Design of a bilingual (FR-UR) website on the sensitive topic of sexual and mental health with Urdu speakers in a Parisian suburb: a qualitative study

BACKGROUND

This article is a continuation of the Musafir study published in 2020. Following the results of this study, we designed an educational website with Urdu-speaking volunteers, using a participatory approach. This type of approach aimed at bringing out situated knowledge around taboo/sensitive topics such as sexual and mental health, by considering the cultural, religious, economic, family, and social background of young Urdu-speaking men. This approach allowed us to build culturally-appropriate content matching the needs of targeted population. We report here the lessons learned from our approach.

METHODS

Urdu-speaking volunteers were recruited via outreach strategies, for participation in focus groups. Four focus group discussions were conducted on three distinct themes: 1/ Sexual Health Promotion, 2/Hepatitis and sexually transmitted infections, and 3/ Mental Health. The focus groups were recorded, with the written consent of the users. Thematic analysis was conducted after transcription of the focus-group discussion.

RESULTS

We succeeded in mobilizing 4 Pakistani users, aged between 19 and 30 years. The group dynamics was very rich and allowed us to highlight numerous social aspects related to the importance of the group belonging, the family, and others points of view on these topics. Many Urdu vocabulary had to be redefined and revealed the extent of the pre-existing taboo.

CONCLUSIONS

Notwithstanding the extreme difficulty of mobilizing an invisible target population on a sensitive topic such as sexual and mental health, our experience highlights the need to consider the knowledge of the people concerned. The participative approach allowed us to fit the content of our medium to, for instance: the collectivist type of society of the target population; the level of literacy in their mother tongue; and to the embodiment of some taboo in their vocabulary. Although time and energy consuming, our approach seems relevant and could be replicated to other communities.

[Evaluation of the satisfaction of healthcare professionals using the CRAT website, and launch of a new version]

In preparation for a new version of the CRAT (Centre de référence sur les agents tératogènes) website, an evaluation of user satisfaction was carried out. An invitation to complete an online questionnaire covering the various dimensions of the website (appearance, content, interactivity, ease of use, technical performance) was sent in April 2022 to healthcare professionals who referred to CRAT for clinical expertise over the previous two years. After sending out 3224 individual e-mail invitations, 758 evaluators completed the questionnaire in full (response rate: 23.5%). The evaluation revealed a high-level of overall satisfaction among site users (98.0% very satisfied or satisfied). Satisfaction with the site's appearance was also high, although comments were made about the site's lack of a modern web design. Health professionals recognized in their responses the reliable, relevant and up-to-date nature of the content of this free, public online resource, independent of the pharmaceutical industry. On the basis of these highly favorable assessments, with content that has been widely acclaimed and areas for improvement that have caught the attention of site users (evolution of its appearance, of the search tool, implementation of a mobile site), a new version of www.lecrat.fr was launched in the fall of 2023.

Development of the Together - Teens&20s microsite, an online resource for adolescent and young adult cancer patients

Objectives

The purpose of this study was to explore the information needs and preferences of adolescent and young adult (AYA) cancer patients to guide next steps for development of a new online resource for this audience. The goals were to understand information needs, prioritize topic areas, and inform website design and functionality.

Methods

Participants were AYA cancer patients ages 13-25 years. We used multiple methods in two phases to gather audience feedback. The first phase collected quantitative data in an electronic survey (n = 45) about AYA patients' internet use and content preferences. The second phase collected qualitative data through focus groups (n = 13) about user preferences for content design and website function.

Results

Survey results showed AYA patients were more interested in content about how treatments would impact their lives rather than the treatments themselves. They preferred content on school, careers, relationships, independence, side effects, and fertility. The focus groups indicated AYA patients prefer a clean, stylish design; infographics and visual aids; and the ability to find information quickly and control the amount they read.

Conclusions

Online resources represent an important opportunity to advance cancer education for AYA patients. However, it is important to consider the information needs and preferences of this audience in content design and delivery.

Innovation

Practitioners should use stakeholder input to guide the creation of patient education resources that are age- and audience-appropriate. This study provides insights into AYA information needs and preferences in pediatric oncology.

Cross-Sectional Analysis of Neurosurgical Residency Websites During the Virtual Interview Cycle

BACKGROUND

The loss of in-person interviews during the COVID-19 pandemic warrants an investigation into what information is provided to applicants through neurosurgery residency program websites (NRPWs). This study examines NRPWs across the United States and Canada to determine what details are provided to applicants through their respective websites.

METHODS

Accreditation Council for Graduate Medical Education accredited neurologic surgery residency programs were identified through the American Association of Neurological Surgeons (AANS) website. NRPWs were searched for 48 criteria, including program overview, application requirements, and curriculum information. Small programs were defined as 1-2 residents per class, while large programs were classified as those with 3-4 residents per year. Content differences were analyzed between the top 20 and remaining programs per the Doximity Residency Navigator Rankings.

RESULTS

The most prevalent information among 122 NRPWs was the neurosurgery residency overview (95%), names of faculty members (95%), and names of current residents (94%). Top-20 NRPWs were more likely to include post PGY-7 fellowships (90% vs. 61% P = 0.0108), operating room virtual reality experience (35% vs. 12% P = 0.0160), and faculty research (90% vs. 62% P = 0.0182) than the remainder of the programs.

CONCLUSIONS

This study investigates NRPW content after the COVID-19 pandemic. We report broad variability in content provided by various neurosurgical training programs. Higher-ranked neurosurgery programs are more likely to include fellowship information, operating room virtual reality experience, and faculty research than lower-ranked programs.

Co-designing a website with and for youth, so they can better manage their health

Objective

To co-design a website aimed to empower youth to ask questions to encourage productive, meaningful conversations with their health care providers.

Methods

The research team recruited adolescent stakeholders (ages 11-17) through flyers distributed at local Young Men's Christian Association (YMCA) locations, clinics, and school nurses. Eleven adolescents who had at least one chronic medical condition were selected as members of the two youth advisory boards. Youth participated in five co-design meetings to give input on website content and refinement over a two-and-a-half-year period. The youth reviewed the website in various stages of development.

Results

Youth wanted a website with simple, straightforward language that would be understood by someone between the ages of 11-17 years with a reputable URL. The website content includes ADHD, asthma, vaping/smoking, diabetes, seizures, anxiety, panic disorder, depression, addiction, stimulants, bullying, eating disorders, and sexually transmitted infections. Youth wanted general background content, helpful resources, question prompt lists, and videos encouraging youth involvement in care.

Conclusions

A credible co-designed website with information on different health topics that contains question prompt lists and videos for utilization during health care visits has the potential to increase adolescent involvement in their care.

Innovation

This website is an innovative intervention aimed at informing and encouraging youth to be more actively involved in their care across a range of healthcare conditions.

Plastic surgery online, how accessible are our units?

BACKGROUND

The Covid-19 pandemic has highlighted the importance of remote patient and professional communication. This has been especially important for highly specialised and regionally-based specialties such as plastic surgery. The aim of this study was to review how UK plastic surgery units represent themselves online and their phone accessibility.

PATIENTS AND METHODS

UK plastic surgery units were identified using the BAPRAS website and their websites and telephone accessibility assessed.

RESULTS

Whilst a minority of units have clearly invested heavily in ensuring comprehensive webpages, nearly a third have no dedicated webpage at all. We found significant variation in quality and user-friendliness of online resources both for patients and for other healthcare professionals, with less than a quarter of units providing comprehensive contact details, emergency referral guidance, or information about changes to services due to Covid-19, to highlight a few areas. Communication with the BAPRAS website was also poor with less than half of web-links connecting to correct and relevant webpage and only 13.5% of phone numbers connecting directly to a useful plastic surgery number. In the phone component of our study we found that 47% of calls to 'direct' numbers went to voicemail but wait-times were significantly less than going through hospital switchboards and connections were more accurate.

CONCLUSION

In a world where a business' credibility is so heavily based on their online appearance and, in an increasingly online era of medicine, we hope that this study may be a resource for units to improve their web-based resources and prompt further research in enhancing patient experience online.

Investigating the quality of Iranian hospitals' websites and their association to the Province's share of medical tourism

BACKGROUND

Nowadays, virtual methods are among the most important and influential marketing instruments in various industries, such as medical tourism. This study aims to investigate the quality of Iranian hospitals' web pages and their association with the province's share of the medical tourism industry in Iran and the ownership type of hospitals.

METHODS

In this analytical cross-sectional study, the quality of hospitals' websites was investigated through a 36-item self-administered questionnaire which was validated, and its reliability was verified (Cronbach's alpha = 74%.). The questionnaire was categorized into three sections: hospital services and facilities, hospital's medical tourism-related services, and tourism information of the destination province. The census method was used for data collection. Data analysis was performed using the independent t-test and analysis of variance in SPSS software (version 25), and a P-value < 0.05 was considered statistically significant.

RESULTS

A total of, 102 hospitals with an IPD (International Patients Department) were included in the study, and 21.6% did not have an English-language page and were excluded from the study. The mean total score was 47 ± 7.5, indicating low-quality content. Public hospitals had lower quality scores than semi-private and private hospitals. The total quality score, information about the hospital and its services, and the score of information about medical tourism-related services were associated with the province's share of national medical tourism.

CONCLUSION

According to the obtained results and the possible role of website quality in increasing provinces' medical tourism development, the IPD page on hospital websites should be revised and regularly updated to make them more informative for prospective medical tourists.

Low E-visibility of embryologists on fertility clinic websites: a web-based cross-sectional study

PURPOSE

This study assessed the visibility of embryologists on fertility clinic websites among Society for Assisted Reproductive Technology (SART) and the Human Fertilisation and Embryology Authority (HFEA) member clinics.

METHODS

During a 1-month interval (March 2022), all Society for Assisted Reproductive Technology (SART) and the Human Fertilisation and Embryology Authority (HFEA) member fertility clinic websites were evaluated. The professional representation of the primary care team was examined including specialties, the presence of headshots, and biographies.

RESULTS

A total of 446 fertility clinic websites were scanned in the search. The embryology team has the least common professional identification by their names (53.58%) compared to gynecology clinicians (96.21%, p < 0.001) and nurses (55.58%, p < 0.001). This trend also applies to other types of professional identifiers, such as headshots and biographies. Professional headshots of embryologists (50.34%) were less prominent than those of gynecology clinicians (93.51%, p < 0.001). A similar trend was observed in the biographies of the embryology team (47.20%) compared to gynecology clinicians (95.08%, p < 0.001).

CONCLUSION

The present study revealed that embryologists have low professional visibility on fertility clinic websites. Fertility clinics may prioritize enhancing the online visibility of their embryology laboratory team. This approach could potentially enhance the recognition of their team, foster transparency, and provide accessible information about the skills and expertise of healthcare professionals involved in the treatment process.

Let's talk early labour: The L-TEL randomised controlled trial

BACKGROUND

Women without complications have lower obstetric intervention if they remain at home in early labour but many women report dissatisfaction in doing this. Using self-efficacy theory as an underpinning framework, a web-based intervention was co-created with women who had previously used maternity services. The intervention provides early labour advice, alongside the videoed, real experiences of women.

METHOD

The pragmatic, randomised control trial aimed to evaluate the impact of the web-based intervention on women's self-reported experiences of early labour. Low-risk, nulliparous, pregnant women (140) were randomised. The intervention group (69) received the web-based intervention antenatally to use at their own convenience and the control group (71) received usual care. Data were collected at 7-28 days postnatally using an online version of the Early Labour Experience Questionnaire (ELEQ). The primary outcome was the ELEQ score. Secondary, clinical outcomes such as labour onset, augmentation and mode of birth were collected from the existing hospital system.

RESULTS

There were no statistically significant differences in the ELEQ scores between trial arms. Women in the intervention group were significantly more likely to progress spontaneously in labour without the need for labour augmentation (39.1 %) compared to the control group (21.1 %) (OR 2.41, CI 95 %; 1.14-5.11).

CONCLUSION

Although the L-TEL Trial found no statistically significant differences in the primary outcome, the innovative intervention to support women during latent phase labour was positively received by women. Web-based resources are a cost effective, user-friendly and accessible way to provide women with education. A larger trial is needed to detect differences in clinical outcomes.

Exploring the design and utility of an integrated web-based chatbot for young adults to support healthy eating: a qualitative study

BACKGROUND

There is a lack of understanding of the potential utility of a chatbot integrated into a website to support healthy eating among young adults. Therefore, the aim was to interview key informants regarding potential utility and design of a chatbot to: (1) increase young adults' return rates and engagement with a purpose-built healthy eating website and, (2) improve young adults' diet quality.

METHODS

Eighteen qualitative, semi-structured interviews were conducted across three stakeholder groups: (i) experts in dietary behaviour change in young adults (n = 6), (ii) young adult users of a healthy eating website (n = 7), and (iii) experts in chatbot design (n = 5). Interview questions were guided by a behaviour change framework and a template analysis was conducted using NVivo.

RESULTS

Interviewees identified three potential roles of a chatbot for supporting healthy eating in young adults; R1: improving healthy eating knowledge and facilitating discovery, R2: reducing time barriers related to healthy eating, R3: providing support and social engagement. To support R1, the following features were suggested: F1: chatbot generated recommendations and F2: triage to website information or externally (e.g., another website) to address current user needs. For R2, suggested features included F3: nudge or behavioural prompts at critical moments and F4: assist users to navigate healthy eating websites. Finally, to support R3 interviewees recommended the following features: F5: enhance interactivity, F6: offer useful anonymous support, F7: facilitate user connection with content in meaningful ways and F8: outreach adjuncts to website (e.g., emails). Additional 'general' chatbot features included authenticity, personalisation and effective and strategic development, while the preferred chatbot style and language included tailoring (e.g., age and gender), with a positive and professional tone. Finally, the preferred chatbot message subjects included training (e.g., would you like to see a video to make this recipe?), enablement (e.g., healthy eating doesn't need to be expensive, we've created a budget meal plan, want to see?) and education or informative approaches (e.g., "Did you know bananas are high in potassium which can aid in reducing blood pressure?").

CONCLUSION

Findings can guide chatbot designers and nutrition behaviour change researchers on potential chatbot roles, features, style and language and messaging in order to support healthy eating knowledge and behaviours in young adults.

Advancing Access to Care through Digital Health: Perspectives from Youth on a Novel Platform to Increase Access to Sexual and Reproductive Health Care and Education for Adolescents and Young Adults

STUDY OBJECTIVE

Youth account for half of new sexually transmitted infections (STIs) in the United States annually. Barriers to STI prevention include a lack of accurate sexual and reproductive health (SRH) education and low STI testing. We sought to obtain youth feedback on a digital health platform prototype designed to address these barriers.

METHODS

The platform prototype included SRH content, free STI testing and treatment, and anonymous question submission. Five focus group discussions, each lasting 45-60 minutes with 5-6 youth living in a high-prevalence STI region (Baltimore, Maryland), were conducted. Thematic analysis was conducted.

RESULTS

There were 28 participants with a mean age of 15.9 years (range 14-19), among whom 89% self-identified as female, 57% Black/African American, 29% Asian American, 14% White, and 7% Hispanic/Latino. Youth felt that the prototype platform was comprehensive and understandable. They suggested adding peer reviews to increase trustworthiness.

CONCLUSION

Youth reported that the platform (violetproject.org) was an acceptable tool for SRH education and STI testing. Participants expressed enthusiasm and willingness to use the platform as a reliable SRH educational tool to combat medical misinformation on the Internet and a non-clinic-based source of STI testing. This platform could fill gaps in access to SRH care and education for youth.

What consumers, general practitioners and mental health professionals want: the co-design and prototype testing of a transdiagnostic, acceptance and commitment therapy-based online intervention to reduce distress and promote wellbeing among Australian adults

BACKGROUND

Many Australians experience mental health challenges, but only a third access face-to-face psychological services, due to multiple barriers including long waitlists. Additional strategies to prevent or help people de-escalate distress at an early stage are needed. Web-based mental health interventions are becoming increasingly acceptable to consumers and referring General Practitioners (GPs), but most are designed for specific disorders/populations. This study explores consumers' and health professionals' preferences and recommendations for the design of a transdiagnostic, Acceptance and Commitment Therapy (ACT)-based, online intervention for Australian adults.

METHODS

Thirty-five people (consumers, carers, GPs, mental health professionals) participated in one or more co-design stages. Stage 1: semi-structured interviews to establish what is wanted from such websites (n = 22). Stage 2: feedback emailed on branding options (n = 20). Stage 3: feedback provided via Zoom or an online survey after testing a website prototype (n = 19). Data were analysed using Thematic Framework Analysis and descriptive statistics.

RESULTS

Stage 1 highlighted nine key design principles (plus 25 subthemes) that participants emphasised as important to ensure the website would have broad appeal and meet their needs: (1) user choice is valued highly; (2) ACT-based content is acceptable as it is focused on helping people be proactive and 'get unstuck'; (3) non-pathologising, direct, empowering, lay language is endorsed; (4) a positive look and feel is appreciated; (5) images and videos are important to break up text and maintain engagement; (6) short text messages to aid engagement are valued; (7) provision of tailored psychoeducation for highly distressed and suicidal users is endorsed; (8) personal and proactive brand name is preferred (icanactnow); (9) diverse marketing and training activities are recommended. In Stage 2, icanactnow branding preferences were elicited (simplicity, colours to represent growth and a call to action). Stage 3 resulted in the inclusion of a safety plan template and a tailored entry portal for people referred to icanactnow by health professionals. High levels of satisfaction with the prototype were reported.

CONCLUSIONS

These findings informed icanactnow and provide insights for the development of other online mental health interventions, in ways that appeal to both consumers and professionals recommending them.

Acceptability and Ease of Use of an Educational Website among Women, Infants, and Children Program Participants in Puerto Rico: A Pilot Study

OBJECTIVE

To evaluate a website for an educational intervention among participants of the Baby-Act Trial. Baby-Act is a community-based intervention to prevent infant obesity by promoting physical activity, sleep, and healthy eating behaviors in Women, Infants, and Children (WIC) program participants in Puerto Rico. The intervention was designed to be delivered through a mobile application, but after the study was launched, participants reported many difficulties, and an alternative educational platform was developed.

METHODS

Participants of the WIC program completed a face-to-face structured interview consisting of several open-ended questions. After completing the interview, they were instructed on how to access the newly developed webpage and completed the lessons found therein. Then followed a survey that explored the overall experience.

RESULTS

Nine participants were interviewed; they all agreed that the website was easy to access, registration was simple, and the webpage was clear; 8 were able to complete at least 1 lesson (1 participant had a very poor signal), and all 9 reported being confident in using the webpage and stated they would use it again.

CONCLUSION

The study participants found this website to be user-friendly and a viable alternative for future educational intervention delivery to WIC participants.

Using medical university websites for health education about COVID-19; an effective solution for public education during a pandemic

BACKGROUND

Medical universities use their websites to teach, research, and promote a culture of health. Therefore, this study aimed to evaluate the performance of medical universities in terms of health information and education regarding COVID-19 by surveying the website of Iranian medical universities.

METHODS

This descriptive-analytical study was conducted in June to August 2020 on the websites of medical universities in three categories of universities (type 1, type 2 and type 3). The information of this study was collected from medical universities located in the east, west, north, south and center of Iran. Data were collected according to a checklist. The checklist contained 3 sections; the first part with 8 components regarding general information of the university websites, the second part with 11 components regarding the information and news related to the coronavirus and the third part with 12 components regarding the content of personal health education and environmental health for the prevention of coronavirus. To determine the status of each website in the two areas of health information and education, websites were divided into three categories based on scores (poor, average and good). Data were analyzed by chi-square.

RESULTS

In this study, 1118 web pages related to 48 Iranian universities of medical sciences were reviewed, where 19 were type 1 universities, 21 type 2 universities, and 8 type 3 universities. The mean scores of the websites regarding the information and news related to the coronavirus (8.54 ± 1.750) and the mean scores of the websites regarding the personal and environmental health education related to coronavirus (10.96 ± 1.148) were in a favorable and positive condition. The ranking of medical universities by type showed that the scores in the two areas of health information and education about the coronavirus were in good condition and none of the universities were in bad condition. Chi-square showed that the information status and news related to the coronavirus had a significantly positive relationship with the type of medical universities (χ2 = 10.343, p = 0.006).

CONCLUSIONS

The results of this study showed that type1 and type 2 and 62.5% of type 3 medical universities were in good condition in terms of total scores in the two areas of health information and education about coronavirus and none of the universities were in a bad situation. It is suggested that the website of medical universities can serve as a reliable and appropriate source of information not only for academics and students but also for the general public.

The metabolomics workbench file status website: a metadata repository promoting FAIR principles of metabolomics data

BACKGROUND

An updated version of the mwtab Python package for programmatic access to the Metabolomics Workbench (MetabolomicsWB) data repository was released at the beginning of 2021. Along with updating the package to match the changes to MetabolomicsWB's 'mwTab' file format specification and enhancing the package's functionality, the included validation facilities were used to detect and catalog file inconsistencies and errors across all publicly available datasets in MetabolomicsWB.

RESULTS

The MetabolomicsWB File Status website was developed to provide continuous validation of MetabolomicsWB data files and a useful interface to all found inconsistencies and errors. This list of detectable issues/errors include format parsing errors, format compliance issues, access problems via MetabolomicsWB's REST interface, and other small inconsistencies that can hinder reusability. The website uses the mwtab Python package to pull down and validate each available analysis file and then generates an html report. The website is updated on a weekly basis. Moreover, the Python website design utilizes GitHub and GitHub.io, providing an easy to replicate template for implementing other metadata, virtual, and meta- repositories.

CONCLUSIONS

The MetabolomicsWB File Status website provides a metadata repository of validation metadata to promote the FAIR use of existing metabolomics datasets from the MetabolomicsWB data repository.

A call to enhance transparency among Egyptian medical schools

BACKGROUND

Making accreditation results easily accessible has become a worldwide essential issue, especially after international standards were created for medical education. The Egyptian Society for Medical Education (ESME) expects Egyptian medical schools to be more open about their accreditation results to build trust with students, families, and the community. This will help ensure newly graduated doctors are of high quality. Our literature review found almost no information on how transparent Egyptian medical school websites are with posting their accreditation results. Students and families use these websites to choose schools and be confident in the quality of education, so accreditation results should be easily accessible.

METHODS

This study was conducted to estimate the information transparency of Egyptian medical colleges' websites regarding their accreditation process. Twenty-five official websites of Egyptian medical colleges, as well as official website of the National Authority for Quality Assurance and Accreditation of Education (NAQAAE) were reviewed. The websites' search considers two main criteria for transparency. Each criterion is further divided into several information items. Data was recorded and analyzed using Research Electronic Data Capture software (REDCap). The authors excluded, from the data analysis, newly established schools of less than five years of age that were not required to apply for accreditation yet.

RESULTS

The results of the research showed that only thirteen colleges registered their credentials on their websites. However, the amount of data available about the process, dates, and documents was very limited. Accreditation information for these thirteen schools is confirmed by information on the NAQAAE website. Other information on other important elements such as accountability and future plans was almost completely missing.

CONCLUSION

The authors concluded that due to the lack of basic information on the websites of Egyptian medical schools about their institutional accreditation status, serious steps should be taken by medical schools and the National Accreditation Authority to encourage openness and ensure transparency towards institutional accreditation.

Impact of a digital web-based asthma platform, a real-life study

BACKGROUND

Digital health technology (DHT) is a growing area in the treatment of chronic diseases. Study results on DHT's effect on asthma control have been mixed, but benefits have been seen for adherence, self-management, symptoms, and quality of life. The aim was to evaluate the impact of an interactive web-based asthma treatment platform on asthma exacerbations and health care visits.

METHODS

In this real-life study, we retrospectively collected data on adult patients registered on a web-based interactive asthma treatment platform between December 2018 and May 2021. Patients who activated their accounts were active users, and patients who did not were inactive users and considered as controls. We compared the number of exacerbations, total number of exacerbation events defined as the sum of oral corticosteroid (OCS) and antimicrobial courses, emergency room visits, hospitalizations, and asthma-related health care visits before and one year after the registration on the platform. Statistical tests used included the t-test, Pearson's chi-square test and Poisson regression models.

RESULTS

Of 147 patients registered on the platform, 106 activated their accounts and 41 did not. The active users had significantly fewer total number of exacerbation events (2.56 per person years, relative decline 0.78, 95% CI 0.6 to 1.0) and asthma-related health care visits (2.38 per person years, relative decline 0.84, 95% CI 0.74 to 0.96) than before registration to the platform, whereas the reductions in health care visits and the total number of exacerbation events were not significant in the inactive users.

CONCLUSIONS

An interactive web-based asthma platform can reduce asthma-related health care visits and exacerbations when used actively.

Readability of online patient education materials for Merkel cell carcinoma

The Internet is a significant source of information for patients. According to the National Institutes of Health, patient education materials (PEMs) should be at or below an eighth-grade reading level. Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer that affects patients over 50 with rising incidence. Unfortunately, US adults aged 65 + have the least proficiency in health literacy. This study assessed the readability of online PEMs and factors that contribute to readability. We retrieved 50 PEM websites and extracted primary content. A readability software package calculated six readability statistics and generated a consensus standard readability. Overall, only eight articles had a standard reading level of eighth-grade level or below (16%). The median standard reading level was at the 11th-grade level. We also examined MCC PEMs from cancer treatment institution websites (N = 20). We determined whether they contained institution-specific information, meaning they contained text information about the institution-specific expertise and specialist team. Websites containing this information (N = 13) had a significantly higher reading level than websites that did not (N = 7) in five of six readability metrics (p < 0.05). We concluded that MCC PEMs with institution-specific information led to significantly higher reading level scores. We propose that such information may increase cognitive load, as patients are learning about their disease and treatment and contending with the institution-specific information. The Cognitive Load Theory principles of intrinsic load (learning the material relevant to the disease and treatment) and extraneous load (institution-specific information and increased reading level) are constrained by limited working memory. Working memory decreases with age; hence, the patient demographic most sensitive to increased extraneous load tends to overlap with that of MCC. As patients typically read pages linked from their search engine, we suggest moving institution-specific information to another page, separate from the PEMs.

Evaluation of Laryngology Fellowship Programs' Online Information

OBJECTIVE

Prospective laryngology fellows have limited opportunities to learn about fellowship programs besides personal conversations with program directors and mentors. Online information about fellowships may optimize the laryngology match process. The purpose of this study was to assess the utility of online information about laryngology fellowship programs through analysis of program websites and surveying current and recent laryngology fellows.

METHODS

The websites of 20 laryngology fellowship programs were analyzed for the presence of 18 unique criteria, previously described in the literature. A survey was distributed to current and recent fellows to determine helpful resources and improvements of fellowship websites.

RESULTS

On average, program websites fulfilled 33% of the 18 criteria used for analysis. The criteria most often fulfilled were "program description," "case descriptions," and "fellowship director contact information." Of respondents from our survey, 47% strongly disagreed that fellowship websites helped them identify desirable programs, and 57% somewhat or strongly agreed that more detailed websites would have made identification of desirable programs easier. Fellows were most interested in finding information about program descriptions, contact information for program directors and coordinators, and current laryngology fellows.

CONCLUSION

Based on our findings, laryngology fellowship program websites can improve, making the application process easier. As programs incorporate more information regarding contact information, current fellows, interviews, and case volume/descriptions on their websites, they will allow applicants to make more informed decisions and find the programs that fit them the best.

Early labour experience and labour characteristics after introduction of an electronic early labour educational intervention

OBJECTIVE

The study's aim was to compare first-time mothers' experience of early labour and subsequent labour characteristics before and after introducing an online early labour educational intervention. This article also reports on further testing of the underlying structure of the of the Early Labour Experience Questionnaire (ELEQ) in a Norwegian setting.

METHODS

Pre- and post-intervention cohorts were recruited. The ELEQ was translated into Norwegian, back-translated and distributed among primiparous mothers whilst in hospital. Confirmatory factor analyses were used to evaluate model fit, and the internal consistency of the scale was measured by Cronbach's α coefficient. The relationship between cohorts and demographic characteristics were analysed using chi-square statistics and t-tests.

RESULTS

Confirmatory factor analysis of the Swedish version of the ELEQ for primiparous women showed an acceptable fit. Neither the overall score nor the scores on the subscales for emotional well-being, emotional distress and perceptions of midwifery care differed significantly, but there was a significant difference between the groups on a few of the items. The cervix was significantly more dilated upon admission in the post-intervention group, and oxytocin use was significantly reduced. The number of telephone consultations increased significantly after the intervention was introduced.

CONCLUSION

The intervention did not improve women's experience with early labour. However, women who received the intervention were admitted in more advanced labour and required less oxytocin. The increased number of telephone consultations may indicate that an online early labour educational programme cannot replace women's need to communicate directly with staff.

CTSA Search Solutions: A novel approach to searching CTSA hub website content

Clinical and Translational Science Award (CTSA) hub websites are a critical communication gateway to assist the clinical and translational science community and promote CTSA hub offerings. The objective of this funded pilot project was to create a website and online database for the CTSA consortium that allows users to conduct structured searches among the 50 + CTSA hub websites. The result is CTSA Search Solutions, an online, searchable database that includes access to 50 + CTSA hub websites with 80+ structured search term options and over 800 links collected, organized, and published. Hubs can be searched by name and filtered by a specific CTSA topic, state, region, or even number of years funded to make detailed comparisons with the data identified. The home page for each hub can be accessed directly from the search page. The CTSA Search Solutions online database will allow for a wide breadth of CTSA personnel (core leads, researchers, administrators, communicators, and evaluators) to find consolidated information to learn about specific CTSA hub program highlights, as well as conduct research into program hub outputs and best practices across the nationwide CTSA consortium.

Are pediatric surgery fellowship websites ready for the changing paradigms in the virtual interview era?

Purpose

With the COVID-19 pandemic, in-person fellowship interviews were curtailed, leading candidates to seek information from other resources. Our main purposes were (1) to determine what information recent participants in the match needed to evaluate programs and (2) to assess which of these were available online.

Methods

A focus group of ten recent graduates/applicants identified information that was important in choosing a fellowship program. In August 2020 and December 2021, websites belonging to the American Pediatric Surgical Association (APSA) and individual programs were assessed.

Results

Recent applicants identified 55 pieces of information considered important to their decision making. Of 57 pediatric surgery fellowships, 98% were listed on APSA's website. Program descriptions on APSA's website listed on average 60% of program information desired by applicants. All listed fellowship director, accreditation status, faculty list, and current fellow(s). Other descriptors frequently noted were alumni (95%), graduate's board performance (83%), ECMO exposure (77%), and curriculum (70%). Information desired but less frequently available were fellow case logs (63%), trauma center designation (53%), burn center designation (40%), research opportunities (30%), candidate interview assistance (25%), and supplemental fellowships (12%). There were 7% of program descriptions that were not updated for at least a year.

Conclusions

APSA and individual program websites were complimentary. Websites often lacked data that applicants sought to inform their rank list. To best adapt to the evolving virtual interview paradigm, we suggest reporting key information on a central APSA website with more nuanced information available via links to program specific websites.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44186-023-00104-w.

Investigating Pangenome Graphs Using Wheat Panache

Pangenome graphs quickly become the central data structure representing the diversity of variation we see across related genomes. Pangenome graphs have been published for some species, including plants of agronomic interest. However, visualizing these graphs is not easy as the graphs are large, and variants within these graphs are complex. Tools are needed to visualize graph data structures. Here, we present a workflow to search and visualize a wheat pangenome graph using Wheat Panache. The approach presented assists researchers interested in wheat genomics.

Dentistry website analysis: An overview of the content of formulated questions and answers

Aim

This study aimed to analyze the content of questions and answers posted on dentistry websites.

Subject and methods

A mixed-method study was conducted in 2020. A total of 1354 related questions were included, of which 1182 were answered by dentists. The data was analyzed quantitatively according to the classification of the questions, main complaints of the subjects and length of the questions and answers using Excel₂₀₁₃. A qualitative content analysis was carried out also for data robustness and triangulation.

Results

Of the 1354 questions, 866 of them were categorized into 11 categories according to the main sub-classes of the International Classification of Diseases to Dentistry and Stomatology. Furthermore, the inquiries were allocated to 3 communication styles to present the users' main complaints that included contextual (52.33%), emotional (6.79%) and focal (40.89%) strategies. Results of the qualitative content analysis have led to 6 main themes: seeking the related recommendations of any actions, treatment seeking, information seeking, seeking for causes and reasons, seeking for oral and dental health recommendations and seeking for the dentists' diagnosis or comments.

Conclusions

The present study can be used for designing specific customized websites of dentistry and help the website managers for better optimization of the websites. All these interventions can pave the way for developing teleconsulting in dentistry for middle-income countries.

Analysis of Surgery Residency Website Content: Implications during the COVID-19 Era

BACKGROUND

Surgery residency program websites (SRW) are an important source of information for prospective applicants. The COVID-19 pandemic spurred a pivot from the traditional in-person interview format to interviews via virtual platforms. Because of the inability to meet in person, the information provided on program websites takes on an increased relevance to applicants. We hypothesized that SRW may be missing content important to applicants. Our study aims to assess SRW for the content which impacts the applicant decision-making process.

METHODS

An internal survey distributed to fourth-year medical students in 2020 at a single academic institution identified the website content most important to applicants. A list of ACGME-accredited SRW as of December 1, 2020 was obtained. Using the Fellowship and Residency Electronic and Interactive Database, websites were assessed for content parameters identified by the survey.

RESULTS

Medical students applying to surgical specialties identified fellowship acquisition (94%), faculty information (88%), application contact information (82%), and resident wellness (77%) as the most important website content. Review of SRW websites identified content pertaining to fellowship acquisition and resident wellness in only 60% and 27% of cases respectively. Overall, the SRW of university programs included the most content parameters, followed by hybrid programs, then community programs.

CONCLUSIONS

Many SRW are missing information that applicants deem important in their decision-making process. Most notably, there is a relative deficiency in information pertaining to fellowship match results and resident wellness. University based programs tend to include more of this information on their websites. SRW should continue to adapt to meet the needs of applicants in an increasingly virtual age.

Optimize Your First Impression: A Comparison of the Aesthetic Websites of Private Practices and Academic Institutions

BACKGROUND

An aesthetic surgery offering within academic programs has positive financial and educational implications. To compete with private practices, academic institutions must view their website as integral to patient recruitment.

OBJECTIVE

This study examines the aesthetic surgery websites of academic and private practices to compare objective website characteristics.

METHODS

Integrated plastic surgery programs with an aesthetic surgery website were matched with nearby private practices offering cosmetic surgery. Data was collected from websites, including information about procedures, media, surgeon characteristics, design, reputation, finances, and readability, and compared using Chi-square and T tests.

RESULTS

The websites of 68 academic institutions (AP) and 68 location-matched private practices (PP) were examined. Fourteen (17.07%) programs did not have a website. Private practice websites provided information about a greater number of procedures (mean AP 21.82, PP 27.04, p = 0.013), preparation for surgery (AP 52.94%, PP 83.82%, p < 0.001), and expectations after surgery (AP 70.59%, PP 88.24%, p = 0.01). Board certification was listed more frequently for private practices (AP 87%, PP 98%, p = 0.01). Academic websites were more likely to discuss research (AP 76%, PP 57.35%, p = 0.02). There was no significant difference in the readability of AP and PP websites (mean SMOG AP 7.70, PP 7.19, p = 0.06).

CONCLUSIONS

This work demonstrates a significant content gap between private and academic aesthetic websites and serves as an action item for institutions to enhance their online presence. In a field traditionally associated with high overhead costs, website modifications represent a cost-effective way for academic practices to increase their appeal in the cosmetic surgery market.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Accessibility and Content of Vitreoretinal Surgery Fellowship Program Websites

Fellowship program websites represent an important information source for applicants. Our results demonstrate that vitreoretinal surgery fellowship websites are inconsistent and often incomplete. Incorporating additional recruitment and education criteria may improve website information potential.

Online information about mammography screening in Italy from 2014 to 2021

Background

Many studies have reported that the information women receive about the risk-to-benefit ratio of breast cancer screening is still scarce and biased toward benefit. In a study we conducted in 2014, we analysed online documents about breast cancer screening that were addressed to the general female public. In the present study, we used the same methodology to verify if the information provided to women was improved.

Methods

We evaluated documents addressed to the general female public and posted on the Internet by the Italian national and regional public health services. False-positive and false-negative screening results, biopsy-proven false-positive results, interval cancer, overdiagnosis, radiation exposure, and decrease in risk of mortality were analysed. In addition, quantitative data were searched.

Results

In 2021, the most frequently reported information was reduction in breast cancer mortality (58.2%). The most frequently reported risk was a false-positive mammogram (42.5%). Similar frequency rates were reported for interval cancer, false-negative result, and radiation exposure (35.8%, 31.3%, and 28.3%, respectively). Overdiagnosis and biopsy-proven false-positive result were the less reported risks (20.1% and 10.4%). Thirteen documents provided quantitative data about reduction of mortality risk (16.7%), and only 19 provided quantitative data about risks or harms (8.4%). Almost all organisations sent letters of invitation to women (92.5%) and provided screening free of charge (92.5%). The most recommended was biennial screening for women aged between 50 and 69 years (48.5%). Compared with the information in 2014, that in 2021 showed some improvements. The most marked improvements were in the numbers of reports on overdiagnosis, which increased from 8.0 to 20.1%, and biopsy-proven false-positive result, which increased from 1.4 to 10.4%. Regarding the benefits of breast cancer screening, reduced mortality risk became increasingly reported from 2014 (34.5%) to 2021 (58.2%). Conversely, quantitative data remained scarce in 2021.

Conclusions

Moderate improvements in information were observed from 2014 to 2021. However, the information on breast cancer screening in documents intended for women published on Italian websites remain scarce.

Online reach and engagement of a child nutrition peer-education program (PICNIC): insights from social media and web analytics

BACKGROUND

Parents frequently seek parental advice online and on social media; thus, these channels should be better utilized in child health interventions. The Parents in Child Nutrition Informing Community (PICNIC) program aims to facilitate peer-to-peer sharing of evidence-based child feeding information and support parents within their social networks. The present study aimed to explore web and social media analytics to evaluate reach and user engagement with the PICNIC online components.

METHODS

Online user activity data from the PICNIC Facebook closed group and public Page were collected through Facebook Insights, and program-specific website traffic data through Google Analytics. Analytics data from Nov-2019 to April-2021 was evaluated through visualisation and summary statistics to obtain insights into program growth and current reach in Australia, compare demographics of audience reached through the online channels, and explore parents' use and engagement in PICNIC content.

RESULTS

Results showed steady program growth in the 18 months of recruitment; participant numbers grew from 102 to 261 peer educators while the Facebook Page audience increased threefold, totalling 1615 followers. Intervention posts shared on Facebook (4-5 posts/week) typically reached only a portion of PICNIC Page followers each week, but also reached a wider audience through their friends. Throughout the evaluated period, Facebook users actively engaged in PICNIC posts, although the level of engagement varied considerably from post to post. Furthermore, results from this study suggest the strategy of directing potentially interested parents from social media to the website for program sign-up was successful. Finally, the explored data gave insights into users' availability, demographics and engagement, which will be used to inform refinement of the PICNIC website and social media strategies.

CONCLUSIONS

Our findings confirm the benefits of using a peer education approach and existing social network channels to disseminate evidence-based child feeding information to parents. This study also demonstrates the usefulness of web and social media analytics to be used as part of a continuous evaluation for gaining insight to inform further development and improvement of program strategies.

TRIAL REGISTRATION

The PICNIC project was retrospectively submitted for registration with the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12622000230752 (09/02/2022).

Developing a web-based oncofertility tool for reproductive-age women with breast cancer based on social support framework

PURPOSE

To develop electronic systems for oncofertility support, and to examine the comprehensibility, feasibility, usability, and effects on social support and preparation for decision-making.

METHODS

The study steps were guided, tested, and utilized to (a) identify the requirements of a patient, (b) guide the development of support interventions, and (c) evaluate the quality of web-based oncofertility support. Alpha testing and beta testing were used to ensure the quality of the web-based oncofertility support tool. The effectiveness was evaluated using the Preparation for Decision-Making Scale and Social Support Questionnaire.

RESULTS

At the alpha testing phase, the mean (± standard deviation) values of the comprehensibility and usability for reproductive-age women with breast cancer were 4.24 (± 0.47) and 4.42 (± 0.57); and the mean values of the acceptability and usability for healthcare providers were 4.04 (± 0.67) and 3.99 (± 0.66), respectively. At the beta testing phase, the mean values of the feasibility for patients and healthcare providers were 3.93 (± 0.67) and 4.17 (± 0.78), respectively. The corresponding mean Preparation for Decision-Making Scale scores were 3.78 ± 0.82 and 4.11 ± 0.93, respectively. The results of the Wilcoxon signed-rank test revealed that the informational and instrumental support scores improved significantly compared with the pre-test data (informational support: 8.94 ± 3.28 vs. 10.06 ± 1.91, p < 0.01; instrumental support: 7.44 ± 2.90 vs. 8.75 ± 2.57, p < 0.01).

CONCLUSIONS

The oncofertility support website demonstrated acceptable comprehensibility, feasibility, and usability, in addition to informational and instrumental support.

TRIAL REGISTRATION

Clinicaltrials.gov NCT05100498, https://clinicaltrials.gov/ct2/show/NCT05100498.

Searching for Homologous Genes Using Daisychain

Genome assemblies have become a standard tool of genomics research and are relatively inexpensive to produce due to falling sequencing costs. For many species, there are now several reference-grade genome assemblies. However, comparing different assemblies or the same or related individuals is not an easy task, especially with different levels of quality of assembly and annotation. Tools are needed to visualise related genes with different IDs across genome assemblies. Here, we present a workflow to search and visualise related genes using Daisychain, a web-based tool aimed at researchers who wish to compare genes between assemblies.

Methods to Engage Patients in the Modern Clinic

OBJECTIVE

To identify current patient and provider engagement methods that utilize technology in allergy and immunology clinics, hospitals and at home.

DATA SOURCES

Apple App Store and Google searches for allergy and immunology technology apps, PubMed search of literature involving keywords of: website, technology, EMR, medical devices, disparity in technology, coding for remote patient monitoring and artificial intelligence.

STUDY SELECTIONS

Studies that addressed the keywords were included and narrowed down based upon their applicability in the allergy and immunology clinic.

RESULTS

There has been rapid innovation in the digital healthcare space with expansion of EMR services and the patient portal, creation of allergy and immunology specific medical devices and apps with remote patient monitoring capabilities, and website and artificial intelligence development to interact with patients.

CONCLUSION

These technological advances provide distinct advantages to the provider and patient, but also have a burden of time for evaluation of the data for the provider and disparate access to certain technologies for patients. The development of these technologies has been fast-tracked since the start of the Covid-19 pandemic. With the explosion in telehealth and medical device development, advancement of medical technology is not showing any signs of slowing down. It is paving a new way to interact with patients in the future.

Assessment of a website aimed at providing information on mental health to secondary school students in Can Tho city, Vietnam

BACKGROUND

The stigmatization of mental health problems is a primary barrier for young people to approach mental health services when they suspect they might have such problems. Nevertheless, the internet has become a common platform on which they are likely to seek information on mental health. As such, this study aimed to explore responses from secondary school students in Can Tho city regarding suckhoetre.vn website. This website provided information on health and mental health, and this study assessed the potential relevance, appeal, accessibility, usefulness, and sustainability of the website.

METHODS

A cross-sectional study included 643 secondary school students in Can Tho city selected by cluster sampling. Two weeks after the students were introduced to the website, they were invited to evaluate it using an anonymous questionnaire. The Chi-squared test was used to assess the significance of differences in the distribution of selected students' sociodemographic characteristics.

RESULTS

Most (98.6%) participants visited the website in the two-week period, 74% once or twice a week, the others more often, up to once a day. Their activities included reading information (85.8%), seeking help (17.7%), sharing information (15.5%), giving advice to others (11.0%), and chatting or giving comments (9.8%). Most students rated the website very highly in terms of appeal, relevance, accessibility, and usefulness, and wanted to have access to the website in the future. These findings are positive signals to pursue the possible use of a website on mental health for secondary school students to help raise awareness and support good mental health among adolescents in Can Tho city and beyond.

CONCLUSION

A website designed to provide information to secondary school students appeared to be a promising way to provide access to information on the topic of mental health. The website should be maintained and introduced widely to students, teachers and parents, with regular evaluation of the effectiveness of this website.

Serving Veterans in their Communities: Evaluation of an Online Resource for Behavioral Health Care Providers

Many veterans receive behavioral health care services from providers in their communities. The Community Provider Toolkit (the Toolkit) is a website developed by the National Center for PTSD and the Department of Veterans Affairs intended to provide community mental health care providers with key veteran-focused educational resources. This mixed-methods study examined the potential impact of the Toolkit on provider knowledge and behaviors. Sixty-four clinicians in the community who currently or plan to provide services to veterans were surveyed. The majority of providers found the website useful and easy to navigate. After visiting the site, many providers found additional online and educational resources that they would add to a hypothetical treatment plan. Forty-five providers completed a 1-month follow-up survey focused on use of the Toolkit. Results indicate that the Toolkit may be a valuable tool for increasing provider knowledge about veteran-specific resources.

Creating an Open-Access Educational Radiology Website for Medical Students: A Guide for Radiology Educators

RATIONALE AND OBJECTIVES

Studies of medical school clerkship websites have reported efficient time management, resource utilization, and hands-on activities. We built a website devoted to medical student education in radiology to address student, educator, and school curricular needs and surveyed students to assess their satisfaction with the site.

MATERIALS AND METHODS

The website was created using an easily-recalled name, no-cost institutional software, and no-cost enterprise-level university hardware. The main menu links to the student formal didactic lecture calendar, custom-built health sciences library e-resources in radiology, American College of Radiology Appropriateness Criteria, each radiology course page, and teaching files. Each course tab includes faculty-curated content from course lectures, supplemental articles and educational modules. At 6, 12, and 24 months, website analytics were assessed. At 12 and 24 months postimplementation, data were evaluated to include student assessment and satisfaction surveys and student course comments. This project was IRB-exempted.

RESULTS

At 6 months, the website had received 5792 views, at 12 months 10,022 views and at 24 months 19,478 views. The website homepage with the formal didactic lecture calendar received 7156 views, the general clerkship page 4233 views, the teaching file page 3884, and thereafter subspecialty pages as follows: breast 1478, body 633, pediatrics 361, neuro 346, cardiothoracic 291, musculoskeletal 249, vascular interventional 178. One hundred fifty-two of 240 (63.3%) of students surveyed replied. Of students who utilized the website on the satisfaction survey, 80 of 97 (82.5%) indicated ratings of "extremely informative" and "very informative" to the question "How would you rate the website?." Students indicated convenience and structure as website strengths in their postcourse evaluations.

CONCLUSION

The radiology medical student website incorporates demands and needs of today's students, faculty, and our medical school. A radiology clerkship website for medical students centralizes access to course resources and promotes an active learning experience with high satisfaction. Instructions on setting up a website are offered to today's radiology educators, including pearls and pitfalls.

Chiropractic website claims related to non-musculoskeletal conditions: a cross-sectional study

BACKGROUND

Chiropractors frequently use spinal manipulation therapy as a treatment modality in the management of musculoskeletal (MSK) conditions such as spinal pain and sometimes in the treatment of non-MSK disorders. The latter is not supported by evidence. This study aimed to investigate the extent of non-MSK website claims from French chiropractors to assess if websites were aligned with current recommendations on evidence-based practice.

METHODS

This was a cross-sectional study of a representative sample of French chiropractors. Information on non-MSK conditions was collected from chiropractic professional websites by two independent observers in June 2020. For each non-MSK condition, it was noted whether a clarifying explanation justifying the mentioning of the condition was available. In addition, data on professional association affiliation status, country of education, years since graduation, and special clinical focus (e.g., seniors, children) were collected.

RESULTS

A total of 287 randomly selected websites were included in the study corresponding to 22% of all chiropractors registered in France. One or more of 42 different non-MSK conditions were identified on 231 websites, of which 5 (2.2%) provided a clarifying explanation. 226 (79%) websites mentioned a non-MSK condition without a clarifying explanation. The non-MSK conditions most often mentioned were sleep problems, constipation/digestive problems, unease/discontent in children and menstrual cramps/pains. A larger proportion of the websites advertising treatment for non-MSK disorders was found among those claiming a special clinical focus on infants/children, seniors, pregnant women or athletes compared to those that did not. Also, a larger proportion of chiropractors who were affiliated with a professional association were advertising treatment for non-MSK disorders compared to those who were not affiliated.

CONCLUSIONS

Eight out of ten chiropractic websites mentioned one or more non-MSK diagnoses or symptoms. It is unclear if this reflects inaccurate communication or if treatments for non-MSK conditions are provided by the chiropractors.

Child and Adolescent Psychiatry Fellowship Program Website Content and Accessibility

OBJECTIVE

When child and adolescent psychiatry fellowship applicants are applying to programs, many will use fellowship websites to gather information. This study assesses the accessibility and content available on child and adolescent fellowship websites.

METHODS

Using the Electronic Residency Application Service (ERAS) list of child and adolescent fellowship programs for 2020, 139 child and adolescent fellowship training websites were compiled. Information on websites was evaluated within the following three categories: program overview, application information and recruitment, and educational opportunities. A total of 22 criteria were evaluated within these three categories. Descriptive statistics were used to analyze the websites.

RESULTS

A list provided by ERAS and a Google search identified child and adolescent fellowship program websites. Analysis of content revealed most websites included an overview of the program (97.8%), but fewer included information such as the number of fellowship spots (51.5%), salary (45.5%), application deadline (41.0%), and call responsibility (19.4%).

CONCLUSION

Results suggest there is room for improvement in the comprehensiveness and accessibility of child and adolescent fellowship websites. Especially during a time when much of the programmatic information will be obtained virtually due to COVID-19, it is critical that fellowship websites are uniformly curated so applicants can more easily find information about programs.

Dietary and herbal supplements for weight loss: assessing the quality of patient information online

Background

Given the high prevalence of dietary and herbal supplement (DHS) use in tandem with the growing ease of internet access, patients commonly search online for consumer health information about these products. One common reason for DHSs use includes weight loss. Healthcare providers need to be aware of the quality of online information about DHSs for weight loss so they can adequately counsel their patients and provide them with guidance surrounding the identification of high-quality information resources. This study aimed to assess the quality of online DHSs consumer health information for weight loss that a “typical” patient might access online.

Methods

Six search terms were used to generate the first 20 websites on the Google search engine in four countries: Australia, Canada, the United Kingdom, and the United States (n = 480 websites). After applying exclusion criteria, eligible websites were quality assessed using the DISCERN instrument. This tool is comprised of 16 questions, each evaluated on a 5-point scale. The averages and standard deviations for each DISCERN instrument item, in addition to overall summed scores between 15 and 75 were calculated.

Results

Across 87 eligible websites, the mean summed score was 44.80 (SD = 11.53), while the mean overall DISCERN score of each website was 2.72 (SD = 0.99). In general, websites detailed and achieved their specified aims and described treatment benefits. However, most websites failed to describe the impact of treatment on overall quality of life and the impact of a no treatment option. The highest-scoring websites were largely government or health portal websites, while the lowest-scoring websites were largely commercial in nature.

Conclusion

High variability in DISCERN instrument scores was found across all websites assessed. Healthcare providers should be aware of the fact that their patients may be accessing misinformation online surrounding the use of DHSs for weight loss. Therefore, it is important for healthcare providers to ensure that they are providing their patients with guidance on how to identify high-quality resources online, in order that safe, effective, and evidence-based decisions are made surrounding the use of DHSs for weight loss.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-021-00729-x.

Evaluating the effects of responsive design on the usability of academic websites in the pandemic

Responsive design allows users to benefit from the web page without having to worry about screen size and resolution. The aim of this study is to investigate the effect of responsive design on usability. For this purpose, a questionnaire consisting of a five-point Likert was applied to university students. According to the results, it was seen that 99.2% of university students had smart phones and used smart phones to connect to internet with a rate of 91.3%. It was observed that the participants' attitudes towards responsive design did not differ according to gender, and students in the 24-26 age group had more desire to use responsive design. And, university students' attitudes towards responsive design did not differ according to the Internet access method. It was found that 38% of the participants had a daily internet usage rate of 4-5 h and they used social media the most. Ease of use has been identified as the most preferred feature (Avg = 3.67/5, 73.4%) of usability in responsive design by evaluating dimensions central tendency measures. With regression analysis, responsive design explains 74.7% of the change in effectiveness (R² = 0.747) among the usability dimensions. With regression analysis, 91.5% of usability can be explained with the responsive design (R² = 0.915). Usability and responsive design (r = 0.92, p < 0.01) were both found to be positively correlated. It can be said that the academic university websites developed with responsive design are preferred by university students in the pandemic and this has increased usability and effectiveness.

Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials

BACKGROUND

Web-based delivered interventions have become an innovative option to treat health problems, like obesity. The aim of this systematic review and network meta-analysis was to analyze the effectiveness of web-based behavioral treatments for adults with overweight and obesity. Web-based interventions and comparison interventions (traditional weight control programs) were classified according to the following feedback characteristics: frequency, personalization, and provider (human versus machine).

METHOD

From the initial 1789 studies, 15 were included in this review. A network meta-analysis was conducted to analyze the efficacy of web-based programs with traditional interventions, considering direct and indirect comparisons. The main outcome was the weight loss mean difference (kg) between baseline and post-treatment. Heterogeneity and consistency assumptions were validated to conduct the network meta-analysis.

RESULTS

Network meta-analysis showed comparisons between different treatment options. The main results were that Intensive Contact Web-based programs were more effective than wait-list (Mean Difference - 1.86 kg; 95% Confidence Interval: - 3.61, - 0.12). Moreover, Intensive Contact Web-based programs were more effective than the other web-based options and self-help traditional interventions. However, the only significant comparison was Intensive Contact Web-based programs versus Guided Self-Help Web-based programs (Mean Difference - 4.31 kg; 95% Confidence Interval: - 5,22, - 3,41). Intensive Contact Web-based programs were the most effective treatment option according the obtained results, achieving the first place in the ranking provided by the network meta-analysis with 98.5% of probabilities.

CONCLUSIONS

Intensive Contact Web-based interventions have obtained the first position in the ranking, proving the relevance of frequent, personalized, and professional feedback and their association with a better prognosis for people with overweight and obesity. These results provide relevant information to design more effective treatments for people with overweight and obesity, in a new format especially appropriate for the current situation.

Development and dissemination of a consumer health information website on infant and toddler sleep

Sleep problems are prevalent in early childhood, with the majority of caregivers desiring to change something about their child's sleep. Quality-assured education and resources are needed to be related to infant and toddler sleep. This article describes the development and dissemination of a global consumer health information website (http://www.babysleep.com) by the Pediatric Sleep Council to provide publicly accessible evidence-based information and resources for caregivers and practitioners. The website includes sleep health-related information and resources. Three phases, including the launch, social media strategy, and search engine optimization, for promotion and dissemination of the site was implemented. Analysis of dissemination indicates exponential growth of the site since its launch. With access across the globe, the site has developed from its inception into a widely-used resource, with over 800,000 users from around the world (99% of countries).

Overview of a new eHealth intervention to promote healthy eating and exercise in pregnancy: Initial user responses and acceptability

PURPOSE

The purpose of this project was to develop and evaluate an eHealth intervention to promote healthy lifestyle for pregnant women. The setting was a low socio-economic and multi-ethnic area in Melbourne, Australia.

METHODS

This paper briefly describes the development of the eHealth intervention, which was aimed at a low level of literacy, and the evaluation of the intervention by pregnant women. A basic descriptive survey was undertaken to evaluate user friendliness, usefulness and acceptability of the intervention.

RESULTS

The intervention was developed by a team of experts and forty pregnant women participated in the evaluation. Results indicated that participants found the intervention informative, useful and easy to navigate. They also identified some minor areas for improvement which will be addressed prior to proceeding to a formal controlled evaluation.

CONCLUSION

Results from this evaluation are encouraging and suggest that women found the intervention convenient, trustworthy and engaging. Most enjoyed navigating the website information. As such, it is likely to prove a useful support for delivering dietary and exercise information to pregnant women in the local low socio-economic area. Further formal evaluation will test the efficacy of the website in improving diet and exercise outcomes during pregnancy.

Too Little Information: Accessibility of Information About Language Services on Hospital Websites

Hospital websites are an important resource to patients with limited English proficiency (LEP) seeking information about a facility's language assistance services. We sought to identify the types of such services described on hospital websites in a diverse state and compare them by hospital characteristics. Washington State acute care hospital websites were systematically reviewed in February 2018 for translated content and information about language assistance services. Hospital characteristics included annual admissions and revenue, bed size and the proportion of populations with LEP in the hospital's county. Of 93 hospitals, 10.8% provided translated websites. Interpreter services were mentioned on 81.7% of websites; access required navigation through 1-4 English webpages. Larger bed-size, higher revenue, and more admissions were positively associated with providing language services information (p < 0.01), whereas county-level population with LEP was not (p = 0.17). Many hospital websites are not translated or lack easily accessible information about language assistance services and consequently may not be a useful resource to patients with LEP.

Adolescent Preferences Regarding a Web Site to Empower Adolescents to Talk With Their Healthcare Providers

PURPOSE

Adolescents experience challenges managing their chronic conditions, partly owing to limited involvement in medical visits. Because adolescents are "digital natives," providing a specific Web site with educational resources may support better adolescent-provider communication. Our purpose was to determine adolescents' opinions about a health communication-focused Web site.

METHODS

Sixty English-speaking adolescents aged 11-17 years with a chronic health condition (mean age: 13.3 years; SD 1.9) were enrolled at a pediatric clinic in rural North Carolina.

RESULTS

Adolescents most commonly accessed YouTube and Google for online health information. Nearly all adolescents supported the creation of a Web site and resources on how to communicate with their healthcare provider. Adolescents most often wanted to talk to specialists about their health and to pharmacists about their medications.

CONCLUSIONS

A Web site and educational resources are currently being codeveloped with adolescents. It is essential that we find ways to engage adolescents in their healthcare management.

Indian endocrine surgery websites are they comparable?

Introduction

In modern day surgical practice, patients and their relatives garner more knowledge through websites rather than direct interaction with the consultant physician. We aimed to assess whether Indian endocrine surgery websites matched with their counterparts abroad.

Materials & methods

We identified 60 endocrine surgery websites worldwide and 12 endocrine surgery websites maintained by trained endocrine surgeons from India. The website parameters, demographic data of the websites, rank, and other parameters were assessed using a professional website (www.Alexa.com). An endocrine surgeon along with a technical website advisor rated the content, presentation, and likes from a scale of 1–5 (1 minimum score and 5 maximum score).

Results

A total of 72 individual endocrine surgery websites, out of which 60 were from abroad and 12 were from India, were analyzed. A majority of foreign websites were ranked (43/60), whereas 2/12 Indian websites were ranked (P < 0.0001). Foreign websites had a better landscape profile. Except for pancreatic facts, which were significantly different (P = 0.006) between Indian and foreign websites, there was no significant difference in thyroid facts, parathyroid facts, adrenal facts, photographs, videos, postop advice, contact information, publications, and complications.

Conclusion

Most parameters were comparable in both groups. Postoperative advice and complications were present in only a few websites. A well-designed endocrine surgery website can aid both the patient and the treating physician.

•

Websites can help patients garner knowledge.

•

Well designed and unbiased website can be a good tool.

•

Websites can safe unnecessary discussion with the consultant.

•

Website can help take decisions.

MRI physics and technical issues: Where do Italian radiographers search for information?

INTRODUCTION

Our aim was to investigate the means radiographers and radiographers in training (RTrs) use to seek information on magnetic resonance imaging (MRI) physics and technical issues.

METHODS

An estimated 3000 radiographers and RTrs were reached by e-mail. We proposed an online survey with eight English-language multiple choice questions investigating how often radiographers have doubts about MRI physics or technical issues, where and what kind of information they search for, and on which websites. The statistical χ² test was used.

RESULTS

We obtained 300 answers from European professionals (228 radiographers, 72 RTrs) from 9 European countries, with 288 of 300 (96%) responses coming from Italy. Within the Italian respondents, 41% of RTrs have doubts about MRI physics versus 56% of radiographers (p = 0.028). Basic MRI sequences details are more searched by RTrs (36%) than radiographers (22%) (p = 0.088), as well as clinical protocols (64% versus 44%, p = 0.054). Radiographers and RTrs mostly search on the Internet (74% versus 81%, p = 0.404); "older colleagues" are more frequently asked for information by RTrs (27% versus 61%, p = 0.001), they consult the "MRI manufacturer" less frequently (11% versus 34%, p = 0.001); and 66% of radiographers and 72% of RTrs search "in mother-language and English" (p = 0.590). For clinical protocols RTrs prefer the website mriquestions.com (17% versus 44%, p = 0.001). Websites most used were: mriquestions.com (41%), radiopaedia.org (31%), and mrimaster.com (13%). In addition, 30 respondents mentioned using the Italian site fermononrespiri.com.

CONCLUSION

Italian radiographers and RTrs frequently search for information about MRI physics and technical issues, with slight differences between groups regarding sources and clinical protocols. Protocol setting, and MRI physics and sequences seem to be the main limitations of RTr knowledge. To remedy this gap, more time on training/university lectures and a rethinking of the practical training activities is required.

Features of patient-education websites for patients with chronic kidney disease: an analysis of recommended websites

BACKGROUND

Chronic kidney disease (CKD) requires lifelong self-management. With the rise in access to the Internet, many CKD patients and their caregivers increasingly use the internet for information on CKD self-management. A recent environmental scan by Smekal et al. identified 11 CKD-related websites that covered the greatest number of content areas. This paper aims to evaluate these 11 selected websites in order to identify those that most effectively address content areas relevant to patients with CKD.

METHODS

Each website was assessed for information to 6 content areas: diet, physical activity, financial information, emotional support, general CKD information, and medication adherence. A three-tiered scoring metric was used in which a 0 was given if a content area was completely unaddressed, a (+) was given for a category that was generally addressed, and a (++) was given for a category that was addressed with actionable guidance.

RESULTS

While CKD information and diet were very comprehensively covered with scores of 11 (++) and 8 (++), respectively; physical activity, emotional support and medication adherence received the fewest (++) scores (3 for physical activity and five for both emotional support and medication adherence). For each content area, recommendations are made for websites that are particularly useful. Common themes for these highlighted websites include specific instructions, multiple modalities of information, downloadable and printable resources, and contact references for personal inquiries.

CONCLUSION

The recommended websites can help CKD patients and caregivers utilize the most applicable information for their specific self-management needs. Website improvements related to physical activity, emotional support, and financial information for persons with CKD are warranted.

Do General Surgery Residency Program Websites Feature Diversity?

OBJECTIVE

This study assesses ways in which General Surgery residency program websites demonstrate diversity.

DESIGN

Literature review and diversity expert opinion informed selection of diversity elements. We limited our evaluation to residency program-specific webpages. We identified 8 program website elements that demonstrate programmatic commitment to diversity: (1) standard nondiscrimination statement; (2) program-specific diversity and inclusion message; (3) community demographics; (4) personalized biographies of faculty, (5) personalized biographies of residents; (6) individual photographs of faculty; (7) individual photographs of residents; and (8) list of additional resources available for trainees. We evaluated the impact of program type (university, independent, or military); city population; region; program director gender and ethnicity; and program size on incorporation of these eight elements. We dichotomized programs that had ≥4 of these elements on their website and determined association with the above factors using chi-square or Fisher's exact test.

SETTING

Website review July to December 2019.

PARTICIPANTS

All nonmilitary-based general surgery residency program members of the Association of Program Directors in Surgery (APDS) (n = 242/251).

RESULTS

General Surgery residency program websites included a mean of 2.7 ± 1.5 elements that showcase diversity. Most program websites (n = 215, 89%) featured ≤4 elements (range 1-4), while 15 (6.2%) had none. When stratified by programs having 4 or more elements on their website, university-based program (p < 0.001) was the only factor associated. Resident photos (n = 147, 61%), resources available to trainees (n = 146, 60%), faculty photos (n = 139, 57%), and community demographics (n = 93, 38%) were the most common of the 8 website elements.

CONCLUSIONS

Residency program websites are vital to recruiting applicants. Featuring specific elements on the General Surgery residency website that display a program's commitment to diversity and inclusion may be important in attracting a diverse candidate pool. This research highlights opportunities programs may use to demonstrate more effectively a residency program's commitment to diversity and inclusion.

Critical Evaluation of Interventional Neuroradiology Fellowship Program Websites in North America

OBJECTIVE

To investigate the accessibility and content of interventional neuroradiology (INR) fellowship program websites in North America.

METHODS

We obtained a list of INR/endovascular surgical neuroradiology (ESN) fellowship programs from the Accreditation Council for Graduate Medical Education, the Committee on Advanced Subspecialty Training, the Society of NeuroInterventional Surgery, and the Neurosurgical Fellowship Training Program Directory websites. Individual program websites were evaluated for 27 different fellow recruitment and education criteria. U.S. programs were grouped based on census region and national ranking, and differences between these groups with regard to fellow recruitment and education characteristics were analyzed using nonparametric statistics.

RESULTS

A total of 79 INR/ESN fellowship websites were evaluated for presence of fellow recruitment and education features. Approximately one third of all features pertinent to recruitment (32.11%) and approximately 1 in 5 features regarding education (19.11%) were described in these websites. Program description (69.6%), program coordinator/administrator contact e-mail (59.5%), program director's name (59.5%), program eligibility requirements (51.9%), research opportunities (40.5%), and faculty listing (39.2%) were among the most frequently described features, whereas details about parking (1.3%), interview day itinerary (1.3%), meal allowance (2.5%), retirement and benefits (3.8%), and call schedule (5.1%) were the least frequently described features. There was no significant difference between surveyed features and programs when stratified by U.S. census region, neurosurgery/neurology hospital rankings, or accreditation status.

CONCLUSIONS

INR/ESN fellowship website content is variable across North America and there is room for improvement to develop and enhance comprehensiveness of program website content.