Association of Online Health Information-Seeking Behavior and Self-Care Activities Among Type 2 Diabetic Patients in Saudi Arabia

The moderating role of e-health literacy and patient-physician communication in the relationship between online diabetes information-seeking behavior and self-care practices among individuals with type 2 diabetes

BACKGROUND

This study examined the moderating role of e-health literacy (eHL) and patient-physician communication in the relationship between online diabetes information-seeking behavior (online DISB) and self-care practices.

METHODS

A total of 1143 individuals with type 2 diabetes mellitus completed a cross-sectional survey assessing sociodemographic characteristics, data relating to diabetes clinical history, online DISB, eHL (eHealth Literacy Scale), aspects of patient-physician communication (IPC survey), patient self-care (Self-Care Inventory-Revised), and medication adherence (measure of adherence to prescribed diabetes medications). The data were analyzed using both bivariate (correlation) and multivariate (multiple linear regression) analyses using maximum likelihood estimation procedures in Mplus.

RESULTS

Our results showed online DISB significantly predicted diabetes self-care (p < 0.001) and medication adherence behaviors (p = 0.005). Lower Hurried Communication (p < 0.001, p = 0.03), higher Elicited Concerns (p = 0.005, p = 0.03), higher Explained Results (p = 0.03, p = 0.008), and higher eHL (p = 0.02, p = 0.02) were significantly associated with better self-care and medication adherence. Explained Results and eHL moderated the relationship between online DISB and both self-care and medication adherence.

CONCLUSIONS

Findings support the role of patient eHL and patient-physician communication in amplifying the positive impact of online DISB on patients' behavioral outcomes in diabetes.

ChatGPT vs. sleep disorder specialist responses to common sleep queries: Ratings by experts and laypeople

BACKGROUND

Many individuals use the Internet, including generative artificial intelligence like ChatGPT, for sleep-related information before consulting medical professionals. This study compared responses from sleep disorder specialists and ChatGPT to common sleep queries, with experts and laypersons evaluating the responses' accuracy and clarity.

METHODS

We assessed responses from sleep medicine specialists and ChatGPT-4 to 140 sleep-related questions from the Korean Sleep Research Society's website. In a blinded study design, sleep disorder experts and laypersons rated the medical helpfulness, emotional supportiveness, and sentence comprehensibility of the responses on a 1-5 scale.

RESULTS

Laypersons rated ChatGPT higher for medical helpfulness (3.79 ± 0.90 vs. 3.44 ± 0.99, p < .001), emotional supportiveness (3.48 ± 0.79 vs. 3.12 ± 0.98, p < .001), and sentence comprehensibility (4.24 ± 0.79 vs. 4.14 ± 0.96, p = .028). Experts also rated ChatGPT higher for emotional supportiveness (3.33 ± 0.62 vs. 3.01 ± 0.67, p < .001) but preferred specialists' responses for sentence comprehensibility (4.15 ± 0.74 vs. 3.94 ± 0.90, p < .001). When it comes to medical helpfulness, the experts rated the specialists' answers slightly higher than the laypersons did (3.70 ± 0.84 vs. 3.63 ± 0.87, p = .109). Experts slightly preferred specialist responses overall (56.0%), while laypersons favored ChatGPT (54.3%; p < .001). ChatGPT's responses were significantly longer (186.76 ± 39.04 vs. 113.16 ± 95.77 words, p < .001).

DISCUSSION

Generative artificial intelligence like ChatGPT may help disseminate sleep-related medical information online. Laypersons appear to prefer ChatGPT's detailed, emotionally supportive responses over those from sleep disorder specialists.

Exploring online health resources and self-care among irritable bowel syndrome patients: analyzing internet use and AI chatbot interactions

Background

The increasing prevalence of irritable bowel syndrome (IBS) in Saudi Arabia has led to a growing interest in understanding how patients seek health information online. While it is known that digital platforms, such as search engines, social media, and artificial intelligence (AI) chatbots, are commonly used for health information seeking, there is limited knowledge about the specific behaviors of IBS patients in this context and how these behaviors correlate with their self-care activities. This study aimed to explore online health information-seeking behavior and its correlation with self-care activities among patients with IBS in Saudi Arabia, focusing on the use of these digital platforms.

Methods

A cross-sectional survey was conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, from January to July 2023. The survey, available in both English and Arabic, targeted IBS patients aged 16 years or older. The questionnaire covered demographics, general internet usage, online health information-seeking behavior, and IBS knowledge and awareness.

Results

In this study, 451 IBS patients completed the survey. Notably, 95.1% of participants were internet users, primarily accessing health information through mobile phones and search engines. The results highlighted a significant correlation between online health information-seeking behaviors and self-care practices (P=0.009) like exercise and dietary adjustments, despite a moderate basic knowledge [standard deviation (SD) 2.26%] of IBS. Symptomatically, 93.3% experienced abdominal pain weekly, yet 63% did not fully meet the Rome criteria for IBS. Common management strategies included hydration, diet modifications, and exercise. About 28.4% visited the emergency room (ER) for severe symptoms, and 20% regularly consulted doctors every 3-6 months. Surprisingly, 80% were unaware of the FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet, often suggested for IBS.

Conclusions

The research indicates a rise in digital health literacy among IBS patients in Saudi Arabia, highlighting the need for accurate and culturally appropriate online resources. It suggests that healthcare professionals and policymakers should direct patients to reliable information and address the digital divide to enhance self-care and IBS management outcomes.

The Googling Effect on patient co-creation in physiotherapy service exchange

We study the process of value co-creation in physiotherapist-patient relationships and the underlying mechanisms of this process. We present the Googling Effect Model outlining the relationship between patients' pre-encounter online information search and their commitment to compliance in physiotherapy service exchange. We tested the model on a sample of physiotherapy service patients (n = 446) in the United States. We analyzed the collected responses using the partial least squares method, using SmartPLS 4.0. Our study contributes to the existing body of knowledge in several ways. We developed and tested the Googling Effect Model. Doing so adds to the healthcare literature on value co-creation in physiotherapy. The Googling Effect Model increases the predictive value of the Service-Dominant Logic as it outlines the mechanism underlying value co-creation in healthcare, including the role and importance of pre-encounter online information search in collaborative healthcare. Moreover, the findings illustrate how the underlying mechanism through which pre-encounter online information search affects commitment to compliance differs between men and women and different ethnic groups. These findings can be used to create an environment that increases service engagement and commitment to compliance by accounting for patients' gender and ethnicity.

Information behaviours of people with type 2 diabetes in Kuwait: a grounded theory study

BACKGROUND

Relative to country-specific epidemiological trends, Kuwait experiences a far greater burden of type 2 diabetes among its population. Information behaviours form a significant component of self-care management for patients diagnosed with type 2 diabetes, however this remains an understudied aspect of disease management. This study aims to investigate the information behaviours of patients with type 2 diabetes in Kuwait, and characterise the methods employed to manage their disease.

METHODS

This qualitative study employed a grounded theory method. Semi-structured interviews were conducted with twenty-seven participants over three phases of data collection in primary, secondary and tertiary healthcare settings across Kuwait. These were complemented by in-depth interviews to detail the information behaviours of these participants. The interviews were translated where appropriate, transcripts, and analysed through qualitative coding to synthesise the information behaviour patterns.

RESULTS

The findings demonstrated that living with type 2 diabetes involved a range of developmental and transformative stages, including changes to the patients' emotional state, reconstruction of their lifestyle and identity, and changes in the ways they find and use information. Living with the chronic condition was viewed as a dynamic and transitional process, where patients' information behaviours continually changed throughout the process across various identifiable stages. This dynamic pattern was reflected most prominently across the participants' behavioural needs, sources and information-seeking patterns.

CONCLUSION

Patients with type 2 diabetes continuously adapted their information behaviours to optimise the self-management of their condition across a relatively predictable pattern. Greater understanding of these behaviours across a wider population would improve the provision of clinical care for patients with diabetes.

Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: a mixed-methods study

BACKGROUND

Women diagnosed with gestational diabetes mellitus often rely on internet-based health information for managing their condition. This study aims to investigate the present state of electronic health literacy among women with gestational diabetes mellitus, analyze the influencing factors, and explore their experiences regarding accessing, comprehending, evaluating, and applying online health information pertinent to gestational diabetes mellitus.

METHODS

A sequential explanatory mixed methods research design was adopted in this study. Initially, 235 women with gestational diabetes mellitus participated in a cross-sectional survey. The research tools included general information and the Chinese version of the electronic Health Literacy Scale (eHEALS). Descriptive analyses were conducted to describe the characteristics of the sample, and multiple linear regression analyses were used to explore the factors influencing electronic health literacy among women with gestational diabetes mellitus. Secondly, 11 women with gestational diabetes mellitus joined semi-structured in-depth interviews to obtain their perceptions about online health information. The data were analyzed using inductive content analysis to develop themes.

RESULTS

The median score of eHEALS in the Chinese version among 235 women diagnosed with gestational diabetes mellitus was 29 (interquartile range [IQR], 26 to 32). Factors influencing electronic health literacy among these women included accessing health information from medical professionals (β = 0.137, p = 0.029) and utilizing health information from applications (β = 0.159, p = 0.013). From the qualitative phase of the study, four thematic categories emerged: reasons and basis for accessing health information from the Internet; address barriers to accessing and applying online health information; desires for a higher level of online health information services; outcomes of accessing and applying online health information.

CONCLUSION

The electronic health literacy of women diagnosed with gestational diabetes mellitus remains suboptimal and warrants improvement. The sources of access to health information affect electronic health literacy in women with gestational diabetes mellitus. Moreover, women facing gestational diabetes encounter numerous impediments when attempting to access health-related information online, underscoring the necessity for enhanced online health information services to meet their needs.

Assessment of Arabic Web-Based Knowledge About Root Canal Treatment: An Infodemiologic Study

BACKGROUND

Root canal treatment (RCT) is a vital dental procedure aimed at preserving tooth function and minimizing infection. Access to accurate and comprehensive information about RCT is crucial for informed decision-making. With the increasing reliance on the Internet for health-related information, it is essential to evaluate the quality and readability of web-based RCT content, particularly in Arabic-speaking regions.

METHODS

This study conducted an extensive web search using three major search engines (Google, Yahoo, and Bing) to identify Arabic-language websites providing information on RCT. Inclusion criteria required websites in Arabic with comprehensive RCT content. Quality assessment employed the DISCERN instrument, JAMA benchmarks, and Health on the Net (HON) assessment tools, while readability was assessed using Flesch Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE) metrics.

RESULTS

Out of 152 websites included, the majority were affiliated with university/medical centers (56.58%) and non-profit organizations (28.29%). Quality assessment revealed that the mean DISCERN score was 2.82, indicating moderate quality. Only one website achieved a high DISCERN score. JAMA benchmarks showed limited compliance, with only two websites meeting all criteria. The HON code was found on only five websites. Readability analysis indicated that most websites were reasonably easy to read by the general population.

CONCLUSION

This study highlights the significant gap in the quality and reliability of web-based health information related to RCT in Arabic. While the majority of websites examined in this study did not meet established quality standards, there is a clear need for improvements in the accuracy and comprehensiveness of online resources. Patients seeking information on RCT should exercise caution and consider consulting healthcare professionals for trustworthy guidance. Further research should explore strategies to enhance the quality of web-based health information and expand the scope of evaluation to ensure that individuals have access to reliable resources for making informed decisions about their dental health.

Digital health literacy and associated factors among internet users from China: a cross-sectional study

BACKGROUND

As the internet develops and 5G technology becomes increasingly prominent, the internet has become a major source of health-related information. Increasingly, people use the internet to find health-related information, and digital health literacy is now a set of essential capabilities to improve their health in the digital era. However, little is known about the factors that influencing digital health literacy. This study aimed to assess digital health literacy scores and identify its influencing factors among internet users in China. Additionally, this study explored the participant's actual skills using an additional set of performance-based items from the Digital Health Literacy Instrument (DHLI).

METHODS

An online cross-sectional study was conducted in August 2022. Participants aged ≥18 years were recruited to complete the survey. Data were collected using the Chinese revised version of the DHLI, the self-reported internet use questionnaire, and the sociodemographic questionnaire. We conducted multivariate linear regression analyses to explore the relationships among the sociodemographic variables, behavior of internet use, and the digital health literacy scores.

RESULTS

In total, 702 participants completed the survey. The mean DHLI score was 2.69 ± 0.61. Multivariate linear regression analyses showed that the age groups 35-49 (β = - 0.08, P = 0.033), 50-64 (β = - 0.161, P < 0.001), and ≥ 65 (β = - 0.138, P < 0.001) were negatively associated with DHL scores. However, education level, including bachelor's or associate degree (β = 0.255, P = 0.002) and master's degree and above (β = 0.256, P < 0.001), frequency of health-related Internet usage (β = 0.192, P < 0.001), the number of digital devices used (β = 0.129, P = 0.001), and OHISB (β = 0.103, P = 0.006) showed a positive relationship with DHL scores.

CONCLUSIONS

The study findings demonstrate that age, educational levels, number of technological devices used, and greater use of the web for health information were independently associated with DHL scores. Healthcare providers should consider providing training programs tailored to specific sociodemographic factors to improve the ability that find and use accurate information online to meet digital health services, which contributes to enhance their self-management and reduce health disparities.

Arabic Web-Based Information on Oral Lichen Planus: Content Analysis

BACKGROUND

The use of web-based health information (WBHI) is on the rise, serving as a valuable tool for educating the public about health concerns and enhancing treatment adherence. Consequently, evaluating the availability and quality of context-specific WBHI is crucial to tackle disparities in health literacy and advance population health outcomes.

OBJECTIVE

This study aims to explore and assess the quality of the WBHI available and accessible to the public on oral lichen planus (OLP) in Arabic.

METHODS

The Arabic translation of the term OLP and its derivatives were searched in three general search platforms, and each platform's first few hundred results were reviewed for inclusion. We excluded content related to cutaneous LP, content not readily accessible to the public (eg, requiring subscription fees or directed to health care providers), and content not created by health care providers or organizations (ie, community forums, blogs, and social media). We assessed the quality of the Arabic WBHI with three standardized and validated tools: DISCERN, Journal of the American Medical Association (JAMA) benchmarks, and Health On the Net (HON).

RESULTS

Of the 911 resources of WBHI reviewed for eligibility, 49 were included in this study. Most WBHI resources were provided by commercial affiliations (n=28, 57.1%), with the remainder from academic or not-for-profit affiliations. WBHI were often presented with visual aids (ie, images; n=33, 67.4%). DISCERN scores were highest for WBHI resources that explicitly stated their aim, while the lowest scores were for providing the effect of OLP (or OLP treatment) on the quality of life. One-quarter of the resources (n=11, 22.4%) met all 4 JAMA benchmarks, indicating the high quality of the WBHI, while the remainder of the WBHI failed to meet one or more of the JAMA benchmarks. HON scores showed that one-third of WBHI sources had scores above 75%, indicating higher reliability and credibility of the WBHI source, while one-fifth of the sources scored below 50%. Only 1 in 7 WBHI resources scored simultaneously high on all three quality instruments. Generally, WBHI from academic affiliations had higher quality scores than content provided by commercial affiliations.

CONCLUSIONS

There are considerable variations in the quality of WBHI on OLP in Arabic. Most WBHI resources were deemed to be of moderate quality at best. Providers of WBHI could benefit from increasing collaboration between commercial and academic institutions in creating WBHI and integrating guidance from international quality assessment tools to improve the quality and, hopefully, the utility of these valuable WBHI resources.

Health information-seeking behavior among people living with the two common chronic diseases in low and middle-income countries (LMICs). A systematic review and meta-analysis

Objective

The main aim of this review was to systematically collect and summarize the available evidence on health information-seeking behavior among people living with the two common types of chronic diseases in LMICs.

Methods

For this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, Google Scholar, and forward and backward citations from included studies. The preferred reporting items for Systematic Reviews and Meta-Analyses (PRISMA) procedure were followed to develop and report the review. The pooled effect size and the effect's 95% confidence interval were calculated using a random-effect model meta-analysis for each research. A sub-group analysis was done to investigate potential sources of heterogeneity. To identify publication bias, Egger-weighted regression tests were employed.

Results

A total of 4281 articles were retrieved, with ten studies meeting the eligibility criteria for qualitative synthesis and only seven studies were eligible for the meta-analysis. The pooled extent of health information-seeking behavior among chronic disease patients was 50.5% (95% CI: 35.36-65.70, p = 0.00), with high heterogeneity (I2 = 98.25). Based on the sub-group analysis, it was found that 55% (95% CI: 29.9-79.4) of cancer patients and 40% (95% CI: 36.9%-43.9%) of DM patients sought out health-related information. In studies conducted before 2015, the level of health information seeking was 49%, increasing to 52% (95% CI: 41.0%-62.2%) after 2015.

Conclusion

The overall health information seeking behavior among diabetes and cancer patients has increased over time, but remains relatively low, with only nearly half actively seeking information. The findings also emphasize that patients require health-related information on various topics.. Health educators and health professionals should consider this diversity when developing interventions and educational materials to provide patients with the most comprehensive information and education regarding their healthcare issues.

Protocol registration number

CRD42023433169.

Navigating online health information: Insights into consumer influence and decision-making strategies-An overview of reviews

Objective

Communities' use of technology and the internet for online health information (OHI) is increasing exponentially. An understanding of how and why individuals access OHI, and how this information influences decisions on health, medicines and self-care practices is critical. This review aims to: (1) identify the factors influencing OHI-seeking behaviour; (2) evaluate the evidence of OHI on self-care practices; and (3) outline strategies to improve online informed decision-making and assess the impact of these strategies on consumer outcomes.

Methods

A review of systematic reviews was conducted in November of 2023, following the Cochrane Handbook and PRISMA guidelines, and using PubMed, Scopus, Web of Science and EBSCOhost databases. The methodological quality of retrieved reviews was appraised using the AMSTAR 2 tool.

Results

The search retrieved 1725 records. Of these, 943 were screened, and 33 were included in the final analysis. The most frequently identified reasons for seeking OHI were to retrieve diagnostic and treatment information, and well-being and emotional support. Level of education and socio-economic status influenced OHI-seeking. OHI directly influenced self-care decision-making by individuals and their relationships and communication with healthcare providers. Overall, OHI-seeking (and interventions to promote the use of OHI) enhanced individuals' confidence, skills and knowledge.

Conclusions

The findings highlight the benefits of OHI-seeking and its potential influence on self-care decisions. Future research should focus on strategies that would promote the pursuit of high-quality, up-to-date OHI and on the development of interventions for healthcare professionals to improve patients' use of OHI in self-care and self-efficacy.

An examination of the content of diabetes websites targeting Arabic speakers

BACKGROUND

There has been an increase in the numbers of people in the Middle East and North Africa (MENA) region seeking online information about diabetes, as the Internet is considered a helpful tool for finding information about disease prevention and treatment. It is important that the sources available are reliable, trustworthy and easily accessible. However, the quality and readability of such information is questionable. This study examines the content of Arabic diabetes websites and offers recommendations to improve engagement and access to health information.

METHODS

This study employed a cross-sectional analysis approach to assess diabetes websites targeting Arabic speakers in the MENA countries. Google trends was utilized to reveal the top searched topics across the MENA region, which were used as search terms to identify the websites in search engines, resulting in the examination of 26 websites. The analysis combined automated tools with expert evaluation methods and involved five dimensions: quality, readability, engagement, popularity, and availability.

RESULTS

Overall, the majority of the websites performed poorly in the five dimensions and thus require careful reassessment of their content, design, and readability; no website performed well in all dimensions. Only two websites (7.6%) were HONcode certified, and none of the websites achieved a high score in the DISCERN analysis. The readability scores indicated that most websites were above the recommended level of reading. The results also revealed that all websites had poor engagement. Half of the websites had good ranking, and 58% of the websites covered all of the target topics. Of the websites examined, the non-commercial and non-professional sites (classified as "others") seem to have greater readability, higher bounce rates and longer visit duration than the commercial sites.

CONCLUSIONS

The results from this study show a need for improving the content of diabetes information websites available to Arabic speakers. In order to develop websites that contain easy-to-read and understand high-quality information, collaboration between multiple stakeholders is necessary.

COVID-19 symptoms, internet information seeking, and stigma influence post-lockdown health anxiety

Background

With the lifting of Zero-COVID policies in China, rapid transmission of the virus has led to new challenges for patients' health anxiety. This study aimed to evaluate the relationship between COVID-19 symptoms and health anxiety, as well as the mediation paths between them in individuals infected with COVID-19.

Method

A cross-sectional study was conducted in December 2022, following the relaxation of anti-COVID measures in China. A validated online questionnaire was used to collect data from COVID-19 patients on the number and severity of symptoms, health anxiety, internet health information-seeking behavior (IHISB), and perceived stigma. Structural equation modeling was used to examine the mediation model in which COVID-19 symptoms would affect health anxiety via IHISB and perceived stigma.

Results

Overall, 1,132 participants (women, 67.6%) were included, with a mean (SD) age of 28.12 (10.07) years. Participants had an average of seven COVID-19 symptoms, with cough (91.3%), nasal congestion (89.1%) and fatigue (87.8%) being the most common. The number and severity of COVID-19 symptoms, IHISB, perceived stigma, and health anxiety were positively correlated with each other after adjusting for covariates (r ranging from 0.10 to 0.81, all p < 0.05). IHISB (effect = 0.14, p < 0.001) and perceived stigma (effect = 0.04, p < 0.001) fully mediated the relationship between COVID-19 symptoms and health anxiety.

Conclusion

Interventions for health anxiety reduction during and after pandemics should target improving the quality of online health information, enhancing individuals' online healthy literacy, and reducing stigma.

The Usage and Trustworthiness of Various Health Information Sources in the United Arab Emirates: An Online National Cross-Sectional Survey

Background: The increase in the quality and availability of health information as well as the accessibility of Internet-based sources, has driven growing demand for online health information. Information preferences are influenced by many factors, including information needs, intentions, trustworthiness, and socioeconomic variables. Hence, understanding the interplay of these factors helps stakeholders provide current and relevant health information sources to assist consumers in assessing their healthcare options and making informed medical decisions. Aims: To assess the different sources of health information sought by the UAE population and to investigate the level of trustworthiness of each source. Methods: The study adopted a descriptive online cross-sectional design. A self-administered questionnaire was used to collect data from UAE residents aged 18 years or above between July 2021 and September 2021. Health information sources, their trustworthiness, and health-oriented beliefs were explored through univariate, bivariate, and multivariate analysis in Python. Results: A total of 1083 responses were collected, out of which 683 (63%) were females. Doctors were the first source of health information (67.41%) before COVID-19, whereas websites were the first source (67.22%) during the pandemic. Other sources, such as pharmacists, social media, and friends and family, were not prioritized as primary sources. Overall, doctors had a high trustworthiness of 82.73%, followed by pharmacists with a high trustworthiness of 59.8%. The Internet had a partial trustworthiness of 58.4%. Social media and friends and family had a low trustworthiness of 32.78% and 23.73%, respectively. Age, marital status, occupation, and degree obtained were all significant predictors of Internet usage for health information. Conclusions: The population in the UAE commonly obtains health information from doctors who have been shown to have the highest trustworthiness; this is despite it not being the most common source used.

The associations among cognitive social factors, eHealth literacy and health-promoting behaviors in Chinese adolescents

The internet is a critical source of health information. It is important to understand online health information seeking related factors among college students, as modifications in this have the potentials to enhance their health-promoting behaviors in their transition into early adulthood. This study assessed the associations among cognitive social factors, eHealth literacy, online health information seeking and health-promoting behaviors; and examined the potential mediation effect of online health information seeking and eHealth literacy on the association between cognitive social factors and health-promoting behaviors. A cross-sectional, Internet-based survey was conducted in a sample of Chinese college students (n = 289) during April to June 2018. The structural model fitted the data well: X2/df = 2.27; CFI = 0.95; TLI = 0.94; RMSEA = 0.07 (95% CI: 0.06, 0.08); SRMR = 0.07 and the results showed that performance expectancy and health motivation were significantly and positively associated with health-promoting behaviors indirectly through eHealth literacy, adjusting for other cognitive social factors, frequency of online health information seeking and background factors. eHealth literacy is a strong mediator of the association between cognitive social factors (performance expectancy and health motivation) and health-promoting behaviors. Implications and potential interventions to promote eHealth literacy and health-promoting behaviors are discussed.

European national health plans and the monitoring of online searches for information on diabetes mellitus in different European healthcare systems

Diabetes mellitus (DM) is a serious non-communicable disease (NCD) and relies on the patient being aware of their condition, proactive, and having adequate medical care. European countries healthcare models are aware of the impact of these variables. This study evaluates the impact of online health information seeking behavior (OHISB) during World Diabetes Mellitus Day (WDMD) in European countries from 2014 to 2019 by grouping countries according to the changes in citizens' search behavior, diabetes mellitus prevalence, the existence of National Health Plans (NHP), and their respective healthcare systems. We extracted data from Global Burden of Disease, Google Trends (GT), Public Health European Commission, European Coalition for Diabetes, and the Spanish Ministry of Health. First, we used the broken-line models to analyze significant changes in search trends (GT) in European Union member countries in the 30-day intervals before and after the WDMD (November 14) from 2014 to 2019. Then the results obtained were used in the second phase to group these countries by factor analysis of mixed data (FAMD) using the prevalence of DM, the existence of NHP, and health models in each country. The calculations were processed using R software (gtrendsR, segmented, Factoextra, and FactoMineR). We established changes in search trends before and after WDMD, highlighting unevenness among European countries. However, significant changes were mostly observed among countries with NHP. These changes in search trends, in addition to being significant, were reiterated over time and occurred especially in countries belonging to the Beveridge Model (Portugal, Spain, and Sweden) and with NHPs in place. Greater awareness of diabetes mellitus among the population and continuous improvements in NHP can improve the patients' quality of life, thus impacting in disease management and healthcare expenditure.

Potential of UK and US newspapers for shaping patients' knowledge and perceptions about antidiabetic medicines: a content analysis

Background

Information about how newspapers portray antidiabetic medicines to readers is lacking. This study investigated the reporting on antidiabetic medicines in the most widely circulated newspapers published in the United Kingdom (UK) and the United States (US) over a 10-year period.

Methods

The Nexis UK database was used to identify and select relevant articles. Systematic content analysis of the articles which met the inclusion criteria (articles of any format that contained reference to antidiabetic medicines) within the highest circulated newspapers in the UK and US between 2009 and 2018 was conducted. Inter-rater reliability of coding was established using a 10% sample of the identified articles.

Results

A total of 560 (369 UK and 191 US) relevant newspaper articles were retrieved. In the UK, the number of relevant articles showed a slightly increasing trend over the study period, while in the US, article numbers declined over the study period. Safety/risk of antidiabetic medicines was the most frequent theme covered by the articles (34.6%). Over one-third of the newspaper articles were written from a clinical perspective (37.7%). Insulin was the most commonly discussed class of antidiabetic medicine (23.1%). Control of blood sugar levels (53.1%) and side effects/toxicity (92.7%) were the most frequently reported benefit and risk of antidiabetic medicines, respectively. The most frequently reported organ systems harmed by antidiabetic medicines were the cardiovascular, endocrine and gastrointestinal systems. The UK newspapers were more likely to report the benefits of antidiabetic medicines (p = 0.005), while the US articles were more likely to report on harms/risks (p = 0.001). The majority of relevant articles (91.8%) were judged as having a balanced judgement, while 8.2% of the articles were rated as exaggerated.

Conclusions

This study has revealed that antidiabetic medicines are indeed reported on by UK and US newspapers. As media portrayal has the potential to negatively or positively influence patients’ views of their medication for diabetes, healthcare professionals should check on patients’ beliefs and knowledge about their medication and proactively provide objective and balanced information (including promotion of medication adherence).

Stroke Survivors and Their Family Caregivers' Experiences of Health Information Seeking: A Qualitative Study

Background

Stroke is a significant and unpredictable event that affects physical and mental functions. A useful approach to returning to a normal life is to seek out health information. This study aimed to explore the experiences from health information seeking in the stroke survivors and their family caregivers.

Methods

This study was carried out using qualitative content analysis. Participants included five stroke survivors and fifteen family caregivers who were selected purposively from the Rofideh Rehabilitation Center and private physiotherapy centers in Tehran. Data were collected from semi-structured interviews. Data analysis was performed using Graneheim and Lundman's method manually in Word software. Sampling was carried out in 2021.

Results

Two main categories were extracted 1): adapting and learning resulting from awareness including optimization of living environment and disease management, and 2) fear and inquietude on the information way including confused and insolvent in receiving information, and doubts about the accuracy of information.

Conclusion

The health information seeking created adaptability and relative stability in some stroke survivors and their family caregivers. However, in others, there was still a sense of anxiety and uncertainty. Thus, understanding health information seeking experiences helps health policymakers and administrators to provide information and training based on evidence and individual needs of the client and family.

Main Aspects of Preparing Diabetic Patients in Poland for Self-Care

Diabetes is a lifestyle disease which can cause many complications and organ-related disorders. The aim of the study was to analyze selected aspects of preparing patients with diabetes for self-care. The study group consisted of 190 people diagnosed with type 1 and type 2 diabetes, including 101 women and 89 men. The mean age of the respondents was 42.2 ± 13.4 years. The study was conducted using an anonymous self-designed questionnaire containing 50 questions. Among the respondents, 23.2% did not control their glucose levels at home. The respondents most often measured glucose once a day (33.6%) or three times a day (26.7%). A total of 64.7% of the respondents declared that they kept a self-monitoring diary. The knowledge of the symptoms of hypoglycemia and the ability to properly manage it was declared by 64.8% of the respondents. A total of 52.1% of the patients did not undertake any activity lasting more than 30 min at least 3 times a week, and 75.2% described their condition as very good and good. Independent participation in therapy, i.e., taking hypoglycemic drugs or insulin, was declared by 63.7% of the respondents. Despite undergoing therapeutic education, the study population diagnosed with diabetes still shows deficiencies in terms of awareness of proper health behaviors. Objective results showed that the patients had insufficient knowledge and skills in terms of self-care and self-observation, blood glucose and blood pressure measurements, physical activity, diet therapy as well as adherence to pharmacotherapy recommendations. Despite the good general preparation for self-care as declared by the respondents, these patients require further systematic, individual educational activities. The results of the present study have implications for nursing practice, patient therapeutic education, and the functioning of the public health and healthcare systems. The number of diabetic patients is constantly increasing. Patients require coordinated care and individualized therapeutic education in order to be prepared for self-care and self-management, thus reducing the risk of complications. Delaying the occurrence of potential complications provides patients with a chance to live an active private and professional life, and protects the health care system from carrying the cost burden of expensive highly specialized services.

The complementary and substitutive value of online health information

The Internet plays a significant role in health information searching, sharing and emotional support. However, scholars have devoted little attention to the complementary and substitute value of online health information from diseases, especially chronic diseases, health insurance, barriers to health resources and their interaction effects with income. This research uses data from the 2020 Health Information National Trends Survey (HINTS 2020), the latest HINTS survey that includes seeking online health information questions critical to this research. This paper proposes that the factors contributing to seeking online health information can be categorized into two modalities - complementary and substitutive. Concerning the complementary value, I argue that individuals with certain health conditions use online health information as a complementary health resource in addition to traditional health resources such as doctors to understand their health issues better. Online health information also functions as substitute information sources for individuals who have experienced more barriers to typical health information resources.

Pretrained Transformer Language Models Versus Pretrained Word Embeddings for the Detection of Accurate Health Information on Arabic Social Media: Comparative Study

Background

In recent years, social media has become a major channel for health-related information in Saudi Arabia. Prior health informatics studies have suggested that a large proportion of health-related posts on social media are inaccurate. Given the subject matter and the scale of dissemination of such information, it is important to be able to automatically discriminate between accurate and inaccurate health-related posts in Arabic.

Objective

The first aim of this study is to generate a data set of generic health-related tweets in Arabic, labeled as either accurate or inaccurate health information. The second aim is to leverage this data set to train a state-of-the-art deep learning model for detecting the accuracy of health-related tweets in Arabic. In particular, this study aims to train and compare the performance of multiple deep learning models that use pretrained word embeddings and transformer language models.

Methods

We used 900 health-related tweets from a previously published data set extracted between July 15, 2019, and August 31, 2019. Furthermore, we applied a pretrained model to extract an additional 900 health-related tweets from a second data set collected specifically for this study between March 1, 2019, and April 15, 2019. The 1800 tweets were labeled by 2 physicians as accurate, inaccurate, or unsure. The physicians agreed on 43.3% (779/1800) of tweets, which were thus labeled as accurate or inaccurate. A total of 9 variations of the pretrained transformer language models were then trained and validated on 79.9% (623/779 tweets) of the data set and tested on 20% (156/779 tweets) of the data set. For comparison, we also trained a bidirectional long short-term memory model with 7 different pretrained word embeddings as the input layer on the same data set. The models were compared in terms of their accuracy, precision, recall, F₁ score, and macroaverage of the F₁ score.

Results

We constructed a data set of labeled tweets, 38% (296/779) of which were labeled as inaccurate health information, and 62% (483/779) of which were labeled as accurate health information. We suggest that this was highly efficacious as we did not include any tweets in which the physician annotators were unsure or in disagreement. Among the investigated deep learning models, the Transformer-based Model for Arabic Language Understanding version 0.2 (AraBERTv0.2)-large model was the most accurate, with an F₁ score of 87%, followed by AraBERT version 2–large and AraBERTv0.2-base.

Conclusions

Our results indicate that the pretrained language model AraBERTv0.2 is the best model for classifying tweets as carrying either inaccurate or accurate health information. Future studies should consider applying ensemble learning to combine the best models as it may produce better results.

Understanding the information culture for self-management support of people living with diabetes in Ghana

Purpose

The purpose of this study is to explore the information culture of people living with Diabetes Mellitus (DM) and how that impacts their self-management practices in Ghana. The study focuses on the information experiences and information cultural patterns and creates awareness of the need for people to be aware of effective information management for sustainable self-management support.

Design/methodology/approach

An interpretive qualitative approach was used. A total of 12 interviewees involving 10 diabetes patients and 2 health professionals provided data for the study. Allowing the participants to freely talk about their attitude and behaviour, defining their experiences around information for their self-management was the best approach to achieve an in-depth understanding this study seeks.

Findings

The specific elements defining the information of people living with DM in Ghana can be identified. People living with the condition are willing to share information about their condition not only with those within their diabetic community but also with anyone interested. They prefer to use information from sources they find reliable and trust, and they have good information-related competencies that are consistent with diabetic patients in other countries’ contexts to help them identify, access, use and share relevant information. Only a few of the interviewees have difficulty in evaluating the accuracy and currency of some of the information. But they receive a lot of support from experienced people from their community. People also prefer to have information about the condition in their ethnic language. It is important for people living with the condition in Ghana to get involved in the diabetic groups, clubs and community, as members appear to receive the most benefit and support from the community to self-manage the condition alone.

Research limitations/implications

The study is limited by the number of participants and the distances between the researchers and the research context. Also, even though two groups of participants were interviewed (diabetic patients and health professionals), the analysis did not separate the responses of the different groups of study participants. This paper provides a useful insight and understanding of the culture of people living with diabetes in Ghana in terms of how they access, use and share the information they need to support their self-management. It will create awareness of the importance of being mindful of information culture patterns in people in other groups in Ghana and beyond. The research processes and procedures described in the paper can be replicated by other researchers in other contexts.

Originality/value

Although there have been a lot of studies about diabetes and people living with the condition in Ghana, to the best of the authors’ knowledge, this is the first study looking at how people define their need for information, how they identify the source of the information and how they access and use the information, including their general behavioural patterns that influence these information experiences.

The Attitudes of Egyptian Web-Based Health Information Seekers Toward Health Information Provided Through the Internet: Qualitative Study

Background

The internet has become an established source of health information for many Egyptian internet users. Understanding users’ attitudes toward the benefits and limitations of web-based health information will explain the influence of this information on users’ health-related behavior and decisions.

Objective

This qualitative study aims to understand the attitude of Egyptian internet users toward internet health information and to explore the impact of obtained health information on users’ behavior and on their physician-patient relationship.

Methods

For this qualitative study, semistructured interviews were conducted with a total of 49 participants (41/49, 84% Egyptian internet users and 8/49, 16% physicians) who participated in focus groups or individual interviews. We used a thematic analysis approach to explain and demonstrate participants’ views, thoughts, and experiences in using web-based health information.

Results

The internet has become an important source of health information in comparison with other health information sources and is the central theme that has emerged across the thematic analysis. The attitude toward the use of internet health was classified into three main themes: feeling toward web-based health information (with subthemes: favoring, disliking, neutral, or having ambivalence feelings), motivators to seek internet health information, and behavioral changes using internet health information (subthemes: confidence, satisfaction, and improved knowledge). Themes that emerged from physicians’ interviews included the accessibility of the internet health information, good communication, and coordination of care between patients and their physicians, and the active engagement of patients with their management plan.

Conclusions

The internet has become an essential source of health information for Egyptian adults. Internet health information can improve the patient-physician relationship, especially when users discuss the obtained health information with their physician. Internet health information provided seekers with social support and self-confidence when making health decisions.

Mapping Individual Differences on the Internet: Case Study of the Type 1 Diabetes Community

Background

Social media platforms, such as Twitter, are increasingly popular among communities of people with chronic conditions, including those with type 1 diabetes (T1D). There is some evidence that social media confers emotional and health-related benefits to people with T1D, including emotional support and practical information regarding health maintenance. Research on social media has primarily relied on self-reports of web-based behavior and qualitative assessment of web-based content, which can be expensive and time-consuming. Meanwhile, recent advances in natural language processing have allowed for large-scale assessment of social media behavior.

Objective

This study attempts to document the major themes of Twitter posts using a natural language processing method to identify topics of interest in the T1D web-based community. We also seek to map social relations on Twitter as they relate to these topics of interest, to determine whether Twitter users in the T1D community post in “echo chambers,” which reflect their own topics back to them, or whether users typically see a mix of topics on the internet.

Methods

Through Twitter scraping, we gathered a data set of 691,691 tweets from 8557 accounts, spanning a date range from 2008 to 2020, which includes people with T1D, their caregivers, health practitioners, and advocates. Tweet content was analyzed for sentiment and topic, using Latent Dirichlet Allocation. We used social network analysis to examine the degree to which identified topics are siloed within specific groups or disseminated through the broader T1D web-based community.

Results

Tweets were, on average, positive in sentiment. Through topic modeling, we identified 6 broad-bandwidth topics, ranging from clinical to advocacy to daily management to emotional health, which can inform researchers and practitioners interested in the needs of people with T1D. These analyses also replicate prior work using machine learning methods to map social behavior on the internet. We extend these results through social network analysis, indicating that users are likely to see a mix of these topics discussed by the accounts they follow.

Conclusions

Twitter communities are sources of information for people with T1D and members related to that community. Topics identified reveal key concerns of the T1D community and may be useful to practitioners and researchers alike. The methods used are efficient (low cost) while providing researchers with enormous amounts of data. We provide code to facilitate the use of these methods with other populations.

Evolutionary Overview of Consumer Health Informatics: Bibliometric Study on the Web of Science from 1999 to 2019

BACKGROUND

Consumer health informatics (CHI) originated in the 1990s. With the rapid development of computer and information technology for health decision making, an increasing number of consumers have obtained health-related information through the internet, and CHI has also attracted the attention of an increasing number of scholars.

OBJECTIVE

The aim of this study was to analyze the research themes and evolution characteristics of different study periods and to discuss the dynamic evolution path and research theme rules in a time-series framework from the perspective of a strategy map and a data flow in CHI.

METHODS

The Web of Science core collection database of the Institute for Scientific Information was used as the data source to retrieve relevant articles in the field of CHI. SciMAT was used to preprocess the literature data and construct the overlapping map, evolution map, strategic diagram, and cluster network characterized by keywords. Besides, a bibliometric analysis of the general characteristics, the evolutionary characteristics of the theme, and the evolutionary path of the theme was conducted.

RESULTS

A total of 986 articles were obtained after the retrieval, and 931 articles met the document-type requirement. In the past 21 years, the number of articles increased every year, with a remarkable growth after 2015. The research content in 4 different study periods formed the following 38 themes: patient education, medicine, needs, and bibliographic database in the 1999-2003 study period; world wide web, patient education, eHealth, patients, medication, terminology, behavior, technology, and disease in the 2004-2008 study period; websites, information seeking, physicians, attitudes, technology, risk, food labeling, patient, strategies, patient education, and eHealth in the 2009-2014 study period; and electronic medical records, health information seeking, attitudes, health communication, breast cancer, health literacy, technology, natural language processing, user-centered design, pharmacy, academic libraries, costs, internet utilization, and online health information in the 2015-2019 study period. Besides, these themes formed 10 evolution paths in 3 research directions: patient education and intervention, consumer demand attitude and behavior, and internet information technology application.

CONCLUSIONS

Averaging 93 publications every year since 2015, CHI research is in a rapid growth period. The research themes mainly focus on patient education, health information needs, health information search behavior, health behavior intervention, health literacy, health information technology, eHealth, and other aspects. Patient education and intervention research, consumer demand, attitude, and behavior research comprise the main theme evolution path, whose evolution process has been relatively stable. This evolution path will continue to become the research hotspot in this field. Research on the internet and information technology application is a secondary theme evolution path with development potential.

Caregivers' Sources of Information About Immunization as Predictors of Delayed Childhood Vaccinations in Saudi Arabia During the COVID-19 Pandemic: A Cross-Sectional Questionnaire Study

Purpose

This study compared the most used sources of information by caregivers for scheduled childhood vaccination in Saudi Arabia before and during the COVID-19 pandemic and examined the effect of this decision-making.

Methods

An electronic survey was administered to 577 caregivers of children aged ≤2 years residing in Saudi Arabia during the COVID-19 pandemic curfew. The sources of information on childhood vaccination considered by the caregivers and their influence on the caregivers’ decision to delay scheduled vaccination were assessed and statistically analyzed.

Results

Most participants (90.8%) were mothers aged 32.6 ± 5.7 years. Before the pandemic, most caregivers sought information about children’s vaccinations personally from the healthcare workers, or trustworthy sources, including the Ministry of Health (MOH), MOH call center 937, and MOH Sehha app. However, during the pandemic, there was a noticeable decrease in the searches for health information through professional consultations (in person and health websites) and a significant increase in the use of social media platforms. Twitter was the most used platform (29.9%) and the use of Snapchat was significantly higher during the lockdown period compared to its use before the pandemic (21.9% vs 17.2%, P < 0.001). The use of social media not only increased the level of fear among the caregivers but also had a negative effect on their decisions about children’s vaccinations. Searches on YouTube and Facebook particularly increased the odds of delaying vaccinations by 2.63 times (P = 0.008) and 3.66 times (P = 0.025), respectively.

Conclusion

During the pandemic, caregivers’ health-information seeking behavior was directed towards social media networking. In Saudi Arabia, YouTube and Facebook, in particular, played an important role in the caregivers’ decision-making about childhood vaccinations. The results of this survey provide valuable information on how to reach the Saudi population and launch an effective awareness campaign using the most commonly accessed and influential sources of information.

Improving service engagement in healthcare through internet of things based healthcare systems

Purpose

The purpose of the study was to empirically validate the linkages between IoT adoption and how it overarched influenced the patient care service engagement. This contributes to the body of knowledge and helps hospital managers to understand the relationship and relevance of IoT adoption; otherwise healthcare sector are late movers towards technology adoption. This gives a nuanced framework towards establishing empirically validated framework which will motivate healthcare services providers to be motivated to adopt and implement IoT enabled care delivery. The physician patient interaction and alignment during decision making will foster positive word of mouth, superior care service and reduce extra overheads for healthcare providers without compromise or rather with increment in service delivery proposition.

Design/methodology/approach

The study theoretically and empirically describes that with the adoption of internet of things (IoT) devices in health care, better services can be provided to patients by using partial least square – structure equation modelling-based robust technique and explains the better understanding of the health-care process with the help of information pervasiveness, physician-patient orientation and improved patient and physician involvement in the decision-making process.

Findings

This study shows that wearable IoT device adoption in health-care service delivery opens new opportunities and disrupts the conventional and traditional way of health-care service delivery by empowering the patient to take part in decision-making and enhancing their engagement in health-care service delivery.

Research limitations/implications

The study might influence by generalizability. Perception-based cross-examination knowledge from the patient’s perspective. It is likely that patients who use these devices will grow accustomed to using them and become more capable of using them. Thus, time-series tests have not been used to catch enhanced skills. New patients’ experiences will be altered over time. Regardless, non-response bias and traditional process bias received excessive interest.

Practical implications

The study aims at unravelling how the adoption of IoT enabled practices and usage of IoT devices bolsters the available data points in the context of healthcare especially with respect to patient care delivery. The study conceptualizes and empirically validates how the usage of IoT interface enabled technology enables better patient treatment and caregiver participation. The study puts forth a nuanced understanding regarding how pervasively available ubiquitous care information fosters shared decision making. This study further emphasizes that importance of ensuring a reliable computing environment devoid of privacy and security risks. The study attempts at Emphasizing empirically how the enhanced information pervasiveness catapults the patient-provider interactions, through health data exchange. Highlighting the importance of search feature in cloud storage and recovery mechanisms. The study not only fulfills the overarching linkage between enhanced service engagement with IoT adoption, it provides a mental map and ready to refer framework for hospital and healthcare experts to refer to, which prescribes thar care providers must build new methods aimed at empowerment of patients to participate and take more inclusive role. This unique confluence between patients and physicians will unravel the sync; helping not only avoid costly decision errors, but also improve patient care delivery environment. Patients should be permitted to participate in decision-making,inspire patients to be participatory.

Originality/value

The study efforts to empirically investigate and discover the link between how wearable sensor-based IoT enhances health-care service engagement is underway. Using primary data this linkage validation allows the community and readers at large to gain a nuanced understanding of how superior interaction is enabled by a digital-health-care process with the help of IoT-enabled information pervasiveness, physician-patient orientation and empowered involvement.

Predictors of COVID-19 Preventive Perceptions and Behaviors Among Millennials: Two Cross-sectional Survey Studies

BACKGROUND

COVID-19 preventive perceptions and behaviors, especially among US millennials, are an important means by which the pandemic can be slowed and negative health outcomes can be averted.

OBJECTIVE

This manuscript aims to advance knowledge on COVID-19 preventive perceptions and behaviors and their main predictors, including digital health information-seeking behavior (HISB), political party identification, and COVID-19 testing status.

METHODS

Two cross-sectional online surveys of US millennials were conducted from April 10 to 14, 2020 (N=274) (ie, Study 1), and from April 27 to May 7, 2020 (N=1037) (ie, Study 2). In the regression models, dependent variables included preventive behaviors (eg, wearing a face mask and social distancing) as well as four preventive perceptions: severity (ie, a person's conception of the seriousness of COVID-19), susceptibility (ie, a person's conception of the likelihood of being infected with COVID-19), self-efficacy (ie, a person's perception that he or she can wear a face mask and perform social distancing to prevent COVID-19 infection), and response efficacy (ie, a person's perception of whether wearing a face mask and social distancing can prevent COVID-19 infection). Key independent variables included digital HISB for self, digital HISB for another person, political party identification, and COVID-19 testing status.

RESULTS

Millennials reported lower levels of perceived susceptibility than the other three preventive perceptions (ie, severity, self-efficacy, and response efficacy), as well as fairly high levels of preventive behaviors. Unlike HISB for another person, digital HISB for self was positively associated with preventive perceptions and behaviors. In Study 1, respondents with higher levels of digital HISB for self had significantly higher perceptions of severity (β=.22, P<.001), self-efficacy (β=.15, P=.02), and response efficacy (β=.25, P<.001) as well as, at nearing significance, higher perceptions of susceptibility (β=.11, P=.07). In Study 2, respondents with higher levels of digital HISB for self had significantly higher perceptions of severity (β=.25, P<.001), susceptibility (β=.14, P<.001), and preventive behaviors (β=.24, P<.001). Preventive behaviors did not vary significantly according to political party identification, but preventive perceptions did. In Study 1, respondents who identified as being more Republican had significantly lower perceptions of self-efficacy (β=-.14, P=.02) and response efficacy (β=-.13, P=.03) and, at nearing significance, lower perceptions of severity (β=-.10, P=.08) and susceptibility (β=-.12, P=.06). In Study 2, respondents who identified as being more Republican had significantly lower perceptions of severity (β=-.08, P=.009). There were mixed effects of COVID-19 testing status on preventive perceptions, with respondents who had tested positive for COVID-19 having significantly higher perceptions of susceptibility in Study 1 (β=.17, P=.006) and significantly lower perceptions of severity in Study 2 (β=-.012, P<.001).

CONCLUSIONS

As the largest and most digitally savvy generation, US millennials saw COVID-19 as a severe threat, but one that they were less susceptible to. For millennials, digital HISB for self, but not for another person, was critical to the development of preventive perceptions and behaviors.

YouTube as a platform for knowledge and awareness of peritoneal dialysis: A content analysis

BACKGROUND

One of the main barriers to choosing peritoneal dialysis (PD) is the lack of awareness and PD knowledge. There is an increasing trend in the use of the internet as a search tool for health-related information. This study aims to determine how useful YouTube videos are to get information about PD.

METHODS

YouTube videos were evaluated independently by two nephrologists. The videos' quality was assessed with DISCERN scoring system, global quality score (GQS) and the Journal of the American Medical Association (JAMA) scoring system. We determined the quartile (Q) of the videos as follows: most reliable top 25% videos Q1 and others Q2-4.

RESULTS

A total of 295 videos were evaluated. University or society-sourced videos made up 15% (n = 43) of all videos, and healthcare providers were the primary target audience compared to patients (p < 0.001). JAMA, GQS and DISCERN scores were significantly higher for the videos that were targeted healthcare providers compared to the patients (p < 0.001, for all). A total of 34% of the videos in Q1 were obtained from the university or society. Nevertheless, only 17% of the videos prepared for the patients were among the Q1. A small number of videos mentioned that PD maintains the residual kidney function (RKF) longer compared to haemodialysis.

CONCLUSIONS

Universities and societies should upload videos to provide easy-to-understand information on PD. Also, the important benefits of PD, like the preservation of RKF, should be further highlighted in these videos. It may increase the PD penetrance by increasing patients' awareness.

Social media use for public health promotion in the Gulf Cooperation Council. An overview

Social media platforms (SMPs) have emerged as powerful tools for public health promotion. As the 6 countries of the Gulf Cooperation Council (GCC) have the highest internet and social media usage rates in the world, and according to the initiatives for the introduction of a new health system and strategies based on non-traditional methods according to the Saudi Vision 2030, this review aimed to investigate different SMPs use and impact on public health promotion in the GCC countries. Accumulating evidence indicated that diabetes knowledge, women’s health, breast-feeding practices, oral health, appropriate antibiotic use, physical activity, road safety awareness, quitting smoking, and breast cancer awareness, were the most common specified topics. Future research should focus on populations that are medically underserved and who have no or limited access to health-care facilities. Also, future research, in particular, the intervention type, is required to cover more countries in the GCC.

Write Like a Pro or an Amateur? Effect of Medical Language Formality

Past years have seen rising engagement among caregivers in online health communities. Although studies indicate that this caregiver-generated online health information benefits patients, how such information can be perceived easily and correctly remains unclear. This study aims to fill this gap by exploring mechanisms to improve the perceived helpfulness of online health information. We propose a multi-method framework, including a novel Medical-Enriched DEep Learning (MEDEL) feature extraction method, econometric analyses, and a randomized experiment. The results show that when the medical language of health information is informal, the senior care information is more helpful. Our findings provide a theoretical foundation to understand the influence of language formality on many other business communications. Our proposed multi-method approach can also be generalized to investigate research questions involving complex textual features. Forum sites could leverage our proposed approach to improve the helpfulness of online health information and user satisfaction.

Information and information resources in COVID-19: Awareness, control, and prevention

This study was conducted with the aim of evaluating the role of information and information resources in the awareness, control, and prevention of COVID-19. This study was a descriptive-analytical survey in which 450 participants were selected for the study. The data collection instrument was a researcher-made questionnaire. Descriptive and inferential statistics were used to analyze the data through SPSS. The findings show that a wide range of mass media has become well known as information resources for COVID-19. Other findings indicate a significant statistical difference in the rate of using information resources during COVID-19 based on age and gender; however, this difference is not significant regarding the reliability of information resources with regard to age and gender. Health information has an undisputable role in the prevention and control of pandemic diseases such as COVID-19. Providing accurate, reliable, and evidence-based information in a timely manner for the use of resources and information channels related to COVID-19 can be a fast and low-cost strategic approach in confronting this disease.

Information-Seeking Behavior and Its Associated Factors Among Patients with Diabetes in a Resource-Limited Country: A Cross-Sectional Study

BACKGROUND

Diabetes mellitus is one of the most common chronic diseases in the world. The burden of diabetes mellitus is increasing rapidly in developing countries, including Ethiopia. Diabetes information seeking is essential for patients with diabetes to better manage and control their diabetes. However, information seeking about disease prevention and treatment is low in developing countries.

OBJECTIVE

This study aims to assess the diabetes information-seeking behavior and its associated factors among patients with diabetes in Debre Markos Referral Hospital, Amhara Region, Northwest Ethiopia.

METHODS

An institution-based cross-sectional quantitative study supplemented with a qualitative study was conducted among 423 subjects from March to April 2019. A structured questionnaire and in-depth interview were used to collect the required data from the study subjects. The data were entered using Epi Info version 7.2.2. Data processing and analysis were conducted using SPSS version 23. Descriptive statistics and a binary logistic regression model were used for the quantitative study, and thematic content analysis was used for the qualitative study. The significance test cut-off value for bivariate analysis was P<0.2 and the cut-off value for multivariate analysis was P<0.05. Adjusted odds ratios with 95% confidence intervals were used to interpret the results.

RESULTS

Out of 423 study participants, only 41.6% of patients with diabetes were diabetes information seekers. After adjusting all other factors in the final model, educational status, place of residence, comorbidity and health literacy were significantly associated with diabetes information seeking.

CONCLUSION

This study result indicates that the overall prevalence of information seeking among patients with diabetes toward diabetes was low. Having higher educational status, urban place of residence, the presence of comorbidity and adequate health literacy level increased the likelihood of diabetes information-seeking behavior among patients with diabetes.

Health information-seeking behavior and self-care in women with osteoporosis: a qualitative study

The main findings of this study on the self-care behaviors contain "identification of knowledge gaps," "established networking for seeking information," "information from trust-to-distrust," "information-seeking inhibiting factors," "information-seeking facilitating factors," and "self-care behaviors based on required knowledge."

PURPOSE

Health information-seeking behavior affects self-care and could promote quality of life and life expectancy. This study aimed at assessing health information-seeking and self-care behaviors of women with osteoporosis in Iran.

METHODS

This study was conducted using a content analysis approach. Data were collected through semi-structured interviews with 15 women with osteoporosis aged above 50 years. The participants were selected by purposeful sampling. The data were analyzed by the conventional content analysis method using MAXQdata software version 10.

RESULTS

From in-depth descriptions of the participants' experiences, 246 primary codes were extracted. Subsequently, constant comparison analysis was done and 35 sub-categories and 6 main categories have appeared from the data.

DISCUSSION

Based on the experiences of women with osteoporosis, they received limited information from the health care providers, so they were seeking reliable information sources to meet their information needs. They obtained most of their information from other patients, family members, and network of friends. In the process of seeking information, they face various barriers such as lack of time in the health care team that affect their ability to self-care.

CONCLUSION

The results can guide health policymakers, patient educators, health care providers, information specialists, and patients and their families.

Health informatics publication trends in Saudi Arabia: a bibliometric analysis over the last twenty-four years

OBJECTIVE

Understanding health informatics (HI) publication trends in Saudi Arabia may serve as a framework for future research efforts and contribute toward meeting national "e-Health" goals. The authors' intention was to understand the state of the HI field in Saudi Arabia by exploring publication trends and their alignment with national goals.

METHODS

A scoping review was performed to identify HI publications from Saudi Arabia in PubMed, Embase, and Web of Science. We analyzed publication trends based on topics, keywords, and how they align with the Ministry of Health's (MOH's) "digital health journey" framework.

RESULTS

The total number of publications included was 242. We found 1 (0.4%) publication in 1995-1999, 11 (4.5%) publications in 2000-2009, and 230 (95.0%) publications in 2010-2019. We categorized publications into 3 main HI fields and 4 subfields: 73.1% (n=177) of publications were in clinical informatics (85.1%, n=151 medical informatics; 5.6%, n=10 pharmacy informatics; 6.8%, n=12 nursing informatics; 2.3%, n=4 dental informatics); 22.3% (n=54) were in consumer health informatics; and 4.5% (n=11) were in public health informatics. The most common keyword was "medical informatics" (21.5%, n=52). MOH framework-based analysis showed that most publications were categorized as "digitally enabled care" and "digital health foundations."

CONCLUSIONS

The years of 2000-2009 may be seen as an infancy stage of the HI field in Saudi Arabia. Exploring how the Saudi Arabian MOH's e-Health initiatives may influence research is valuable for advancing the field. Data exchange and interoperability, artificial intelligence, and intelligent health enterprises might be future research directions in Saudi Arabia.

Use of Electronic Health (eHealth) Among Saudi Type 2 Diabetic Patients and Its Association With Their Diabetic Self-Management: A Cross-Sectional Study

Background Type 2 diabetes mellitus (T2DM) is a prevalent, chronic, non-communicable disease that requires continuous multidisciplinary health care. Electronic health (eHealth) refers to "the transfer of health information resources and health care services using different electronic platforms." This may have an effect on diabetes self-management (DSM). Objectives This study aimed to identify the use of eHealth among patients with T2DM as well as its association with DSM. Method An analytical cross-sectional study was conducted online using a newly adapted three-part questionnaire using Google Forms through different social media platforms. A total of 2,228 adult Saudi T2DM patients from different provinces were selected based on the non-probability voluntary response sampling technique. The survey included demographic, clinical, and eHealth data, and diabetic self-care management. Results The study results revealed an average DSM score of 5.2/10, and 74.1% were receiving diabetes care at primary health care centers. Of these, 87.1% used eHealth, mainly through Google (55.7%) and other social media (12.9%), and were satisfied with the quality of health care (70.4%). Moreover, 82% wanted to discuss the eHealth information with their physicians, but some (34.5%) had no online access to them. eHealth dependency was 44.2% and was associated with a lower mean DSM (5.6 vs. 5.3; p = 0.000) with significantly lower health care use (6.7 vs. 5.6; p = 0.000) and glucose management (4.7 vs. 4.0, p=0.000) compared to the independent group. The DSM total score was a significant predictor of eHealth dependency (OR: 1.022; 95% CI: 1.006-1.039; p = 0.007). Conclusion Most Saudi T2DM patients with an average DSM use different eHealth resources and are satisfied with their quality. Dependency to eHealth is significantly associated with lower DSM, especially for health care use and glucose management, a finding that could affect patient outcomes. Still, patients need to communicate with their physicians in person who should have different options for remote consultation, such as telemedicine, to support their patients.

Understanding information behavior of diabetic patients: a case of the diabetic's institute Pakistan

Purpose

Pakistan is a developing country where one of the rapidly growing diseases is diabetes. Well-informed diabetic patients are expected to improve the quality of life, self-care behaviors and better cooperation with the health care team. The present study is designed to investigate the information behavior of diabetic patients, and to investigate the role of one institution that is working for diabetes management, treatment, education and counseling in Pakistan i.e. Diabetic's Institute Pakistan (DIP).

Design/methodology/approach

The “Embedded Design” based on the mixed methods research approach was adopted to carry out the current research. The study was mainly based on quantitative research design, quantitative data were collected through an adapted questionnaire, the supportive/supplementary qualitative data was collected through an in-depth interview of the medical director, observation record sheets and analysis of the available relevant documents i.e. prescription (prescription notepad with information), brochure and the website was applied.

Findings

Diabetic patients want to know about how to control diabetes and mostly rely on humans particularly health professionals and interpersonal networks. The use of books, journals, seminars, libraries is comparatively low. It is an important finding that health-related information is mostly required in national language by Pakistani patients. Lack of computer literacy and information overload were among the barriers that were reported by diabetic patients.

Practical implications

Health information seeking channels, formats and language preferences should be considered to design patients' cantered information services. Health information service providers i.e. government, health practitioners, health-related institutions and libraries should work in a liaison for creating health awareness. Identified barriers faced by diabetic patients are important to consider for designing health-related information services.

Originality/value

Investigating health information behavior is crucial particularly of the patients from developing countries. The study is first of its kind that is reported from Pakistan. The results of the study may help libraries, health professionals and diabetes-related organizations to design patient's centered policies and information-based services. These institutions may work together to create awareness and to help patients in managing their disease. The study findings are maybe helpful for other developing countries also.

Socio-demographic characteristics affect health information seeking on the Internet in Turkey

OBJECTIVE

The objective of this paper was to determine the effects of certain socio-demographic characteristics of Turkish individuals who seek health information on the Internet.

METHODS

This study was granted permission to use data obtained by the Turkish Statistical Institute (TSI) in 2018 under their Household Information Technology Use (HITU) study. The original sample for this research comprised 19,389 participants.

RESULTS

Age, gender, educational level, place of residence and frequency of Internet use were all found to impact the participants' health information seeking behaviour on the Internet. Health information was sought more frequently by women than men, by younger than older people and by those with higher levels of education. Also, health information searches were conducted more often in developed regions than in less-developed regions. In addition, it was also found that the habit of seeking health information was more common among those who use the Internet more frequently.

CONCLUSION

Several socio-demographic characteristics of individuals affect their health information seeking behaviour on the Internet. All individuals should be granted equivalent access to reliable health information by taking sociodemographic characteristics and discrepancies into consideration.

Use of eHealth by Patients With Rheumatoid Arthritis: Observational, Cross-sectional, Multicenter Study

Background

The use of eHealth tools (eg, the internet, mobile apps, and connected devices) in the management of chronic diseases and for rheumatoid arthritis is growing. eHealth may improve the overall quality of care provided to patients with chronic diseases.

Objective

The primary objective of this study was to describe eHealth use by patients with rheumatoid arthritis in France. The secondary objectives were to identify associations between patient demographics and disease characteristics and the use of eHealth tools, and assess their expectations of eHealth.

Methods

In this cross-sectional, multicenter study, patients with rheumatoid arthritis, according to the 2010 ACR/EULAR classification criteria, were recruited from 5 university hospitals (Bordeaux, Clermont-Ferrand, Limoges, Montpellier, and Toulouse). Patients completed an anonymous self-questionnaire, including demographic data, evaluating their eHealth use (ie, access, support, frequency of use, type of use, and reason for use). The rheumatologist in charge of each patient completed an independent medical questionnaire on disease characteristics, activity of rheumatoid arthritis, and treatments. Data were collected between December 2018 and July 2019.

Results

Questionnaires were completed by 575 participants, with a mean age of 62 (SD 13) years, 447 (77.7%) of whom were female. Overall, 82.2% (473/575) of the participants had access to eHealth through a computer (402/467, 86.1%), tablet (188/467, 40.2%), or smartphone (221/467, 47.3%). Of these, 36.4% (170/467) of the participants used the internet for health in general, and 28.7% (134/467) used it specifically for rheumatoid arthritis–related reasons. All these 134 patients used eHealth to learn about disease pathology, and 66.4% (89/134) of them used it as a tool to help monitor rheumatoid arthritis. Most patients (87/125, 69.6%) had a paper file, 19.2% (24/125) used a digital tool (spreadsheets, 10/125, 8%; mobile app, 9/125, 7.2%; or website, 5/125, 4%), and 24.8% (31/125) did not use any tools for monitoring. Few patients (16/125, 12.8%) used tools for treatment reminders. About 21.6% (27/125) of the patients using eHealth used a specific app for rheumatoid arthritis. Univariate analysis showed that age, education level, employment status, treatment, comorbidities, membership of a patient association, and patient education program were associated with eHealth use for rheumatoid arthritis. Multivariate analysis showed that membership of a patient association (odds ratio [OR] 5.8, 95% CI 3.0-11.2), use of biologic disease-modifying antirheumatic drugs (OR 0.6, 95% CI 0.4-1.0), and comorbidities (OR 0.7, 95% CI 0.6-0.8) remained associated with eHealth use for rheumatoid arthritis. Recommendation by a doctor (225/330, 68.2%), ease of use (105/330, 31.8%), and data security (69/330, 20.9%) were factors favoring the use of eHealth.

Conclusions

To date, few patients have used eHealth for disease management. The use of a reliable and validated eHealth tool for rheumatoid arthritis could therefore be promoted by rheumatologists and could optimize therapeutic adherence.

Phobia among residents in board training programs in Abha, Kingdom of Saudi Arabia, 2019

Background:

Phobia is an extreme form of anxiety or fear which is triggered by a given situation or object or even danger associated with a situation or object for more than 6 months. There are three main forms of phobia: social phobia (social anxiety disorder), specific phobia, or agoraphobia. Agoraphobia is a form of anxiety disorder where one fears and avoids situations or places that might cause them to panic. The main purpose of this study is to investigate phobia among residents in broad training programs in Abha city and compare phobia between residents in broad training programs and general practitioners in Abha city.

Methods:

It is a cross-sectional study. The study was conducted in Abha city of Saudi Arabia from December 2019 to March 2020. It included a representative sample of medical doctors under broad training programs and general practitioners (none trained) in all the health-care centers. A link for the survey questionnaires was created and shared with the respondents. The questionnaire included sociodemographics of the participants, the Kutcher Generalized Social Anxiety Disorder Scale, and the Psychometric Properties and Clinical Utility of the Specific Phobia Questionnaire in an Anxiety Disorders Sample for specific phobia.

Results:

The study included 300 physicians. Majority of them (81%) were in the age group between 25 and 30 years. Males represent 54% of them. There was no statistically significant difference between resident physicians and general practitioners regarding the avoidance of different social situations.

Conclusion:

Overall, the residents in board training programs in Abha city expressed lower levels of discomfort, anxiety, distress, avoidance, fear, and life interference of some social and specific situations compared to general practitioners.

Health information seeking behaviour using mobile devices among people with diabetes: A comparison between Middle and high income country

Objective

The internet has become a primary source of information for many individuals especially those with chronic diseases. This study aims to understand and compare the health seeking behaviour using mobile devices among individuals with diabetes and between a high (Singapore) and middle (Malaysia) income country.

Methods

A cross sectional survey was conducted among people with diabetes in Malaysia and Singapore. Participants attending the primary health clinic for the treatment of diabetes were approached to participate in this survey. Data on demographics, health status and beliefs to health were collected and compared.

Results

A total of 673 respondents were included in the study. Most of the respondents reported to have access to the Internet, with a high ownership of mobile phones (99.3%). However, only one in every three respondents sought information online. Younger individuals (≤50 years) and those with higher education more likely to seek information using mobile devices. Respondents in Singapore reported to be more likely to use mobile devices to monitor their health as compared to respondents in Malaysia. However, most respondents would seek health information from their healthcare professionals’ especially physicians.

Conclusion

There was limited differences in the health-seeking behaviour among the respondents from both countries, suggesting for a need to identify for more effective means of distribution of health related information.

Information needs and information seeking behaviors of patients and families in acute healthcare settings: a scoping review

OBJECTIVE

The objective of this scoping review was to explore the information needs and information seeking behaviors of patients and families from healthcare providers in acute healthcare settings in existing literature.

INTRODUCTION

A well-informed family can be crucial to a patient's capacity to cope with their diagnosis and hospital care during acute or chronic illness. Information is therefore critical to both the patient's and family's understanding of the illness and healthcare process. Providing appropriate and timely information can empower patients and families with knowledge and alleviate the anxiety and stress associated with a hospital admission. However, acutely ill patients and families in different acute care settings have considerable and differing information needs.

INCLUSION CRITERIA

This scoping review included studies undertaken in acute healthcare facilities where patients were over 18 years of age and family members were of any sex, culture and ethnicity. Family was defined as anyone connected to the patient by blood, marriage or other significant relationship. Healthcare provider perspectives of family and patient information needs were excluded. Concepts related to type of information, timing of information, preferences for who delivers the information and method of information delivery. Qualitative and quantitative study designs published from 2010 to 2017 in English were included.

METHODS

Multiple databases were searched to find published and unpublished studies. A three-step search strategy was utilized. A charting table was developed for the data extraction process to record data relating to the review objectives. Specific data extracted included details on research design, geographical location, year of publication, characteristics of study population, research aims and outcomes as well as key findings related to patient and family information needs.

RESULTS

The scoping review included 109 studies from across 34 countries. Of these studies, 68 used quantitative research designs, 29 were qualitative in nature and 12 included studies reported using mixed methods. One study used an action research methodology. Nine studies were specific to family information needs. A majority of studies were conducted in the cancer care context, with other acute settings comprising intensive care units, surgical settings and individual medical or surgical units/wards within and across the hospital. While most of the included studies addressed the type of content patients and/or families prefer, a few studies explored the timing of information provision.

CONCLUSIONS

The international literature on information needs of patient and families comprises multiple published studies on differing aspects of the topic and situated within various acute care contexts. Despite the broad nature of the research, studies suggest that preferences regarding information content, timing of information delivery and choices regarding who delivers information vary across contexts and according to the patient/family member. The complexity behind this variation and strategies to address tailoring information delivery requires further in-depth research.

Internet Use, eHealth Literacy, and Dietary Supplement Use Among Young Adults in Pakistan: Cross-Sectional Study

Background

Increased access to the internet has facilitated widespread availability of health information. Thus, electronic health (eHealth) literacy—the ability to seek, find, understand, and appraise health information from electronic resources and apply that knowledge in making a health-related decision—is a crucial skill. Despite the increasing use of the internet as a source of health information in developing countries, only a few studies have examined the eHealth literacy of young adults, who frequently use the internet to access health information in these developing countries.

Objective

The aim of this study was to assess the patterns of internet use and eHealth literacy levels among university students pursuing a non–health-related degree in Pakistan. We also examined the association of the eHealth literacy levels of these young adults with their physical activity levels and dietary supplement intake.

Methods

Students from 2 leading engineering universities in Pakistan were invited to participate in a cross-sectional anonymous web-based survey in order to collect data on their internet use, eHealth literacy, and dietary supplement intake. Of the 900 eligible university students who were invited to participate, 505 (56.1%) students who completed the questionnaire were included in the analysis. The findings were converted to median values and frequency analyses were performed. The associations between the variables were determined using the chi-square test; P≤.05 was considered significant.

Results

In this study, the median eHealth literacy scale (eHEALS) score was 29, which did not vary across gender. The most common type of health-related information that was searched by the participants was that related to maintaining a healthy lifestyle (305/505, 60.4%). Participants with high eHEALS scores were those who used the internet frequently for finding people with similar health issues (P<.001). The use of specific social media platforms was not associated with the perceived eHealth literacy levels. Neither the frequency of physical activity nor the dietary supplement use was associated with the eHealth literacy of the participants.

Conclusions

University students in non–health-related disciplines in Pakistan expressed high confidence in their skills to find health-related information on the internet, as indicated by the aggregate eHEALS scores. However, the findings of our study show that the perceived eHealth literacy was not associated with health behaviors such as physical activity and dietary supplement intake. Further research is necessary to investigate the extent to which eHealth literacy can be considered as a panacea for solving public health challenges in developing countries.

Health App Use and Its Correlates Among Individuals With and Without Type 2 Diabetes: Nationwide Population-Based Survey

BACKGROUND

Evidence suggests that mobile health app use is beneficial for the prevention and management of type 2 diabetes (T2D) and its associated complications; however, population-based research on specific determinants of health app use in people with and without T2D is scarce.

OBJECTIVE

This cross-sectional study aimed to provide population-based evidence on rates and determinants of health app use among adults with and without T2D, thereby covering a prevention perspective and a diabetes management perspective, respectively.

METHODS

The study population included 2327 adults without a known diabetes diagnosis and 1149 adults with known T2D from a nationwide telephone survey in Germany conducted in 2017. Rates of smartphone ownership and health app use were estimated based on weighted sample proportions. Among smartphone owners, determinants of health app use were identified for both groups separately in multivariable logistic regression models. Sociodemographic factors, diabetes-related factors or indicators, psychological and health-related factors, and physician-provided information were selected as potential determinants.

RESULTS

Among participants without known diabetes, 74.72% (1690/2327) were smartphone owners. Of those, 49.27% (717/1690) used health apps, most often to improve regular physical activity. Among participants with T2D, 42.26% (481/1149) were smartphone owners. Of those, 41.1% (171/481) used health apps, most commonly to target a healthy diet. Among people without known diabetes, determinants significantly (all P values <.05) associated with an increased likelihood of health app use compared with their reference group were as follows: younger and middle age of 18 to 44 or 45 to 64 years (odds ratios [ORs] 3.89; P<.001 and 1.76; P=.004, respectively), overweight or obesity (ORs 1.58; P<.001 and 2.07; P<.001, respectively), hypertension diagnosis (OR 1.31; P=.045), former or current smoking (ORs 1.51; P=.002 and 1.58; P<.001, respectively), perceiving health as very good (OR 2.21; P<.001), other chronic diseases (OR 1.48; P=.002), and having received health advice from a physician (OR 1.48; P<.001). A slight or high perceived diabetes risk (ORs 0.78; P=.04 and 0.23; P<.001, respectively) was significantly associated with a decreased likelihood of health app use. Among people with T2D, younger and middle age (18-64 years; OR 1.84; P=.007), female gender (OR 1.61; P=.02), and using a glucose sensor in addition or instead of a glucose meter (OR 2.74; P=.04) were significantly positively associated with health app use.

CONCLUSIONS

In terms of T2D prevention, age, diabetes-related risk factors, psychological and health-related factors, and medical health advice may inform app development for specific target groups. In addition, health professionals may encourage health app use when giving advice on health behaviors. Concerning T2D management, only a few determinants seem relevant for explaining health app use among people with T2D, indicating a need for more future research on which people with T2D use health apps and why.

Quality Assessment of Information on Oral Cancer Provided at Arabic Speaking Websites

BACKGROUND

Patients often use Inernet to explore information about their health and disease. This study aimed to evaluate the quality of information on oral cancer provided at Arabic websites.

MATERIAL AND METHOD

The translated Arabic keywords of "oral cancer" and treatment of oral cancer" and 6 search engines were used. The top 100 websites were selected. Irrelevant and duplicates websites were excluded. To evaluate the quality of websites and their information, DISCERN, HON, and JAMA benchmarks were used.

RESULTS

The majority (n = 64, 74.4%) of websites were founded by profit organizations. The mean overall rating was 2.23 (1.6) out of 5 and the median overall rating was 1 (1-3) based on DISCERN. According to HON, only 4.7% of the websites achieved a high score (≥75) and 37.2% of the websites gained a low score (<50). Based on JAMA benchmarks, 15% of the websites did not fulfill any criteria and only 2% of them fulfilled the four criteria proposed by the JAMA benchmarks.

CONCLUSION

This study suggested the poor quality of web-based Arabic information on oral cancer. It is recommended to develop a websites based system by which enable to the Arabic websites related to oral cancer know their shortfalls, therefore, improve their quality according to evaluation tools which will ensure finding reliable data from the websites.<br />.

Health information seeking behaviour: a concept analysis

BACKGROUND

In 2007, Lambert and Loiselle conducted an extensive concept analysis of the term health information seeking behaviour (HISB) to examine the concept's level of maturity and critically analyse its characteristics. Since their groundbreaking work, HISB has evolved with the proliferation of ICTs. The Internet is now a common and often preferred medium for the pursuit of health information.

OBJECTIVES

The previous analysis spanned 42 years of literature; this article describes an analysis of the last 10 years of literature on HISB and how online seeking has caused the concept to evolve in the literature.

METHODS

This study used the concept analysis methodology employed by Lambert and Loiselle in the original analysis. It also included a systematic search conducted in five databases to identify studies from 2007 to 2017, using similar inclusion criteria from the original study.

RESULTS

Of the more than 500 articles retrieved, 85 journal articles met the inclusion criteria. Consistent with the original work, articles that included outcomes were identified as either behavioural or cognitive.

CONCLUSION

Most of the attention of the works studied focused on individuals and their information source preferences. This HISB analysis can be incorporated with studies to understand how various communities seek information in online versus non-online contexts.

Online health information-seeking behavior by endocrinology patients

PURPOSE

Given that the Internet is important for health-related information (HRI) and the fact that online health information (OHI)-seeking behavior has never been studied in endocrinology, we set out to examine how and why the Internet is utilized for HRI, the frequency of such activity, its impact, future information needs, and the effect of language.

METHODS

A mainly quantitative, embedded mixed-methods study was performed, employing a questionnaire survey. We included 312 patients (78.4% response rate).

RESULTS

OHI-seeking was reported by 175 patients (56.1%), especially in younger (p = 0.037) and more educated (p = 0.006) patients. OHI-seekers perceived OHI to be high-quality (135, 77.1%) but 104 (59.4%) were unaware of website certification tools. Among OHI-seekers, 63 (36.6%) reported positive behavioral changes after seeking OHI. Only 45 (25.7%) OHI-seekers discussed their gathered information with their endocrinologist. If an interactive e-learning module was available, 194/312 (62.2%) patients expressed willingness to use it, especially those reporting a need for more HRI (p = 0.024). Native speakers were more likely to report that OHI did not meet their information needs (p < 0.001).

CONCLUSIONS

OHI-seeking by patients attending the endocrinology outpatients is widely practiced. The availability of OHI in the native language and e-learning modules may enhance the utility of the Internet for health information.

Trustworthy Health-Related Tweets on Social Media in Saudi Arabia: Tweet Metadata Analysis

Background

Social media platforms play a vital role in the dissemination of health information. However, evidence suggests that a high proportion of Twitter posts (ie, tweets) are not necessarily accurate, and many studies suggest that tweets do not need to be accurate, or at least evidence based, to receive traction. This is a dangerous combination in the sphere of health information.

Objective

The first objective of this study is to examine health-related tweets originating from Saudi Arabia in terms of their accuracy. The second objective is to find factors that relate to the accuracy and dissemination of these tweets, thereby enabling the identification of ways to enhance the dissemination of accurate tweets. The initial findings from this study and methodological improvements will then be employed in a larger-scale study that will address these issues in more detail.

Methods

A health lexicon was used to extract health-related tweets using the Twitter application programming interface and the results were further filtered manually. A total of 300 tweets were each labeled by two medical doctors; the doctors agreed that 109 tweets were either accurate or inaccurate. Other measures were taken from these tweets’ metadata to see if there was any relationship between the measures and either the accuracy or the dissemination of the tweets. The entire range of this metadata was analyzed using Python, version 3.6.5 (Python Software Foundation), to answer the research questions posed.

Results

A total of 34 out of 109 tweets (31.2%) in the dataset used in this study were classified as untrustworthy health information. These came mainly from users with a non-health care background and social media accounts that had no corresponding physical (ie, organization) manifestation. Unsurprisingly, we found that traditionally trusted health sources were more likely to tweet accurate health information than other users. Likewise, these provisional results suggest that tweets posted in the morning are more trustworthy than tweets posted at night, possibly corresponding to official and casual posts, respectively. Our results also suggest that the crowd was quite good at identifying trustworthy information sources, as evidenced by the number of times a tweet’s author was tagged as favorited by the community.

Conclusions

The results indicate some initially surprising factors that might correlate with the accuracy of tweets and their dissemination. For example, the time a tweet was posted correlated with its accuracy, which may reflect a difference between professional (ie, morning) and hobbyist (ie, evening) tweets. More surprisingly, tweets containing a kashida—a decorative element in Arabic writing used to justify the text within lines—were more likely to be disseminated through retweets. These findings will be further assessed using data analysis techniques on a much larger dataset in future work.

Health literacy in Saudi Arabia: Implications for public health and healthcare access

This study aims to describe the distribution of low health literacy (HL) in the population in the Kingdom of Saudi Arabia (KSA), and to analyze factors associated with low HL in KSA. A cross-sectional national survey using quota sampling, population-based of residents of KSA conducted via phone interviews supplemented by in-person interviews. The survey included an overall evidence-based measurement of HL. Both descriptive statistics of the sample and a multivariable logistic regression model predicting low HL were developed. A total of 3557 surveys were available for analysis, and 46% of the respondents were classified as having low HL. In regression modelling, low HL was associated with older age groups (age 47-56 odds ratio [OR] 1.60, 95% confidence interval [CI] 1.30-1.97; age 57-66 OR 1.38, 95% CI 0.98-1.94), the regions of Ha'il (OR 0.65, 95% CI 0.5-0.85) and Najran (OR 1.27, 95% CI 0.99-1.64), having been formerly married, lower levels of education (less than elementary OR 3.20, 95% CI 2.10-4.88; and elementary, OR 1.62, 95% CI 1.14-2.30), lower levels of income, and having sought healthcare exactly three times in the last year. Approximately half of KSA has low HL, and risk factors for low HL were older ages, lower income and education, having been formerly married, and a moderate pattern of health use. Future studies are needed to better characterize the distribution and determinants of low HL across KSA.