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Zhang Y, Fu J, Lai J, Deng S, Guo Z, Zhong C, Tang J, Cao W, Wu Y. Reporting of Ethical Considerations in Qualitative Research Utilizing Social Media Data on Public Health Care: Scoping Review. J Med Internet Res 2024; 26:e51496. [PMID: 38758590 PMCID: PMC11143395 DOI: 10.2196/51496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/29/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The internet community has become a significant source for researchers to conduct qualitative studies analyzing users' views, attitudes, and experiences about public health. However, few studies have assessed the ethical issues in qualitative research using social media data. OBJECTIVE This study aims to review the reportage of ethical considerations in qualitative research utilizing social media data on public health care. METHODS We performed a scoping review of studies mining text from internet communities and published in peer-reviewed journals from 2010 to May 31, 2023. These studies, limited to the English language, were retrieved to evaluate the rates of reporting ethical approval, informed consent, and privacy issues. We searched 5 databases, that is, PubMed, Web of Science, CINAHL, Cochrane, and Embase. Gray literature was supplemented from Google Scholar and OpenGrey websites. Studies using qualitative methods mining text from the internet community focusing on health care topics were deemed eligible. Data extraction was performed using a standardized data extraction spreadsheet. Findings were reported using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. RESULTS After 4674 titles, abstracts, and full texts were screened, 108 studies on mining text from the internet community were included. Nearly half of the studies were published in the United States, with more studies from 2019 to 2022. Only 59.3% (64/108) of the studies sought ethical approval, 45.3% (49/108) mentioned informed consent, and only 12.9% (14/108) of the studies explicitly obtained informed consent. Approximately 86% (12/14) of the studies that reported informed consent obtained digital informed consent from participants/administrators, while 14% (2/14) did not describe the method used to obtain informed consent. Notably, 70.3% (76/108) of the studies contained users' written content or posts: 68% (52/76) contained verbatim quotes, while 32% (24/76) paraphrased the quotes to prevent traceability. However, 16% (4/24) of the studies that paraphrased the quotes did not report the paraphrasing methods. Moreover, 18.5% (20/108) of the studies used aggregated data analysis to protect users' privacy. Furthermore, the rates of reporting ethical approval were different between different countries (P=.02) and between papers that contained users' written content (both direct and paraphrased quotes) and papers that did not contain users' written content (P<.001). CONCLUSIONS Our scoping review demonstrates that the reporting of ethical considerations is widely neglected in qualitative research studies using social media data; such studies should be more cautious in citing user quotes to maintain user privacy. Further, our review reveals the need for detailed information on the precautions of obtaining informed consent and paraphrasing to reduce the potential bias. A national consensus of ethical considerations such as ethical approval, informed consent, and privacy issues is needed for qualitative research of health care using social media data of internet communities.
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Affiliation(s)
- Yujie Zhang
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Jiaqi Fu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Jie Lai
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Shisi Deng
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Zihan Guo
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Chuhan Zhong
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Jianyao Tang
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Wenqiong Cao
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanni Wu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
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Hermans C, Johnsen JM, Curry N. Women and girls with inherited bleeding disorders: Focus on haemophilia carriers and heavy menstrual bleeding. Haemophilia 2024; 30 Suppl 3:45-51. [PMID: 38532560 DOI: 10.1111/hae.14983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/15/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024]
Abstract
Raising awareness and improving recognition, accurate classification, and enhanced access to new treatments represent current key challenges for carriers of haemophilia. Women and girls carrying genes for haemophilia often experience significant bleeding and/or low factor levels. The bleeding associated with female haemophilia is frequently overlooked, has a weak correlation with factor levels, and manifests differently than in males, with heavy menstrual bleeding being a predominant symptom. Recent changes in terminology now allow the diagnosis of haemophilia in females with low factor levels and differentiate between symptomatic and asymptomatic carriers of the gene. Observations from real-world experiences and limited clinical trial data have highlighted the positive impact of various new haemophilia treatments for women and girls with clotting factor deficiencies. There is an urgent need for initiatives that increase their access to these treatments and encourage well-designed clinical trials focusing on female-specific outcomes. In women with inherited bleeding disorders, early recognition and optimal management of heavy menstrual bleeding are crucial. However, treatment options and guidance from high-quality clinical trials are currently insufficient. Menstrual health assessment should be a regular part of monitoring women and girls with inherited bleeding disorders throughout their lives, emphasizing the importance of gathering data to improve future management.
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Affiliation(s)
- Cedric Hermans
- Division of Hematology, Hemostasis and Thrombosis Unit, Saint-Luc University Hospital, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Jill M Johnsen
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Institute for Stem Cell & Regenerative Medicine, University of Washington, Seattle, Washington, USA
- Center for Cardiovascular Biology, University of Washington, Seattle, Washington, USA
| | - Nicola Curry
- Radcliffe Department of Medicine, Oxford University Hospitals NHS Foundation Trust, Nuffield Orthopedic Centre, Oxford University, Oxford, UK
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Casola AR, Pando O, Medley L, Kunes B, McGlone N, Rea O. Examining menstrual health experiences in Philadelphia, PA: A qualitative investigation. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241251975. [PMID: 38738597 DOI: 10.1177/17455057241251975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
BACKGROUND While menstruation is a physiologic process, it remains highly stigmatized. Despite the sheer number of menstruators, menstruation is a highly individualized experience, with wide variation in duration, symptoms, and management. This wide variability lends itself to large disparities in access to menstruation management products and subsequently the lived experience of menstruators. OBJECTIVES The research team sought to understand lived menstrual experiences, symptoms, management tactics, and commonly used and desired resources among 20 cisgendered women aged 18-45 years in Philadelphia. DESIGN This project was a qualitative research study. METHODS We used a collaborative, community-based participatory research approach with No More Secrets, a Philadelphia-based grassroots sexuality awareness and menstrual health hub. Semi-structured telephone interviews were used to gain insight into general menstruation-related experiences, communication, worries, and concerns, with subsequent thematic analysis via Key Words in Context approach. RESULTS Four themes emerged following analysis: cycle characteristics, menstruation management, coping resources, and future resources. Participants largely spoke about their menses as a negative experience, asked for more comprehensive, verified sources of information and needed greater access to menstrual management supplies. CONCLUSION Menstruation is a highly individualized experience with a large variety in knowledge, menstrual product use, and individual needs. Despite the individuality of menstruation, our community-based research shows that there is a dire need for interventions that promotes knowledge and access to menstrual care.
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Affiliation(s)
- Allison R Casola
- Department of Family & Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Oriana Pando
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Lynette Medley
- No More Secrets Mind Body Spirit Inc., Philadelphia, PA, USA
| | - Brianna Kunes
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nya McGlone
- No More Secrets Mind Body Spirit Inc., Philadelphia, PA, USA
| | - Olivia Rea
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Taim BC, Lye J, Suppiah HT, Chan TW, Chia M, Clarke A. Menstrual cycle characteristics, perceived impact on performance, and barriers to communication: Perspectives of high-performance adolescent athletes in Singapore. Scand J Med Sci Sports 2024; 34:e14488. [PMID: 37682006 DOI: 10.1111/sms.14488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/09/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Abstract
The purpose of this study was to examine the menstrual cycle (MC) characteristics, explore the impact on performance, and identify barriers to and facilitators of MC-related communication among high-performance female adolescent athletes in Singapore. Ninety athletes (15.4 ± 1.8 years) from multiple sports completed an online questionnaire. Eighty-four athletes were postmenarcheal (menarcheal age 11.9 ± 1.3 years), including two who were using an oral contraceptive pill (OCP). Secondary amenorrhea, current or history of, was self-reported in 16% of athletes. Sixty-two percent and 67% of non-OCP athletes perceived that the MC affected their ability to train and compete, respectively. Athletes preferred speaking to a parent (85%) and a female figure (67%) about MC-related concerns. Through thematic analysis, three barriers to communication were constructed: (1) pervasive menstrual stigma, (2) constraints of the training environment, and (3) the low value placed on MC-related conversations. Two facilitators of communication were constructed: (1) respect athletes' individual experiences as menstruating girls and (2) foster a safe space for MC-related conversations. Findings demonstrated that menstrual irregularities are common in adolescent athletes and screening for MC disorders, particularly primary amenorrhea should be undertaken in this population, with clear support pathways for management including symptom mitigation. To support athletes in raising MC-related concerns when needed, structured communication pathways that consider individual preferences and involve a (female) point of contact should be established within the training environment. Improving menstrual health literacy among adolescent athletes before any misinformation or negative perceptions are firmly established may contribute to longevity in their athletic careers.
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Affiliation(s)
- Bernadette Cherianne Taim
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, Athlone, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, Athlone, Ireland
- National Youth Sports Institute, Singapore
| | - Jamie Lye
- National Youth Sports Institute, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Haresh T Suppiah
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | | | - Michael Chia
- Physical Education and Sports Science Group, National Institute of Education, Nanyang Technological University, Singapore
| | - Anthea Clarke
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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Ramaiyer M, Lulseged B, Michel R, Ali F, Liang J, Borahay MA. Menstruation in the USA. CURR EPIDEMIOL REP 2023; 10:186-195. [PMID: 38275000 PMCID: PMC10810236 DOI: 10.1007/s40471-023-00333-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 01/27/2024]
Abstract
Purpose of review Menstruation touches all spheres of human society, including psychology, education, business, policy, race, and religion. This narrative review aims to describe the relationship menstruation holds with these spaces. Recent findings First, menstruation plays many roles in psychology - premenstrual syndrome affects psychological wellbeing and in turn, psychological stress impacts menstruation. Functional hypothalamic amenorrhea can result when stress hormones inhibit the Hypothalamus-Pituitary-Ovarian axis. Furthermore, menstruation has many implications for all aged individuals, especially adolescents and those who are menopausal. These implications underscore the importance of proper education surrounding menstruation, which can be achieved via social media, school systems, family, and clinicians. However, menstrual health education is highly variable depending on the state and family that someone is raised in. Additionally, menstruation can pose a financial burden as menstrual products can be expensive and access to these products is limited for those who are homeless, incarcerated, and low-income. Recent public policy measures in various states have aimed to achieve "menstrual equity," by requiring public schools to supply free menstrual products in bathrooms. Furthermore, racial disparities exist with menstrual disorders. Uterine fibroids occur more frequently in Black menstruators compared to White menstruators, and Black women experience worse outcomes overall with fibroids and endometriosis management. Finally, analysis of religion and its relationship to menstruation underscores the immense stigma and "impurity" associated with menstruation. Summary Overall, this review highlights the universality of menstruation in society. As a "fifth vital sign", there is significant room for improvement in terms of education, research, and cultural acceptance of menstruation. Future research should explore interventions to reduce these gaps.
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Affiliation(s)
| | | | | | - Fiza Ali
- Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, MD
| | - Jinxiao Liang
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore MD
| | - Mostafa A. Borahay
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD
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Davies S, Darien K, Bazyar F, Biddle J, Brown B, Christman C, Saurman M, Wood S, Thomas D, Dowshen N. A Multimodal Qualitative Approach to Understanding Menstrual Health Equity among Adolescents and Young Adults. J Pediatr Adolesc Gynecol 2023; 36:511-517. [PMID: 37543239 DOI: 10.1016/j.jpag.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/20/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023]
Abstract
STUDY OBJECTIVE Menstrual inequity-unequal access to menstrual health care or products-negatively affects well-being in relation to the menstrual cycle, a construct known as menstrual health. Few studies have explored menstrual inequities among adolescent and young adult populations in the United States. This multimodal qualitative research aimed to explore factors that influence the lived experience of menstruation among this population. METHODS This qualitative study consisted of individual interviews among menstruators ages 13-24, recruited from an urban academic medical center. Participants (N = 20) were a mean age of 19 years; 25% previously endorsed period poverty, and 90% were publicly insured. We conducted semi-structured interviews using participant video diaries in a video elicitation exercise. Data were coded by 2 investigators using thematic analysis driven by grounded theory. RESULTS Emergent themes included the need to normalize menstruation, the need for comprehensive menstrual health education, and the need for menstrual products to be more accessible. Twelve youth prepared video diaries, and all reported positive experiences with the video process. CONCLUSIONS This youth-centered, multimodal study is one of the first to qualitatively explore the lived experiences of menstruation among adolescents in the United States and identified key inequities in menstrual health from their own perspectives. Thematic findings were mapped onto a proposed framework for menstrual equity that can be applied to future research and efforts around policy change. More research is needed to assess the impacts of these policies.
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Affiliation(s)
- Shelby Davies
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Kaja Darien
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Farnaz Bazyar
- Menstrual Health Equity Youth Advisory Board, Adolescent Specialty Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Janaya Biddle
- Menstrual Health Equity Youth Advisory Board, Adolescent Specialty Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Bernice Brown
- Menstrual Health Equity Youth Advisory Board, Adolescent Specialty Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Colton Christman
- Menstrual Health Equity Youth Advisory Board, Adolescent Specialty Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Maxwell Saurman
- Menstrual Health Equity Youth Advisory Board, Adolescent Specialty Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sarah Wood
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Nadia Dowshen
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania
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Ford CA, Boyer CB, Halpern CT, Katzman DK, Ross DA. The Journal of Adolescent Health's Commitment to Diversity, Equity, and Inclusion. J Adolesc Health 2023; 72:165-170. [PMID: 36604008 DOI: 10.1016/j.jadohealth.2022.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 01/04/2023]
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Poladian N, Maron A, Ghazarian T, Fernandez-Sweeny Y, Nelson AL. Unmet Needs Discussed on Reddit by Women with Premenstrual Dysphoric Disorder. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2022; 25:810-813. [PMID: 36318501 DOI: 10.1089/cyber.2022.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Premenstrual dysphoric disorder (PMDD) is a disabling disorder that impacts 1.8 percent to 5.8 percent of menstruating women for 1-2 weeks each month. Many affected women turn to social media platforms for the information and the support they feel that they do not get from other sources. We sought to better understand the most strongly expressed unmet needs of women with PMDD by analyzing their posts and comments on one of the largest social media platforms (Reddit), which has been providing important insights into other medical problems. We searched Reddit using the subreddit title "r/PMDD" for posts from January 2020 through November 2021. To identify the most prevalent issues, we included all written posts with a submission score of at least 5 and at least three comments. Two authors classified each post; inconsistencies were resolved by a third reviewer. Over 800 posts were reviewed; 250 met study criteria; additionally, over 875 comments were evaluated. Four main themes emerged from the analysis: emotional responses to PMDD; unanswered questions women had about the diagnosis and treatment of PMDD; the impact that PMDD had on personal relationships, and, finally, the recommendations women made to others based on their own experience, accurate or not. These themes are detailed in this article to provide insights into what many women with PMDD experience and what their frustrations and misunderstandings are about the condition so that clinicians may better help address women's unspoken questions and correct their possible misinformation.
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Affiliation(s)
- Nicole Poladian
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California, USA
| | - Angela Maron
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California, USA
| | - Tania Ghazarian
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California, USA
| | - Yadi Fernandez-Sweeny
- Behavioral Medicine and Psychiatry, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California, USA
| | - Anita L Nelson
- Obstetrics & Gynaecology, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California, USA
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