Detecting adherence to the recommended childhood vaccination schedule from user-generated content in a US parenting forum

Social media as a source of drug safety information in the paediatric population

AIMS

The paediatric population is vulnerable to suffering adverse drug events (ADEs) such as negative outcomes due to medication (NOMs)-drug related problems (DRPs), especially adverse drug reactions (ADRs) and medication errors (MEs). Social media (SM) is considered an interesting tool for pharmacovigilance. This study aims to assess descriptions of ADRs, NOM-DRPs and MEs in SM.

METHODS

Observational, ambispective study assessing NOM-DRPs, ADRs and MEs in posts of child-rearing public parenting forums from inception until December 2021 of drugs dispensed in outpatient setting. ADEs were classified, assessing causality by Liverpool Causality Assessment Tool and seriousness by the World Health Organization criteria. Summary of product characteristics were used to determine ADR prevalence.

RESULTS

In total, 3573 posts of 2 child-rearing public parenting forums were retrieved; 906 (25%) contained descriptions of medicine of which 823 (91%) were analysed; 425 posts (52%) described 636 NOM-DRPs (1 NOM-DRP median per child, interquartile range [IQR] 1-8), from which 161 (26%) were ADRs in 105 posts (1.5 ADR median per child, IQR 1-4) and 95 (15%) were MEs in 64 posts (1 ME median per child, IQR 1-4). From posts mined with medicines mentions, 70% included NOM-DRPs, 18% ADRs and 10% MEs. More ADRs occurred in females and infants. Most ADRs (158; 98%) were evaluated as possible and 17 ADRs (11%) were serious. Uncommon 19 (12%), (14, 9%), very rare (3, 2%) and rare (1, 1%) ADRs were also found.

CONCLUSION

Results suggest that information retrieved from SM may be useful to assess paediatric ADEs and provide valuable pharmacovigilance complementary data.

Narratives, Information and Manifestations of Resistance to Persuasion in Online Discussions of HPV Vaccination

There are both theoretical accounts and empirical evidence for the fact that, in health communication, narratives (story telling) may have a persuasive advantage when compared with information (the provision of facts). The dominant explanation for this potential advantage is that narratives inhibit people's resistance to persuasion, particularly in the form of counterarguing. Evidence in this area to date has most often been gathered through lab or field experiments. In the current study we took a novel approach, gathering our data from naturally-occurring, non-experimental and organically evolving online interactions about vaccinations. We focus on five threads from the parenting forum Mumsnet Talk that centered on indecision about the HPV vaccination. Our analysis revealed that narratives and information were used by posters in similar quantities as a means of providing vaccination-related advice. We also found similar frequencies of direct engagement with both narratives and information. However, our findings showed that narratives resulted in a significantly higher proportion of posts exhibiting supportive engagement, whereas information resulted in posts exhibiting a significantly higher proportion of challenges, including counterarguing and other manifestations of posters' resistance to persuasion. The proportions of supportive versus challenging engagement also varied depending on the topic and vaccine stance of narratives. Notwithstanding contextual explanations for these patterns, our findings, based on this original approach of using naturalistic data, provide a novel kind of evidence for the potential of narratives to inhibit counterarguing in authentic health-related discourse.

Understanding barriers and facilitators of appropriate antibiotic use: a qualitative analysis of an online parenting forum

PURPOSE

Antibiotic use and misuse are common in pregnant women and young children. Few studies have assessed real-world discussions of antibiotics in these populations. Using social media posts of pregnant women and parents, our goal was to identify key themes about facilitators and barriers to appropriate antibiotic usage.

METHODS

A purposive sample of public posts and comments relevant to antibiotic use was collected from the BabyCenter United States social media site. Using a directed content analysis, themes related to facilitators and barriers to appropriate antibiotic use were identified.

RESULTS

Seven hundred and twenty-six posts and 5227 comments were analysed. Themes centred around individual factors, interpersonal factors, and structural factors. Individual factors included knowledge and beliefs. Though misinformation was present, most parents were aware of appropriate antibiotic usage and perceived antibiotics as safe and effective. Some hesitance around using antibiotics led to recommendations for home remedies or over-the-counter treatments. Interpersonal factors focused on a lack of available offline peer support, the expertise of providers, as well as a potential lack of attention from those providers. Structural factors, including access to care, also impacted parents' antibiotic use and misuse.

CONCLUSION

Though most parents demonstrated appropriate knowledge about antibiotics and a willingness to follow guidelines, negative experiences with their providers, a lack of support from peers, and structural factors presented as potential barriers to appropriate antibiotic use. Implementing avenues for peer support for parents, allowing more time for providers to address parents' concerns, and improving access to providers could improve appropriate antibiotic use in parents.

Pro-vaccination personal narratives in response to online hesitancy about the HPV vaccine: The challenge of tellability

Experimental studies have shown that narratives can be effective persuasive tools in addressing vaccine hesitancy, including regarding the vaccine against the human papillomavirus (HPV), which is transmitted via sexual contact and can cause cervical cancer. This paper presents an analysis of a thread from the online parenting forum Mumsnet Talk where an initially undecided Original Poster is persuaded to vaccinate their child against HPV by a respondent's narrative of cervical cancer that they describe as difficult to share. This paper considers this particular narrative alongside all other narratives that precede the decision announced on the Mumsnet thread. It shows how producing pro-vaccination narratives about HPV involves challenges regarding 'tellability' - what makes the events in a narrative reportable or worth telling. We suggest that this has implications for the context-dependent nature of tellability, the role of parenting forums in vaccination-related discussions, and narrative-based communication about vaccinations more generally.