Sources of Health Information, Technology Access, and Use Among Non-English-Speaking Immigrant Women: Descriptive Correlational Study

Raising awareness about physical activity's role in reducing cancer risk: qualitative interviews with immigrant women and community agency managers

OBJECTIVES

To explore how to reach immigrant women through community agencies to raise awareness of the role of physical activity (PA) in reducing cancer risk.

STUDY DESIGN

Qualitative description.

METHODS

We conducted semi-structured telephone interviews with immigrant women and community agency managers to discuss the ideal design of an education session on PA and cancer risk, and identified themes using content analysis.

RESULTS

Participants included 22 women (6 African or Caribbean Black, 4 Chinese, 3 Filipino, 5 Indian, 4 Pakistani) and 16 agency managers from across Canada. Women were not familiar with Canada's PA guidelines, and few were aware that PA reduces the risk of cancer. All expressed interest in education about PA and cancer. Diverse women and managers expressed similar preferences for education session design including content (e.g. PA amount/type), format (e.g. in person preferred but virtual more practical), personnel (external expert plus agency staff), cultural tailoring (e.g. translated supplemental take home information) and reinforcing (e.g. follow-up with participants) strategies. Women and managers identified few barriers to participating in education sessions, chiefly, that women lacked time due to work and family responsibilities; and noted several enablers of participation (e.g. emphasize social aspect, provide gift cards or recreation centre passes).

CONCLUSIONS

We generated insight on the ideal characteristics of a community-based education session that could raise awareness among immigrant women of the importance of PA in reducing cancer risk. Further research is needed to assess the feasibility and impact of PA education sessions designed based on these findings.

Sources of information on monkeypox virus infection. A systematic review with meta-analysis

BACKGROUND

Monkeypox (Mpox) virus infection is a topic of growing interest today because of its potential public health impact and concern about possible outbreaks. Reliable and up-to-date sources of information that provide accurate data on its transmission, symptoms, prevention, and treatment are essential for understanding and effectively addressing this disease. Therefore, the aim of the present study is to determine the prevalence of sources of information on Mpox virus infection.

METHODS

An exhaustive systematic review and meta-analysis was carried out using the information available in the PubMed, Scopus, Web of Science, Embase, and ScienceDirect databases up to August 3, 2023. The data were analyzed using R software version 4.2.3. The quality of the cross-sectional studies that formed part of this review was assessed using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) tool. In addition, a subgroup analysis was performed based on the study populations.

RESULTS

Through electronic searches of five databases, a total of 1833 studies were identified. Twenty-four cross-sectional articles were included, with a total sample of 35,959 participants from 34 countries. The pooled prevalence of each of the included information sources was: social networks reached 59% (95% CI: 50-68%; 29,146 participants; 22 studies; I2 = 100%; p < 0.01); the Internet was 61% (95% CI: 44-77%; 14,002 participants; 5 studies; I2 = 100%; p < 0.01), radio reached 10% (95% CI: 07-13%; 8917 participants; 4 studies; I2 = 93%; p < 0.01), television accounted for 24% (95% CI: 09-43%; 14,896 participants; 8 studies; I2 = 100%; p < 0.01), and the combination of radio and television accounted for 45% (95% CI: 31-60%; 4207 participants; 7 studies; I2 = 99%; p < 0.01); for newspapers, it was 15% (95% CI: 05-27%; 2841 participants; 6 studies; I2 = 99%; p < 0.01), friends and relatives accounted for 19% (95% CI: 12-28%; 28,470 participants; 19 studies; I2 = 100%; p < 0.01), the World Health Organization (WHO) accounted for 17% (95% CI: 07-29%; 1656 participants; 3 studies; I2 = 97%; p < 0.01), the Centers for Disease Control and Prevention (CDC) accounted for 10% (95% CI: 03-21%; 2378 participants; 3 studies; I2 = 98%; p < 0.01), and the combination of WHO and CDC websites accounted for 60% (95% CI: 48-72%; 1828 participants; 4 studies; I2 = 96%; p < 0.01), and finally, scientific articles and journals accounted for 24% (95% CI: 16-33%; 16,775 participants; 13 studies; I2 = 99%; p < 0.01).

CONCLUSION

The study suggests that people access a variety of information sources to gain knowledge about Mpox virus infection, with a strong emphasis on online sources such as social networks and the Internet. However, it is important to note that the quality and accuracy of information available from these sources can vary, underscoring the need to promote access to reliable and up-to-date information about this disease to ensure public health.

Ethnic Disparities in Patient-Centered Communication with Healthcare Providers: A Comparison of Non-Hispanic Asians and Non-Hispanic Whites

BACKGROUND

Patient-centered communication (PCC) is an important metric related to patient health outcomes. Non-Hispanic Asian (NHA) individuals reported lower PCC scores with healthcare providers than individuals of other races and ethnicities. We aim to determine the ethnic disparities in PCC and further investigate the association between PCC, individual's confidence in obtaining health-related information (health literacy), and confidence in taking care of themselves (health self-efficacy) among NHA in comparison to the Non-Hispanic White (NHW) population.

METHODS

This is a cross-sectional study. We used data from the Health Information National Trends Survey 5 (HINTS) cycles 1 and 3. PCC was measured using seven validated survey questions with scores ranging from 7 to 28. Individuals' health literacy and self-efficacy were accessed using two-item survey questions. Multivariable logistic regression analyses were performed to determine the association of independent factors (e.g., self-efficacy, health literacy, and race and ethnicity) with PCC.

RESULTS

We included 3,831 participants. Fewer NHAs (35.43%) reported high PCC scores compared to NHWs (48.99%, p = 0.0184). In fully adjusted logistic regression model, although NHAs were less likely to have high PCC scores (aOR = 0.78, 95% CI 0.46-1.32) compared to NHWs, the association was not statistically significant (p = 0.350). However, the aOR of confidence in self-efficacy associated with high PCC scores was 2.27 (95% CI 1.68-3.07, p < 0.001) and the aOR of confidence in health literacy with high PCC scores was 2.13 (95% CI 1.64-2.76, p < 0.001).

CONCLUSIONS

High PCC scores reported by NHA were not significantly different from those of NHW individuals in adjusted comparisons. Individual's confidence in self-efficacy and health literacy was positively associated with high PCC regardless of race and ethnicity.

A Moderating Role of Gender in Online Health Information Seeking Behaviors for Colorectal Cancer Knowledge among Korean Americans Aged 50 to 75 Years

Korean Americans have consistently reported the underutilization of colorectal cancer (CRC) screening, despite their high rates of CRC incidence and mortality. Research has indicated suboptimal CRC knowledge in Korean Americans as one of the main barriers to their recommended CRC screening. Also, research has shown the potential of online health information seeking (OHIS) to improving cancer knowledge and the gender-based differences in the link between OHIS and cancer knowledge. Thus, this study aimed to examine the association between OHIS and CRC knowledge and the moderating effect of gender in this association among Korean Americans. A cross-sectional survey with purposive sampling was conducted of 421 Korean Americans aged 50 to 75 years in the Southeastern U.S. Three-step hierarchical multiple regression analyses were performed to investigate if three blocks of variables-Block 1: control variables (sociodemographics and health-related information), Block 2: independent variables (OHIS and gender), and Block 3: an (OHIS × gender) interaction term-significantly reduce unexplained variance in CRC knowledge. The analyses showed that the final model fits best accounting for 29.3% of the variance in CRC knowledge. Also, the analyses showed that OHIS was positively associated with CRC knowledge and gender moderated the association between OHIS and CRC knowledge. The findings close the knowledge gap existing in the body of literature on the connection of OHIS to CRC knowledge in Korean Americans. Findings also extend the understanding of gender-specific approaches leveraging OHIS for CRC prevention education among Korean Americans.

Effectiveness of Interventions to Improve Digital Health Literacy in Forced Migrant Populations: Protocol for a Mixed Methods Systematic Review

BACKGROUND

Digital health literacy is considered a health determinant that can influence improved health and well-being, health equity, and the reduction of social health inequalities. Therefore, it serves as an asset for individuals to promote their health. However, low digital health literacy is a major problem among forced migrant populations. They do not always have the capacity and skills to access digital health resources and use them appropriately. To our knowledge, no studies are currently available to examine effective interventions for improving digital health literacy among forced migrant populations.

OBJECTIVE

This paper presents the protocol for a systematic review that aims to assess the effectiveness of digital health literacy interventions among forced migrant populations. With this review, our objectives are as follows: (1) identify interventions designed to improve digital health literacy among forced migrant populations, including interventions aimed at creating enabling conditions or environments that cater to the needs and expectations of forced migrants limited by low levels of digital health literacy, with the goal of facilitating their access to and use of eHealth resources; (2) define the categories and describe the characteristics of these interventions, which are designed to enhance the abilities of forced migrants or adapt digital health services to meet the needs and expectations of forced migrant populations.

METHODS

A mixed methods systematic review will be conducted according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) checklist. The research will be conducted in an iterative process among the different authors. With the help of a medical information specialist, a specific search strategy will be formulated for the 6 most relevant databases (ie, MEDLINE, Embase, CINAHL, Web of Science, Academic Search Premier, PsycINFO, and the Google Scholar search engine). A literature search covering studies published between 2000 and 2022 has already been conducted. Two reviewers then proceeded, individually and independently, to conduct a double selection of titles, abstracts, and then full texts. Data extraction will be conducted by a reviewer and validated by a senior researcher. We will use the narrative synthesis method (ie, structured narrative summaries of key themes) to present a comprehensive picture of effective digital health literacy interventions among forced migrant populations and the success factors of these interventions.

RESULTS

The search strategy and literature search were completed in December 2022. A total of 1232 articles were identified. The first selection was completed in July 2023. The second selection is still in progress. The publication of the systematic review is scheduled for December 2023.

CONCLUSIONS

This mixed methods systematic review will provide comprehensive knowledge on effective interventions for digital literacy among forced migrant populations. The evidence generated will further inform stakeholders and aid decision makers in promoting equitable access to and use of digital health resources for forced migrant populations and the general population in host countries.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/50798.

Cross-sectional review of US websites providing lung cancer screening recommendations following the 2021 US Preventive Services Task Force updates

BACKGROUND

Lung cancer remains the leading cause of cancer death worldwide and an urgent public health priority. Early detection by low-dose CT (LDCT) screening and treatment of lung cancer has been shown to reduce mortality but uptake remains dismal, particularly among historically underserved groups. Following the US Preventive Services Task Force (USPSTF) expansion of its eligibility criteria to address inequities in utilization, efforts are needed to ensure dissemination of updated health information through digital means such as websites.

OBJECTIVE

The objective of this study was to investigate whether online websites have been updated to reflect the recent USPSTF guidelines that expanded the recommended age and smoking pack-years for lung cancer screening.

METHODS

In this cross-sectional study, we identified websites that provide information on lung cancer screening guidelines on May 24, 2022, approximately one year after the emergence of the updated USPSTF guidelines. The websites were assessed for recommended age to begin lung cancer screening and smoking pack-year quantity.

RESULTS

Our study found that a lag in dissemination of updated lung cancer screening information exists. Approximately 1 year after the USPSTF guidelines were updated, 17-32% of websites providing information on lung cancer screening guidelines had not been updated.

CONCLUSION

Routine monitoring of websites that provide information on lung cancer screening can help reduce misinformation, improve uptake of lung cancer screening, and prevent delays in diagnostic evaluation which disproportionally affects traditionally underserved populations.

Identifying Challenges, Enabling Practices, and Reviewing Existing Policies Regarding Digital Equity and Digital Divide Toward Smart and Healthy Cities: Protocol for an Integrative Review

BACKGROUND

Digital equity denotes that all individuals and communities have equitable access to the information technology required to participate in digital life and can fully capitalize on this technology for their individual and community gain and benefits. Recent research highlighted that COVID-19 heightened the existing structural inequities and further exacerbated the technology-related social divide, especially for racialized communities, including new immigrants, refugees, and ethnic minorities. The intersection of challenges associated with racial identity (eg, racial discrimination and cultural differences), socioeconomic marginalization, and age- and gender-related barriers affects their access to health and social services, education, economic activity, and social life owing to digital inequity.

OBJECTIVE

Our aim is to understand the current state of knowledge on digital equity and the digital divide (which is often considered a complex social-political challenge) among racialized communities in urban cities of high-income countries and how they impact the social interactions, economic activities, and mental well-being of racialized city dwellers.

METHODS

We will conduct an integrative review adapting the Whittemore and Knafl methodology to summarize past empirical or theoretical literature describing digital equity issues pertaining to urban racialized communities. The context will be limited to studies on multicultural cities in high-income countries (eg, Calgary, Alberta) in the last 10 years. We will use a comprehensive search of 8 major databases across multiple disciplines and gray literature (eg, Google Scholar), using appropriate search terms related to digital "in/equity" and "divide." A 2-stage screening will be conducted, including single citation tracking and a hand search of reference lists. Results will be synthesized using thematic analysis guidelines.

RESULTS

As of August 25, 2022, we have completed a systematic search of 8 major academic databases from multiple disciplines, gray literature, and citation or hand searching. After duplicate removal, we identified 8647 articles from all sources. Two independent reviewers are expected to complete the 2-step screening (title, abstract, and full-text screening) using Covidence followed by data extraction and analysis in 4 months (by December 2022). Data will be extracted regarding digital equity-related initiatives, programs, activities, research findings, issues, barriers, policies, recommendations, etc. Thematic analysis will reveal how barriers and facilitators of digital equity affect or benefit racialized population groups and what social, material, and systemic issues need to be addressed to establish digital equity for racialized communities in the context of a multicultural city.

CONCLUSIONS

This project will inform public policy about digital inequity alongside conventional systemic inequities (eg, education and income levels); promote digital equity by exploring and examining the pattern, extent, and determinants and barriers of digital inequity across sociodemographic variables and groups; and analyze its interconnectedness with spatial dimensions and variations of the urban sphere (geographic differences).

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/40068.

COVID-19 Information-Seeking, Health Literacy, and Worry and Anxiety During the Early Stage of the Pandemic in Switzerland: A Cross-Sectional Study

Objectives: To describe COVID-19 information-seeking behavior (CISB) during the first stage of the pandemic in Switzerland and identify its determinants.

Methods: We conducted an online cross-sectional survey (4 May to 6 July 2020). Participants self-reported their CISB (information sources and frequency), personal COVID-19 situation (e.g., perception about having had COVID-19), sociodemographic information, and completed validated measures of health literacy, and worry and anxiety. Data were analyzed using descriptive statistics and logistic regressions.

Results: We included 1,505 participants (24.7% male; mean age = 43.0 years, SD = 13.9). Most participants reported searching for information daily (n = 1,023, 68.0%) and referring to multiple information sources (mean 3.7, SD = 1.5). Commonly used sources were official websites (n = 1,129, 75.0%) and newspapers (n = 997, 66.2%). Participants with higher health literacy were more likely to seek information daily and use online resources, but less likely to use personal networks than those with lower health literacy. We did not find any association between CISB and worry and anxiety.

Conclusion: More opportunities for personal dialogue and education about reliable online information resources should be encouraged to optimize the CISB of groups with lower health literacy.

Assessing Telemedicine Efficiency in Follow-up Care With Video Consultations for Patients in Orthopedic and Trauma Surgery in Germany: Randomized Controlled Trial

Background

Telemedicine can help mitigate important health care challenges, such as demographic changes and the current COVID-19 pandemic, in high-income countries such as Germany. It gives physicians and patients the opportunity to interact via video consultations, regardless of their location, thus offering cost and time savings for both sides.

Objective

We aimed to investigate whether telemedicine can be implemented efficiently in the follow-up care for patients in orthopedic and trauma surgery, with respect to patient satisfaction, physician satisfaction, and quality of care.

Methods

We conducted a prospective randomized controlled trial in a German university hospital and enrolled 60 patients with different knee and shoulder conditions. For follow-up appointments, patients received either an in-person consultation in the clinic (control group) or a video consultation with their physician (telemedicine group). Patients’ and physicians’ subsequent evaluations of these follow-up appointments were collected and assessed using separate questionnaires.

Results

On the basis of data from 52 consultations after 8 withdrawals, it was found that patients were slightly more satisfied with video consultations (mean 1.58, SD 0.643) than with in-clinic consultations (mean 1.64, SD 0.569), although the difference was not statistically significant (P=.69). After excluding video consultations marred by technical problems, no significant difference was found in physician satisfaction between the groups (mean 1.47, SD 0.516 vs mean 1.32, SD 0.557; P=.31). Further analysis indicated that telemedicine can be applied to broader groups of patients and that patients who have prior experience with telemedicine are more willing to use telemedicine for follow-up care.

Conclusions

Telemedicine can be an alternative and efficient form of follow-up care for patients in orthopedic and trauma surgery in Germany, and it has no significant disadvantages compared with in-person consultations in the clinic.

Trial Registration

German Clinical Trials Register DRKS00023445; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023445

A retrospective analysis of social media posts pertaining to COVID-19 vaccination side effects

OBJECTIVES

With an uprising influence of social media platforms like Twitter and Instagram a multitude of worldwide accessible information is available. Since the beginning of COVID-19 pandemic the exchange of medical information about several topics related to this infectious disease and its vaccination has increased rapidly. The purpose of this investigation was to assess the content associated with COVID-19 vaccination and its side effects and evaluate its educational quality.

METHODS

We conducted this retrospective study to investigate 600 Twitter and Instagram posts by #covidvaccinesideeffects due to number of 'likes', comments, type of post, language, its purpose and source. In addition, posts were evaluated due to educational quality by three examiners of different educational levels.

RESULTS

The majority of posts showed 0 to 50 "likes" and 0 to 5 comments in English language. A comparison between Twitter and Instagram by the influence of application showed significant differences in number of posts and "likes" or comments (p < 0.05). The major post type were texts for Twitter (251; 83.7%) and videos for Instagram (104; 34.7%). While a majority of posts by #covidvaccinesideeffects report about the occurrence of side effects, the majority of them were mild and general COVID-19 vaccination feedback during the first 4 months was positive. But, only 3 to 7% were rated by "excellent" educational and validatable content. Interrater reliability between all three examiners presented a high concordance with 89% (p = 0.001).

CONCLUSIONS

This study presents an analysis of quantity and quality of social media content according to COVID-19 vaccinations and its side effects. It supports the deduction that most of the content on Twitter and Instagram is shared by patients and unclear sources and thus is limited informative. Nevertheless, influence of social media on medical information especially during COVID-19 pandemic is increasing and practitioners have to face its effect on their patients.