, worry, and cervical cancer screening.

CONCLUSION

This study identified populations with HPV knowledge and hesitated cervical cancer screening and tested hypothesized models that combine social media use with the KAP survey.

PRACTICE IMPLICATIONS

Future health interventions should strategically leverage the role of social media to enhance public awareness of HPV knowledge and cancer concerns. By promoting HPV knowledge and awareness, such interventions can subsequently encourage timely cervical cancer screening.

Measuring e-Professional Behavior of Doctors of Medicine and Dental Medicine on Social Networking Sites: Indexes Construction With Formative Indicators

BACKGROUND

Previous studies have predominantly measured e-professionalism through perceptions or attitudes, yet there exists no validated measure specifically targeting the actual behaviors of health care professionals (HCPs) in this realm. This study addresses this gap by constructing a normative framework, drawing from 3 primary sources to define e-professional behavior across 6 domains. Four domains pertain to the dangers of social networking sites (SNSs), encompassing confidentiality, privacy, patient interaction, and equitable resource allocation. Meanwhile, 2 domains focus on the opportunities of SNSs, namely, the proactive dissemination of public health information and maintaining scientific integrity.

OBJECTIVE

This study aims to develop and validate 2 new measures assessing the e-professional behavior of doctors of medicine (MDs) and doctors of dental medicine (DMDs), focusing on both the dangers and opportunities associated with SNSs.

METHODS

The study used a purposive sample of MDs and DMDs in Croatia who were users of at least one SNS. Data collection took place in 2021 through an online survey. Validation of both indexes used a formative approach, which involved a 5-step methodology: content specification, indicators definition with instructions for item coding and index construction, indicators collinearity check using the variance inflation factor (VIF), external validity test using multiple indicators multiple causes (MIMIC) model, and external validity test by checking the relationships of the indexes with the scale of attitude toward SNSs using Pearson correlation coefficients.

RESULTS

A total of 753 responses were included in the analysis. The first e-professionalism index, assessing the dangers associated with SNSs, comprises 14 items. During the indicators collinearity check, all indicators displayed acceptable VIF values below 2.5. The MIMIC model showed good fit (χ213=9.4, P=.742; χ2/df=0.723; root-mean-square error of approximation<.001; goodness-of-fit index=0.998; comparative fit index=1.000). The external validity of the index is supported by a statistically significant negative correlation with the scale measuring attitudes toward SNSs (r=-0.225, P<.001). Following the removal of 1 item, the second e-professionalism index, focusing on the opportunities associated with SNSs, comprises 5 items. During the indicators collinearity check, all indicators exhibited acceptable VIF values below 2.5. Additionally, the MIMIC model demonstrated a good fit (χ24=2.5, P=.718; χ2/df=0.637; root-mean-square error of approximation<0.001; goodness-of-fit index=0.999; comparative fit index=1.000). The external validity of the index is supported by a statistically significant positive correlation with the scale of attitude toward SNSs (r=0.338; P<.001).

CONCLUSIONS

Following the validation process, the instrument designed for gauging the e-professional behavior of MDs and DMDs consists of 19 items, which contribute to the formation of 2 distinct indexes: the e-professionalism index, focusing on the dangers associated with SNSs, comprising 14 items, and the e-professionalism index, highlighting the opportunities offered by SNSs, consisting of 5 items. These indexes serve as valid measures of the e-professional behavior of MDs and DMDs, with the potential for further refinement to encompass emerging forms of unprofessional behavior that may arise over time.

Using social media for patient care, research, and professional development: A North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition position paper

The advent of social media has changed numerous aspects of modern life, with users developing and maintaining personal and professional relationships, following and sharing breaking news and importantly, searching for and disseminating health information and medical research. In the present paper, we reviewed available literature to outline the potential uses, pitfalls and impacts of social media for providers, scientists and institutions involved in digestive health in the domains of patient care, research and professional development. We recommend that these groups become more active participants on social media platforms to combat misinformation, advocate for patients, and curate and disseminate valuable research and educational materials. We also recommend that societies such as NASPGHAN assist its members in accessing training on effective social media use and the creation and maintenance of public-facing profiles and that academic institutions incorporate substantive social media contributions into academic promotion processes.

Perception towards the implementation of telemedicine during COVID-19 pandemic: a cross-sectional study

BACKGROUND

The COVID-19 pandemic has led to a surge in the use of telemedicine as a means of delivering healthcare services remotely. Healthcare providers play a key role in the adoption and implementation of telemedicine for its effectiveness. Despite its benefits, there have been unclear concerns about its effectiveness and acceptance in the process of implementing telemedicine. The objective of the study was to assess health professionals' perceptions towards the implementation of telemedicine during the COVID-19 pandemic.

METHODS

A cross-sectional study design was conducted among eight hundred forty-five study participants from December 2020 to February 2021. A pre-test was performed on 5% of the total sample size, and the quality of the data was ensured by checking its completeness and consistency. Descriptive statistics and bivariable and multivariable logistic regression were used. The Variables with a P-value equal to or less than 0.25 in bivariable logistic regression were entered into a multivariable logistic regression, and model fitness was assessed.

RESULT

The study revealed that 60.9% of professionals had a good perception toward telemedicine implementation, with an 87.2% response rate. Health professionals with IT support staff, ICT training, who use social media platforms regularly, and availability of computer or smartphone within/outside their health facility were 4.7, 3.3, 3.7, and 13.2 times more likely to have a positive association towards telemedicine implementation respectively.

CONCLUSION

More than half of the health professionals had a good perception of telemedicine. Social media use, ICT training, computer accessibility, and the presence of IT support staff were all found to have positive associations with the telemedicine perception. In the era of the COVID-19 pandemic, the government should take the initiative to strengthen opportunities for health professionals to learn and apply telemedicine in their medical practice by providing ICT training, IT infrastructure and support staff, improving computer access, and recommending health professionals' positive use of social media in the health facility.

The Emotional Impact of Educational Productivity Videos on YouTube: A Global, Cross-Sectional Survey

Introduction YouTube is the most popular video-sharing website, and many students use it as a resource to find educational content. One type of video category is "productivity," in which the creator teaches viewers how to lead a more productive lifestyle by sharing ways to maximize studying, reshape daily habits, or set achievable goals. Little research has been conducted on whether these videos actually promote positive or negative feelings among viewers. Methods A survey was created through Qualtrics and shared through YouTube and Instagram. The survey asked about exposure to productivity videos and also asked individuals to share their experiences with consuming productivity-related educational content on YouTube. Survey items asked students to rate the helpfulness of these videos and share their feelings about the content. Respondents were asked to share whether YouTube videos on productivity made them feel anxious, motivated, inspired, neutral/indifferent, or inadequate. Participants were also asked to rate how helpful they found productivity videos on YouTube (1-10, with 10 being most helpful). The survey included free response sections to assess viewers' perceptions and attitudes toward productivity videos. Results The cross-sectional survey amassed 595 responses across 60 countries, with 364 responses coming from individuals within the United States. Of the respondents, 397 of the respondents were female, 177 were male, and 21 preferred not to say or identified as non-binary. The average age of participants was 22 years; 79 were in high school, 174 were in college, 223 were in medical school, and the remainder identified as "other" (graduate school, gap year, etc.). Of the 595 completed responses, 494 reported watching videos on YouTube related to improving productivity; when asked how these videos made them feel, 127 participants answered "anxious," 357 answered "motivated," 308 answered "inspired," 95 answered "neutral/indifferent," and 97 answered "inadequate." When rating how helpful they found these videos (1-10), an average score of 6.8 was recorded. Conclusion Most viewers feel motivated or inspired by productivity videos on YouTube. Based on the free responses provided by survey participants, productivity videos can be made more effective by showing more relatable routines and demonstrating what viewers should do when goals are not met.

Comparative assessment of attitudes among medical and dental professionals in Saudi Arabia toward e-professionalism using the SMEPROF-S scale

Background

Social media (SM) usage is on the rise among health professionals at all levels to align with the emerging digital and SM era. e-Professionalism is described as attitudes and actions that resemble traditional professionalism paradigms but are expressed through digital media. Although there are a number of studies conducted in the past several years measuring e-professionalism of medical and dental professionals, there is no validated scale to assess the level of e-professionalism among medical and dental professionals in Saudi Arabia. Therefore, this study aimed to assess attitudes toward e-professionalism among medical and dental professionals in Saudi Arabia using the SMePROF-S scale.

Methods

This cross-sectional study recruited 338 medical and dental students and practitioners from 20 cities in Saudi Arabia to complete an online SMePROF-S self-reported questionnaire measuring attitudes about e-professionalism.

Results

Among participants, 31.66% believed that it is acceptable to communicate with patients through SM, but only 16.86% agreed with communicating via personal SM account messaging. Many participants (35.80%-50%) fear that SM use can cause problems with getting hired, people making inaccurate assumptions and perceptions, and job losses. There were 31.36% who believed that sharing patient information without consent is acceptable. The majority (63.02%-63.31%) do not believe that medical/dental professionals should be barred from using SM, and 40.53% believe that schools/organizations have no right to interfere with their online activities. Only 22.19% believed that SM use removed professional protections from the public. A few statements were statistically different by specialty and gender.

Conclusion

There is a variability of attitudes about e-professionalism among medical and dental professionals in Saudi Arabia, with some alarming issues requiring national guidelines to ensure patient rights, privacy, and confidentiality.

Social media promotion, risk perception, and parental support for adolescent girls' HPV vaccination: Taking consideration of future consequences and sexual attitudes as moderators

HPV vaccine hesitancy in Asia is unique compared to western countries. Concerning whether social media promotion about HPV vaccine will be related with parental support for Chinese adolescent girls, we investigated the correlation among social media promotion, risk perception of HPV vaccine and parental support. Through the theoretical lens of Health Action Process Approach model (HAPA), we found that social media promotion could reduce the risk perception of HPV vaccine and promoted parental supportive decision, and risk perception played a mediation role between social media information exposure to vaccine and parental support. Consideration of future consequences has been found to play a moderating role between social media promotion and risk perception, and parents' sexual attitudes moderated the effect of social media promotion on parental support. Implications of the findings are discussed.

Postgraduate-Year-1 Residents' Perceptions of Social Media and Virtual Applicant Recruitment: Cross-sectional Survey Study

BACKGROUND

The dissemination of information about residency programs is a vital step in residency recruitment. Traditional methods of distributing information have been printed brochures, websites, in-person interviews, and increasingly, social media. Away rotations and in-person interviews were cancelled, and interviews were virtual for the first time during the COVID-19 pandemic.

OBJECTIVE

The purpose of our study was to describe postgraduate-year-1 (PGY1) residents' social media habits in regard to residency recruitment and their perceptions of the residency programs' social media accounts in light of the transition to virtual interviews.

METHODS

A web-based 33-question survey was developed to evaluate personal social media use, perceptions of social media use by residency programs, and perceptions of the residency program content. Surveys were sent in 2021 to PGY1 residents at Mayo Clinic in Arizona, Florida, and Minnesota who participated in the 2020-2021 interview cycle.

RESULTS

Of the 31 program directors contacted, 22 (71%) provided permission for their residents to complete the survey. Of 219 residents who received the survey, 67 (30%) completed the survey. Most respondents applied to a single specialty, and greater than 61% (41/67) of respondents applied to more than 30 programs. The social media platforms used most regularly by the respondents were Instagram (42/67, 63%), Facebook (36/67, 54%), and Twitter (22/67, 33%). Respondents used the program website (66/67, 99%), residents (47/67, 70%), and social media (43/67, 64%) as the most frequent resources to research programs. The most commonly used social media platforms to research programs were Instagram (38/66, 58%), Twitter (22/66, 33%), and Doximity (20/66, 30%). The type of social media post ranked as most interesting by the respondents was "resident life outside of the hospital." In addition, 68% (39/57) of the respondents agreed or strongly agreed that their perception of a program was positively influenced by the residency program's social media account.

CONCLUSIONS

In this multispecialty survey of PGY1 residents participating in the 2020-2021 virtual interview season, respondents preferred Instagram to Twitter or Facebook for gathering information on prospective residency programs. In addition, the program website, current residents, and social media platforms were the top-ranked resources used by prospective applicants. Having an up-to-date website and robust social media presence, particularly on Instagram, may become increasingly important in the virtual interview environment.

Cues Disseminated by Professional Associations That Represent 5 Health Care Professions Across 5 Nations: Lexical Analysis of Tweets

BACKGROUND

Collaboration across health care professions is critical in efficiently and effectively managing complex and chronic health conditions, yet interprofessional care does not happen automatically. Professional associations have a key role in setting a profession's agenda, maintaining professional identity, and establishing priorities. The associations' external communication is commonly undertaken through social media platforms, such as Twitter. Despite the valuable insights potentially available into professional associations through such communication, to date, their messaging has not been examined.

OBJECTIVE

This study aimed to identify the cues disseminated by professional associations that represent 5 health care professions spanning 5 nations.

METHODS

Using a back-iterative application programming interface methodology, public tweets were sourced from professional associations that represent 5 health care professions that have key roles in community-based health care: general practice, nursing, pharmacy, physiotherapy, and social work. Furthermore, the professional associations spanned Australia, Canada, New Zealand, the United Kingdom, and the United States. A lexical analysis was conducted of the tweets using Leximancer (Leximancer Pty Ltd) to clarify relationships within the discourse.

RESULTS

After completing a lexical analysis of 50,638 tweets, 7 key findings were identified. First, the discourse was largely devoid of references to interprofessional care. Second, there was no explicit discourse pertaining to physiotherapists. Third, although all the professions represented in this study support patients, discourse pertaining to general practitioners was most likely to be connected with that pertaining to patients. Fourth, tweets pertaining to pharmacists were most likely to be connected with discourse pertaining to latest and research. Fifth, tweets about social workers were unlikely to be connected with discourse pertaining to health or care. Sixth, notwithstanding a few exceptions, the findings across the different nations were generally similar, suggesting their generality. Seventh and last, tweets pertaining to physiotherapists were most likely to refer to discourse pertaining to profession.

CONCLUSIONS

The findings indicate that health care professional associations do not use Twitter to disseminate cues that reinforce the importance of interprofessional care. Instead, they largely use this platform to emphasize what they individually deem to be important and advance the interests of their respective professions. Therefore, there is considerable opportunity for professional associations to assert how the profession they represent complements other health care professions and how the professionals they represent can enact interprofessional care for the benefit of patients and carers.

Age in the Acceptance of Mobile Social Media

This paper focuses on determining the age-based differences among consumers in terms of the acceptance of mobile social media. In doing so, the younger age group is represented by Generation Y and the elderly by Baby Boomers. Further, the famous UTAUT2 model is applied, and relationships mentioned in it are evaluated for the two age groups. For this purpose, a sample of 249 respondents was obtained from the online survey conducted in the state of Punjab in India. The statistical technique of multi-group path analysis using structural equation modelling (SEM) is applied to the generated data. The findings of the study reveal that the young age and elderly groups differ significantly in terms of the impact of effort expectancy, facilitating conditions, hedonic motivation on behavioral intention, and facilitating conditions on use behavior. It may provide important implications for future research related to internet marketing and mobile social media.

Social Media Use Among Members of the Assessment of Spondyloarthritis International Society: Results of a Web-Based Survey

BACKGROUND

The use of social media in health care may serve as a beneficial tool for education, information dissemination, telemedicine, research, networking, and communications. To better leverage the benefits of social media, it is imperative to understand the patterns of its use and potential barriers to its implementation in health care. A previous study in 2016 that investigated social media use among young clinical rheumatologists (≤45 years) and basic scientists showed that there was substantial social media use among them for social and professional reasons. However, there is a limited inquiry into social media use in different areas of rheumatology, such as spondyloarthritis.

OBJECTIVE

We aimed to explore the motivations, barriers, and patterns of social media use among an international group of experts in spondyloarthritis.

METHODS

We distributed a web-based survey via email from March 2021 to June 2021 to 198 members of the Assessment of Spondyloarthritis International Society. It contained 24 questions about demographic characteristics, patterns of current social media use, and perceptions of utility. Univariable and multivariable logistic regression analyses were performed to identify the characteristics associated with use trends.

RESULTS

The response rate was 78.8% (156/198). Of these, 93.6% (146/156) of participants used at least one social media platform. Apart from internet-based shopping and entertainment, the use of social media for clinical updates (odds ratio [OR] 6.25, 95% CI 2.43-16.03) and research updates (OR 3.45, 95% CI 1.35-8.78) were associated with higher social media consumption. Among the respondents, 66% (103/156) used social media in a work-related manner. The use of social media for new web-based resources (OR 6.55, 95% CI 2.01-21.37), interaction with international colleagues (OR 4.66, 95% CI 1.21-17.90), and establishing a web-based presence (OR 4.05, 95% CI 1.25-13.13) were associated with higher levels of consumption for work-related purposes. Time investment, confidentiality concerns, and security concerns were the top 3 challenges to a wider adoption of social media.

CONCLUSIONS

Most respondents (103/156, 66%) use social media in a work-related manner. Professional development, establishing a web-based presence, and international collaboration were associated with higher use. Challenges to social media adoption should be addressed to maximize its benefits.

#Ophthalmology: Social Media Utilization and Impact in Ophthalmology Journals, Professional Societies, and Eye Health Organizations

Aim

To evaluate and quantify social media presence of ophthalmology peer-reviewed journals, professional societies, and eye health organizations, and to determine if there is a correlation between social media utilization and Twitter engagement metrics or journal impact measures.

Methods

We searched for online profiles of 100 ophthalmology peer-reviewed journals, 333 professional ophthalmology societies, and 40 eye health organizations on Facebook, Twitter, and Instagram. Impact was quantified by recording the number of “likes” on Facebook and number of followers on Twitter and Instagram. We also used Twitonomy software to obtain advanced Twitter metrics for all journal accounts from 2018 to 2021, and compared to journal impact measured by SCImago Journal Rank (SJR) score, the h-index, and impact factor.

Results

Eye health organizations averaged significantly greater Facebooks “likes” and Twitter followers than both peer-reviewed journals and professional societies (p < 0.0001). Of 100 journals studied, 30% were active on Twitter, 25% on Facebook, and 6% on Instagram. Slightly more than half of all journal-affiliated social media accounts were accessible from the journal website. Among journals with active Twitter accounts, total followers, total tweets, average retweets, and average “favorites” were all significantly positively correlated with academic metrics such as the SJR, h-index, and/or impact factor.

Conclusion

Greater social media engagement is associated with higher ophthalmology journal impact metrics; however, ophthalmology journals and professional societies lag behind eye health organizations in social media engagement. Although unable to demonstrate causality, social media may be an underutilized visibility, communication, and dissemination tool.

Use of Social Media for Implementing Diagnoses, Consultation, Training, and Case Reporting Among Medical Professionals to Improve Patient Care: Case Study of WeChat Groups Across Health Care Settings

BACKGROUND

Health professionals in low- and middle-resource settings have limited access to up-to-date resources for diagnosing and treating illnesses, training medical staff, reviewing newly disseminated guidelines and publications, and preparing data for international disease reporting. A concomitant difficulty in high-resource settings is the need for continuing education and skills up-training in innovative procedures on unfamiliar social media platforms. These challenges can delay both patient care and epidemiological surveillance efforts. To overcome these challenges, health professionals have adapted WeChat Groups to implement timely, low-cost, and high-quality patient care.

OBJECTIVE

The primary study aim was to describe the processes taken by medical professionals across their diverse physical and virtual networks in adapting a bottom-up approach to collectively overcome resource shortages. The secondary study aim was to delineate the pathways, procedures, and resource/information sharing implemented by medical professionals using an international publicly available popular social media app (WeChat) to enhance performance of facility-based procedures and protocols for improved patient care.

METHODS

In-depth interviews, observations, and digital ethnography of WeChat Groups communications were collected from medical professionals in interconnected networks of health care facilities. Participants' WeChat Groups usage and observations of their professional functions in interconnected networks were collected from November 2018 to 2019. Qualitative analysis and thematic coding were used to develop constructs and themes in NVivo. Constructs incorporated descriptions for the implementation and uses of WeChat Groups for professional connections, health care procedures, and patient care. Themes supporting the constructs focused on the pathways and venues used by medical professionals to build trust, to establish and solidify online networks, and to identify requests and resource sharing within WeChat Groups.

RESULTS

There were 58 participants (males 36 and females 22) distributed across 24 health care settings spanning geographical networks in south China. Analysis yielded 4 constructs and 11 themes delineating the bottom-up usage of WeChat Groups among clinicians, technicians, nurses, pharmacists, and public health administrators. Participants used WeChat Groups for collectively training hospital staff in complex new procedures, processing timely diagnoses of biological specimens, staying abreast of latest trends and clinical procedures and symptoms, and contributing to case reporting for emergent illnesses and international surveillance reporting. An unexpected strength of implementing clinical, training, and research support on a popular app with international coverage is the added ability to overcome administrative and geographic barriers in resource distribution. This advantage increased a network's access to WeChat Groups members both working within China and abroad, greatly expanding the scope of shared resources.

CONCLUSIONS

The organic, bottom-up approach of repurposing extant social media apps is low cost and efficient for timely implementation to improve patient care. WeChat's international user base enables medical staff to access widespread professional networks across geographic, administrative, and economic barriers, with potential to reduce health disparities in low-resource settings.

Emerging technologies adoption in healthcare: A SOHI model

The internet and emerging technologies have increased the utilisation of digital platforms. This study aims to draw on performance expectancy, social influence, and satisfaction to investigate a proposed model which is geared toward social media healthcare information (SOHI) adoption. The proposed model uses a structured online questionnaire, and 300 responses were evaluated using partial least squares and structural equation modelling [PLS-SEM]. From the findings, performance expectancy of social media (PESM) and satisfaction with social media (SATSM) were revealed to be significant predictors of behavioural intention towards social media (BISM). Satisfaction with social media (SATSM) had the greatest impact on BISM, accounting for 63.8 per cent of the variance in users' intentions to utilise SOHI. Similarly, PESM and social influence on social media (SISM) had the most predictive influence on SATSM, accounting for 50.5 per cent of the variance in users' social media satisfaction, which led to SOHI adoption. Unlike others, the social influence on social media (SISM) did not have a significant effect on BISM. BISM and satisfaction with social media (SATSM) were significant predictors of SOHI adoption, accounting for 54.5 per cent of the variance in SOHI adoption. The recommendations in this study would help healthcare professionals change their approach to digital healthcare engagement.

Health Professionals' Attitude Toward the Use of Social Media for COVID-19 Related Information in Northwest Ethiopia: A Cross-Sectional Study

Background

Social media platform is one way to share online information regarding pandemic prevention. However, there is no study regarding the attitude of health professionals toward social media use for the COVID-19-related information. This study aimed to assess health professionals' attitudes toward using social media for COVID-19-related information.

Methods

An institution-based cross-sectional study was conducted among 355 health professionals in Bahir Dar city public health centers, Northwest Ethiopia. A pretested self-administered questionnaire was used to collect the data. The data were entered by EPI-data version 4.6 and analyzed using SPSS version 23 software. Descriptive statistics, bivariable, and multivariable logistic regression analysis were used to describe respondents' attitudes toward using social media for COVID-19 information and identify associated factors. An adjusted odds ratio (OR) and a p-value with a 95% CI were calculated to measure the strength of the association and assess statistical significance.

Result

Out of 341 participants, about 73% of the participants had a good attitude toward the use of social media for COVID-19 information. Age < 24 [adjusted odds ratio (AOR) = 3.74, 95% CI: (1.53-9.13)] and age group 25-34 years [AOR = 2.25, 95% CI: (1.04-4.86)], computer training [AOR = 2.03, 95% CI: (1.03-4.00)], usefulness of social media [AOR = 3.25, 95% CI: (1.58-6.67)], and trustworthiness [AOR = 3.57, 95% CI: (1.93-6.60)] were enabling factors for attitude toward the use of social media for COVID-19 related information.

Conclusion

Health professionals had a moderate attitude toward using social media for accessing COVID-19-related information. This implies that after considering positive attitude predictors, such as providing basic computer training, emphasizing the usefulness of social media, and building trusted social media pages, social media platforms can be used as a source of COVID-19-related information for health professionals.

The effects of internet and social media use on the work performance of physicians and nurses at workplaces in Palestine

Background

The use of internet and social media applications in the workplace has increased dramatically with both beneficial and harmful effects. Their use also appears to affect job performance in the workplace.

Aim

To assess the beneficial and harmful effects of internet and social media application use in the workplace, and on the work performance of health professional in the major 4 referral hospitals in the cities of Hebron and Bethlehem.

Method

A cross-sectional study was conducted using self-reported questionnaires: a work-related social media questionnaire (WSMQ), and the William Anderson Work Performance Scale. The sample of the study included 409 participants (169 physicians and 240 nurses).

Results

The Pearson correlation test showed a weak positive statistically significant relationship between the WSMQ and William Anderson Work Performance Scale. The findings revealed that the overall mean score for the WSMQ was high (mean score 3.57), and the higher mean was for the beneficial WSMQ compared with the harmful WSMQ. The mean for the William Anderson Work Performance Scale was moderate performance (3.35). The higher mean was for Organizational Citizenship Behavior-Individual (OCBI), followed by In Role Behavior (IRB).

Conclusion

Palestinian healthcare professionals should be encouraged to use internet and social media applications to improve health outcomes, and provide health information to the community rather than simply using these tools for communication. Administrative staff and policy makers in Palestinian hospitals should regulate the use of internet and social media applications in hospitals by developing a clear policy on this topic for the workplace.

Climate change and global health: A call to more research and more action

There is increasing understanding, globally, that climate change and increased pollution will have a profound and mostly harmful effect on human health. This review brings together international experts to describe both the direct (such as heat waves) and indirect (such as vector-borne disease incidence) health impacts of climate change. These impacts vary depending on vulnerability (i.e., existing diseases) and the international, economic, political, and environmental context. This unique review also expands on these issues to address a third category of potential longer-term impacts on global health: famine, population dislocation, and environmental justice and education. This scholarly resource explores these issues fully, linking them to global health in urban and rural settings in developed and developing countries. The review finishes with a practical discussion of action that health professionals around the world in our field can yet take.

WhatsApp and Gynecologist-Patient Interaction: Development and Validation of a Questionnaire to Assess the Stress Perceived by the Doctor

OBJECTIVE

 Construction and validation of the WhatsApp Stress Scale (WASS), a questionnaire designed for physicians that measures how the use of smartphones and related software communication applications affects the quality of life of gynecologists who use this tool to communicate with patients.

METHODS

 The present cross-sectional observational study analyzed 60 gynecologists according to weekly WhatsApp usage time for communication with patients and compared the data with the perception of the doctor on the use of this virtual interaction as a stressor. Physicians were equally divided into three groups: < 2 hours, 2 to 5 hours, and > 5 hours. The authors created a questionnaire in Likert scale format. The study proceeded in three phases: development of the questionnaire items, pretesting, constructing, and validity and reliability testing using factor analysis, Cronbach α coefficient, and paired t-test.

RESULTS

 A 9-item instrument using a 5-point Likert scale was created and administered to the participants in 3 different times: T0, T1 (15 minutes after the end of T0), and T2 (15 days later). All questionnaire items possessed adequate content validity indices and the internal consistency of the instrument was satisfactory (Cronbach α 0.935; 95% confidence interval [CI]: 0.744-0.989; p = 0.0001). No statistically significant differences were observed in the responses between the rounds of testing, indicating good test-retest reliability. A positive association between the high frequency of WhatsApp usage for communication with patients and the stress perceived by the doctor was shown.

CONCLUSION

 The WASS is a valid and reliable instrument for assessing the use of messaging applications to communicate with patients as a stressor perceived by gynecologists.

Social Media for ImpLementing Evidence (SMILE): Conceptual Framework

Background

Social media has become widely used by individual researchers and professional organizations to translate research evidence into health care practice. Despite its increasing popularity, few social media initiatives consider the theoretical perspectives of how social media works as a knowledge translation strategy to affect research use.

Objective

The purpose of this paper is to propose a conceptual framework to understand how social media works as a knowledge translation strategy for health care providers, policy makers, and patients to inform their health care decision-making.

Methods

We developed this framework using an integrative approach that first involved reviewing 5 long-standing social media initiatives. We then drafted the initial framework using a deductive approach by referring to 5 theories on social media studies and knowledge translation. A total of 58 empirical studies on factors that influenced the use of social media and its messages and strategies for promoting the use of research evidence via social media were further integrated to substantiate and fine-tune our initial framework. Through an iterative process, we developed the Social Media for ImpLementing Evidence (SMILE) framework.

Results

The SMILE framework has six key constructs: developers, messages and delivery strategies, recipients, context, triggers, and outcomes. For social media to effectively enable recipients to use research evidence in their decision-making, the framework proposes that social media content developers respond to target recipients’ needs and context and develop relevant messages and appropriate delivery strategies. The recipients’ use of social media messages is influenced by the virtual–technical, individual, organizational, and system contexts and can be activated by three types of triggers: sparks, facilitators, and signals.

Conclusions

The SMILE framework maps the factors that are hypothesized to influence the use of social media messages by recipients and offers a heuristic device for social media content developers to create interventions for promoting the use of evidence in health care decision-making. Empirical studies are now needed to test the propositions of this framework.

The effect of Covid-19 in digital media use of Finnish physicians - Four wave longitudinal panel survey

BACKGROUND

Covid-19 pandemic has boosted digitalization in healthcare, as mobility restrictions and social distancing rules have made healthcare providers to adopt digital tools to replace or complement face-to-face interactions.

PURPOSE

We discuss the effects of Covid-19 pandemic on physicians' use of digital media. We examine whether Covid-19 conditions have changed how physicians use internet resources for information search, how they engage in social media, and their attitude towards online events.

BASIC PROCEDURES

The study was done as a longitudinal panel survey in four waves. The sample was a panel including active physicians in Finland. The panel was updated annually. Identical surveys were administered in 2018, 2019, 2020 and 2021. Spring 2020 was the time when Finland executed mobility restrictions and re-organization of healthcare because of pandemic. Comparing results of the survey before and after Covid-19 restrictions gives us a unique opportunity to do comparative analysis of Covid-19 effects.

MAIN FINDINGS

Our results show that the use of digital media for information search stayed relatively stable without statistically significant change during the four-year period covered in the study. The use of social media rose steadily from 2018 to 2021 with no significant difference in the trend. However, there was a significant change in the attitude of Finnish physicians on online events. Year 2021, the attitude remained in this more positive level.

PRINCIPAL CONCLUSIONS

As use of digital media including social media was already high prior Covid-19 in Finland, our results do not show significant change because of special circumstances introduced in 2020. However, our results show that the attitudes towards online events turned more positive during Covid-19 related restrictions. This could indicate that Covid-19 era has triggered a change that might continue also when pandemic related restrictions will be removed.

Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women

Background: Digital health literacy (DHL) increases the self-efficacy and empowerment of pregnant and lactating women (PLW) in using the Internet for health issues. The European project IC-Health aimed to improve DHL among PLW, through the co-creation of Massive Open Online Courses (MOOCs). Methods: The co-creation of the MOOCs included focus groups and the creation of communities of practice (CoPs) with PLW and healthcare professionals aimed to co-design the MOOCs. The quantitative measures of MOOCs’ acceptability, experience in the co-creation process and increase in DHL (dimensions of finding, understanding and appraisal) were assessed. Results: 17 PLW participated in focus groups, 113 participants were included in CoPs and 68 participants evaluated the acceptability of MOOCs. A total of 6 MOOCs aimed at improving PLW’s DHL were co-designed. There was a significant improvement in self-perceived DHL after using MOOCs (p-value < 0.001). The acceptability of MOOCs and co-creation experience were positively valued. Conclusions: The preliminary results of the quantitative assessment showed a higher self-perceived DHL after the IC-Health MOOCs. These results suggest that IC-Health MOOCs and the co-creation methodology appear to be a viable process to carry out an intervention aimed to improve DHL levels in European PLW.

Digital Entrepreneurship via Sustainable Online Communication of Dentistry Profession, Oradea, Romania: A Longitudinal Analysis

Dentistry is an entrepreneurially oriented public interest profession that must maintain a balance between professional specificity and business sustainability. Communicating with patients is vital in a competitive system, and the dentist needs to use handy resources such as websites and social media. The aim of this research is (a) to examine whether websites and social networks are a digital entrepreneurship tool used in the dentistry profession in Oradea, a city in full economic development in Romania, to promote the profession nationally and internationally, (b) to compare the changes made using digital tools in the period between 2018–2021 for all licensed dentists in the mentioned city (between 430–450 people, depending on the stage of analysis) using the content analysis method and (c) to identify how the lockdown period imposed by the emergence of the COVID-19 pandemic influenced not only the sustainability of the medical services provided to the population but also the communication practices of the dental offices. The results of examining the dentist’s online presence reveal that there is an interest among practitioners to grow their business sustainably through a digital presence that is increasingly relevant to them and their clients, but the potential remains under-exploited.

Factors associated with the professional use of social media by speech-language therapists and audiologists working in Brazil: a web-based survey

ABSTRACT Purpose: to verify personal and work factors, and specialties of Brazilian speech-language therapists and audiologists who use social media profiles, professionally. Methods: an online questionnaire was used to carry out a population survey with working speech-language therapists and audiologists in Brazil, in 2020. The outcome of “How would you describe your use of social media?” was recategorized into “personal use” and “professional use”. Absolute and relative frequencies were calculated. Multivariate prevalence ratios were adjusted using the Poisson regression model with robust variance and 95% confidence intervals. Results: out of the 442 respondents, 93.7% were females, with a mean age of 38.0 years (± 11.1). The primary outcome, “professional use of social media”, occurred for 64.7% of the participants. In the multivariate analysis, private employment, participants in the 31-45 age range, and >26 years of work history after graduation were significantly associated with the professional use of social media. Conclusion: social media are used by approximately two-thirds of Brazilian speech-language therapists and audiologists. This finding suggests a need for reflection and discussion about the proper use of social media for work purposes.

Fatores associados ao uso profissional de mídias sociais por fonoaudiólogos que atuam no Brasil: inquérito populacional via web

RESUMO Objetivo: verificar os fatores individuais, laborais e a região de atuação dos fonoaudiólogos atuantes no Brasil, com perfil em redes sociais e que as utilizam profissionalmente. Métodos: inquérito populacional via Web, realizado com fonoaudiólogos atuantes no Brasil no ano de 2020, por meio de um questionário on-line. O desfecho “Como você descreveria seu uso das mídias sociais?” foi recategorizado em “uso pessoal” e “uso profissional”. As frequências absolutas e relativas e análises multivariáveis ajustadas por Regressão de Poisson com variância robusta com seus respectivos intervalos de confiança de 95% são apresentados. Resultados: dos 442 entrevistados, 93,7% eram do sexo feminino, com média de idade de 38,0 anos (± 11,1). O desfecho “usar mídias sociais profissionalmente” foi encontrado em 64,7% dos entrevistados. Na análise multivariável, a relação de trabalho privada, idade entre 31 e 45 anos e mais de 26 anos de formação na graduação foram aspectos associados significantemente com o uso profissional das mídias sociais. Conclusão: aproximadamente dois terços dos fonoaudiólogos brasileiros com perfis em mídias sociais as utilizam profissionalmente, isso sugere a necessidade de reflexão e discussão sobre os caminhos desejáveis e aceitos em relação a adequada utilização destes meios para o trabalho.

To Tweet or Not to Tweet: A Longitudinal Analysis of Social Media Use by Global Diabetes Researchers

BACKGROUND

Engaging influential stakeholders in meaningful exchange is essential for pharmaceutical companies aiming to improve care. At a time where opportunities for face-to-face engagement are limited, the ability to interact, learn and generate actionable insights through digital channels such as Twitter, is of considerable value.

AIM

The aim of this study was to evaluate digital engagement among global diabetes mellitus researchers.

MATERIALS AND METHODS

We identified every global tweet (20,614,515) and scientific publication (44,135) regarding diabetes mellitus from 1 August 2018 to 1 August 2020. Through author matching we combined datasets, resulting in a list of digitally active scientific authors. Generalised linear modelling identified factors predicting their digital engagement.

FINDINGS

Globally, 2686 diabetes researchers used Twitter to discuss the management of diabetes mellitus, posting 110,346 diabetes-related tweets. As Twitter followers increased, so did tweet frequency (p < 0.001), retweets (p < 0.001) and replies (p < 0.001) to their content. Publication count (overall/per month) and proportion of first/last authorships were unrelated to tweet frequency and the likelihood of being retweeted or replied to (p > 0.05). Those with the most  academic co-authors were significantly less likely to tweet than those with smaller networks (< 50; p = 0.001). Finally, those publishing most frequently on specific themes, including insulin (p = 0.041) and paediatrics (p < 0.001), were significantly more likely to tweet about these themes.

CONCLUSION

Academic expertise and seniority cannot be assumed as proxies for digital influence. Those aiming to promote science and obtain digital insights regarding condition management should consider looking beyond well-known 'key opinion leaders' to perhaps lesser known 'digital opinion leaders' with smaller academic networks, who are likely to specialise in the delivery of highly specific content to captive audiences.

Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review

BACKGROUND

As we are witnessing the evolution of social media (SM) use worldwide among the general population, the popularity of SM has also been embraced by health care professionals (HCPs). In the context of SM evolution and exponential growth of users, this scoping review summarizes recent findings of the e-professionalism of HCPs.

OBJECTIVE

The purpose of this scoping review is to characterize the recent original peer-reviewed research studies published between November 1, 2014, to December 31, 2020, on e-professionalism of HCPs; to assess the quality of the methodologies and approaches used; to explore the impact of SM on e-professionalism of HCPs; to recognize the benefits and dangers of SM; and to provide insights to guide future research in this area.

METHODS

A search of the literature published from November 1, 2014, to December 31, 2020, was performed in January 2021 using 3 databases (PubMed, CINAHL, and Scopus). The searches were conducted using the following defined search terms: "professionalism" AND "social media" OR "social networks" OR "Internet" OR "Facebook" OR "Twitter" OR "Instagram" OR "TikTok." The search strategy was limited to studies published in English. This scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines.

RESULTS

Of the 1632 retrieved papers, a total of 88 studies were finally included in this review. Overall, the quality of the studies was satisfactory. Participants in the reviewed studies were from diverse health care professions. Medical health professionals were involved in about three-quarters of the studies. Three key benefits of SM on e-professionalism of HCPs were identified: (1) professional networking and collaboration, (2) professional education and training, and (3) patient education and health promotion. For the selected studies, there were five recognized dangers of SM on e-professionalism of HCPs: (1) loosening accountability, (2) compromising confidentiality, (3) blurred professional boundaries, (4) depiction of unprofessional behavior, and (5) legal issues and disciplinary consequences. This scoping review also recognizes recommendations for changes in educational curricula regarding e-professionalism as opportunities for improvement and barriers that influence HCPs use of SM in the context of e-professionalism.

CONCLUSIONS

Findings in the reviewed studies indicate the existence of both benefits and dangers of SM on e-professionalism of HCPs. Even though there are some barriers recognized, this review has highlighted existing recommendations for including e-professionalism in the educational curricula of HCPs. Based on all evidence provided, this review provided new insights and guides for future research on this area. There is a clear need for robust research to investigate new emerging SM platforms, the efficiency of guidelines and educational interventions, and the specifics of each profession regarding their SM potential and use.

Using social media in contemporary nursing: risks and benefits

Social media has become incorporated into the practice of contemporary nursing. It must be acknowledged by the nurse and the nursing profession that social media has the power to enable the nurse to network with colleagues and share research findings through both private and open forums. However, it also has the potential to negatively influence patient care. This article discusses the use of social media and the dilemmas both ethical and legal. It highlights the need for the nurse and the nursing profession to remain vigilant regarding its use within both their personal and professional lives, to ensure that no boundaries are inadvertently crossed.

Orthorexia tendency and social media addiction among candidate doctors and nurses

PURPOSE

To determine orthorexia tendency and social media addiction among candidate doctors and nurses.

DESIGN AND METHODS

This was a cross-sectional study conducted in 2019 with 969 candidate doctors and nurses training in a peripheral public university. Data were collected via ORTO-15 and Social Media addiction scales and analyzed by using percentage, mean, χ ² test, and binary logistic regression.

FINDINGS

Of the study population, 78.8% were social media addicts and 62.2% had orthorexic tendencies. The ratio of orthorexic tendency was 31.0% among high/very high addicts (p < 0.05).

PRACTICE IMPLICATIONS

In preclinical years, both groups should be screened for early detection of orthorexia tendency and social media addiction. A combination of therapy and nutrition education should be used and social media literacy should be promoted to raise awareness of orthorexia.

Development and validation of scale for measuring attitudes towards e-professionalism among medical and dental students: SMePROF-S scale

BACKGROUND

Social media permeated everyday life and consequently it brought some changes to behaviour of health professionals. New form of professionalism emerged called e-professionalism depicting professional behaviour while using social media. There are a number of studies conducted in the past several years measuring behaviour of different populations of health professionals on social media and social media sites. Many studies have investigated aspects of e-professionalism of medical or dental students as future health professionals, but there are no validated instruments made for assessing attitude towards e-professionalism of those two populations. Objective of this paper is to validate a newly developed scale for measuring attitudes towards e-professionalism among medical and dental students.

METHODS

The original 32-item scale was developed and administered to 411 medical students (RR 69%), and 287 dental students (RR 49.7%). Exploratory factor analysis was used to investigate the existence of underlying factors. Principal component analysis was used as an extraction method with oblimin as selected oblique rotation method. Cronbach's alpha was used to assess reliability.

RESULTS

Total of 698 student answers entered analysis. The final scale had 24 items that formed seven factors named: ethical aspects, dangers of social media, excluding physicians, freedom of choice, importance of professionalism, physicians in the digital age, negative consequences. Cronbach's alpha indicating scale reliability was .72. Reliability conducted on each factor ranged from .570 to .877.

CONCLUSIONS

The scale measures seven factors of attitude towards e-professionalism and exhibits satisfactory reliability. Based on insights from validation, some possible improvements are suggested.

Dental education and undue exposure of patients' image in social media: A literature review

INTRODUCTION

The benefits of social media for health education and communication have been discussed in the literature. However, the indiscriminate utilisation by dental students and professionals, and the effects on patients' privacy and confidentiality are still little explored.

OBJECTIVE

To investigate the exposure of patients' images in social media by dental students and professionals, as well as to explore how this issue is addressed in dental schools.

MATERIALS AND METHODS

A literature review was performed. Search strategies were developed for the following bibliographic databases: PubMed/MEDLINE, Latin American and Caribbean Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), and Scopus. There were no restrictions about the year of publication.

RESULTS

231 articles were identified through search strategies. After a two-phase process of selection, 7 studies were included. Articles mainly described how social media have been used by healthcare students and professionals and warned that this usage has often been unprofessional, risking patients' privacy and confidentiality. Thus, it is the faculty's role, as a whole, to instruct students about the wise social media usage.

CONCLUSION

The undue exposure of patients' images by dental students and professionals in social media has often been observed. Educators should include social media awareness discussions on the undergraduate curriculum.

Exploring the Social Networks' Use in the Health-Care Industry: A Multi-Level Analysis

The application of social networks in the health domain has become increasingly prevalent. They are web-based technologies which bring together a group of people and health-care providers having in common health-related interests, who share text, image, video and audio contents and interact with each other. This explains the increasing amount of attention paid to this topic by researchers who have investigated a variety of issues dealing with the specific applications in the health-care industry. The aim of this study is to systematize this fragmented body of literature, and provide a comprehensive and multi-level overview of the studies that has been carried out to date on social network uses in healthcare, taking into account the great level of diversity that characterizes this industry. To this end, we conduct a scoping review enabling to identify the major research streams, whose aggregate knowledge are discussed according to three levels of analysis that reflect the viewpoints of the major actors using social networks for health-care purposes, i.e., governments, health-care providers (including health-care organizations and professionals) and social networks’ users (including ill patients and general public). We conclude by proposing directions for future research.

Patterns of use and perceived value of social media for population health among population health stakeholders: a cross-sectional web-based survey

Background

Although existing studies have described patterns of social media use in healthcare, most are focused on health professionals in one discipline. Population health requires a multi-disciplinary approach to ensure diversity and to include diverse stakeholders. To date, what is known about using social media in population health is focused on its potential as a communication tool. This study aims to investigate patterns of use and perceived value of social media usage among stakeholders in population health practice, policy, or research.

Methods

We conducted a web-based survey of delegates attending the Singapore Population Health Conversations and Workshop. We designed a 24-item questionnaire to assess 1) social media use in terms of type of platform and frequency of use; 2) perceptions of social media relevance and impact on population health; and 3) top three areas in population health that would benefit from social media. We used descriptive and logistic regression analyses to assess the relationships between variables.

Results

Of the 308 survey respondents, 97.7% reported that they use social media in some form. Messaging (96.8%) was the most dominant activity when using social media. Challenges in implementing social media for population health were time investment by health care professionals (56.2%) and patient adoption (52.9%). The top three population health areas that would benefit most from using social media were the promotion of healthy behaviors (60.7%), community engagement (47.7%), and preventive care (40.6%). Older respondents (> = 40 years) were less likely to view social media as useful for the promotion of healthy behaviors (OR = 0.34; 95% CI: 0.19–0.60). Non-social/healthcare professionals were more likely to consider social media to be useful for community engagement (OR = 1.74; 95% CI: 1.10–2.76). For preventive care, older respondents (OR = 0.51; 95% CI: 0.32–0.82) and non-social/healthcare professionals were less likely to view social media as useful (OR = 0.61; 95% CI: 0.38–0.97).

Conclusions

Our findings suggest that it may be important to select the specific care areas that would benefit most from using social media. The time investment needed by population health professionals should be fully addressed in planning to maximize the application and potential value of social media.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11370-y.

Social media health interventions to improve diabetes mellitus patient outcome: a systematic review

OBJECTIVES

The use of modern technology and social media has revolutionized the way health information is distributed to diabetes mellitus patients. Social media can be used as a medium of providing health interventions to improve patient health outcomes. Social media is able to provide a more intensive communication facility between healthcare professionals and patients. We aim to systematically review and describe the effect of social media interventions on health outcomes of patients with diabetes mellitus.

METHODS

A systematic review was carried out from three electronic databases (Pubmed, Scopus, and Medline). Eligible publications are studies that describe the application of social media interventions on the health outcomes of patients with diabetes mellitus.

RESULTS

Fourteen studies were selected for this systematic review, 10 studies with a randomized controlled trial design, and 4 studies with a nonrandomized controlled trial design. Six studies only used interventions using social media, A blend of face-to-face social media intervention was used in 6 studies, 2 studies used a combination of telephone and social media intervention. One study had treatment behavior outcomes with improvement in treatment behavior, 6 studies had clinical outcomes (an improvement in HbA1c values in the four studies), 6 studies had treatment behavior outcomes and clinical outcomes (1 study had improved treatment behavior and clinical outcomes, 3 studies had improved treatment behavior outcome only), and 1 study had medication adherence outcome (no improvement in medication adherence).

CONCLUSIONS

These findings indicate that the intervention using social media can improve the health outcomes of diabetes mellitus patients.

Using WhatsApp messenger for health systems research: a scoping review of available literature

Globally, the use of mobile phones for improving access to healthcare and conducting health research has gained traction in recent years as rates of ownership increase, particularly in low- and middle-income countries (LMICs). Mobile instant messaging applications, including WhatsApp Messenger, provide new and affordable opportunities for health research across time and place, potentially addressing the challenges of maintaining contact and participation involved in research with migrant and mobile populations, for example. However, little is known about the opportunities and challenges associated with the use of WhatsApp as a tool for health research. To inform our study, we conducted a scoping review of published health research that uses WhatsApp as a data collection tool. A key reason for focusing on WhatsApp is the ability to retain contact with participants when they cross international borders. Five key public health databases were searched for articles containing the words ‘WhatsApp’ and ‘health research’ in their titles and abstracts. We identified 69 articles, 16 of which met our inclusion criteria for review. We extracted data pertaining to the characteristics of the research. Across the 16 studies—11 of which were based in LMICs—WhatsApp was primarily used in one of two ways. In the eight quantitative studies identified, seven used WhatsApp to send hyperlinks to online surveys. With one exception, the eight studies that employed a qualitative (n = 6) or mixed-method (n = 2) design analysed the WhatsApp content generated through a WhatsApp-based programmatic intervention. We found a lack of attention paid to research ethics across the studies, which is concerning given the controversies WhatsApp has faced with regard to data protection in relation to end-to-end encryption. We provide recommendations to address these issues for researchers considering using WhatsApp as a data collection tool over time and place.

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

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

Determining the impact of orthodontic patients' characteristics on their usage and preferences of social media

Objective

This study aims to assess the impact of orthodontic patients' characteristics on their usage and personal preferences of social media.

Methods

We developed a descriptive cross-sectional study. The questionnaire contained demographic data and questions about the usage of social media and their preferred platforms. The validity and reliability of the questionnaire were examined. The final Arabic version was adopted, and Google Drive was used to conduct the survey. The survey link was sent to the general public via different social media platforms and applications.

Results

A total of 477 respondents participated in this study, which included 274 women and 203 men. Significant variation in the use of social media was observed between the genders. The use of Twitter, Snapchat, and YouTube was significantly higher in the 21–30-year-old group than in the other groups. Instagram was favoured by the 13–20-year-old group, while WhatsApp was most frequently used by those aged around 40 years. Social media usage was significantly more apparent among university graduates in both the orthodontic and non-orthodontic groups. The use of Twitter, Snapchat, YouTube, Instagram, and WhatsApp was significantly more common in the medium-income group than in any other group. Snapchat was the most commonly used platform across both groups.

Conclusion

Our study revealed that Twitter, Snapchat, and YouTube were the preferred social media applications for the middle-aged group. The use of Instagram was greatest in the teenage group, while WhatsApp was favoured by the older groups. Social media usage was most prevalent among university graduates, regardless of whether they were orthodontic or non-orthodontic patients.

Defining the Digital Self: A Qualitative Study to Explore the Digital Component of Professional Identity in the Health Professions

Background

Recent medical education literature pertaining to professional identity development fails to reflect the impact social media has on professional identity theory. Social media is transforming the field of medicine, as the web-based medium is now an avenue for professional development and socialization for medical students and residents. Research regarding identity development in social media has been primarily confined to electronic professionalism through best practice guidelines. However, this neglects other potential aspects pertinent to digital identity that have not yet been explored.

Objective

This study aims to define the properties and development of the digital self and its interactions with the current professional identity development theory.

Methods

A qualitative study was conducted using thematic analysis. A total of 17 participants who are social media education and knowledge translation experts were interviewed. The initial participants were from emergency medicine, and a snowball sampling method was used following their respective web-based semistructured interviews to enable global recruitment of other participants from interprofessional disciplines. The research team consisted of a diverse group of researchers including one current social media knowledge translation physician clinician educator, one postdoctoral researcher who is regularly engaged in social media knowledge translation, and 3 nonphysician research assistants who are not social media users. Half of the team conducted the initial coding and analysis, whereas the other 2 investigators audited the procedures followed.

Results

A total of 4 themes were identified that pertain to digital identity. In the first theme, origins of initial digital identity formation were found to be derived from perceived needs in professional roles (eg, as a medical student or resident). The second theme consisted of the cultivation of digital identity, in which digital identity was developed parallel to professional identity. The third theme that emerged was the management between the professional and personal components of digital identity. Participants initially preferred keeping these components completely separate; however, attempts to do so were inadequate while the integration of both components provided benefits. The fourth theme was the management of real-life identity and digital identity. Participants preferred real-life identity to be wholly represented on the web. Instances of misalignment resulted in identity conflict, compromising one of the identities.

Conclusions

Social media introduces new features to professional identity in the digital world. The formation of digital identity, its development, and reconciliation with other identities were features captured in our analysis. The virtual component of professional identity must not be neglected but instead further explored, as educational institutions continue to give more importance to navigating professional identity development.

What electronic information resources do physiotherapists prefer to use to support their CPD?

BACKGROUND AND PURPOSE

The way health professionals consume that informal professional education is changing. Physiotherapists are relying more on using electronic sources of information, including social media, to answer clinical questions. This study aims to identify the sources of electronic information physiotherapists in New Zealand use within their informal professional education.

METHODS

A cross-sectional survey of 203 physiotherapists and physiotherapy students was undertaken at the National Physiotherapy New Zealand Conference in 2018.

RESULTS

One hundred and seventy nine participated in the survey providing a response rate of 88%. Median engagement in electronic professional learning was 1-3 h per week (82/179, 47%). Search engines were the most frequently used resource for accessing professional learning (171/179, 98%). Electronic Journal articles and webinars were seen as the most useful electronic learning resources. Social media sites, such as Twitter and Facebook, were used less frequently. Just over half (94/179, 53%) of participants in the survey reported to regularly critically appraising information.

CONCLUSION

Physiotherapists in New Zealand embark on a significant amount of electronic professional learning. Electronic journal articles are seen as the most valuable resource. Critical appraisal of learning material was not always completed by physiotherapists when consuming informal professional education.

Assessment of dentists' behaviour on the use of patients' images

BACKGROUND

Photographs and radiographs are indispensable resources for dental education, research and dissemination of clinical cases in scientific journals. The objective of this study was to evaluate the behaviour of dentists on the use of patients' images.

MATERIAL AND METHODS

Fifty-two dentists were interviewed using a semi-structured script containing open-ended questions on the use of patients' images. The answers were analysed using a qualitative-quantitative method of the discourse of the collective subject, and the distribution of the absolute and relative frequency of the answers was presented according to the central ideas obtained from the discourses.

RESULTS

The following central ideas on the use of patients' images were identified: (a) purpose: didactic and/or academic; (b) informed consent: verbal or absent when the patient cannot be identified; (c) discussion groups on social media contribute to learning; (d) most dentists would not appreciate and sue the author if they had their own photographs/imaging examinations posted on social media; 5. most dentists received some information on ethical regulations during dental school and state that images can be used with patient authorisation, without identification and for didactic/academic purposes.

CONCLUSION

Dentists consider the use of patients' images for didactic and scientific purposes beneficial, request informed consent to share mainly images that reveal the identity and would not appreciate if their personal images were shared without consent.

The Development of a Smart Health Awareness Message Framework Based on the Use of Social Media: Quantitative Study

Background

Social media has recently provided a remarkable means of delivering health information broadly and in a cost-effective way. Despite its benefits, some difficulties are encountered in attempting to influence the public to change their behavior in response to social media health messages.

Objective

This study aimed to explore the factors that affect individuals’ acceptance of using social media as a tool for receiving health awareness messages and adapting such content accordingly by developing a smart health awareness message framework.

Methods

A quantitative method was adapted to validate the hypotheses and proposed framework through the development of a survey based on the technology acceptance model with the extension of other constructs. The survey was distributed on the web to 701 participants from different countries via Qualtrics software; it generated 391 completed questionnaires, and the response rate was 55.8% (391/701).

Results

Of the 391 respondents, 121 (30.9%) used social media platforms often during the week, and 27 participants (6.9%) did not use social media. In addition, 24.0% (94/391) of the respondents used these platforms to seek health information. On the basis of the results, perceived usefulness (β=.37; P<.001), gain-framed message (β=.04; P<.001), and loss-framed message (β=.08; P<.001) were seen to positively and significantly influence people’s intention to use social media as a means to spread information about health promotion. The proposed smart health awareness message framework identifies 64.2% of the variance in intention to use, 55.4% of the variance of perceived usefulness, and 26.2% of the variance of perceived ease of use.

Conclusions

This study sheds light on the factors that are associated with people’s intention to use and adopt social media in the health promotion domain. The findings reveal that the intention of using social media for health awareness purposes is positively impacted by the perception of usefulness of social media and the design of health messages. Future research might seek to explore other factors that relate to people’s behavior. This point of view will assist health organizations in developing their health messages more effectively and to be patient friendly.

Effects of Health Information Dissemination on User Follows and Likes during COVID-19 Outbreak in China: Data and Content Analysis

Background: COVID-19 has greatly attacked China, spreading in the whole world. Articles were posted on many official WeChat accounts to transmit health information about this pandemic. The public also sought related information via social media more frequently. However, little is known about what kinds of information satisfy them better. This study aimed to explore the characteristics of health information dissemination that affected users' information behavior on WeChat. Methods: Two-wave data were collected from the top 200 WeChat official accounts on the Xigua website. The data included the change in the number of followers and the total number of likes on each account in a 7-day period, as well as the number of each type of article and headlines about coronavirus. It was used to developed regression models and conduct content analysis to figure out information characteristics in quantity and content. Results: For nonmedical institution accounts in the model, report and story types of articles had positive effects on users' following behaviors. The number of headlines on coronavirus positively impacts liking behaviors. For medical institution accounts, report and science types had a positive effect, too. In the content analysis, several common characteristics were identified. Conclusions: Characteristics in terms of the quantity and content in health information dissemination contribute to users' information behavior. In terms of the content in the headlines, via coding and word frequency analysis, organizational structure, multimedia applications, and instructions-the common dimension in different articles-composed the common features in information that impacted users' liking behaviors.

Exploring the Characteristics and Behaviors of Nurses Who Have Attained Microcelebrity Status on Instagram: Content Analysis

Background

Instagram is a social media platform that enables users to share images and videos worldwide. Some nurses have used Instagram to document their experiences as a nurse and have subsequently gained microcelebrity status—that is, a user who purposefully seeks to amass a substantive Web-based following and has become recognized as a niche area of interest.

Objective

This study aimed to identify the characteristics and behaviors of microcelebrity nurses who act as influencers on Instagram and use their nursing profile to gain attention and presence on the Web.

Methods

A qualitative, exploratory, nonparticipatory content analysis of media and text generated by a purposeful sample of 10 registered nurses who use Instagram and sustain a definable microcelebrity status was conducted. In this study, manifest and latent data were examined to gain an understanding of the characteristics and behaviors of nurses who have attained microcelebrity status on Instagram.

Results

Data analysis revealed 5 themes of Instagram posts: (1) engaging Instagram users, (2) educational opportunities and insights, (3) nursing-related humor, (4) emotions experienced by nurses, and (5) media and narratives including patient details or work context. Messages were primarily positive in nature; however, multiple potential privacy, ethical, and professional issues were noted throughout the posted content.

Conclusions

The findings of this study help to expand the current knowledge related to the use of social media platforms such as Instagram, especially in regard to the emergence of nurses who use this form of technology to achieve or maintain a microcelebrity status. This study calls for additional research on nurses’ attainment of microcelebrity status on social media as well as further policy development to adequately prepare nurses to navigate social media.

Ethical Considerations for Participatory Health through Social Media: Healthcare Workforce and Policy Maker Perspectives

OBJECTIVES

To identify the different ethical issues that should be considered in participatory health through social media from different stakeholder perspectives (i.e., patients/service users, health professionals, health information technology (If) professionals, and policy makers) in any healthcare context.

METHODS

We implemented a two-round survey composed of open ended questions in the first round, aggregated into a list of ethical issues rated for importance by participants in the second round, to generate a ranked list of possible ethical issues in participatory health based on healthcare professionals' and policy makers' opinions on both their own point of view and their beliefs for other stakeholders' perspectives.

RESULTS

Twenty-six individuals responded in the first round of the survey. Multiple ethical issues were identified for each perspective. Data privacy, data security, and digital literacy were common themes in all perspectives. Thirty-three individuals completed the second round of the survey. Data privacy and data security were ranked among the three most important ethical issues in all perspectives. Quality assurance was the most important issue from the healthcare professionals' perspective and the second most important issue from the patients' perspective. Data privacy was the most important consideration for patients/service users. Digital literacy was ranked as the fourth most important issue, except for policy makers' perspective.

CONCLUSIONS

Different stakeholders' opinions fairly agreed that there are common ethical issues that should be considered across the four groups (patients, healthcare professionals, health IT professionals, policy makers) such as data privacy, security, and quality assurance.

External validation of the unified model of information systems continuance (UMISC): An international comparison

CONTEXT

The Unified Model of Information Systems Continuance (UMISC) is a metamodel for the evaluation of clinical information systems (CISs) that integrates constructs from five models that have previously been published in the literature. UMISC was developed at the Georges Pompidou University Hospital (HEGP) in Paris and was partially validated at the Saint Joseph Hospital Group (HPSJ), another acute care institution using the same CIS as HEGP.

OBJECTIVE

The aim of this replication study was twofold: (1) to perform an external validation of UMISC in two different hospitals and country contexts: the Italian Hospital of Buenos Aires (HIBA) in Argentina and the Hospital Sirio Libanes in Sao Paulo, Brazil (HSL); (2) to compare, using the same evaluation model, the determinants of satisfaction, use, and continuance intention observed at HIBA and HSL with those previously observed at HEGP and HPSJ.

METHODS

The UMISC evaluation questionnaires were translated from their original languages (English and French) to Brazilian Portuguese and Spanish following the translation/back-translation method. These questionnaires were then applied at each target site. The 21 UMISC-associated hypotheses were tested using structural equation modeling (SEM).

RESULTS

A total of 3020 users, 1079 at HIBA and 1941 at the HSL, were included in the analysis. The respondents included 1406 medical staff and 1001 nursing staff. The average profession-adjusted use, overall satisfaction and continuance intention were significantly higher at HIBA than at HSL in the medical and nursing groups. In SEM analysis, UMISC explained 23% and 11% of the CIS use dimension, 72% and 85% of health professionals' satisfaction, and 41% and 60% of continuance intention at HIBA and HSL, respectively. Twenty of the 21 UMISC-related hypotheses were validated in at least one of the four evaluation sites, and 16 were validated in two or more sites.

CONCLUSION

The UMISC evaluation metamodel appears to be a robust comparison and explanatory model of satisfaction, use and continuance intention for CISs in late post adoption situations.

The Rise of the Empowered Physician in the Digital Health Era: Viewpoint

Being a 21st-century health care provider is extremely demanding. The growing number of chronic diseases, lack of medical workforce, increasing amounts of administrative tasks, the cost of medical treatment, and rising life expectancy result in an immense challenge for medical professionals. This transformation has been triggered by the growing presence of digital health. Digital health does not only refer to technological transformation; it also fundamentally reshapes the physician-patient relationship and treatment circumstances. We argue that patient empowerment, the spread of digital health, the biopsychosocial-digital approach, and the disappearance of the ivory tower of medicine lead to a new role for physicians. Digital health allows the job of being a medical professional to become more rewarding and creative. The characteristics of a physician-as-idol could shift from self-confident to curious, from rule follower to creative, and from lone hero to team worker. Empowered physicians (e-physicians) can be described as "electronic," where they use digital technologies in their practice with ease; "enabled," where they are enabled by regulations and guidelines; and "empowered," where they are empowered by technologies that support their job and their empowered patients (e-patients). They can be described as "experts" in the use of technologies in their practice or in knowing the best, most reliable, and trustworthy digital health sources and technologies. They can also be described as "engaged," when understanding the feelings and points of view of their patients, giving relevant feedback, and involving them throughout the whole healing process. The skills and approaches that characterize this era of e-physicians, such as face-to-face communication skills, digital literacy, interdisciplinarity, knowing where to find information, translating large amounts of data into insights for patients, among others, should always have been at the core of practicing medicine. However, the economical, technological, and administrative burden of the profession has not made it possible for most physicians to enjoy the benefits of their training, individual capabilities, and creativity. By understanding how digital health technologies can support or augment their capabilities, physicians would have the chance to practice the art of medicine like never before.