Characterizing COVID-19 Content Posted to TikTok: Public Sentiment and Response During the First Phase of the COVID-19 Pandemic

COVID-19 Vaccines #ForYou: Analyzing COVID-19 Vaccine Videos on TikTok During the Early Phase of the Vaccine Rollout in the U.S

This study examined COVID-19 vaccine videos on TikTok (n = 216 collected in March 2021) during the early days of the vaccine rollout in the U.S., including video source, overall stance toward COVID-19 vaccines, Health Belief Model (HBM)-related content, message features (i.e. humor, video type, message sensation value, on-screen text, and unoriginal sound), and user engagement indices (number of views, shares, comments, and likes). Regarding source, health professionals and general users were two of the main sources, which varied depending on video stance. Pro-vaccine videos occurred the most often from health professionals whereas anti-vaccine videos occurred the most often from general users. Health professionals (vs. general users) generated more views, shares, comments, and likes. Regarding stance, we found more pro- than anti-vaccine videos (57.9% vs. 37.5%). Stance was not related with any user engagement index. Though many videos were pro-vaccine, the content corresponding to HBM-specified factors, which likely facilitate a positive behavioral change, was largely lacking, such as mentions of COVID-19 severity (5.6%), susceptibility (2.8%) and information boosting vaccination self-efficacy (3.7%). Mentions of side effects (34%) emerged as the major vaccination barrier. HBM-related mentions were not related with any user engagement index. COVID-19 vaccine videos used several features, which varied across stance. Pro-vaccine videos featured more musical performance, while anti-vaccine videos used more humor, playacting, sound effects, and unoriginal sound. Several message features (e.g. humor and on-screen text) were positively associated with users' engagement with a video. Practical and theoretical implications of the findings are discussed.

Evaluation of treatment information quality on hypertension and diabetes on WeChat and TikTok: A cross-sectional content analysis

Objective: This study aimed to assess the quality of the information in WeChat and TikTok videos related to hypertension and diabetes treatment. Methods: A sample of 120 Chinese videos was collected based on specific inclusion and exclusion criteria. The quality was evaluated using DISCERN, JAMA and the latest edition of Chinese guidelines for hypertension and diabetes prevention and treatment, and two observers independently scored each video using the three assessment tools. Results: Among all 120 videos, only 10 scored above 38 points in DISCERN, with 45 videos rated as "very poor". None of the video met all JAMA criteria simultaneously, and there were gaps in accuracy and completeness compared to the two guidelines. Furthermore, there was no significant correlation between information quality and the number of likes and comments. Conclusion: The current quality of information on the treatment of hypertension and diabetes on WeChat and TikTok was unsatisfactory. Consequently, the government should strengthen oversight of information quality, and social media platforms should actively review health-related content to prevent inaccurate information dissemination. Individuals should enhance their digital and health literacy.

Evaluation of TikTok videos on acute pancreatitis: content quality and reliability analysis

BACKGROUND

Acute pancreatitis (AP) is a common acute digestive system disorder, with patients often turning to TikTok for AP-related information. However, the platform's video quality on AP has not been thoroughly investigated.

OBJECTIVE

The main purpose of this study is to evaluate the quality of videos about AP on TikTok, and the secondary purpose is to study the related factors of video quality.

METHODS

This study involved retrieving AP-related videos from TikTok, determining, and analyzing them based on predefined inclusion and exclusion criteria. Relevant data were extracted and compiled for evaluation. Video quality was scored using the DISCERN instrument and the Health on the Net (HONcode) score, complemented by introducing the Acute Pancreatitis Content Score (APCS). Pearson correlation analysis was used to assess the correlation between video quality scores and user engagement metrics such as likes, comments, favorites, retweets, and video duration.

RESULTS

A total of 111 TikTok videos were included for analysis, and video publishers were composed of physicians (89.18%), news media organizations (13.51%), individual users (5.41%), and medical institutions (0.9%). The majority of videos focused on AP-related educational content (64.87%), followed by physicians' diagnostic and treatment records (15.32%), and personal experiences (19.81%). The mean scores for DISCERN, HONcode, and APCS were 33.05 ± 7.87, 3.09 ± 0.93, and 1.86 ± 1.30, respectively. The highest video scores were those posted by physicians (35.17 ± 7.02 for DISCERN, 3.31 ± 0.56 for HONcode, and 1.94 ± 1.34 for APCS, respectively). According to the APCS, the main contents focused on etiology (n = 55, 49.5%) and clinical presentations (n = 36, 32.4%), followed by treatment (n = 24, 21.6%), severity (n = 20, 18.0%), prevention (n = 19, 17.1%), pathophysiology (n = 17, 15.3%), definitions (n = 13, 11.7%), examinations (n = 10, 9%), and other related content. There was no correlation between the scores of the three evaluation tools and the number of followers, likes, comments, favorites, and retweets of the video. However, DISCERN (r = 0.309) and APCS (r = 0.407) showed a significant positive correlation with video duration, while HONcode showed no correlation with the duration of the video.

CONCLUSIONS

The general quality of TikTok videos related to AP is poor; however, the content posted by medical professionals shows relatively higher quality, predominantly focusing on clinical presentations and etiologies. There is a discernible correlation between video duration and quality ratings, indicating that a combined approach incorporating the guideline can comprehensively evaluate AP-related content on TikTok.

Evaluating public opinions: informing public health policy adaptations in China amid the COVID-19 pandemic

Public concern regarding safety policies serious consequences is anticipated to persist over an extended duration. A study examining a case of rapid public health policy adaptation in China during the COVID-19 epidemic was conducted by gathering public opinion data from major social media platforms. A systematic approach to comprehend public opinion was developed. Five fundamental elements and four dimensions were delineated. An indicator system was established utilizing the K-means text clustering model. Public prediction, expectation, and their evolution underlying public concern were elucidated employing TF-IDF text mining models. The HMM elucidated the way public opinion influences policy adjustments. The findings underscore that public concern regarding enduring events undergoes temporal shifts, mirroring the evolution of public opinion towards policy. Public opinion aroused by both the original event and derived events collaboratively influence policy adjustments. In China, public opinion serves as a mechanism for policy feedback and oversight; notably, negative public sentiment plays a pivotal role in expediting policy transitions. These findings aid in refining policies to mitigate emergencies through a feedback loop, thereby averting the emergence of safety risks such as social unrest prompted by public opinion.

Willingness to reduce alcohol consumption predicted by short-form video exposure, media involvement, psychological bias, and cognitive factor

Introduction

Through previous studies, Chinese college students are known to be prone to alcohol consumption, which can lead to health-risk behaviors such as high blood pressure, heart disease, stroke, liver disease, and digestive problems. However, little is known about how popular social media platforms (e.g., short-form video applications) can positively impact their willingness to reduce alcohol consumption. This study was guided by the theory of optimistic bias; we investigated the direct, mediated, and moderating effects of exposure to anti-alcohol consumption short-form videos and short-form video involvement on Chinese college students' willingness to reduce their alcohol consumption.

Methods

The current study has an empirical cross-sectional design and employed an online survey from September 1st, 2022, to November 1st, 2022. The survey specifically targeted Chinese college students, who are the most common users of short-form video applications. The accumulated data underwent rigorous examination, including hierarchical regression, mediation, and moderation analyses, all conducted using the PROCESS macro 4.0 within SPSS version 22.

Results

A total of 434 participants, aged 18-24 years, were included in this study. There were mediating effects regarding Chinese college students' exposure to anti-alcohol consumption short-form videos (β = 0.35, p < 0.01, 95% CI [0.17, 0.63]) and short-form video involvement (β = 0.44, p < 0.001, 95% CI [0.20, 0.65]) on their willingness to reduce alcohol consumption via reversed optimistic bias. Moreover, perceived prevention of heavy drinking control (β = 0.05, p < 0.001, 95% CI [0.01, 0.09]) played mediating roles in the relationship between exposure to anti-alcohol consumption short-form videos and willingness to reduce alcohol consumption.

Conclusion

This study is one of the earliest studies to examine the intricate effects of exposure to anti-alcohol consumption short-form videos and short-form video involvement on the willingness to reduce alcohol consumption among Chinese college students. In addition, this study confirms that regardless of whether Chinese college students are conscientious, exposure to anti-alcohol consumption short-form videos did not increase their level of reversed optimistic bias. The empirical findings of this study are critical and can provide practical insights for Chinese health departments that encourage Chinese college students to minimize alcohol consumption.

The role of social media in public health crises caused by infectious disease: a scoping review

IMPORTANCE

The onset of the COVID-19 global pandemic highlighted the increasing role played by social media in the generation, dissemination and consumption of outbreak-related information.

OBJECTIVE

The objective of the current review is to identify and summarise the role of social media in public health crises caused by infectious disease, using a five-step scoping review protocol.

EVIDENCE REVIEW

Keyword lists for two categories were generated: social media and public health crisis. By combining these keywords, an advanced search of various relevant databases was performed to identify all articles of interest from 2000 to 2021, with an initial retrieval date of 13 December 2021. A total of six medical and health science, psychology, social science and communication databases were searched: PubMed, Web of Science, Scopus, Embase, PsycINFO and CNKI. A three-stage screening process against inclusion and exclusion criteria was conducted.

FINDINGS

A total of 338 studies were identified for data extraction, with the earliest study published in 2010. Thematic analysis of the role of social media revealed three broad themes: surveillance monitoring, risk communication and disease control. Within these themes, 12 subthemes were also identified. Within surveillance monitoring, the subthemes were disease detection and prediction, public attitude and attention, public sentiment and mental health. Within risk communication, the subthemes were health advice, information-seeking behaviour, infodemics/misinformation circulation, seeking help online, online distance education and telehealth. Finally, within disease control, the subthemes were government response, public behaviour change and health education information quality. It was clear that the pace of research in this area has gradually increased over time as social media has evolved, with an explosion in attention following the outbreak of COVID-19.

CONCLUSIONS AND RELEVANCE

Social media has become a hugely powerful force in public health and cannot be ignored or viewed as a minor consideration when developing public health policy. Limitations of the study are discussed, along with implications for government, health authorities and individual users. The pressing need for government and health authorities to formalise evidence-based strategies for communicating via social media is highlighted, as well as issues for individual users in assessing the quality and reliability of information consumed on social media platforms.

Infodemic: Challenges and solutions in topic discovery and data process

BACKGROUND

The Coronavirus Disease 2019 (COVID-19) pandemic was a huge shock to society, and the ensuing information problems had a huge impact on society at the same time. The urgent need to understand the Infodemic, i.e., the importance of the spread of false information related to the epidemic, has been highlighted. However, while there is a growing interest in this phenomenon, studies on the topic discovery, data collection, and data preparation phases of the information analysis process have been lacking.

OBJECTIVE

Since the epidemic is unprecedented and has not ended to this day, we aimed to examine the existing Infodemic-related literature from January 2019 to December 2022.

METHODS

We have systematically searched ScienceDirect and IEEE Xplore databases with some search limitations. From the searched literature we selected titles, abstracts and keywords, and limitations sections. We conducted an extensive structured literature search and analysis by filtering the literature and sorting out the available information.

RESULTS

A total of 47 papers ended up meeting the requirements of this review. Researchers in all of these literatures encountered different challenges, most of which were focused on the data collection step, with few challenges encountered in the data preparation phase and almost none in the topic discovery section. The challenges were mainly divided into the points of how to collect data quickly, how to get the required data samples, how to filter the data, what to do if the data set is too small, how to pick the right classifier and how to deal with topic drift and diversity. In addition, researchers have proposed partial solutions to the challenges, and we have also proposed possible solutions.

CONCLUSIONS

This review found that Infodemic is a rapidly growing research area that attracts the interest of researchers from different disciplines. The number of studies in this field has increased significantly in recent years, with researchers from different countries, including the United States, India, and China. Infodemic topic discovery, data collection, and data preparation are not easy, and each step faces different challenges. While there is some research in this emerging field, there are still many challenges that need to be addressed. These findings highlight the need for more articles to address these issues and fill these gaps.

#Coronavirus on TikTok: user engagement with misinformation as a potential threat to public health behavior

Coronavirus disease (COVID)-related misinformation is prevalent online, including on social media. The purpose of this study was to explore factors associated with user engagement with COVID-related misinformation on the social media platform, TikTok. A sample of TikTok videos associated with the hashtag #coronavirus was downloaded on September 20, 2020. Misinformation was evaluated on a scale (low, medium, and high) using a codebook developed by experts in infectious diseases. Multivariable modeling was used to evaluate factors associated with number of views and presence of user comments indicating intention to change behavior. One hundred and sixty-six TikTok videos were identified and reviewed. Moderate misinformation was present in 36 (22%) videos viewed a median of 6.8 million times (interquartile range [IQR] 3.6-16 million), and high-level misinformation was present in 11 (7%) videos viewed a median of 9.4 million times (IQR 5.1-18 million). After controlling for characteristics and content, videos containing moderate misinformation were less likely to generate a user response indicating intended behavior change. By contrast, videos containing high-level misinformation were less likely to be viewed but demonstrated a nonsignificant trend towards higher engagement among viewers. COVID-related misinformation is less frequently viewed on TikTok but more likely to engage viewers. Public health authorities can combat misinformation on social media by posting informative content of their own.

Quantified multidimensional public sentiment characteristics on social media for public opinion management: Evidence from the COVID-19 pandemic

Background

Public sentiments arising from public opinion communication pose a serious psychological risk to public and interfere the communication of nonpharmacological intervention information during the COVID-19 pandemic. Problems caused by public sentiments need to be timely addressed and resolved to support public opinion management.

Objective

This study aims to investigate the quantified multidimensional public sentiments characteristics for helping solve the public sentiments issues and strengthen public opinion management.

Methods

This study collected the user interaction data from the Weibo platform, including 73,604 Weibo posts and 1,811,703 Weibo comments. Deep learning based on pretraining model, topics clustering and correlation analysis were used to conduct quantitative analysis on time series characteristics, content-based characteristics and audience response characteristics of public sentiments in public opinion during the pandemic.

Results

The research findings were as follows: first, public sentiments erupted after priming, and the time series of public sentiments had window periods. Second, public sentiments were related to public discussion topics. The more negative the audience sentiments were, the more deeply the public participated in public discussions. Third, audience sentiments were independent of Weibo posts and user attributes, the steering role of opinion leaders was invalid in changing audience sentiments.

Discussion

Since the COVID-19 pandemic, there has been an increasing demand for public opinion management on social media. Our study on the quantified multidimensional public sentiments characteristics is one of the methodological contributions to reinforce public opinion management from a practical perspective.

Exposure to Healthy Weight Information on Short-Form Video Applications to Acquire Healthy Weight-Control Behaviors: A Serial Mediation Model

This study explored the effects of Chinese college students' (20-34 years old) exposure to healthy weight information on short-form video applications on their intention to acquire healthy weight-control behaviors (reducing high-fat diet intake, accessing physical activity to control body weight, etc.). Specifically, this study investigated the direct and mediated effect on such a relationship via healthy weight awareness, the first-person effect, and perceived herd. The data were collected using a web-based survey and thoroughly tested questionnaire with a sample of 380 Chinese college students. Hierarchical regression, parallel mediation, and serial mediation analysis were applied to test the hypotheses. The results indicated that healthy weight awareness, first-person effect, and perceived herd all played mediator roles that induced the relationship between Chinese college students' exposure to healthy weight information and their intention to acquire healthy weight-control behaviors. In addition, healthy weight awareness and the first-person effect sequentially mediated this relationship.

Palliative Care TikTok: Describing the Landscape and Explaining Social Media Engagement

Background: Although palliative care programs are beneficial to patients and families, most of the public is unfamiliar with and underutilizes palliative services. TikTok, a fast-growing social media platform worldwide, allows users to share short live-recorded videos and could be used to educate the public about palliative care. Objective: This study characterized palliative care TikTok videos and determined characteristics associated with higher user engagement metrics (views, likes, comments, and shares). Methods: The investigators analyzed the content and engagement metrics of palliative care TikTok videos. Each video was coded for author type (health care professional, patient, caregiver, or other) and demographics, features, and themes. Negative binomial regression analyses identified whether author type and themes were associated with engagement statistics. Results: After screening 510 videos, 146 met criteria for analysis. The most prominent author types were health care professionals (55.5%), followed by patients (32.9%) and caregivers (7.5%). Authors were often female (71.2%) and played music (59.5%) while talking (45.9%). Themes were describing personal experiences (47.3%), educating (39.7%), addressing misconceptions (16.4%), responding to questions and comments (14.4%), and raising awareness (11.0%). Caregivers' videos were most likely to be viewed (p = 0.003) and liked (p < 0.001), whereas health care professionals' videos were most frequently shared (p = 0.01). Engagement was highest among videos describing personal experiences (views: p < 0.001, likes: p = 0.002, shares: p = 0.003) and educating (views: p = 0.005, likes: p = 0.002, comments: p = 0.02, shares: p < 0.001). Conclusion: TikTok provides an interactive platform for patients, professionals, and caregivers to share information and experiences about palliative care, making it potentially valuable for explaining palliative care to the public.

Popular science and education of cosmetic surgery in China: Quality and reliability evaluation of Douyin short videos

BACKGROUND

Douyin APP is the short video APP with the largest number of users in China.

OBJECTIVE

This study aimed to evaluate the quality and reliability of short videos about cosmetic surgery on Douyin.

METHODS

In August 2022, we retrieved and screened 300 short videos related to cosmetic surgery from Douyin, extracted basic video information, encoded the content and identified the video source. The quality and reliability of short video information were evaluated using the DISCERN instrument.

RESULTS

A total of 168 short videos of cosmetic surgery were included in the survey, and the video sources included personal accounts and institutional accounts. Overall, the total proportion of institutional accounts (47/168, 27.98%) is significantly less than that of personal accounts (121/168, 72.02%); nonhealth professionals received the most praises, comments and even collections and reposts, while for-profit academic organizations or institutions received the least. The DISCERN scores of 168 short videos of cosmetic surgery were 3.74-4.58 (average 4.22). Content reliability (p = .04) and overall short video quality (p = .02) are significantly different, but short videos published from different sources have no significant difference in treatment selection (p = .052).

CONCLUSION

The overall information quality and reliability of short videos about cosmetic surgery on Douyin are satisfactory in China.

PATIENT OR PUBLIC CONTRIBUTION

The participants were involved in developing research questions, study design, management and conduct, interpretation of evidence and dissemination.

Protocol of a scoping review of systematic reviews and meta-analyses about COVID-19 vaccines and associated adverse events from vaccination

The continuous dissemination of coronavirus disease of 2019 (COVID-19) literature can inform decision-makers and the public. Since the widespread use of COVID-19 vaccines, more systematic reviews have summarized the effectiveness and reported adverse events associated with vaccination. Previous systematic and scoping reviews on COVID-19 summarized various aspects surrounding COVID-19, however, a scoping review is needed to summarize the characteristics of COVID-19 vaccines and associated adverse events reported in systematic reviews and meta-analyses to provide comprehensive evidence for informed medical decision-making. We will conduct a scoping review concerning COVID-19 vaccines and adverse events from vaccines. We will search from December 2019 to present in Epistemonikos, Campbell Library, CINAHL (Ovid), MEDLINE (Ovid), Scopus, CENTRAL (Ovid), Web of Science, WHO COVID-19 database, Joanna Briggs Institute of Excellence, and COVID-19 Evidence Reviews resource. We will include systematic reviews, meta-analyses, or both of randomized controlled trials and observational studies and exclude individual randomized controlled trials and observational studies. Abstracts and full-texts will be screened prior to selection. Investigators will independently use a calibrated quantitative and qualitative data extraction sheet and rate the quality of articles with AMSTAR, resolving disagreements to aim for good agreement (≥80%). An updated scoping review of the characteristics and safety of COVID-19 vaccines would highlight the accuracy of the evidence to inform decision-making concerning COVID-19 vaccination.

Using TikTok for public and youth mental health - A systematic review and content analysis

Globally, TikTok is now the fastest growing social media platform among children and young people; but it remains surprisingly under-researched in psychology and psychiatry. This is despite the fact that social media platforms have been subject to intense academic and societal scrutiny regarding their potentially adverse effects on youth mental health and wellbeing, notwithstanding the inconsistent findings across the literature. In this two part study, we conducted a systematic review concerning studies that have examined TikTok for any public health or mental health purpose; and a follow-up content analysis of TikTok within an Irish context. For study 1, a predetermined search strategy covering representative public and mental health terminology was applied to six databases - PSYCINFO, Google Scholar, PUBMED, Wiley, Journal of Medical Internet Research, ACM - within the period 2016 to 2021. Included studies were limited to English-speaking publications of any design where TikTok was the primary focus of the study. The quality appraisal tool by Dunne et al., (2018) was applied to all included studies. For study 2, we replicated our search strategy from study 1, and converted this terminology to TikTok hashtags to search within TikTok in combination with Irish-specific hashtags. As quantified by the app, the top two "most liked" videos were selected for inclusion across the following three targeted groups: official public health accounts; registered Irish charities; and personal TikTok creators. A full descriptive analysis was applied in both studies. Study 1 found 24 studies that covered a range of public and mental health issues: COVID-19 (n = 10), dermatology (n = 7), eating disorders (n = 1), cancer (n = 1), tics (n = 1), radiology (n = 1), sexual health (n = 1), DNA (n = 1), and public health promotion (n = 1). Studies were predominately from the USA, applied a content analysis design, and were of acceptable quality overall. In study 2, 29 Irish TikTok accounts were analysed, including the accounts of public health authorities (n = 2), charity or non-profit (n = 5), and personal TikTok creators (n = 22). The overall engagement data from these accounts represented a significant outreach to younger populations: total likes n = 2,588,181; total comments n = 13,775; and total shares n = 21,254. TikTok has been utilised for a range of public health purposes, but remains poorly engaged by institutional accounts. The various mechanisms for connecting with younger audiences presents a unique opportunity for youth mental health practitioners to consider, yet there were distinct differences in how TikTok accounts used platform features to interact. Overall, there is an absence of high quality mixed methodological evaluations of TikTok content for public and mental health, despite it being the most used platform for children and young people.

Filipinos' COVID-19 vaccine hesitancy comments in TikTok videos: A manifest content analysis

OBJECTIVES

Vaccine hesitancy is one of the top 10 threats to world health. The ongoing pandemic highlighted this health threat. The COVID-19 vaccine hesitancy remains underreported in the Philippines. Thus, this study aimed to describe and analyze the comments of Filipinos in TikTok videos about COVID-19 vaccine hesitancy.

DESIGN

Manifest content analysis.

SAMPLE

A total of 25 TikTok videos and their comments (n = 4564) were analyzed.

METHODS

We collected data between July 2021 and October 2021. Bengtsson's approach to content analysis was utilized to analyze the data. Data were validated using member-checking and intercoder reliability.

RESULTS

This study afforded three themes of COVID-19 vaccine hesitancy: (a) fear and mistrust (subthemes: influence of Dengvaxia vaccine, the influence of people who refuse to be vaccinated, lack of trust in the government, lack of trust in healthcare workers, doubts on vaccines' effectiveness), (b) misinformation and disinformation (subthemes: misbeliefs, insufficient knowledge), and (c) adamant attitudes (subthemes: unwillingness to be vaccinated, picky on vaccine brand).

CONCLUSION

Our study established Filipinos' diverse reasons for COVID-19 vaccine hesitancy. TikTok, as a social media platform, is used for COVID-19 vaccine discussions and the dissemination of misinformation. To prepare for the next pandemic or public health disaster, the government, HCWs, and the public must efficiently convey timely, accurate health information and dispel misinformation on social media platforms.

Characterizing Responses to COVID-19 Vaccine Promotion on TikTok

PURPOSE

The Alabama Department of Public Health (ADPH) sponsored a TikTok contest to improve vaccination rates among young people. This analysis sought to advance understanding of COVID-19 vaccine perceptions among ADPH contestants and TikTok commenters.

APPROACH

This exploratory content analysis characterized sentiment and imagery in the TikTok videos and comments. Videos were coded by two reviewers and engagement metrics were collected for each video.

SETTING

Publicly available TikTok videos entered into ADPH's contest with the hashtags #getvaccinatedAL and #ADPH between July 16 - August 6, 2021.

PARTICIPANTS

ADPH contestants (n = 44) and TikTok comments (n = 502).

METHOD

A content analysis was conducted; videos were coded by two reviewers and engagement metrics was collected for each video (e.g., reason for vaccination, content, type of vaccination received). Video comments were analyzed using VADER, a lexicon and rule-based sentiment analysis tool).

RESULTS

Of 44 videos tagged with #getvaccinatedAL and #ADPH, 37 were related to the contest. Of the 37 videos, most cited family/friends and civic duty as their reason to get the COVID-19 vaccine. Videos were shared an average of 9 times and viewed 977 times. 70% of videos had comments, ranging from 0-61 (mean 44). Words used most in positively coded comments included, "beautiful," "smiling face emoji with 3 hearts," "masks," and "good.;" whereas words used most in negatively coded comments included "baby," "me," "chips," and "cold."

CONCLUSION

Understanding COVID-19 vaccine sentiment expressed on social media platforms like TikTok can be a powerful tool and resource for public health messaging.

Original Research: TikTok's 'Dancing Nurses' During the COVID-19 Pandemic: A Content Analysis

BACKGROUND

Amid the challenges of the ongoing COVID-19 pandemic, health care workers are using social media to publish increasing numbers of posts, memes, and videos. On TikTok, a rapidly growing and widely used social networking platform, videos labeled "dancing nurses" have recently been trending. Whether nurses or the general public consider such videos to breach professional ethical standards is unknown.

PURPOSE

The aim of this study was to analyze and describe the use of the social media platform TikTok by nurses whose videos featured dancing nurses during the ongoing pandemic.

METHODS

Between March 1 and December 31, 2020, we conducted a search on TikTok using terms such as dancing nurse and hashtags such as "#dancingnurse." For each identified video, the numbers of followers, views, likes, concurrent COVID-19 morbidity and mortality rates, and other data were collected. For videos meeting the inclusion criteria, content analysis was performed to evaluate dancing nurse behaviors and apply the American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements, ANA social networking principles, and National Council of State Boards of Nursing social media guidelines.

RESULTS

A total of 52 videos met all inclusion criteria and were included for analysis. These videos had a mean of 1.51 million views each. Among these videos, there were 356 violations of Code of Ethics provisions, social networking principles, and social media guidelines. Forty of the videos (77%) included a choreographed dance; 24 (46%) contained twerking and three (6%) featured dance moves such as pelvic thrusts and gyrations.

CONCLUSION

The findings offer insight into how nurses are using TikTok, specifically with regard to posting videos that feature dancing nurses. Some of the analyzed videos included content that could be construed, in our view, as inappropriate and even sexually suggestive. The concern is that such videos could damage the professional image of nurses and downplay the seriousness of the current pandemic. It's essential that nurses who use social media consider the content and presentation of what they post. There is an urgent need for nurses to understand professional and workplace guidelines and policies regarding the use of social media, and how these may apply to content developed and posted on platforms such as TikTok.

How public health agencies communicate with the public on TikTok under the normalization of COVID-19: A case of 2022 Shanghai's outbreak

Objective

As life with COVID-19 became a norm in 2022, the public's demand for and perception of COVID-19-related information has changed. This study analyzed the performance and responses of Healthy China and the public at various stages of COVID-19 normalization using the crisis and emergency risk communication (CERC) theory.

Methods

This study was based on the 2022 Shanghai COVID-19 outbreak and data from "Healthy China," the official TikTok account of the National Health Commission of the People's Republic of China (NHCC). First, we divided the Shanghai lockdown into five stages in accordance with the CERC. Second, the videos released by Healthy China were open-coded. Third, to understand the distribution of strategies across the stages, we used counts and percentages to summarize the categorical variables. Fourth, we investigated the distribution of public participation indicators using descriptive statistical analysis. Finally, the relationship between stage and communication strategy was examined using the chi-square test and negative binomial regression.

Results

(1) Healthy China adopted a more flexible approach to communication strategies; (2) new cases per day was the commonly used substrategy for uncertainty reduction; (3) there was a significant difference in the strategies used by Healthy China at different stages; (4) public participation was highest in the pre-crisis period; and (5) the stage had a significant positive impact on the number of views, favorites, likes, and shares.

Conclusions

This research provides insight into effective communication strategies for the government or public health agencies to employ during COVID-19 normalization.

Resilience resources and coping strategies of COVID-19 female long haulers: A qualitative study

Background

Female long haulers deal with persistent post-acute COVID-19 symptoms that have serious health implications. This study aimed to identify resilience resources at multiple socio-ecological levels for female long haulers and describe how resilience resources affect their responses to long COVID.

Methods

Purposive sampling was adopted to recruit participants through social media from April to June 2021 followed by 15 semi-structured interviews. An inductive analytical approach was adopted to categorize themes by open and axial coding that were verified by peer review.

Results

Female long haulers relied on resources at various socio-ecological levels to foster their resilience in response to long COVID. At the individual level, they utilized cognitive and emotional resources to increase knowledge, learn new skills, set goals, and manage emotions; behavioral resources (e.g., internal motivation and executive functioning) to perform physical, creative, and recreational activities, and adopt healthier eating habits; and spiritual resources to perform spiritual rituals and connect with God. At the social level, the support from existing relationships and/or online social support groups enhanced their social identity and provided material and informational resources. At the health systems level, the guidance from counselors and physicians and availability of clinics, medicines, and health equipment assisted them in symptom management and medication adherence.

Conclusion

The resilience of female long haulers can be enhanced through (1) offering financial and health-related resources, (2) developing online social-support groups, (3) counseling and care service training for healthcare professionals, and (4) implementing more psychosocial interventions by labor organizations.

Investigating COVID-19 Vaccine Communication and Misinformation on TikTok: Cross-sectional Study

Background

The COVID-19 pandemic has highlighted the need for reliable information, especially around vaccines. Vaccine hesitancy is a growing concern and a great threat to broader public health. The prevalence of social media within our daily lives emphasizes the importance of accurately analyzing how health information is being disseminated to the public. TikTok is of particular interest, as it is an emerging social media platform that young adults may be increasingly using to access health information.

Objective

The objective of this study was to examine and describe the content within the top 100 TikToks trending with the hashtag #covidvaccine.

Methods

The top 250 most viewed TikToks with the hashtag #covidvaccine were batch downloaded on July 1, 2021, with their respective metadata. Each TikTok was subsequently viewed and encoded by 2 independent reviewers. Coding continued until 100 TikToks could be included based on language and content. Descriptive features were recorded including health care professional (HCP) status of creator, verification of HCP status, genre, and misinformation addressed. Primary inclusion criteria were any TikToks in English with discussion of a COVID-19 vaccine.

Results

Of 102 videos included, the median number of plays was 1,700,000, with median shares of 9224 and 62,200 followers. Upon analysis, 14.7% (15/102) of TikToks included HCPs, of which 80% (12/102) could be verified via social media or regulatory body search; 100% (15/15) of HCP-created TikToks supported vaccine use, and overall, 81.3% (83/102) of all TikToks (created by either a layperson or an HCP) supported vaccine use.

Conclusions

As the pandemic continues, vaccine hesitancy poses a threat to lifting restrictions, and discovering reasons for this hesitancy is important to public health measures. This study summarizes the discourse around vaccine use on TikTok. Importantly, it opens a frank discussion about the necessity to incorporate new social media platforms into medical education, so we might ensure our trainees are ready to engage with patients on novel platforms.

Public Confidence for Undergoing Elective Plastic Surgery Procedures during the COVID-19 Pandemic

Background:

The COVID-19 vaccine rollout has since been followed by a gradual resumption of elective surgery. Many individuals remain cautious about visiting a hospital or clinic to undergo surgery. As plastic surgeons are starting to resume elective surgery at this time, it is important to understand the perspectives of potential patients and the concerns they may have.

Methods:

A survey was distributed to participants in the United States through Amazon’s Mechanical Turk (mTurk) during March of 2021. Participants were surveyed regarding their views on the severity of COVID-19, vaccination status, and how much COVID-19 has affected their interest in undergoing surgery.

Results:

Thirty-nine percent of respondents were either no longer willing or less willing to undergo elective plastic surgery. Seventy-three percent of respondents felt comfortable going to an office for a consultation. With regards to feeling comfortable visiting a hospital, 43.4% reported they would feel safe, 36% felt they would feel safe only if they could be discharged on the same day, and 30.6% reported not feeling safe. Fifty-two percent of respondents reported feeling comfortable undergoing surgery now or within the next year. Respondents who do not think COVID-19 is still a major health issue were more likely to still want plastic surgery.

Conclusion:

The results of this study highlight that the majority of patients, regardless of vaccination status, currently feel comfortable undergoing elective plastic surgery, particularly in an office setting. Plastic surgeons may expect to see a return in demand for elective procedures in the coming months.

Adaptation and Dissemination of a National Cancer Institute HPV Vaccine Evidence-Based Cancer Control Program to the Social Media Messaging Environment

Social media offers a unique opportunity to widely disseminate HPV vaccine messaging to reach youth and parents, given the information channel has become mainstream with 330 million monthly users in the United States and 4.2 billion users worldwide. Yet, a gap remains on how to adapt evidence-based vaccine interventions for the in vivo competitive social media messaging environment and what strategies to employ to make vaccine messages go viral. Push-pull and RE-AIM dissemination frameworks guided our adaptation of a National Cancer Institute video-based HPV vaccine cancer control program, the HPV Vaccine Decision Narratives, for the social media environment. We also aimed to understand how dissemination might differ across three platforms, namely Instagram, TikTok, and Twitter, to increase reach and engagement. Centering theory and a question-answer framework guided the adaptation process of segmenting vaccine decision story videos into shorter coherent segments for social media. Twelve strategies were implemented over 4 months to build a following and disseminate the intervention. The evaluation showed that all platforms increased following, but Instagram and TikTok outperformed Twitter on impressions, followers, engagement, and reach metrics. Although TikTok increased reach the most (unique accounts that viewed content), Instagram increased followers, engagement, and impressions the most. For Instagram, the top performer, six of 12 strategies contributed to increasing reach, including the use of videos, more than 11 hashtags, COVID-19 hashtags, mentions, and follow-for-follow strategies. This observational social media study identified dissemination strategies that significantly increased the reach of vaccine messages in a real-world competitive social media messaging environment. Engagement presented greater challenges. Results inform the planning and adaptation considerations necessary for transforming public health HPV vaccine interventions for social media environments, with unique considerations depending on the platform.

Exploring content of misinformation about HPV vaccine on twitter

Although social media can be a source of guidance about HPV vaccination for parents, the information may not always be complete or accurate. We conducted a retrospective content analysis to identify content and frequencies of occurrence of disinformation and misinformation about HPV vaccine posted on Twitter between December 15, 2019, through March 31, 2020, among 3876 unique, English language #HPV Tweets, excluding retweets. We found that 24% of Tweets contained disinformation or misinformation, and the remaining 76% contained support/education. The most prevalent categories of disinformation/misinformation were (1) adverse health effects (59%), (2) mandatory vaccination (19%), and (3) inefficacy of the vaccine (14%). Among the adverse health effects Tweets, non-specific harm/injury (51%) and death (23%) were most frequent. Disinformation/misinformation Tweets vs. supportive Tweets had 5.44 (95% CI 5.33–5.56) times the incidence rate of retweet. In conclusion, almost one-quarter of #HPV Tweets contained disinformation or misinformation about the HPV vaccine and these tweets received higher audience engagement including likes and retweets. Implications for vaccine hesitancy are discussed.

Supporting Vaccination on TikTok During the COVID-19 Pandemic: Vaccine Beliefs, Emotions, and Comments

TikTok has been one of the most important social media platforms where pandemic-related information converged and has been disseminated. However, how vaccination-related visual content, particularly pro-vaccine videos, influences audiences remains unclear. Using Betsch et al.’s 5C model and Ekman’s basic emotion model, we identified 200 trending videos under the hashtag #vaccine on TikTok, and examined the types of vaccine-related beliefs and emotions expressed in videos and the relationship between beliefs, emotions, and supportive comments. Confidence and joy were the most frequently expressed belief and emotion, respectively; confidence (B = 14.84, P &lt; 0.05), surprise (B = 11.29, P &lt; 0.05), and sadness (B = 37.49, P &lt; 0.01) predicted the number of supportive comments. This study expands the 5C framework of vaccine hesitancy into the analysis of pro-vaccine content on social media and offers detailed insights into the specific type of beliefs and emotions and their effects. Practical implications regarding how to address vaccine hesitancy are discussed.

Appeal of word of mouth: Influences of public opinions and sentiment on ports in corporate choice of import and export trade in the post-COVID-19 era

With the advent of the post-COVID-19 era, corporate managers of import and export trade are now more sensitive in their daily work, and their decisions are more likely to be influenced by the emotional bias of public opinions, especially regarding cooperation with trade ports of frequent circulation. Therefore, how to manage public opinion and sentiment in the post-COVID-19 era will be a new opportunity and challenge for the marketing management of ports. For the above considerations, through the same frequency verification between public opinions and sentiment on ports and corporate choice of import and export trade, and through analysis of the influence mechanism, the present study demonstrates the positive effects of public opinions and sentiment on ports in corporate choice of import and export trade in the post-COVID-19 era, verifies the significance of shaping word of mouth in port management, puts forward the great role of public opinions and sentiment in the cognitive and emotional empathy in the choice of import and export trade, and provides theoretical guidance for port managers' strategic choices in the post-COVID-19 era.

Just a Joke? Adolescents' Preferences for Humor in Media Entertainment and Real-Life Aggression

Humorous media entertainment frequently punctuates the everyday lives of adolescents. Theorists have suggested that this exposure may impact behavior, particularly real-life aggression. Specifically, exposure to prosocial (coping) humor in media entertainment is posited to decrease aggression, whereas the reverse has been argued for exposure to antisocial (disparaging and slapstick) humor. Despite these suppositions, little empirical evidence about this relationship exists. To fill this gap, this study employed a cohort-sequential design using latent growth curve models to estimate the (co-)development of adolescents' preferences for television shows featuring disparaging, slapstick, and coping humor and aggression from age 10 to 17. Results showed that at the onset of adolescence, especially boys had a higher preference for shows with disparaging and slapstick humor than with coping humor. However, over the course of adolescence, boys' and girls' preferences for shows with coping humor increased, while especially girls' preferences for shows with disparaging and slapstick humor decreased. These preferences were unrelated to adolescents' aggression. Our findings provide an important addition to the ongoing media effects debate. Taken together, they offer room for optimism and point toward an increased focus on the potential positive rather than the negative sides of humor in the lives of young people.

Youth, Social Media, and Telehealth: How COVID-19 Changed Our Interactions

Adolescents and young adults (AYA) use social media more than any other generation, including to learn about their health. The coronavirus disease 2019 pandemic further accelerated both health harming and health benefits of technology use. Also, during this time, medical professionals moved more quickly to virtual visits, changing AYA, family, and provider interactions and expectations. Remote health care, broader technology use, and improved youth engagement have the potential to address long-standing barriers to health equity. Telehealth disadvantages still exist, however, especially for those with decreased access. Recent rapid changes have not allowed for sufficient study to address optimizing the experience, effectiveness, and utilization of remote health care. Fortunately, because of their expansive engagement with social media and technology, AYA are paving the way toward a digital health future. Health professionals are encouraged to improve their virtual and social media interactions with AYA patients, while finding ways to improve health equity. [Pediatr Ann. 2022;51(4):e161-e166.].

TikTok as an Information Hodgepodge: Evaluation of the Quality and Reliability of Genitourinary Cancers Related Content

Background

TikTok is the world’s fastest-growing video application, with 1.6 billion users in 2021. More and more patients are searching for information on genitourinary cancers via TikTok. We aim to evaluate the functional quality and reliability of genitourinary cancer-related videos on it and share our thoughts based on the results for better public health promotion.

Materials and Methods

We retrieved 167 videos on bladder, prostate, and kidney cancer from TikTok. Only 61 videos (36.53%) met the inclusion criteria and were eventually regarded as sample videos. Each video’s length and descriptions, hashtags, number of views/likes/comments, forms of expression, and the uploader’s profile were included. Three validated assessment instruments: the Hexagonal Radar Schema, the Health on the Net Code scale, and the DISCERN instrument, were used for evaluating the quality and reliability of the information. All misinformation was counted and categorized. Univariate analysis of variance was performed for analyzing the results. The Post-Hoc least significant difference test was conducted to explore further explanation.

Results

Amongst 61 sample videos, healthcare practitioners contributed the most content (n = 29, 47.54%). However, 22 posts (36.07%) were misinformative, and the most common type was using outdated data. More than half of the videos could provide good (> 1 point) content on the diseases’ symptoms and examinations. However, the definition and outcomes were less addressed (tied at 21%). The HONcode scale and the DISCERN instrument revealed a consistent conclusion that most videos (n = 59, 96.72%) on TikTok were of poor to mediocre quality. Videos published by media agencies were statistically better in terms of reliability and overall score (P = 0.003 and 0.008, respectively). Fifty-three videos (86.89%) had at least two unexplained medical terms. Healthcare professionals tend to use professional terms most (mean = 5.28 words).

Conclusions

Most videos on genitourinary cancers on TikTok are of poor to medium quality and reliability. However, videos posted by media agencies enjoyed great public attention and interaction. Medical practitioners could improve the video quality by cooperating with media agencies and avoiding unexplained terminologies.

Evaluation of quality and reliability of videos about orthodontics on TikTok (DouYin)

Objectives:

TikTok is the world’s most popular short video application, where orthodontics-related content is viewed billions of times. This study aimed to evaluate the quality and reliability of video content about orthodontics on TikTok.

Material and Methods:

TikTok mobile application was searched for videos with the hashtag “#orthodontics” on July 9, 2021. The content and quality of the first 150 videos were evaluated using the global quality score (GQS) and reliability score (modified DISCERN tool) which is an evaluation tool for health information on social media.

Results:

The mean of the two researchers’ GQS values and reliability score was 2.1 ± 1.1 and 1.2 ± 1.4, respectively. There was no statistically significant difference between the median values of GQS and reliability score according to categorical descriptive variables (P > 0.050). A statistically significant weak positive correlation was found between like no. and reliability scores (r = 0.245; P = 0.037). Most of the videos were uploaded by orthodontists (72.6%).

Conclusion:

Both the quality and reliability of the content about orthodontics on TikTok were very low. Even the most of the accounts were professionals, they did not prefer to give scientific information due to the medium’s own dynamics and target population’s likes.

The effect of short music videos on needs satisfaction and separation anxiety of children's family members during COVID-19: The example of TikTok

OBJECTIVE

To investigate the effect of short music videos on needs satisfaction and separation anxiety of the family members of children with congenital heart disease (CHD) in the cardiac intensive care unit (CICU) during the COVID-19 pandemic.

METHODS

Eighty-seven children's family members were divided into the study group and the control group between February 2020 and March 2021. During the COVID-19 pandemic, the participants in the control group were visited by telephone, while the participants in the study group used the TikTok short music video application and WeChat as communication tools. After the intervention, the critical care family needs inventory (CCFNI) and separation anxiety scale (SAS) for all participants were recorded and analyzed.

RESULTS

There were no statistically significant differences in general characteristics or preintervention data between the two groups. However, the two dimensions of the support scale and information scale of the CCFNI in the study group were significantly different from those in the control group after the intervention (P = 0.008, and P = 0.021, respectively). There were significant differences in the three dimensions of the SAS between the two groups (P = 0.004, P = 0.007, and P = 0.041, respectively).

CONCLUSION

The visiting system of the ICU changed during the COVID-19 pandemic, and the use of the TikTok short music video application and WeChat was conducive to optimizing the CICU ward visiting process, reducing the separation anxiety of the family members of children in the CICU, and improving their needs satisfaction.

A Framework of AI-Based Approaches to Improving eHealth Literacy and Combating Infodemic

The global COVID-19 pandemic has put everyone in an urgent need of accessing and comprehending health information online. Meanwhile, there has been vast amount of information/misinformation/disinformation generated over the Internet, particularly social media platforms, resulting in an infodemic. This public health crisis of COVID-19 pandemic has put each individual and the entire society in a test: what is the level of eHealth literacy is needed to seek accurate health information from online resources and to combat infodemic during a pandemic? This article aims to summarize the significances and challenges of improving eHealth literacy in both communicable (e.g., COVID-19) and non-communicable diseases [e.g., cancer, Alzheimer's disease, and cardiovascular diseases (CVDs)]. Also, this article will make our recommendations of a general framework of AI-based approaches to improving eHealth literacy and combating infodemic, including AI-augmented lifelong learning, AI-assisted translation, simplification, and summarization, and AI-based content filtering. This general framework of AI-based approaches to improving eHealth literacy and combating infodemic has the general advantage of matching the right online health information to the right people.