Consumer Health-Related Activities on Social Media: Exploratory Study

Privacy Concerns About Sharing General and Specific Health Information on Twitter: Quantitative Study

BACKGROUND

Twitter is a common platform for people to share opinions, discuss health-related topics, and engage in conversations with a wide audience. Twitter users frequently share health information related to chronic diseases, mental health, and general wellness topics. However, sharing health information on Twitter raises privacy concerns as it involves sharing personal and sensitive data on a web-based platform.

OBJECTIVE

This study aims to adopt an interactive approach and develop a model consisting of privacy concerns related to web-based vendors and web-based peers. The research model integrates the 4 dimensions of concern for information privacy that express concerns related to the practices of companies and the 4 dimensions of peer privacy concern that reflect concerns related to web-based interactions with peers. This study examined how this interaction may affect individuals' information-sharing behavior on Twitter.

METHODS

Data were collected from 329 Twitter users in the United States using a web-based survey.

RESULTS

Results suggest that privacy concerns related to company practices might not significantly influence the sharing of general health information, such as details about hospitals and medications. However, privacy concerns related to companies and third parties can negatively shape the disclosure of specific health information, such as personal medical issues (β=-.43; P<.001). Findings show that peer-related privacy concerns significantly predict sharing patterns associated with general (β=-.38; P<.001) and specific health information (β=-.72; P<.001). In addition, results suggest that people may disclose more general health information than specific health information owing to peer-related privacy concerns (t165=4.72; P<.001). The model explains 41% of the variance in general health information disclosure and 67% in specific health information sharing on Twitter.

CONCLUSIONS

The results can contribute to privacy research and propose some practical implications. The findings provide insights for developers, policy makers, and health communication professionals about mitigating privacy concerns in web-based health information sharing. It particularly underlines the importance of addressing peer-related privacy concerns. The study underscores the need to build a secure and trustworthy web-based environment, emphasizing the significance of peer interactions and highlighting the need for improved regulations, clear data handling policies, and users' control over their own data.

Research on the mechanism of short video information interaction behavior of college students with psychological disorders based on grounded theory

BACKGROUND

The utilization of short videos by individuals often leads to the emergence of information exchange behavior. Previous studies have shown that certain students with psychological disorders exhibit addictive tendencies towards short video-related software. Therefore, it is essential to address the psychology and behavior of college students with psychological disorders while engaging with short videos. This study aims to explore the mechanism of short video information interaction behavior among college students with psychological disorders.

METHODS

We conducted semi-structured interviews with 30 college students afflicted by psychological disorders in a prefecture-level city in Henan Province, China from September to December 2022. Based on the Grounded theory, we encoded 30 text materials across three levels to explore the mechanism of short video information interaction behavior among college students with psychological disorders, and subsequently build a model framework.

RESULTS

The findings of this study suggest that college students with psychological disorders exhibit negative cognition tendencies that can lead to strongly negative emotions, excacerbated by a lack of social support. These adverse factors collectively drive the consumption of short video content in this demographic, providing a virtual environment where they can fulfill their unmet social needs. Therefore, the mechanism governing short video messages interaction among college students with psychological disorders encompasses negative cognitive tendencies, negative emotions, lack of social support, post-video-watching behaviors, and the gratification of social needs within the confines of a virtual environment.

CONCLUSIONS

This study comprehensively analyzes the motivation and complexity of college students with psychological disorders in short video interaction. Although short videos provide this group with some ways of self-expression and emotional support, they still have a negative impact on their physical and mental health. The short video interaction of college students with psychological disorders is affected by many factors, including their negative cognitive tendencies, negative emotions, lack of social support, post-video-watching behaviors, and the gratification of social needs within the confines of a virtual environment. These findings deepened our understanding to the mechanism of short video information interaction behavior among college students with psychological disorders, also provided us with guidance on facilitating the proper use of short video and maintaining the mental health. In future researches, researchers can discuss more about intervention measures to help this demographic cope with the challenges from short video interaction.

Characterizing Precision Nutrition Discourse on Twitter: Quantitative Content Analysis

BACKGROUND

It is possible that tailoring dietary approaches to an individual's genomic profile could provide optimal dietary inputs for biological functioning and support adherence to dietary management protocols. The science required for such nutrigenetic and nutrigenomic profiling is not yet considered ready for broad application by the scientific and medical communities; however, many personalized nutrition products are available in the marketplace, creating the potential for hype and misleading information on social media. Twitter provides a unique big data source that provides real-time information. Therefore, it has the potential to disseminate evidence-based health information, as well as misinformation.

OBJECTIVE

We sought to characterize the landscape of precision nutrition content on Twitter, with a specific focus on nutrigenetics and nutrigenomics. We focused on tweet authors, types of content, and presence of misinformation.

METHODS

Twitter Archiver was used to capture tweets from September 1, 2020, to December 1, 2020, using keywords related to nutrition and genetics. A random sample of tweets was coded using quantitative content analysis by 4 trained coders. Codebook-driven, quantified information about tweet authors, content details, information quality, and engagement metrics were compiled and analyzed.

RESULTS

The most common categories of tweets were precision nutrition products and nutrigenomic concepts. About a quarter (132/504, 26.2%) of tweet authors presented themselves as science experts, medicine experts, or both. Nutrigenetics concepts most frequently came from authors with science and medicine expertise, and tweets about the influence of genes on weight were more likely to come from authors with neither type of expertise. A total of 14.9% (75/504) of the tweets were noted to contain untrue information; these were most likely to occur in the nutrigenomics concepts topic category.

CONCLUSIONS

By evaluating social media discourse on precision nutrition on Twitter, we made several observations about the content available in the information environment through which individuals can learn about related concepts and products. Tweet content was consistent with the indicators of medical hype, and the inclusion of potentially misleading and untrue information was common. We identified a contingent of users with scientific and medical expertise who were active in discussing nutrigenomics concepts and products and who may be encouraged to share credible expert advice on precision nutrition and tackle false information as this technology develops.

An Intervention Mapping Approach to Developing a Stroke Literacy Video for Recent Stroke Survivors: Development and Usability Study

BACKGROUND

Most vascular events after stroke may be prevented by modifying vascular risk factors through medical and behavioral interventions. Stroke literacy-an understanding of stroke symptoms, risk factors, and treatment-likely contributes to vascular risk factor control and in turn stroke recurrence risk. Stroke literacy is the lowest among adults belonging to racial and ethnic minority populations in the United States. Video-based interventions targeting stroke literacy may help acute stroke survivors understand stroke and subsequently reduce the risk of stroke recurrence. However, the failure of prior stroke literacy interventions may be due in part to the fact that the interventions were not theory-driven. Intervention mapping (IM) provides a framework for use in the development, implementation, and evaluation of evidence-informed, health-related interventions.

OBJECTIVE

We aimed to develop a video-based educational intervention to improve stroke literacy in hospitalized patients with acute stroke.

METHODS

The 6-step iterative process of IM was used to develop a video-based educational intervention and related implementation and evaluation plans. The six steps included a needs assessment, the identification of outcomes and change objectives, the selection of theory- and video-based intervention methods and practical applications, the development of a video-based stroke educational intervention, plans for implementation, and evaluation strategies.

RESULTS

A 5-minute video-based educational intervention was developed. The IM approach led to successful intervention development by emphasizing stakeholder involvement, generation and adoption, and information retainment in the planning phase of the intervention. A planned approach to video adoption, implementation, and evaluation was also developed.

CONCLUSIONS

An IM approach guided the development of a 5-minute video-based educational intervention to promote stroke literacy among acute stroke survivors. Future studies are needed to assess the use of technology and digital media to support widespread access and participation in video-based health literacy interventions for populations with acute and chronic stroke. Studies are needed to assess the impact of video-based educational interventions that are paired with stroke systems of care optimization to reduce the risk of stroke recurrence. Furthermore, studies on culturally and linguistically sensitive video-based stroke literacy interventions are needed to address known racial and ethnic disparities in stroke literacy.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1371/journal.pone.0171952.

Quality and Content Analysis of Hallux Valgus Videos on YouTube®

Our aim in this study is to analyze the content and quality of the videos about hallux valgus on YouTube®. The first 50 videos published by typing "hallux valgus" in the search engine on the YouTube® site were analyzed. The number of views of all videos, likes, dislikes, who uploaded the video, video duration, content, watch rate, and how many days it was uploaded were analyzed and recorded. All videos were analyzed with Journal of the American Medical Association (JAMA), DISCERN, GQS, and VPI scores. Six of the videos (12%) were from academic sources, 14 (28%) from commercial product vendors, 13 (26%) by medical animation organizers, 8 (16%) by physicians, 4 (8%) by physiotherapists, 2 (4%) by physical training trainers, 1 (2%) by patients, and last 2 (4%) by trainers. The JAMA mean score of the videos was recorded as 2 (1-4), GQS 3.02 (2-5), DISCERN score 37.56 (26-68), and Video Power Index 41.35 (0-470). The quality of YouTube® videos about hallux valgus is low. The content and quality of health-related information obtained through the Internet are of increasing importance for both healthcare professionals and patients.

Motivational Influences Affecting Middle-Aged and Elderly Users' Participation Intention in Health-Related Social Media

Social media provide users with multi-directional dialogue for creating and sharing health information that can effectively promote the self-management of health. In regard to the 'greying' trend in social media, most researchers have studied the health-related social media (HRSM) acceptance status and use behavior of middle-aged and elderly people, and have explored the role of HRSM in this group. However, the continuous participation of users is the key to the successful operation of HRSM, and is an essential prerequisite for the subsequent HRSM behavior habits of middle-aged and elderly people. Therefore, we aimed to explore what motivations drive the first use of HRSM among middle-aged and older adults, and the impact of their perception of HRSM, after personal use, on their intention to use it continually. In the study, we used the partial least squares structural equation model (PLS-SEM) to analyze data collected from online questionnaires. The results showed that a self-protection motivation and a social motivation promoted the initial participation of middle-aged and elderly individuals. In addition, these people experienced deeper levels of perceived usefulness and perceived entertainment after their initial participation. The results also revealed that these two perceptions could positively influence middle-aged and elderly individuals' intention to continue with their participation. Our findings should help service platforms to better understand the needs of middle-aged and elderly users. This would help researchers and practitioners to gain a more complete understanding of the motivation of middle-aged and elderly people for participating in HRSM, and the related impacts this may have.

Predictive Factors for Online Health Information-Seeking Behavior among Adults in the Russian Federation

Background

The internet is fast becoming one of the key instruments for seeking health-related information. This study aimed to investigate factors associated with internet use for health information among adults in the Russian Federation and to identify factors that explain its variation.

Methods

The data were collected from the online survey conducted in Russian Federation on Aug-Sep 2020. A bivariate chi-square test was used to identify factors for further analysis. The binomial logistic regression model was fitted to the data to determine the relationship between dependent and independent variables.

Results

Overall, 1319 adults' survey submissions were analyzed. The binomial regression model showed women (OR 1.507, 95% CI 1.152-1.972), those with higher education level (OR 2.688, 95% CI 1.380-5.234), avid Internet users (3-4 h per day OR 2.187, 95% CI 1.383-3.460; 5+ h per day OR 2.361, 95% CI 1.475-3.781) are more likely to seek the health information on the Internet. Older participants (35-49 yr OR .701, 95% CI .498-.988; 50+ yr OR .624, 95% CI .430-.907) and those who live in rural areas (OR .469, 95% CI .308-.712) are less likely to use the internet for health information.

Conclusion

It is important to promote health information-seeking behavior among men, older, less educated individuals, and those who live in rural areas. The improvement of digital skills and infrastructure may engage those who experience difficulties accessing health information over the internet.

Improving Health Literacy: Analysis of the Relationship between Residents' Usage of Information Channels and Health Literacy in Shanghai, China

Background: This study aimed to examine the relationship between residents’ health literacy (HL) and their use of and trust in information channels. Methods: A community-based cross-sectional health survey utilizing a cluster sampling design was conducted in January 2022. The sample consisted of 1067 residents in Shanghai, China. Those who correctly answered over 80% of the questions were regarded as qualified. The differences in residents’ HL and the dimensions of knowledge HL, lifestyle HL, and skills HL were analyzed based on their use of and trust in traditional media, the internet, and offline activities. Logistic regression was conducted to examine the effects of the usage of these channels on all four types of HL. Results: A total of 27.65% of participants were qualified for HL. The use of traditional media (OR = 1.405, p < 0.05) and engagement in offline activities (OR = 1.951, p < 0.05) were significantly related to HL. Disbelief in traditional media was related to being qualified in knowledge HL (OR = 1.262; p < 0.05), whereas disbelief in offline activities had an adverse effect on knowledge HL and skills HL (OR = 0.700, 0.807; p < 0.05). Conclusion: Effort should be made to improve the efficiency of offline health education, and ensure the reliability and quality of health-related information from mass media and the internet to improve residents’ HL.

Tracking the trackers: Self-tracking in households as social practice

The purpose of this article is to examine the effect of different types of self-tracking users (trackers) on the health behaviours of others living in the same household. The study takes an international perspective, examining tracking practises from 13 households based in Europe, the United Kingdom and the United States to determine how trackers contribute to emerging cultural and social factors across life stages. The findings contribute to digital health understandings by shedding light on collective practises formed within frequently intergenerational households. The study emphasises the importance of cross-cultural and intergenerational tracking research to foster collective and symbolic health engagement. The article delves into the intersection of online and offline dynamics to describe the social practice of digital health culture. It sheds new light on structural and agency issues in households sharing self-tracking experiences.

Evaluation of the Usefulness of YouTube Videos on Retinal Detachment Surgery

Introduction

The aim of this study is to evaluate the usefulness of YouTube videos about retinal detachment surgery as a resource.

Methods

The first 100 videos were evaluated when they were scanned by typing "retinal detachment surgery " in the YouTube search engine. These videos were also analyzed and scored using DISCERN, Journal of the American Medical Association (JAMA), and Global Quality (GQ) scoring systems.

Results

The DISCERN score of the evaluated videos was 39.5±8.4; JAMA score was 1.9±0.5; and the GQ score was 2.1±0.5. According to the results, retinal detachment surgery videos, DISCERN score is medium; The JAMA score was evaluated as low quality and poor quality in the GQ score.

Conclusion

Although there are enough videos on YouTube with retinal detachment surgery, its usefulness as a resource is low, and its quality is poor.

Understanding digital health ecosystem from Australian citizens' perspective: A scoping review

BACKGROUND

Digital health (DH) and the benefits of related services are fairly well understood. However, it still is critical to map the digital health care landscape including the key elements that define it as an ecosystem. Particularly, knowing the perspectives of citizens on this digital transformation is an important angle to capture. In this review we aim to analyze the relevant studies to identify how DH is understood and experienced by Australian citizens and what they may require from DH platforms.

MATERIALS AND METHODS

A scoping literature review was conducted across several electronic databases (ACM Digital Library, OVID, PubMed, Scopus, IEEE, Science Direct, SAGE), as well as grey literature. Additionally, citation mining was conducted to identify further relevant studies. Identified studies were subjected to eligibility criteria and the final set of articles was independently reviewed, analyzed, discussed and interpreted by three reviewers.

RESULTS

Of 3811 articles, 98 articles met the inclusion criteria with research-based articles-as opposed to review articles or white papers- comprising the largest proportion (72%) of the selected literature. The qualitative analysis of the literature revealed five key elements that capture the essence of the digital health ecosystem interventions from the viewpoint of the Australian citizens. The identified elements were "consumer/user", "health care", "technology", "use and usability", "data and information". These elements were further found to be associated with 127 subcategories.

CONCLUSIONS

This study is the first of its kind to analyze and synthesize the relevant literature on DH ecosystems from the citizens' perspective. Through the lens of two research questions, this study defines the key components that were found crucial to understanding citizens' experiences with DH. This understanding lays a strong foundation for designing and fostering DH ecosystem. The results provide a solid ground for empirical testing.

Seeking Mental Health Support Among College Students in Video-Based Social Media: Content and Statistical Analysis of YouTube Videos

Background

Mental health is a highly stigmatized disease, especially for young people. Due to its free, accessible format, college students increasingly use video-based social media for many aspects of information needs, including how-to tips, career, or health-related needs. The accessibility of video-based social media brings potential in supporting stigmatized contexts, such as college students’ mental health. Understanding which kinds of videos about college students’ mental health have increased viewer engagement will help build a foundation for exploring this potential. Little research has been done to identify video types systematically, how they have changed over time, and their associations on viewer engagement both short term and long term.

Objective

This study aims to identify strategies for using video-based social media to combat stigmatized diseases, such as mental health, among college students. We identify who, with what perspective, purpose, and content, makes up the videos available on social media (ie, YouTube) about college students’ mental health and how these factors associate with viewer engagement. We then identify effective strategies for designing video-based social media content for supporting college students’ mental health.

Methods

We performed inductive content analysis to identify different types of YouTube videos concerning college students’ mental health (N=452) according to video attributes, including poster, perspective, and purpose. Time analysis showed how video types have changed over time. Fisher’s exact test was used to examine the relationships between video attributes. The Mann-Whitney U test was used to test the association between video types and viewer engagement. Lastly, we investigated the difference in viewer engagement across time between two major types of videos (ie, individuals’ storytelling and organization’s informational videos).

Results

Time trend analysis showed a notable increase in the number of (1) videos by individuals, (2) videos that represent students’ perspectives, and (3) videos that share stories and experiential knowledge over the recent years. Fisher’s exact test found all video attributes (ie, poster, perspective, and purpose) are significantly correlated with each other. In addition, the Mann-Whitney U test found that poster (individual vs organization) and purpose (storytelling vs sharing information) type has a significant association with viewer engagement (P<.001). Lastly, individuals’ storytelling videos had a greater engagement in the short term and the long term.

Conclusions

The study shows that YouTube videos on college students’ mental health can be well differentiated by the types of posters and the purpose of the videos. Taken together, the videos where individuals share their personal stories, as well as experiential knowledge (ie, tips and advice), engaged more viewers in both the short term and long term. Individuals’ videos on YouTube showed the potential to support college students' mental health in unique ways, such as providing social support, validating experience, and sharing the positive experience of help-seeking.

Quality of YouTube Videos on Laparoscopic Cholecystectomy for Patient Education

Background

Surgical patients frequently seek information from digital sources, particularly before common operations such as laparoscopic cholecystectomy (LC). YouTube provides a large amount of free educational content; however, it lacks regulation or peer review. To inform patient education, we evaluated the quality of YouTube videos on LC.

Methods

We searched YouTube with the phrase “laparoscopic cholecystectomy.” Two authors independently rated quality of the first 50 videos retrieved using the JAMA, Health on the Net (HON), and DISCERN scoring systems. Data collected for each video included total views, time since upload, video length, total comments, and percentage positivity (proportion of likes relative to total likes plus dislikes). Interobserver reliability was assessed using an intraclass correlation coefficient (ICC). Association between quality and video characteristics was tested.

Results

Mean video quality scores were poor, scoring 1.9/4 for JAMA, 2.0/5.0 for DISCERN, and 4.9/8.0 for HON. There was good interobserver reliability with an ICC of 0.78, 0.81, and 0.74, respectively. Median number of views was 21,789 (IQR 3000–61,690). Videos were mostly published by private corporations. No video characteristic demonstrated significant association with video quality.

Conclusion

YouTube videos for LC are of low quality and insufficient for patient education. Treating surgeons should advise of the website's limitations and direct patients to trusted sources of information.

The Relationship of Corporate Social Responsibility on Digital Platforms, Electronic Word-of-Mouth, and Consumer-Company Identification: An Application of Social Identity Theory

The concept of corporate social responsibility (CSR) is an ever-evolving concept in the field of business management. Even in 2021, its boundaries are evolving and researchers are linking the concept of CSR to different variables to achieve different outcomes. However, the concept of CSR in the healthcare sector is not well-explored in prior literature. The current study is an application of social identity theory to induce electronic word-of-mouth (eWOM) from consumers for a specific brand, through its CSR engagement on social media (CSRS) and consumer-company identification (CCI) in the healthcare sector of an emerging economy. The data of the current survey were collected from different patients of four large hospitals in a large city through a self-administered questionnaire (paper-pencil technique). To validate different hypotheses of the current study, the authors employed the structural-equation-modeling (SEM) technique using AMOS software. The output of SEM analysis confirmed that CSRS positively influences eWOM, and CCI mediates this relationship. The findings of the current study will be helpful for policymakers in the healthcare industry to improve their understanding of CSRS and CCI, inducing eWOM through the lens of social identity theory.

'How to Botox' on YouTube: Influence and Beauty Procedures in the Era of User-Generated Content

The current media environment is complex and has important effects on all aspects of life, including beauty and health. In this sense, YouTube has become one of the main contexts for the dissemination of tutorials and content related to medical procedures such as the application of Botox. Thus, the present study constitutes the first exploratory analysis of YouTube videos in Spanish related to this procedure. A preliminary analysis of 221 YouTube videos yielded a final sample of the 50 most viewed videos within this genre. The analysis was carried out through a quantitative content analysis assessing the popularity of the videos, contact and emotive strategies by the creator, the credibility conveyed, and the characteristics of information about the procedure itself. Results suggest that these influencers align with mainstream Internet celebrity culture in practices that aim at increasing their following and views, as well as calls for subscriptions and visits to other platforms and profiles. Moreover, they include different strategies to establish their credibility but emphasize personal experience. The positive portrayal of the procedure, including positive emotions and content that highlights the benefits, is interesting and supports the commercial nature of much of the content.

The Quality of Instructional YouTube Videos for the Administration of Intranasal Spray: Observational Study

BACKGROUND

Allergic rhinitis is a common disorder affecting both children and adults. Recommended treatment consists of intranasal corticosteroid spray administration, but only few patients administer the nasal spray in the correct technical manner. A wrong administration technique may result in side effects and affect the efficacy and adherence, thus making accurate administration instructions indispensable. Unfortunately, information about intranasal drug administration is generally not explained accurately, thereby leading to confusion among patients and inaccuracy in the self-administration of drugs.

OBJECTIVE

In this study, we analyzed instructional videos available on YouTube for the administration of nasal sprays for allergic rhinitis. Our aim was to determine if the videos provided instructions in accordance with the standardized nationwide patient protocol in the Netherlands for intranasal spray administration.

METHODS

Instructional videos for the administration of aqueous formulations of nasal spray for allergic rhinitis were found on YouTube. All videos were reviewed by 2 researchers and scored using the instructions from the Dutch standardized protocol. Correct instructions were given a score of 1, while incorrect or missing instructions were given a score of 0. The interrater reliability using Cohen ĸ was used to determine the differences in the scores between the researchers.

RESULTS

We identified 33 YouTube videos made by different health care professionals and pharmaceutical companies around the world. None of the videos displayed all the steps correctly, while 5 of the 33 (15%) videos displayed over 75% of the steps correctly. The median score of the correctly displayed steps was 11 out of 19 (range 2-17, IQR 6). The interrater reliability using Cohen ĸ was statistically significant (range 0.872-1.00, P<.001). The steps "neutral position of the head," "breathing out through the mouth," and "periodically cleaning with water" scored the lowest and were incorrectly displayed in 28 (85%), 28 (85%), and 30 (91%) of the 33 videos, respectively.

CONCLUSIONS

The findings of our study revealed that only few instructional videos on YouTube provided correct instructions for the administration of nasal sprays to patients. The inaccuracy of the instructions for nasal spray administration in the majority of the videos may lead to confusion in patients and incorrect use of nasal sprays. In the future, it is important to make evidence-based instructional videos that show patients the correct technique of nasal spray administration.

TRIAL REGISTRATION

Not applicable.

Factors affecting the quality and reliability of online health information

Background

Internet represents a relevant source of information, but reliability of data that can be obtained by the web is still an unsolved issue. Non-reliable online information may have a relevance, especially in taking decisions related to health problems. Uncertainties on the quality of online health data may have a negative impact on health-related choices of citizens.

Objective

This work consisted in a cross-sectional literature review of published papers on online health information. The two main research objectives consisted in the analysis of trends in the use of health web sites and in the quality assessment and reliability levels of web medical sites.

Methods

Literature research was made using four digital reference databases, namely PubMed, British Medical Journal, Biomed, and CINAHL. Entries used were “trustworthy of medical information online,” “survey to evaluate medical information online,” “medical information online,” and “habits of web-based health information users”. Analysis included only papers published in English. The Newcastle Ottawa Scale was used to conduct quality checks of selected works.

Results

Literature analysis using the above entries resulted in 212 studies. Twenty-four articles in line with study objectives, and user characteristics were selected. People more prone to use the internet for obtaining health information were females, younger people, scholars, and employees. Reliability of different online health sites is an issue taken into account by the majority of people using the internet for obtaining health information and physician assistance could help people to surf more safe health web sites.

Conclusions

Limited health information and/or web literacy can cause misunderstandings in evaluating medical data found in the web. An appropriate education plan and evaluation tools could enhance user skills and bring to a more cautious analysis of health information found in the web.

Analysis of user behavior on the website of a university eye hospital in Germany

Medical information websites are usually targeted toward patients, physicians, and medical students. Most of the latest studies researched the usability of such websites. However, reports on user numbers and behavior are rare.The goal of our study is to analyze the utility of a website of a large tertiary referral center in ophthalmology in terms of various target audiences (patients, applicants, medical students, referring ophthalmologists).The web access data from our institutional website was assessed with Google Analytics. Data collection started in 2016.From 2016 to 2018, we counted a total of 763,942 page views. The overall number of users dropped from 81,572 to 67,740. This drop's onset correlates with a change in the website structure. All target audience pages received constant traffic from 2016 to 2019, with the patients' and doctors' sites attracting the most traffic. The pages for medical students and job applicants, although not viewed often, revealed a long session duration.Our website is used by all our target audiences. The behavior and the user numbers of each target group differ. Changes to a website's structure can influence the number of users and their behavior. It is not possible to make a direct comparison to other institutions' websites as there are so few similar reports available. By adding more parameters to the analytics profile in a prospective setting, more detailed analyses of user behavior may be possible in the future.

Characterizing HPV Vaccine Sentiments and Content on Instagram

Background. With its growing popularity, inclusion of image and text, and user-friendly interface, Instagram is uniquely positioned for exploring health behaviors and sources and types of informational exposure related to the human papillomavirus (HPV) vaccine. Aims. To characterize public Instagram posts about the HPV vaccine and quantify the impact of sentiment and context on engagement via likes. Method. Using Netlytic, 3,378 publicly available English-language posts were collected using the search terms "#HPV," "#HPVVaccine," and "#Gardasil." We randomly selected 1,200 posts to content analyze. Our final analytic sample included 360 posts after excluding posts whose links were no longer active (n = 221) or that were not relevant (n = 619). Results. A higher proportion of posts were pro-vaccine (55.8%) than anti-vaccine (42.2%). Pro-HPV vaccination posts were liked significantly less than anti-vaccination posts (24 vs. 86 likes; p < .001). More posts contained actionable information/resources (63.9%) than personal narrative elements (36.1%). Less than one in three posts (30.0%) came from health-related sources. Discussion. Pro-vaccine posts were more prevalent on Instagram, and anti-vaccine posts had higher engagement and typically included misleading information about the HPV vaccine. Personal narratives skewed toward anti-vaccine sentiments and most were produced by individual users. Pro-vaccine narratives portrayed individuals who received the vaccine, but provided limited details on vaccine experiences, starkly contrasting with the depth of details in anti-vaccine personal narrative posts. Conclusion. On Instagram, individuals and organizations have an opportunity to promote HPV vaccination by continuing to provide informational resources in addition to creating more narrative-style posts.

Customers' information seeking behavior prior to community pharmacy visits: A community pharmacy survey

BACKGROUND

Customers are commonly seeking information, e.g. via the internet, to achieve information on health, diseases, and treatment options. However, little is known about customers' information seeking behavior prior to community pharmacy visits.

OBJECTIVE

To quantify and describe customers' information seeking behavior prior to community pharmacy visits, and to describe how pharmacy staff utilize information obtained by customers.

METHODS

Six Danish community pharmacies collected data on customers' information seeking behavior through an online survey for five days in a three week-period in November 2018. Customers were asked about their information seeking behavior regarding their errand at the pharmacy that specific day, what kind of information they had sought, which sources they had used, and their motivation for seeking that information. Hereafter, the pharmacy staff recorded whether they confirmed or disconfirmed the information, and whether they used the information in their counselling. The results were reported using descriptive statistics.

RESULTS

A total of 3424 customers were invited to participate in the study. Among 2623 customers agreeing to participate, 14.4% (n = 377) had obtained information prior to the pharmacy visit. Information seeking was more frequent among younger customers (<40 years: 22%; 40-60 years: 17%; ≥60 years: 10%). Further, women sought information more often (17%) than men (11%). Customers sought information to gain knowledge about self-management (42%), the purchased product (35%), and how others might help (29%). Information was mainly obtained from official sources of health and drug information (44%), Google (41%), and non-pharmacy health care professionals (28%). The information presented by the customer was generally confirmed or integrated into the pharmacy counselling (70%) and only rarely disconfirmed by pharmacy staff (5%).

CONCLUSION

A total of 14.4% of customers had sought information prior to visiting the community pharmacy. The majority of customers had used reliable sources, and the information was used during pharmacy counselling.

Effect of Emotion, Expectation, and Privacy on Purchase Intention in WeChat Health Product Consumption: The Mediating Role of Trust

With the aging of the population and the upgrading of the consumption structure of national health demand in China, it has become a new trend for the public to actively seek health products and services on social networks. Based on the theory of reasoned behavior and the theory of expectancy confirmation, this study aims to analyze the cognitive factors and their effects on WeChat users' purchase intention in the process of health product consumption. Considering that safety is a key feature of health products that distinguishes them from other consumer products, the "satisfaction" concept in the expectancy confirmation model is replaced by "trust" in this study. Two hundred and two (202) valid samples were collected by a questionnaire survey to analyze their intentions to buy health products on WeChat. Theoretical models and corresponding research hypotheses were verified by structural equation modeling. The research results show that emotional price and emotional experience are positively correlated with trust and purchase intention. There is an obvious negative correlation between privacy invasion and trust. Expectation confirmation is positively associated with trust. Moreover, the intermediary test shows that trust has completely mediated between emotional price and purchase intention, and trust also has a full intermediary effect on expectation confirmation and purchase intention.

Impact of the Internet on Patient-Physician Communication

Data from the Health Information National Trends Survey (HINTS) show that the Internet is the first place people go to when they need information about health or medical topics. Searches for online health information have both benefits and challenges for patient-physician communication. To fully appreciate these issues, it is important to understand the following: (1) who is going online; (2) why are they going; (3) where are they going; (4) what needs are being met; and (5) how, if at all, do they discuss health information found online with their doctors. The objective of this mini-review is to highlight contemporary issues regarding the impact of the internet on patient-physician communication and to present directions for future research. PATIENT SUMMARY: The growing use of the Internet has implications for people seeking information on health matters. Our review shows that the Internet can be helpful for patient-physician communication, but this depends on the quality of health information found and whether the information is discussed during medical visits.

Perceived Patient-Provider Communication Quality and Sociodemographic Factors Associated With Watching Health-Related Videos on YouTube: A Cross-Sectional Analysis

BACKGROUND

Approximately 73% of US adults use YouTube, making it the most popular social media platform. Misinformation on social media is a growing concern; recent studies show a high proportion of misinformative health-related videos. Several studies on patient-provider communication and general health information seeking have been conducted. However, few studies to date have examined the potential association between patient-provider communication and health information seeking on specific social media platforms such as YouTube. A better understanding of this relationship may inform future health communication interventions.

OBJECTIVE

The aim was to use nationally representative cross-sectional data to describe the association between perceived patient-provider communication quality and sociodemographic factors on watching YouTube health-related videos.

METHODS

Data from the 2018 Health Information National Trends Survey were analyzed (N=3504). The primary outcome was whether participants watched a health-related video on YouTube over the past 12 months. A patient-provider communication composite score was created by summing responses about how often providers did the following: (1) gave you the chance to ask all the health-related questions you had, (2) gave attention to your feelings, (3) involved you in health care decisions as much as you wanted, (4) made sure that you understood the things you needed to do to take care of your health, (5) explained things in a way that you could understand, (6) spent enough time with you, and (7) helped you deal with feelings of uncertainty. Sociodemographic factors included age, gender, race/ethnicity, and education. Descriptive statistics and multivariable logistic regression were conducted.

RESULTS

Approximately 1067 (35% weighted prevalence) participants reported watching a health-related video on YouTube. Higher perceived quality of patient-provider communication on the composite score was significantly associated with lower odds of watching health-related videos on YouTube. Regarding sociodemographic factors, increasing age and being a high school graduate (compared with college graduate) were associated with lower odds of watching health-related videos on YouTube; whereas, Hispanic and non-Hispanic Asians were more likely to have watched a health-related video on YouTube. For individual aspects of patient-physician communication, two of seven patient-provider communication variables were significant. Those who reported that providers "sometimes" spent enough time with them had higher odds of watching a health-related video on YouTube, compared with those who said providers "always" spent enough time with them. Participants reporting that they "never" have a chance to ask all their health-related questions also had higher odds of watching health-related videos on YouTube compared with those who reported "always."

CONCLUSIONS

Higher perceived quality of patient-provider communication is associated with lower odds of watching health-related videos on YouTube. When providers do not spend enough time or give an opportunity to ask questions, patients are more likely to pursue health information on social media.

A Quality Analysis of Disc Herniation Videos on YouTube

BACKGROUND

An increasing number of patients are investigating health information by using the Internet because of its exponential growth. Therefore, it is important to test the accuracy of the information presented to determine which information should not be shared. This study investigated the information available on YouTube with regard to disc herniation.

METHODS

The first 50 videos found after the keyword "disc herniation" was used in the YouTube search engine were included in the study. Video popularity was evaluated with an index called the video power index (VPI). The quality and accuracy of the information were evaluated by 2 independent spinal surgeons using the Journal of American Medical Association (JAMA) score and the DISCERN scoring system. Interobserver agreement and individual correlations of the data of each video were statistically analyzed.

RESULTS

Of the 50 videos evaluated, 16 (32%) contained animation and 34 (64%) contained real images. The mean duration was 6.587 minutes, and the mean view was 423.472. The mean DISCERN score was 30.7 (±10.3), and the mean JAMA score was 1.8 (±0.5). There was good agreement between the 2 researchers in terms of DISCERN and JAMA scores. No statistically significant correlation was found between the JAMA and DISCERN scores of both researchers and VPI values, video lengths, animation, or real images.

CONCLUSIONS

The quality of the disc herniation information offered on YouTube is low. The evaluation of medical information obtained from the Internet by health professionals is an important step in guiding the correct flow of medical information to patients.

Evaluation of website information provided by paediatric surgery centres in Australia and New Zealand

BACKGROUND

Hospital websites are an important source of information for patients, parents and healthcare providers. There are currently no standardized recommendations for the information provided on paediatric surgery websites. We aimed to assess the information available on each hospital website, in Australia and New Zealand, which provides paediatric surgical care.

METHODS

Google search was performed of the 16 paediatric surgical centres in Australia and New Zealand to determine whether they had a hospital website and to assess its contents. The presence of patient fact sheets and clinical practice guidelines was recorded. Access to contact information, hospital Facebook page and Twitter handles were noted.

RESULTS

We found that 11 (69%) centres had a specific paediatric surgical section to the hospital website, all provided contact information. Five centres (31%) had paediatric-specific guidelines available for health professionals. Six websites (37.5%) provided health information sheets on common paediatric surgical conditions. Facebook and Twitter facilities were present on the majority of the websites (75%).

CONCLUSION

The internet presence of paediatric surgery in Australia and New Zealand is sparse. One-third of centres do not have hospital web presence. The availability of clinical guidelines and patient information sheets on hospital websites is limited. Our findings would suggest that improvement and increase in the internet presence of paediatric surgery in Australia and New Zealand is needed.

Generating Engagement on the Make Healthy Normal Campaign Facebook Page: Analysis of Facebook Analytics

Background

Facebook is increasingly being used as part of mass media campaigns in public health, including the Make Healthy Normal (MHN) campaign in New South Wales, Australia. Therefore, it is important to understand what role Facebook can play in mass media campaigns and how best to use it to augment or amplify campaign effects. However, few studies have explored this.

Objective

This study aimed to investigate usage of and engagement with the MHN Facebook page and to identify influential factors in driving engagement with the page.

Methods

We examined both post-level and page-level analytic data from Facebook from the campaign’s launch in June 2015 to September 2017. For post-level data, we conducted a series of negative binomial regressions with four different outcome measures (likes, shares, comments, post consumers), including some characteristics of Facebook posts as predictors. We also conducted time series analyses to examine associations between page-level outcomes (new page likes or “fans” and number of engaged users) and different measures of exposure to the page (number of unique users reached and total count of impressions) and to television advertising.

Results

Of the 392 posts reviewed, 20.7% (n=81) received a paid boost and 58.9% (n=231) were photo posts. We found that posts that received a paid boost reached significantly more users and subsequently received significantly more engagement than organic (unpaid) posts (P<.001). After adjusting for reach, we found the effect of being paid was incremental for all outcome measures for photos and links, but not videos. There were also associations between day of the week and time of post and engagement, with Mondays generally receiving less engagement and posts on a Friday and those made between 8 AM and 5 PM receiving more. At the page level, our time series analyses found that organic impressions predicted a higher number of new fans and engaged users, compared to paid impressions, especially for women. We also found no association between television advertising and engagement with the Facebook page.

Conclusions

Our study shows that paying for posts is important for increasing their reach, but that page administrators should look to maximize organic reach because it is associated with significantly higher engagement. Once reach is accounted for, video posts do not benefit from being paid, unlike the other post types. This suggests that page administrators should carefully consider how they use videos as part of a Facebook campaign. Additionally, the lack of association between television advertising and engagement suggests that future campaigns consider how best to link different channels to amplify effects. These results highlight the need for ongoing evaluation of Facebook pages if administrators are to maximize engagement.

Building pharmaceutical relationship marketing and social media impact

Purpose

The purpose of this paper is to identify key social medial channels which pharmaceutical firms need to consider when desiring to understand consumer behavior, build, maintain and proactively manage relationships. Also, it proposes the application of analytic hierarchy process (AHP) sensitivity analysis algorithm to test the stability or robustness of the priority ranking. Specifically, this paper leverages performance sensitivity analysis to evaluate how small changes (perturbation) in the major objectives of the pharmaceutical relationship marketing (PRM) tactics within the social media environment will influence the ranking of the alternative course of actions.

Design/methodology/approach

This paper used AHP-based questionnaire survey to evaluate the relative importance of factors accounting for PRM and the impact of social media channels. The major objectives and the alternative strategies used were from literature reviewed. Interviews with senior managers were insightful and helpful in the wording, content and format of the questionnaire.

Findings

Customer engagement is the most important PRM tactic, followed by communication and trust. The performance sensitivity analysis carried out on the PRM tactics showed that the ranking associated with social media channel options remained robust or insensitive to small perturbations.

Research limitations/implications

The data procured for this paper were based on one focal pharmaceutical firm. Convincing the same to grant an interview and late responding to the questionnaire was a great challenge.

Practical implications

Social media impact on pharmaceutical marketing relationship is important for pharmaceutical marketers. PRM bodes well with the social media environment. Pharmaceutical industry can build and maintain relationships with consumers through social media. Firms that leverage social media to enhance their PRM tactics will be viewed favorably in terms of trust, transparency, openness and honesty. The results provide pharmaceutical marketing managers with insightful and valuable information with respect to the role or social media impact on the PRM. The AHP model, objectives and their relative importance provide valuable information for managers on how to monitor the values that matters to customers the most.

Originality/value

This paper is one of the very few on the PRM and perhaps the first that examines social impact leveraging the AHP model. In addition, this paper contributes to the relationship marketing literature by leveraging a multi-criteria decision-making algorithm to prioritize the most important factors accounting for the PRM strategies.

Medical YouTube Videos and Methods of Evaluation: Literature Review

BACKGROUND

Online medical education has relevance to public health literacy and physician efficacy, yet it requires a certain standard of reliability. While the internet has the potential to be a viable medical education tool, the viewer must be able to discern which information is reliable.

OBJECTIVE

Our aim was to perform a literature review to determine and compare the various methods used when analyzing YouTube videos for patient education efficacy, information accuracy, and quality.

METHODS

In November 2016, a comprehensive search within PubMed and Embase resulted in 37 included studies.

RESULTS

The review revealed that each video evaluation study first established search terms, exclusion criteria, and methods to analyze the videos in a consistent manner. The majority of the evaluators devised a scoring system, but variations were innumerable within each study's methods.

CONCLUSIONS

In comparing the 37 studies, we found that overall, common steps were taken to evaluate the content. However, a concrete set of methods did not exist. This is notable since many patients turn to the internet for medical information yet lack the tools to evaluate the advice being given. There was, however, a common aim of discovering what health-related content the public is accessing, and how credible that material is.