Health information on social media. Perceptions, attitudes, and practices of patients and their companions

Social networking sites use and life satisfaction: a moderated mediation model of e-health literacy, fatigue, uncertainty, and stress

Excessive social media use during health crises can lead to information overload and psychological distress, yet the mechanisms underlying this relationship remain unclear. This study investigated how social networking sites (SNS) affected life satisfaction during the COVID-19 pandemic in Iran and whether this relationship was explained by SNS fatigue, uncertainty about disease, and stress. The research also examined whether e-health literacy was a protective factor in this process. Results confirmed that SNS use negatively affected life satisfaction through a sequential pathway of increased fatigue, uncertainty, and stress. E-health literacy moderated the initial link between SNS use and fatigue, with higher literacy weakening this relationship. The results demonstrate the complex relationship between SNS use and wellbeing during health crises and highlight the potential protective role of e-health literacy.

Clinical Trial Awareness, Perceptions, and Participation Among Cancer Patients in Saudi Arabia

Background: Clinical trials are essential tools for advancing cancer treatment, improving survival rates, and introducing innovative therapies. However, patient participation in clinical trials remains low in the Middle East, including Saudi Arabia. This study explores Saudi cancer patients' awareness, perceptions, and willingness to participate in clinical trials while identifying key barriers to enrollment. Methods: A cross-sectional survey was conducted using a self-administered questionnaire distributed via email and social media. Saudi cancer patients aged 14 and older, fluent in Arabic or English, and with a confirmed cancer diagnosis were eligible. Ethical approval was obtained, and participation was voluntary with ensured data confidentiality. The survey assessed awareness of clinical trials, perceived benefits, willingness to enroll, and barriers to participation. Data were analyzed using SPSS version 23, with chi-square tests used to examine associations. Results: A total of 201 participants completed the survey. Most were female (69.2%), with a mean age of 39.5 years. Awareness of clinical trials was moderate (51.2%), with social media and healthcare providers being primary information sources. While 57.2% recognized the benefits of clinical trials, 44.8% expressed concerns about risks. Trust in healthcare providers influenced willingness to participate, with 49.8% confident in their physician's recommendations. The most common barriers were fear of side effects (82.6%) and lack of information (42.8%). Only 5.5% had prior experience with clinical trials, but 35.3% expressed willingness to enroll if recommended by a healthcare provider. Gender and income were significantly associated with perceptions and willingness to participate. Conclusions: Findings highlight the need for targeted educational initiatives to improve awareness and trust in clinical trials among Saudi cancer patients. Addressing key barriers, particularly concerns about side effects and limited information, could enhance participation, ultimately advancing cancer research and treatment in the region.

The Role of Digital Opinion Leaders in Dengue Prevention Through Health Promotion and Public Health Collaboration: Qualitative Semistructured Interview Study

BACKGROUND

Dengue fever is a significant public health concern. The advent of social media has introduced digital opinion leaders (DOLs), health care professionals with substantial online followings who play a pivotal role in disseminating health information and combating misinformation.

OBJECTIVE

We aimed to investigate the role of DOLs in dengue prevention and explore their preferences for collaboration with health sector entities to strengthen dengue prevention initiatives.

METHODS

A qualitative study was conducted using semistructured interviews with 37 purposively selected DOLs from 8 countries in Latin America and Southeast Asia. They were selected based on their active online presence, dissemination of dengue-related content, and substantial social media followings. Interviews took place either in person or online, according to the participants' chosen languages. Each session, lasting approximately 60 minutes, was audio recorded, transcribed verbatim, and subjected to thematic analysis to identify recurring themes.

RESULTS

The thematic analysis led to several key findings. First, DOLs used social media to enhance public health communication, focusing on raising awareness (16/37, 43%), correcting misconceptions (17/37, 46%), and modeling preventive behaviors (8/37, 22%) for infectious diseases. They educated audiences on disease symptoms and prevention, addressed vaccine hesitancy, and shared personal practices to encourage similar actions among followers. Second, 35% (13/37) of the DOLs reported a widespread lack of public knowledge about dengue and its prevention, with even less awareness of vaccine availability. In addition, 27% (10/37) of them identified challenges due to antivaccination sentiments and misinformation, while 8% (3/37) noted obstacles from perceived inadequate government leadership in dengue prevention. In response, DOLs leveraged their social media influence to educate the public. A significant number (22/37, 59%) of the DOLs emphasized the importance of regular promotion of vector control measures as the cornerstone of dengue prevention and 68% (25/37) highlighted the critical role of vaccines, particularly among vulnerable groups. Finally, collaboration was essential for expanding DOLs' reach and credibility, with 54% (20/37) of them partnering with pharmaceutical companies, 43% (16/37) with government agencies, and 27% (10/37) with nongovernmental organizations. In these collaborations, 38% (14/37) of the DOLs emphasized the importance of adhering to ethical standards, and 57% (21/37) prioritized projects aligning with their personal values and professional standards, avoiding producing content that contradicted their beliefs or goals.

CONCLUSIONS

DOLs are essential in disseminating dengue prevention information. They recognize their responsibility to raise awareness about dengue vaccines and dispel related misconceptions to combat vaccine hesitancy. Unlike nonmedical social media influencers, whose content may lack medical accuracy and be driven by monetization, DOLs provide evidence-based information, enhancing their credibility. Collaborations between DOLs and health sector stakeholders, although currently limited, hold significant potential for effective dengue prevention, provided they adhere to ethical standards and are supported by credible scientific evidence.

Social media and internet use among orthopedic patients in Germany-a multicenter survey

Background

Social media (SM) is increasingly used in the healthcare system and offers various benefits for patients such as accessible health information and communication with other patients and healthcare professionals. However, SM also poses risks, including the dissemination of medical misinformation and privacy concerns. This in turn can influence patients' health-related decision-making and the patient-physician relationship. There is limited data regarding which SM orthopedic patients use and what benefits and risks of SM they perceive.

Methods

An online survey was conducted from April to December 2023 among orthopedic and trauma patients in five German orthopedic clinics. The questionnaire with 32 variables was designed to assess internet and SM usage patterns, platform preferences, and perceived benefits and risks. Statistical analysis was performed, including subgroup analyses.

Results

A total of 267 patients participated, with 82.0% reporting regular SM use. In total 45.9% of the patients used SM for general health questions and 51.3% for orthopedic-related questions. The most used information platforms were conventional websites, YouTube, Instagram, and messenger apps. A total of 45.9% used SM infrequently for general health questions, and 51.3% for orthopedic-related queries. Only 13.7% of patients agreed that SM helped in medical decision-making, and 31.1% felt confident in assessing the credibility of SM content. Additionally, 58.6% of patients were unsure about allowing physicians to present their cases on SM, and 62.3% were uncertain about posting their medical images.

Conclusion

Among German orthopedic patients, the use of SM for health-related and gain of orthopedic information was low in the given study. While SM may offer valuable health information, their role in medical decision-making remains limited due to concerns over content credibility and privacy. Video-based content seems to achieve the best reach. Future research should explore these aspects longitudinally and across diverse populations to better understand and address the challenges and benefits of SM in healthcare.

Reddit users' questions and concerns about glaucoma

PURPOSE

This study aims to analyze the discussions of glaucoma patients on the Reddit forum /r/Glaucoma to identify key concerns and explore how these insights can inform clinical practice.

METHODS

Posts published on the Reddit forum /r/Glaucoma were used for analysis. Big Query was used to collect posts from /r/Glaucoma. We collected 1593 posts published between the years 2018 and 2019. We collected a control group of 4779 posts from a Reddit forum not related to Glaucoma (/r/AskReddit). Using latent Dirichlet allocation (LDA) we extracted 30 topics from our data set. The LDA topic themes most associated with posts in /r/Glaucoma compared to the control group were determined.

RESULTS

LDA analysis of posts in /r/Glaucoma relative to a control group produced 8 distinct categories of posts: "prognosis, diagnostics, medication, optometry role, symptoms, personal inquiries, research, and financial burden." The posts most associated with /r/Glaucoma when compared to a control group were posts belonging to the "Prognosis" category (Cohen's d = 1.26) while the posts least associated with /r/Glaucoma were from the "Financial Burden" category of posts (Cohen's d = -0.12). Example experiences from members of the /r/Glaucoma forum highlight the questions and concerns of patients on the forum.

CONCLUSION

Discussions regarding patient questions and concerns about glaucoma care on the social media site Reddit provide essential insights into the shared experiences patients face while managing their condition. Ophthalmologists can mitigate patient uncertainty by both providing verified physician insights on Reddit as well as incorporating Reddit discussion themes directly in their clinical practice.

Transformer-Based Tool for Automated Fact-Checking of Online Health Information: Development Study

BACKGROUND

Many people seek health-related information online. The significance of reliable information became particularly evident due to the potential dangers of misinformation. Therefore, discerning true and reliable information from false information has become increasingly challenging.

OBJECTIVE

This study aimed to present a pilot study in which we introduced a novel approach to automate the fact-checking process, leveraging PubMed resources as a source of truth using natural language processing transformer models to enhance the process.

METHODS

A total of 538 health-related web pages, covering 7 different disease subjects, were manually selected by Factually Health Company. The process included the following steps: (1) using transformer models of bidirectional encoder representations from transformers (BERT), BioBERT, and SciBERT, and traditional models of random forests and support vector machines, to classify the contents of web pages into 3 thematic categories (semiology, epidemiology, and management), (2) for each category in the web pages, a PubMed query was automatically produced using a combination of the "WellcomeBertMesh" and "KeyBERT" models, (3) top 20 related literatures were automatically extracted from PubMed, and finally, (4) the similarity checking techniques of cosine similarity and Jaccard distance were applied to compare the content of extracted literature and web pages.

RESULTS

The BERT model for the categorization of web page contents had good performance, with F1-scores and recall of 93% and 94% for semiology and epidemiology, respectively, and 96% for both the recall and F1-score for management. For each of the 3 categories in a web page, 1 PubMed query was generated and with each query, the 20 most related, open access articles within the category of systematic reviews and meta-analyses were extracted. Less than 10% of the extracted literature was irrelevant; those were deleted. For each web page, an average of 23% of the sentences were found to be very similar to the literature. Moreover, during the evaluation, it was found that cosine similarity outperformed the Jaccard distance measure when comparing the similarity between sentences from web pages and academic papers vectorized by BERT. However, there was a significant issue with false positives in the retrieved sentences when compared with accurate similarities, as some sentences had a similarity score exceeding 80%, but they could not be considered similar sentences.

CONCLUSIONS

In this pilot study, we have proposed an approach to automate the fact-checking of health-related online information. Incorporating content from PubMed or other scientific article databases as trustworthy resources can automate the discovery of similarly credible information in the health domain.

Social Media Use and Oral Health-Related Misconceptions in Saudi Arabia: Cross-Sectional Study

BACKGROUND

Social media has become a central tool in health communication, offering both opportunities and challenges. In Saudi Arabia, where platforms like WhatsApp, Snapchat, and Instagram are widely used, the quality and credibility of oral health information shared digitally remain critical issues. Misconceptions about oral health can negatively influence individuals' behaviors and oral health outcomes.

OBJECTIVE

This study aimed to describe the patterns of social media use and estimate the prevalence of oral health-related misconceptions among adults in Saudi Arabia. Additionally, it assessed the associations between engagement with oral health information, self-reported oral health, and the presence and count of these misconceptions.

METHODS

A cross-sectional survey was conducted over 10 weeks, targeting adults aged 15 years and older in Saudi Arabia. Data were collected from a total sample size (n=387) via a questionnaire distributed through targeted advertisements on Instagram, TikTok, Snapchat, and X (Twitter). The prevalence of oral health-related misconceptions was estimated using descriptive statistics, including counts and percentages. Chi-square tests described sociodemographic, social media engagement, and self-reported oral health. Logistic and Poisson regression analyses were used to assess associations between engagement and self-reported oral health with misconceptions. Logistic regression models provided odds ratios and adjusted odds ratios with 95% CI to assess the presence of oral health misconceptions. Poisson regression was used to calculate mean ratios and adjusted mean ratios (AMRs) for the count of misconceptions.

RESULTS

WhatsApp (n=344, 89.8%) and Instagram (n=304, 78.9%) were the most frequently used social media platforms daily. Common oral health misconceptions included beliefs that "Pregnancy causes calcium loss in teeth" (n=337, 87%) and "Dental treatment should be avoided during pregnancy" (n=245, 63.3%). Following dental-specific accounts was significantly associated with lower odds of having any misconceptions (adjusted odds ratio 0.41, 95% CI 0.22-0.78) and a lower count of misconceptions (AMR 0.87, 95% CI 0.77-0.98). Conversely, trust in social media as a source of oral health information was associated with a higher count of misconceptions (AMR 1.16, 95% CI 1.02-1.31).

CONCLUSIONS

Social media platforms are essential yet double-edged tools for oral health information dissemination in Saudi Arabia. Participants who followed dental-specific accounts had significantly lower misconceptions, while trust in social media as a source of information was linked to higher counts of misconceptions. These findings highlight the importance of promoting credible content from verified sources to combat misconceptions. Strategic collaborations with dental professionals are necessary to enhance the dissemination of accurate oral health information and public awareness and reduce the prevalence of oral health-related misconceptions.

Influence of Social Media in Multidisciplinary Cleft Care in Indonesia

Social media has played a pivotal role in relaying healthcare-related information, especially in efforts to improve cleft management. Cleft management involves a multidisciplinary team throughout the years of comprehensive intervention, from birth to adulthood.

To investigate the behaviors of parents and patients with clefts regarding social media use in improving cleft-related outcomes, knowledge, and awareness.

This questionnaire-based descriptive study was conducted online and involved both closed- and short-ended questions.

Parents and patients with cleft lip and palate provided consent to participate in the study.

Patient demographics, history, and timing of cleft treatment, barriers to care, and social media use were explored.

Fifty-six participants were enrolled in this study. The mean ages of the mothers and fathers of children with cleft were 34 (range, 24-57) and 36 (range, 26-59) years, respectively, and more than one-half were university graduates. WhatsApp, Instagram, and YouTube were used by 100%, 89%, and 89% of parents, respectively, 82% of whom were part of a cleft community group. Seventy-two percent underwent labioplasty, and 75% underwent palatoplasty at the ideal time. Parents exhibited low perceived barriers to care, with 33% and 37% reporting limitations on knowledge and accommodation, respectively.

Social media is the key to bridging the gap between the large number of cases and facility limitations and specialized human resources. Cleft centers should integrate combined platforms (WhatsApp, YouTube, and Instagram) for marketing and education purposes. Social media and community groups facilitate sharing, engagement, and empowerment of patients and caregivers to improve cleft-related outcomes.

Attitudes and Awareness Regarding Health Information Sought on Social Media by the Saudi Population: A Cross-Sectional Study

Background Social media (SM) platforms are commonly used in Saudi Arabia, even for health information. SM platforms allow users to have conversations, share information, and create web content. Given the growing dependence on social media for health-related concerns, it is critical to understand how Saudis use these platforms to get health information. This study aimed to determine the Saudi population's attitude and awareness regarding health information sought on SM. Subject and methods This cross-sectional study was conducted among adults in Riyadh, Kingdom of Saudi Arabia, from September to October 2024. A self-administered questionnaire was distributed randomly in the Medical City King Saud University family medicine clinic. The questionnaire includes socio-demographic data (i.e., age, gender, marital status, etc.), the most commonly used type of SM, and various questions to assess the knowledge and influence of SM on health information.  Results Among the 330 participants, 117 (63%) were female respondents, and 126 (38.2%) were between 31 and 40 years old. WhatsApp was the most prominent type of SM used at 192 (58.2%). Disease or medical problems were the most notable health information being seen online at 172 (52.1%), and "to be informed" was the most common reason for seeking health information online at 237 (72.4%). The perception of unemployed female respondents that health information obtained from SM is reliable was significantly higher than that of unemployed male respondents (p<0.05). Surprisingly, male participants usually do believe SM can enhance awareness (p = 0.015). Conclusion The findings of this study suggest that SM influences the behavior of the adult population seeking health information in Saudi Arabia. Female participants tended to believe that the health information obtained from SM was credible. To be more informed was the primary reason for seeking health information online. There is a need to educate patients visiting family medicine clinics about the reliability of health information obtained online.

Social media use and adolescent oral health: A scoping review

Introduction

Social media has revolutionized information sharing, particularly among adolescents who frequently use it for health-related content. However, their use of social media concerning oral health remains unclear. This scoping review aims to map available literature on the use of social media regarding oral health among adolescents.

Methods

Following Arksey & O'Malley's framework and PRISMA-SCR guidelines, comprehensive searches were conducted in Medline (Ovid), PubMed, and Scopus databases from January 2013 to December 2024. Reference lists of relevant studies were also reviewed. Two researchers independently screened and extracted relevant data from eligible studies. The data included publication year, authors, country, study design, aims, social media platforms, comparisons, assessed outcomes, and key findings. Descriptive statistics were used to summarize quantifiable aspects and content analysis was employed to define categories and report the key findings.

Results

Of 1938 records, 1312 titles and abstracts and 73 full-text articles were screened. Seventeen relevant studies were identified, including 2 reviews and 15 primary studies. These studies included six clinical trials and five cross-sectional studies. Three studies didn't indicate the study design. In addition to social media's effectiveness in improving oral health literacy, behaviors, and outcomes, such as plaque, gingival, and caries indices, the studies reported on patient compliance and sharing treatment-related experiences.

Conclusion

This review highlights the growing influence of social media on adolescents' oral health literacy and practices. Further research is necessary to explore adolescents' perspectives on social media use for oral health and develop effective interventions that address the unique needs of this demographic.

Quality Assessment of Online Health Information on Thyroid Cancer in the Arabic Language: A Cross-Sectional Study

Introduction The internet is a crucial source of health information, including cancer-related topics, but the quality and reliability of these resources can vary, affecting patient decision-making. Objectives This study aimed to evaluate the quality of thyroid cancer-related websites in the Arabic language, using the DISCERN tool, and explore the content and sources provided by different types of websites. Methods A total of 78 websites were included after excluding 21 based on predefined criteria (e.g., duplicates, non-functional uniform resource locators (URLs)). The websites were categorized into commercial, non-profit, and individual types. Two independent reviewers assessed the websites using the DISCERN tool. Interrater agreement was measured using the k-score. A one-way analysis of variance (ANOVA) was used to compare DISCERN scores across website types, and Spearman's rank correlation was used to analyze the relationship between website ranking and DISCERN scores. Results Almost all websites included a definition of thyroid cancer. Additionally, 15 websites (19.2%) covered the definition, clinical presentation, risk factors, diagnosis, and treatment, while 14 websites (17.9%) offered only clinical presentation, diagnosis, and treatment, and 11 websites (14.1%) offered other combinations of similar content. However, there was a lack of information regarding prognosis and predictors of outcomes following thyroid cancer surgery. The average overall DISCERN score for the 78 websites was 42.65 ± 12.35. Statistically significant differences were found in DISCERN scores across website types, with non-profit websites scoring the highest (38.93 ± 14.12), followed by commercial (37.67 ± 10.34) and individual websites (28.63 ± 10.02). A significant negative correlation was also found between website rank and DISCERN scores (Spearman's r = -0.38, p < 0.0001). Conclusion The study found that non-profit websites provide higher-quality thyroid cancer information compared to commercial and individual sites. Website ranking also affects content quality, emphasizing the importance of patients assessing online resources critically. Health organizations are encouraged to improve the visibility and quality of trustworthy information.

The Assessment of TikTok as a Source of Quality Health Information on Human Papillomavirus: A Content Analysis

Background Various studies have evaluated the quality of health-related information on TikTok (ByteDance Ltd., Beijing, China), including topics such as COVID-19, diabetes, varicoceles, bladder cancer, colorectal cancer, and others. However, there is a paucity of data on studies that examined TikTok as a source of quality health information on human papillomavirus (HPV). This study, therefore, evaluated the quality of health information on HPV on TikTok. Methods The terms "HPV" and "human papillomavirus" were searched on TikTok on a single day in August 2024, and 200 videos were retrieved. Relevant user metrics were collected for each video, including the number of likes, shares, and followers, the video length, and the uploader type. Two independent raters assessed each video regarding the completeness of six types of content (the definition of HPV, symptoms, risk factors, evaluation, management, and outcomes). Then, the two raters independently assessed the quality of information in the videos using the DISCERN instrument. Results Sixty-nine videos met inclusion criteria; 11 were created by general users, 44 by healthcare professionals, and 14 by organizations. Videos uploaded by general users and health professionals have a longer duration (p < 0.001) and more likes (p = 0.048) than those uploaded by organizations. More than 60% of the videos contained little or no content on the HPV content assessed. Although the reliability and quality of treatment choices were higher among videos uploaded by healthcare professionals, the overall quality of HPV health information using the DISCERN instrument was "very poor" (24.2 (±6.92)). Conclusions The overall quality of HPV videos uploaded on TikTok is very poor and not acceptable, thus failing to satisfy public health needs. Healthcare professionals must enhance their social media presence, produce reliable and substantive material, and collaborate with social media platforms and high-engagement accounts to facilitate users' access to high-quality data. TikTok users must recognize that material regarding HPV may lack medical accuracy and should consistently consult healthcare providers for medical guidance.

Evaluating the Quality and Reliability of Total Knee Arthroplasty Rehabilitation Exercises on the Social Media Platform TikTok

Background

The utilization of social media for health-related purposes has surged, especially during the COVID-19 pandemic. TikTok, a short-form video platform, has seen substantial growth, becoming a prominent medium for health information dissemination. However, the lack of regulation poses challenges in evaluating the validity of TikTok content.

Methods

This cross-sectional study assesses TikTok videos related to total knee arthroplasty rehabilitation exercises. Search terms identified 84 videos, with 64 meeting the inclusion criteria. Engagement metrics and quality scores were analyzed, utilizing the DISCERN tool and the Total Knee Replacement Exercises Education Score.

Results

The analyzed videos accumulated nearly 6 million views, with a median of 10,293.5 (interquartile range = 4139.3-26,100.0). Health-care professionals contributed 48% of the content. Despite higher engagement metrics for health-care professional videos, the overall quality, as indicated by DISCERN and Total Knee Replacement Exercises Education scores, remained poor. No videos achieved an "excellent" rating, with the majority categorized as "poor."

Conclusions

This study underscores TikTok's substantial role in total knee arthroplasty rehabilitation information dissemination but reveals a critical deficit in content quality and reliability. Health-care professionals marginally outperformed general users but displayed overall inadequacy. The study emphasizes the necessity for improving the quality of health-related content on emerging social media platforms, especially within the realm of orthopaedic surgery.

Level of Evidence

Level III, Cross-sectional study.

Primary headache content on online community platforms: a scoping review protocol

INTRODUCTION

As the usage of online platforms becomes increasingly prevalent to share information, it is essential to garner a better understanding of the content disseminated across the internet. Studies have found that patients are relying on online resources to gather medical information, potentially encountering misinformation. The sharing of information concerning primary headaches, despite affecting a large portion of the world's population, has not been comprehensively analysed through the lens of online content. This scoping review seeks to explore the extent of available information, uncover existing gaps in knowledge, and to serve as a resource for healthcare providers to educate themselves to provide informed care to patients.

METHODS AND ANALYSIS

Studies considered for inclusion are those focused on primary headache (including migraines, tension headaches and cluster headaches) content posted on a community platform. Any online community forum will be eligible, including but not limited to TikTok, Twitter, Facebook, YouTube, Instagram, online forums and blogs. Studies will be limited to those published in English, with no geographic restriction. Five electronic databases, namely PubMed, Cochrane Library, Scopus, EMBASE, PsycInfo, will be searched for published reports. Two reviewers will independently screen titles and abstracts. The reviewers will then assess the full texts selected. In both cases, disagreements will be discussed with a third reviewer and consensus will be achieved. Data analysis will be descriptive with a narrative summary.

ETHICS AND DISSEMINATION

Since this is a scoping review of previously published summary data, ethical approval for this study is not needed. Findings will be published in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER

This protocol is registered on the Open Science Framework Repository (https://doi.org/10.17605/OSF.IO/2MAFN).

Exploring predictors of COVID-19 precautionary behaviors during the initial rollout of COVID-19 vaccines in a predominately Hispanic sample

•Precautionary behaviors were lower if primary language in household was Spanish.•Testing positive for COVID-19 was inversely associated with precautionary behaviors.•Healthcare practitioners were the most trusted source of COVID-19 information.

Social Media and Digital Inequity: Reducing Health Inequities by Closing the Digital Divide

As its usage has grown, social media has positively and negatively impacted public health. Although social media presents known harms to mental health and spreads misinformation, it also offers rapid dissemination of public health information, expanded access to health resources, and a robust source of health information. However, these benefits are not equitably shared due in part to the "digital divide" of unequal access and use of information and communication technologies. Measurable inequalities in digital access exist among regions, with an eight-fold difference between Central Africa (9.8% social media penetration) and Northern Europe (80.2% social media penetration). Digital inequalities also differ by gender, age, and socioeconomic classes within countries. Increased digital access has been positively associated with improved health information and outcomes related to chronic diseases, infectious disease outbreaks, and reproductive health. Given the expanding role of social media in public health and the emerging evidence on the health benefits of digital access, we argue for reducing digital inequities by (1) creating an enabling government policy and regulatory environment that views digital health access as a social determinant of health; (2) targeting public and private investments to expand digital access for underserved regions and populations; (3) making digital access and use affordable to low-resource populations; and (4) improving digital competency among these groups through digital literacy programs.

What Are the Most Popular Articles in Urogynecology and Who Is Disseminating Them

IMPORTANCE

This research describes which articles published in Urogynecology are garnering the most attention online. Understanding which articles are having the largest impact in the online community has become increasingly important due to the exponential increase in the use of social media on the internet.

OBJECTIVE

The Altmetric Attention Score (AAS) is a quantitative and qualitative measure of the articles' online attention in social media and news outlets, blogs, and reference managers. The aim of this study was to provide an analysis of those accessing and sharing the 100 most popular articles published in Urogynecology.

STUDY DESIGN

This was a retrospective descriptive analysis. Using Dimensions, a "linked research knowledge system," data about each article's demographics on Twitter and other media sources was extracted from each of the articles within Urogynecology with the highest AAS. No articles were excluded. The articles were categorized by topic and metrics of online sharing were compared among categories.

RESULTS

Fifteen categories were created. Sexual health and education articles had the highest average Altmetric scores per article and reached the highest impressions per article and had the highest average follower count per Twitter user. On average, social justice in medicine had the highest number of tweets per article. Tweets were most often composed by members of the public (58%) compared with health care practitioners (14%), researchers (13%), and science communicators (12%).

CONCLUSIONS

Sexual health and education articles had the highest average AAS and impressions on Twitter. We observed a difference in which articles are being shared most among the general public and health care professionals. The general public comprised a majority of those sharing articles online regardless of category. Additionally, there may be a disparity in research, its funding, and online scientific communications within the field of urogynecology.

The association of social networks with the job performance of primary health care professionals: the mediating effect of knowledge sharing

Background and aims

Social networks formed through social media platforms have facilitated knowledge sharing among primary health care professionals (PHCPs). However, the impact of these networks on PHCPs' job performance and the mediating role of knowledge sharing remain underexplored. This study aimed to investigate the association between social networks formed via social media and the job performance of PHCPs, and to explore the mediating role of knowledge sharing in this association.

Methods

A cross-sectional survey was carried out among PHCPs in Henan Province, China, involving 655 valid responses. Validated scales measured the key variables, and structural equation modeling (SEM) tested the proposed hypotheses, including the mediating effect of knowledge sharing through bootstrap method. Statistical analysis was performed using SPSS 24.0 and AMOS 24.0.

Results

The degree centrality (β = 0.225; p = 0.001) and network heterogeneity (β = 0.093; p = 0.043) of the social network had a significant direct association with job performance, whereas the direct associations of betweenness centrality and network tie strength with job performance were not significant. Knowledge sharing mediated the relationship between degree centrality (β = 0.147; p = 0.001), network heterogeneity (β = 0.251; p = 0.043), and job performance.

Conclusion

The study revealed the internal mechanisms by which social network characteristics influence PHCPs' job performance, highlighting the mediating role of knowledge sharing. Social networks formed within social media contexts have multifaceted effects on job performance, with knowledge sharing as a critical mediating variable. These findings underscore the importance of leveraging social media for professional networking and knowledge exchange to enhance PHCPs' job performance.

Characterizing the Adoption and Experiences of Users of Artificial Intelligence-Generated Health Information in the United States: Cross-Sectional Questionnaire Study

BACKGROUND

OpenAI's ChatGPT is a source of advanced online health information (OHI) that may be integrated into individuals' health information-seeking routines. However, concerns have been raised about its factual accuracy and impact on health outcomes. To forecast implications for medical practice and public health, more information is needed on who uses the tool, how often, and for what.

OBJECTIVE

This study aims to characterize the reasons for and types of ChatGPT OHI use and describe the users most likely to engage with the platform.

METHODS

In this cross-sectional survey, patients received invitations to participate via the ResearchMatch platform, a nonprofit affiliate of the National Institutes of Health. A web-based survey measured demographic characteristics, use of ChatGPT and other sources of OHI, experience characterization, and resultant health behaviors. Descriptive statistics were used to summarize the data. Both 2-tailed t tests and Pearson chi-square tests were used to compare users of ChatGPT OHI to nonusers.

RESULTS

Of 2406 respondents, 21.5% (n=517) respondents reported using ChatGPT for OHI. ChatGPT users were younger than nonusers (32.8 vs 39.1 years, P<.001) with lower advanced degree attainment (BA or higher; 49.9% vs 67%, P<.001) and greater use of transient health care (ED and urgent care; P<.001). ChatGPT users were more avid consumers of general non-ChatGPT OHI (percentage of weekly or greater OHI seeking frequency in past 6 months, 28.2% vs 22.8%, P<.001). Around 39.3% (n=206) respondents endorsed using the platform for OHI 2-3 times weekly or more, and most sought the tool to determine if a consultation was required (47.4%, n=245) or to explore alternative treatment (46.2%, n=239). Use characterization was favorable as many believed ChatGPT to be just as or more useful than other OHIs (87.7%, n=429) and their doctor (81%, n=407). About one-third of respondents requested a referral (35.6%, n=184) or changed medications (31%, n=160) based on the information received from ChatGPT. As many users reported skepticism regarding the ChatGPT output (67.9%, n=336), most turned to their physicians (67.5%, n=349).

CONCLUSIONS

This study underscores the significant role of AI-generated OHI in shaping health-seeking behaviors and the potential evolution of patient-provider interactions. Given the proclivity of these users to enact health behavior changes based on AI-generated content, there is an opportunity for physicians to guide ChatGPT OHI users on an informed and examined use of the technology.

Understanding the influence of social media on COVID-19 vaccine acceptance in a war-torn Syria: A cross-sectional study

Social media has become a source of disseminating information to the public during the COVID-19 outbreak which has been a great advantage for healthcare centers. However, foreign anti-vaccination campaigns on social media increased the disbelief in vaccine safety. To our knowledge, the effects of social media on COVID-19 vaccine acceptance are not well-studied in low-income countries. The primary objective of this survey is to investigate Syrians' dependence on social media platforms to get information about vaccines, and to what extent it affects their vaccination decision. A web-based cross-sectional study was conducted in Syria from May 26th to July 26th, 2022 using an online questionnaire as Google Form posted on various social media platforms. The questionnaire consisted of 53 questions related to each of the socio-demographic characteristics, beliefs, and knowledge about COVID-19 vaccination, willingness to get vaccinated, and social media frequency use and its effects. Univariate and multivariate logistic regression was performed to identify factors associated with vaccination behavior. A total of 780 questionnaires were completed; around 42.2% of study participants did not get the vaccine, and 24% would take it only under compulsory rules. Also, only 3.08% of the participants answered correctly on the knowledge-evaluation questions. Results of the univariate analysis showed that being female, living in an urban residential area, and having good vaccine knowledge were positive predictors of vaccine receiving. The unvaccinated group had a higher likelihood of being college students, not trusting in the vaccine, knowing relatively less about the vaccine, and not having previously been exposed to the virus. No significant correlation between vaccination status and using social media was shown in our investigation. However, our results show the importance of social media information in health-related decisions in war-torn countries and emphasize further investigations to confirm causality and determine the best health policy choice.

Oocyte cryopreservation on TikTok and Instagram: Who is teaching whom?

PURPOSE

Oocyte cryopreservation (OC) is a medical intervention for reproductive-aged women, a demographic that uses social media heavily. This study characterizes the top TikTok videos and Instagram reels on OC.

METHODS

Five hashtags pertaining to OC were selected: #oocytepreservation, #oocytecryopreservation, #eggfreezing, #oocytefreezing, and #fertilitypreservation. Top videos for each hashtag were evaluated for source, content, impact, and quality on both platforms. Descriptive and inferential statistics were performed to analyze differences between laypeople and medical professionals.

RESULTS

From March to April 2023, 332 posts were reviewed. The most popular hashtags on TikTok and Instagram were #eggfreezing (n = 5.6 million views, n = 68,500 + posts) and #fertilitypreservation (n = 9 million views, n = 20,700 + posts). Laypeople dominated as sources (57.8%, 35.2%), followed by physicians (17.0%, 32.4%). No professional societies videos were found. Educational information (53.1%, 48.6%) was most frequently shared on both platforms respectively, followed by personal experiences (36.1%, 21.6%). Laypersons' posts were dominated by personal experiences (62.0%) with educational content second (33.3%). Educational content by medical professionals was more accurate on both TikTok and Instagram than patients (p < 0.001, p < 0.001). #Eggfreezing had the greatest impact for both patients and medical professionals based on shares (n = 9653, n = 3093), likes (n = 713,263, n = 120,700), and comments (n = 35,453, n = 1478). Notably, laypersons had a larger follower count than medical professionals (p < 0.001).

CONCLUSION

The majority of available videos are from laypeople, focus on education topics, and are less accurate in comparison to those from medical professionals. Professional societies have an opportunity to enhance their social media presence for better availability and accuracy of OC information.

An Evaluation of the Content Quality, Readability, and Reliability of Publicly Available Web-Based Information on Pneumothorax Surgery in Ireland

Introduction The internet is increasingly the first port of call for patients introduced to new treatments. Unfortunately, many websites are of poor quality, thereby limiting patients' ability to make informed health decisions. Within thoracic surgery, the treatment options for pneumothoraces may be less intuitive for patients to understand compared to procedures such as lobectomies and wedge resections. Therefore, patients must receive high-quality information to make informed treatment decisions. No study to date has evaluated online information regarding pneumothorax surgery. Knowledge regarding the same may allow physicians to recommend appropriate websites to patients and supplement remaining knowledge gaps. Objective This study aims to evaluate the content, readability, and reliability of online information regarding pneumothorax surgery. Methods A total of 11 search terms including "pneumothorax surgery," "pleurectomy," and "pleurodesis" were each entered into Google, Bing, and Yahoo. The top 20 websites found through each search were screened, yielding 660 websites. Only free websites designed for patient consumption that provided information on pneumothorax surgery were included. This criterion excluded 581 websites, leaving 79 websites to be evaluated. To evaluate website reliability, the Journal of American Medical Association (JAMA) and DISCERN benchmark criteria were applied. To evaluate the readability, 10 standardized tools were utilized including the Flesch-Kincaid Reading Ease Score. To evaluate website content, a novel, self-designed 10-part questionnaire was utilized to assess whether information deemed essential by the authors was included. It evaluated whether websites comprehensively described the surgery process for patients, including pre- and post-operative care. Website authorship and year of publication were also noted. Results The mean JAMA score was 1.69 ± 1.29 out of 4, with only nine websites achieving all four reliability criteria. The median readability score was 13.42 (IQR: 11.48-16.23), which corresponded to a 13th-14th school grade standard. Only four websites were written at a sixth-grade reading level. In the novel content questionnaire, 31.6% of websites (n = 25) did not mention any side effects of pneumothorax surgery. Similarly, 39.2% (n = 31) did not mention alternative treatment options. There was no correlation between the date of website update and JAMA (r = 0.158, p = 0.123), DISCERN (r = 0.098, p = 0.341), or readability (r = 0.053, p = 0.606) scores. Conclusion Most websites were written above the sixth-grade reading level, as recommended by the US Department of Health and Human Services. Furthermore, the exclusion of essential information regarding pneumothorax surgery from websites highlights the current gaps in online information. These findings emphasize the need to create and disseminate comprehensive, reliable websites on pneumothorax surgery that enable patients to make informed health decisions.

Readability of Online Spanish Materials for Breast Reconstruction Using Deep Inferior Epigastric Perforator Flaps

Background The internet has become an increasingly popular tool for patients to find information pertaining to medical procedures. Although the information is easily accessible, data shows that many online educational materials pertaining to surgical subspecialties are far above the average reading level in the United States. The aim of this study was to evaluate the English and Spanish online materials for the deep inferior epigastric perforator (DIEP) flap reconstruction procedure. Methods The first eight institutional or organizational websites that provided information on the DIEP procedure in English and Spanish were included. Each website was evaluated using the Patient Education and Materials Assessment Tool (PEMAT), Cultural Sensitivity Assessment Tool (CSAT), and either Simplified Measure of Gobbledygook (SMOG) for English websites or Spanish Orthographic Length (SOL) for Spanish websites. Results The English websites had a statistically lower CSAT score compared to the Spanish websites (p=0.006). However, Spanish websites had a statistically higher percentage of complex words compared to English sources (p<0.001). An analysis of reading grade levels through SMOG and SOL scores revealed that Spanish websites had statistically lower scores (p<0.001). There were no statistically significant differences in the understandability or actionability scores between the English and Spanish websites. Conclusions Online educational materials on the DIEP flap reconstruction procedure should be readable, understandable, actionable, and culturally sensitive. Our analysis revealed that improvements can be made in understandability and actionability on these websites. Plastic surgeons should be aware of what constitutes a great online educational resource and what online educational materials their patients will have access to.

From Likes to Lifestyle: Predicting the Impact of Following Fitness Influencers on the Adoption of Healthy Habits in Saudi Arabia

BACKGROUND

 The increasing popularity of fitness influencers on social media has the potential to significantly impact public health by promoting healthy behaviors. Understanding how these influencers affect the adoption of healthy habits among Saudi residents can provide insights into effective public health strategies.

OBJECTIVE

 This study aims to quantitatively assess the influence of following fitness influencers on social media on adopting healthy behaviors among Saudi residents, focusing on socio-demographic factors, characteristics of influencers, and participants' perceptions.

METHODS

 A descriptive, cross-sectional study with an analytical component was carried out from March 25, 2023, to August 15, 2023. The study included Saudi residents aged 18 and older who actively follow fitness influencers. Data was gathered through an online questionnaire and analyzed using descriptive statistics, Pearson's chi-square test, and logistic regression analyses to identify factors associated with positive health outcomes.

RESULTS

 The study included 561 participants, revealing that marital status and residential region significantly influenced the adoption of healthy habits, with married participants and those from the Southern and Central regions more likely to report positive outcomes. Notably, engagement in physical activity more than three times a week and adherence to a healthy diet were strongly associated with positive health outcomes (p<0.05). Analysis of influencer characteristics showed that following fewer than 10 influencers and being unaware of their follower count were predictors of positive results with p<0.05. Specifically, 76.6% of participants experienced positive results after following health advice from social media, highlighting the impactful yet complex role of influencers in shaping health behaviors. Logistic regression analyses underscored the significance of socio-demographic factors, influencer characteristics, and participant perceptions in predicting the likelihood of experiencing positive health outcomes.

CONCLUSION

 Following fitness influencers on social media can positively impact the adoption of healthy habits, moderated by socio-demographic factors and influencer characteristics.

Quality assessment of health science-related short videos on TikTok: A scoping review

OBJECTIVE

The aims of this review are to clarify the current state of research in terms of assessment tools and assessors of the quality of health science-related short videos on TikTok, to identify limitations in existing research; and to provide a reference for future studies.

METHODS

A scoping review was conducted. The Cochrane Library, PubMed, MEDLINE, Web of Science, Embase, Scopus, EBSCO, CNKI, VIP, Wanfang Data, and CBM databases were searched from September 2016 to November 2022. Manual searching was also performed to identify additional eligible studies. A total of 2620 documents were initially retrieved, and 29 were ultimately included. The literature was screened and collected, and data were extracted and summarized by 2 researchers.

RESULTS

(1) The quality evaluation tools used in the 29 papers included the DISCERN, PEMAT(A/V), GQS, JAMA, HONcode, guidelines and self-developed tools. Twenty-four of the included articles used the DISCERN for quality assessment, which was the most frequently used evaluation tool. However, most of these tools were not developed to assess health science-related short videos, lacked credibility tests, and had poor applicability; therefore, the accuracy of the evaluation results might be biased. (2) The assessors of the quality of health science-related short videos on TikTok were mainly experts in related fields and medical students, with doctors (12/14) being the most common evaluators. Fifteen studies did not report the identity of the evaluators, and 12 studies did not report interrater reliability.

CONCLUSION

This scoping review found that there is a lack of specific quality assessment tools for health science-related short videos on TikTok. Second, the current quality assessors of health science-related short videos on TikTok are limited. Future research should focus on the development of reliable, scientific quality assessment tools for health science-related short videos; unifying the evaluation standards; inviting users with different backgrounds and different health literacy levels to conduct quality assessments; exploring the quality assessment of health science-related short videos on TikTok from different perspectives.

Evaluation of public awareness, knowledge, and attitudes about colorectal cancer screening among the general population in Al-qunfudah

Colorectal cancer (CRC) is a malignant tumor of the colon and rectum. It can be cured if detected in the early stage through established screening programs. CRC screening is the best way to improve cancer morbidity and mortality. Various approaches such as stool tests, virtual colonoscopy, and sigmoidoscopy are available for early detection. On average, a person after reaching the age of 45 should begin the screening process for CRC periodically for 5 years. Our study aims to measure the population's awareness and knowledge of the effect of CRC screening on CRC outcomes. A cross-sectional study questionnaire was designed and distributed among Saudi residents of the Al-Qunfudah region. A total of 385 participants replied: 55.8% of the participants were males, 78.8% of the study participants mentioned that they had heard about CRC, and 27.3% reported that CRC is common in Al-Qunfudah. In addition, 62.1% knew that CRC is more common in men but only 32.2% had a good awareness level. Moreover, 16.4% of the participants reported that they had received a colonoscopy/sigmoidoscopy; 69.9% did not think of the colonoscopy/sigmoidoscopy procedure as the main barrier to undergoing early screening for CRC. Good awareness regarding CRC was demonstrated in 34.4% of highly educated participants, which was directly associated with levels of education. In conclusion, much more awareness regarding CRC screening is needed in the Al-Qunfudah region. Educational seminars and programs should be made mandatory, and the healthcare system should focus on high-risk individuals.

The Readability of Patient-Facing Social Media Posts on Common Otolaryngologic Diagnoses

OBJECTIVE

To assess the readability of patient-facing educational information about the most common otolaryngology diagnoses on popular social media platforms.

STUDY DESIGN

Cross-sectional study.

SETTING

Social media platforms.

METHODS

The top 5 otolaryngologic diagnoses were identified from the National Ambulatory Medical Care Survey Database. Facebook, Twitter, TikTok, and Instagram were searched using these terms, and the top 25 patient-facing posts from unique accounts for each search term and poster type (otolaryngologist, other medical professional, layperson) were identified. Captions, text, and audio from images and video, and linked articles were extracted. The readability of each post element was calculated with multiple readability formulae. Readability was summarized and was compared between poster types, platforms, and search terms via Kruskal-Wallis testing.

RESULTS

Median readability, by grade level, by grade level, was greater than 10 for captions, 5 for image-associated text, and 9 for linked articles. Captions and images in posts by laypeople were significantly more readable than captions by otolaryngologists or other medical professionals, but there was no difference for linked articles. All post components were more readable in posts about cerumen than those about other search terms.

CONCLUSIONS

When examining the readability of posts on social media regarding the most common otolaryngology diagnoses, we found that many posts are less readable than recommended for patients, and found that posts by laypeople were significantly more readable than those by medical professionals. Medical professionals should work to make educational social media posts more readable to facilitate patient comprehension.

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.

Common myths and misconceptions about breast cancer causation among Palestinian women: a national cross-sectional study

BACKGROUND

The discussion about breast cancer (BC) causation continues to be surrounded by a number of myths and misbeliefs. If efforts are misdirected towards reducing risk from false mythical causes, individuals might be less likely to consider and adopt risk-reducing behaviors for evidence-based BC causes. This national study aimed to assess the awareness of BC causation myths and misbeliefs among Palestinian women, and examine the factors associated with having good awareness.

METHODS

This national cross-sectional study recruited adult women from government hospitals, primary healthcare centers, and public spaces in 11 governorates in Palestine. A modified version of the Cancer Awareness Measure-Mythical Causes Scale was used to collect data. The level of awareness of BC causation myths was determined based on the number of myths recognized to be incorrect: poor (0-5), fair (6-10), or good (11-15).

RESULTS

A total of 5,257 questionnaires were included. Only 269 participants (5.1%) demonstrated good awareness (i.e., recognizing more than 10 out of 15 BC mythical causes). There were no notable differences in displaying good awareness between the main areas of Palestine, the Gaza Strip and the West Bank and Jerusalem (5.1% vs. 5.1%). Having chronic disease as well as visiting hospitals and primary healthcare centers were associated with a decrease in the likelihood of displaying good awareness. Myths related to food were less frequently recognized as incorrect than food-unrelated myths. 'Eating burnt food' was the most recognized food-related myth (n = 1414, 26.9%), while 'eating food containing additives' was the least recognized (n = 599, 11.4%). 'Having a physical trauma' was the most recognized food-unrelated myth (n = 2795, 53.2%), whereas the least recognized was 'wearing tight bra' (n = 1018, 19.4%).

CONCLUSIONS

A very small proportion of Palestinian women could recognize 10 or more myths around BC causation. There is a substantial need to include clear information about BC causation in future educational interventions besides focusing on BC screening, signs and symptoms, and risk factors.

Identifying mental health discussion topic in social media community: subreddit of bipolar disorder analysis

Online platforms allow individuals to connect with others, share experiences, and find communities with similar interests, providing a sense of belonging and reducing feelings of isolation. Numerous previous studies examined the content of online health communities to gain insights into the sentiments surrounding mental health conditions. However, there is a noticeable gap in the research landscape, as no study has specifically concentrated on conducting an in-depth analysis or providing a comprehensive visualization of Bipolar disorder. Therefore, this study aimed to address this gap by examining the Bipolar subreddit online community, where we collected 1,460,447 posts as plain text documents for analysis. By employing LDA topic modeling and sentiment analysis, we found that the Bipolar disorder online community on Reddit discussed various aspects of the condition, including symptoms, mood swings, diagnosis, and medication. Users shared personal experiences, challenges, and coping strategies, seeking support and connection. Discussions related to therapy and medication were prevalent, emphasizing the importance of finding suitable therapists and managing medication side effects. The online community serves as a platform for seeking help, advice, and information, highlighting the role of social support in managing bipolar disorder. This study enhances our understanding of individuals living with bipolar disorder and provides valuable insights and feedback for researchers developing mental health interventions.

COVID-19 pandemic fatigue among well-educated egyptian population: Cross-sectional study

Aim

The study explores the emergence of COVID-19 pandemic fatigue among well-educated Egyptians measured in terms of their level of adherence toward COVID-19 protective measures along 20 months since the beginning of the pandemic.

Setting and Design

A cross-sectional study was conducted in October 2021, using an online questionnaire for well-educated Egyptians in different governorates.

Results

A total of 888 participants completed the questionnaire, their mean age was 39 ± 7.2 years and 60% of them were females. There was a strong association between the presence of either behavioral risk factors or chronic conditions and % of infection. The main sources of COVID-19 information were social media, followed by the Egyptian Ministry of health and population and WHO websites. A pandemic fatigue was observed after nearly 7 to 10 months from the pandemic emergence. The participant's age, previous COVID-19 infection, and occupation status were significant predictors for adherence to COVID-19 protective measures. The participants claimed that difficulty in remaining at home, feeling uncomfortable with face masks, the high cost of protective supplies, absence of governmental enforcement, and forgetfulness are the most perceptive barriers hindering their adherence to COVID-19 protective measures. They suggested some strategies for better adherence and reduced pandemic fatigue that includes: the implementation of governmental enforcement measures, including penalties for nonwearing masks, educational health programs, and availability of free protective supplies at the workplace.

Conclusions

Pandemic fatigue was observed after 7 to 10 months from the pandemic emergence even though the high education level of the participants.

Social Media Use Among Orthopedic and Trauma Surgeons in Germany: Cross-Sectional Survey Study

BACKGROUND

Social media (SM) has gained importance in the health care sector as a means of communication and a source of information for physicians and patients. However, the scope of professional SM use by orthopedic and trauma surgeons remains largely unknown.

OBJECTIVE

This study presents an overview of professional SM use among orthopedic and trauma surgeons in Germany in terms of the platforms used, frequency of use, and SM content management.

METHODS

We developed a web-based questionnaire with 33 variables and 2 separate sections based on a review of current literature. This study analyzed the first section of the questionnaire and included questions on demographics, type of SM used, frequency of use, and SM content management. Statistical analysis was performed using SPSS (version 26.0). Subgroup analysis was performed for sex, age groups (<60 years vs ≥60 years), and type of workplace (practice vs hospital). Differences between groups were assessed with a chi-square test for categorical data.

RESULTS

A total of 208 participants answered the questionnaire (166/208, 79.8% male), of whom 70.2% (146/208) were younger than 60 years and 77.4% (161/208) worked in a practice. All participants stated that they use SM for private and professional purposes. On average, participants used 1.6 SM platforms for professional purposes. More than half had separate SM accounts for private and professional use. The most frequently used SM platforms were messenger apps (119/200, 59.5%), employment-oriented SM (60/200, 30%), and YouTube (54/200, 27%). All other SM, including Facebook and Instagram, were only used by a minority of the participants. Women and younger participants were more likely to use Instagram (P<.001 and P=.03, respectively). The participants working in a hospital were more likely to use employment-oriented SM (P=.02) and messenger apps (P=.009) than participants working in a practice. In a professional context, 20.2% (39/193) of the participants produced their own content on SM, 24.9% (48/193) used SM daily, 39.9% (77/193) used SM during work, and 13.8% (26/188) stated that they checked the number of followers they had. Younger participants were more likely to have participated in professional SM training and to have separate private and professional accounts (P=.04 and P=.02, respectively). Younger participants tended toward increased production of their own content (P=.06).

CONCLUSIONS

SM is commonly used for professional purposes by orthopedic and trauma surgeons in Germany. However, it seems that professional SM use is not exploited to its full potential, and a structured implementation into daily professional work routines is still lacking. SM can have a profound impact on medical practices and communication, so orthopedic and trauma surgeons in Germany should consider increasing their SM presence by actively contributing to SM.

Complementary, alternative, and integrative medicine-specific COVID-19 misinformation on social media: A scoping review

Background

The sharing of health-related information has become increasingly popular on social media. Unregulated information sharing has led to the spread of misinformation, especially regarding complementary, alternative, and integrative medicine (CAIM). This scoping review synthesized evidence surrounding the spread of CAIM-related misinformation on social media during the COVID-19 pandemic.

Methods

This review was informed by a modified version of the Arksey and O'Malley scoping review framework. AMED, EMBASE, PsycINFO and MEDLINE databases were searched systematically from inception to January 2022. Eligible articles explored COVID-19 misinformation on social media and contained sufficient information on CAIM therapies. Common themes were identified using an inductive thematic analysis approach.

Results

Twenty-eight articles were included. The following themes were synthesized: 1) misinformation prompts unsafe and harmful behaviours, 2) misinformation can be separated into different categories, 3) individuals are capable of identifying and refuting CAIM misinformation, and 4) studies argue governments and social media companies have a responsibility to resolve the spread of COVID-19 misinformation.

Conclusions

Misinformation can spread more easily when shared on social media. Our review suggests that misinformation about COVID-19 related to CAIM that is disseminated online contributes to unsafe health behaviours, however, this may be remedied via public education initiatives and stricter media guidelines. The results of this scoping review are crucial to understanding the behavioural impacts of the spread of COVID-19 misinformation about CAIM therapies, and can inform the development of public health policies to mitigate these issues.

COVID-19: Factors Associated with the Psychological Distress, Fear and Resilient Coping Strategies among Community Members in Saudi Arabia

(1) Background: COVID-19 caused the worst international public health crisis, accompanied by major global economic downturns and mass-scale job losses, which impacted the psychosocial wellbeing of the worldwide population, including Saudi Arabia. Evidence of the high-risk groups impacted by the pandemic has been non-existent in Saudi Arabia. Therefore, this study examined factors associated with psychosocial distress, fear of COVID-19 and coping strategies among the general population in Saudi Arabia. (2) Methods: A cross-sectional study was conducted in healthcare and community settings in the Saudi Arabia using an anonymous online questionnaire. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used to assess psychological distress, fear and coping strategies, respectively. Multivariate logistic regressions were used, and an Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CIs) was reported. (3) Results: Among 803 participants, 70% (n = 556) were females, and the median age was 27 years; 35% (n = 278) were frontline or essential service workers; and 24% (n = 195) reported comorbid conditions including mental health illness. Of the respondents, 175 (21.8%) and 207 (25.8%) reported high and very high psychological distress, respectively. Factors associated with moderate to high levels of psychological distress were: youth, females, non-Saudi nationals, those experiencing a change in employment or a negative financial impact, having comorbidities, and current smoking. A high level of fear was reported by 89 participants (11.1%), and this was associated with being ex-smokers (3.72, 1.14-12.14, 0.029) and changes in employment (3.42, 1.91-6.11, 0.000). A high resilience was reported by 115 participants (14.3%), and 333 participants (41.5%) had medium resilience. Financial impact and contact with known/suspected cases (1.63, 1.12-2.38, 0.011) were associated with low, medium, to high resilient coping. (4) Conclusions: People in Saudi Arabia were at a higher risk of psychosocial distress along with medium-high resilience during the COVID-19 pandemic, warranting urgent attention from healthcare providers and policymakers to provide specific mental health support strategies for their current wellbeing and to avoid a post-pandemic mental health crisis.

The Use of Social Media in Delivering Rehabilitation Services by Healthcare Professionals at a Rehabilitation Healthcare City in Riyadh, Saudi Arabia

Background:

The growing popularity of social media has been welcomed by medical professionals. With an increase in the number of healthcare providers addressing healthcare issues by using social media, such as Facebook, Twitter, YouTube, Snapchat, and Instagram, as well as communicating and educating patients on public health, this new technology has a substantial impact on improving the overall public health.

Objective:

The primary purpose of this study was to examine the challenges and benefits of using social media in delivering rehabilitation healthcare services from the perspective of healthcare workers at a private institution in a rehabilitation healthcare city in Riyadh, Saudi Arabia.

Methods:

A cross-sectional study was conducted among rehabilitation department staff working at a selected rehabilitation healthcare city in Riyadh, Saudi Arabia. An online web-based questionnaire was developed based on previous studies. The survey was distributed to the employees of the rehabilitation department via their work email addresses.

Results:

The study population was 108 healthcare providers. Overall, 77.78% of participants had used social media for over five years. Participants reported using social media for numerous purposes. The majority (35.19%) used it for education purposes, 30.56% used it for networking, and others used it for other things, such as communication with patients, online consultations, and job hunting. Furthermore, 49.07% of participants were already using social media to deliver rehabilitation services.

Conclusion:

The study found that most healthcare providers agreed on the benefits of utilizing social media in the healthcare sector. Most of the benefits were expanding the knowledge of both healthcare workers and patients, easier communication with patients, and also a cost-effective means of communication. However, some of the concerns that were raised by healthcare providers were regarding patients’ privacy and confidentiality, the dissemination of false or misleading information, and legal and ethical considerations.

Mpox (monkeypox) information on TikTok: analysis of quality and audience engagement

BACKGROUND

Online information on mpox (monkeypox) is not well studied. We have analysed the video content, information quality, and audience engagement of mpox-related videos on TikTok.

METHODS

Using a hashtag-based searching strategy, we identified 2462 mpox-related videos on TikTok from 1 January to 11 August 2022; 85 were included after exclusion criteria screening. Videos were evaluated for content on features and treatment of mpox. Video and information quality was assessed using the DISCERN instrument and the Journal of the American Medical Association (JAMA) criteria. We recorded video source, evaluation scores, and viewer engagement metrics. The Kruskal-Wallis test was used for statistical analysis and multiple linear regression for factor-association studies.

RESULTS

Of the 85 videos, two assessed all content topics and highlighted 33% of all content items in clinical guidelines. The overall average score for the videos was 39.56 of 80 on the DISCERN instrument and 1.93 of 4 on the JAMA criteria. No video met all JAMA criteria. Subgroup analysis based on author identity suggested the variance in video scores by source (p<0.05 for all). Overall scores were higher for videos produced by doctors and science communicators than for those made by institutional users, nurses, and the general public. Multiple linear regression analysis showed that having people in the video (69.20, p=0.0001) and including information on treatment choices (1.15, p=0.045) were significant, independent determinants of audience engagement.

CONCLUSION

Public-directed TikTok videos on mpox frequently provide incomplete, inaccurate information, highlighting the potential risks of using TikTok as a health information source.

Quality and Popularity Trends of Weight Loss Procedure Videos on TikTok

INTRODUCTION

The use of social media as a medical information tool parallels rising obesity rates. TikTok, the popular video-sharing platform, contains nearly 99,000 videos hashtagged "weightloss." Prior studies have analyzed the quality of medical information on TikTok in other areas of medicine. However, the quality of videos regarding weight loss procedures has not yet been determined.

METHODS

Hashtags encompassing three weight loss modalities were searched using TikTok's algorithm. The first 50 videos meeting inclusion criteria for each modality were considered. Two independent reviewers categorized videos and assessed their content quality using DISCERN. Quality scores and popularity were compared between videos sources, modalities, and content categories.

RESULTS

Of 150 videos included, 20.7% were created by physicians versus 79.3% by non-physicians (p < 0.001). The average DISCERN score for physician-created content was significantly higher than that of non-physicians (p < 0.001), despite significantly less popularity (p < 0.002). The 50 most popular videos had significantly lower DISCERN scores than the 50 least popular (p < 0.02). The average DISCERN score for endoscopic sleeve gastroplasty (ESG) videos were significantly higher than videos related to Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) (p < 0.001). VSG-related videos were significantly more popular than RYGB- and ESG-related videos (p < 0.001 and p < 0.001). Finally, educational videos had significantly higher DISCERN scores than weight loss transformation and personal experience videos (p < 0.001).

CONCLUSION

Videos on TikTok related to weight loss procedures are poor, and greater popularity trends with lower quality. Assessment of content can encourage viewers to seek better information and allow providers to improve patient information tools.

Reddit Users' Questions and Concerns about Anesthesia

Background: Patients utilize social media in search of support networks. Reddit is one of the most popular social media sites and allows users to anonymously connect. Anesthesia patients are actively using Reddit to discuss their treatment options and experiences within the medical system. Methods: Posts published on an active Reddit forum on Anesthesia (i.e., /r/Anesthesia) were used. Big Query was used to collect posts from /r/Anesthesia. We collected 3,288 posts published between December 2015 and August 2019. We collected a control group of 3,288 posts from a Reddit forum not related to Anesthesia. Using latent Dirichlet allocation (LDA) we extracted 20 topics from our data set. The LDA topic themes most associated with posts in /r/Anesthesia compared to the control group were determined. Results: LDA analysis of posts in /r/Anesthesia relative to a control group produced 6 distinct categories of posts (Table 1). The posts most associated with /r/Anesthesia when compared to a control group were posts belonging to the “Physician-Patient Experience” category (Cohen’s d= 0.389) while the posts least associated with /r/Anesthesia were from the “Uncertainties” category of posts (Cohen’s d= 0.147). Example experiences from members of the /r/Anesthesia forum highlight subjective experiences of patients undergoing anesthesia. Conclusions: The language used on social media can provide insights into an individual's experience with anesthesia and inform physicians about patient concerns. Anesthesiologists are poised to address these concerns and prevent anonymous misinformation by providing verified physician insights on the forum /r/Anesthesia.

Social Media Content on Immunology: Is an Assessment by the Scientific Community Required?

In recent years, vaccines and immunotherapy have become two of the most promising and effective tools in the fight against a wide range of diseases, from the common cold to cancer [...].

Attitudes of Family Medicine Trainees Towards Patient-Centeredness Practice

Objective

The interaction between physicians and patients is essential in clinical practice. Patient-centered care (PCC) is becoming popular in healthcare and provides an approach to deliver high-quality healthcare to yield positive clinical outcomes. This study explores family medicine residents' attitudes toward the physician-patient relationship and patient-centered care and the possible influence of demographic characteristics, level of training, school of graduation, and previous training.

Methods

A cross-sectional study was conducted among family medicine residents in Riyadh. They were invited to enroll in a web-based survey that includes demographic data, training details, and the "Patient Practitioner Orientation Scale (PPOS).".

Results

A total of 114 family medicine residents completed the survey. There were 68 (59.6%) males and 46 (40.4%) female residents. The overall PPOS was 4.23 ± 0.53. The mean score for sharing domain was 3.97 ± 0.66. The caring domain scored 4.49 ± 0.57. No correlations were found between the residents' demographic data and other included variables, and the means of sharing domain, caring domain, and overall score.

Conclusion

Family medicine residents were found to have positive attitudes toward patient-centeredness. Integrating patient-centered training early in the curriculum can improve healthcare students' and trainees' attitudes toward patient-centered care. Future research can explore the possible interventions in systematic assessment and training programs that can improve PCP.

Assessing the Validity of Health Messages Used by the Saudi Public in WhatsApp

OBJECTIVE

WhatsApp is the most frequently used social media platform in Saudi Arabia. Inaccurate information could negatively impact public health. The number of studies worldwide investigating health-related misinformation in social media increased steadily, with limited data from Arabic-speaking communities. This study aimed to estimate the validity and safety of Arabic-language health information messages circulated on WhatsApp and identify the different categories of these messages based on their credibility.

PARTICIPANTS AND METHODS

A descriptive, analytical cross-sectional study was conducted from February to April 2021. A total of 374 students were randomly selected from the common first preparatory year college at King Saud University in Riyadh, Saudi Arabia, and participated by sharing up to three health-related WhatsApp messages per student that they or their relatives had recently read. Four board-certified physicians reviewed and classified the messages based on their credibility and sources.

RESULTS

282 students provided 326 messages (1.2 messages per student). Most messages (86%) had either invalid or inaccurate content, and 83.7% came from unknown sources. Only 26 messages (8%) of the total were written by trusted scientific sources. Most of the messages from unknown sources or unqualified persons were either invalid or invalid, with potential health risks for the public, and the difference from trusted sources was statistically significant.

CONCLUSION

This study showed a high percentage of inaccurate and invalid health-related messages on WhatsApp. Invalid messages with potential health risks were authored mostly by unknown sources or unqualified persons. Most health messages written by trusted authorities and qualified persons were valid. Trusted scientific authorities should thus be more active in public education on social media platforms. They should advise their communities on how to discern the validity of such messages. More efforts are needed to guide patients from where to obtain accurate and valid health information.

Ethical principles for infodemiology and infoveillance studies concerning infodemic management on social media

Big data originating from user interactions on social media play an essential role in infodemiology and infoveillance outcomes, supporting the planning and implementation of public health actions. Notably, the extrapolation of these data requires an awareness of different ethical elements. Previous studies have investigated and discussed the adoption of conventional ethical approaches in the contemporary public health digital surveillance space. However, there is a lack of specific ethical guidelines to orient infodemiology and infoveillance studies concerning infodemic on social media, making it challenging to design digital strategies to combat this phenomenon. Hence, it is necessary to explore if traditional ethical pillars can support digital purposes or whether new ones must be proposed since we are confronted with a complex online misinformation scenario. Therefore, this perspective provides an overview of the current scenario of ethics-related issues of infodemiology and infoveillance on social media for infodemic studies.

Online Health (Mis)Information: The Role of Medical Students

The public perceive social media as a convenient source of health information. Some physicians might use this to enhance their visibility and market value. In this study, we aimed to assess medical students' awareness of regulations for dispersion of health-related information on social media and physicians' online self-promotional activities. A cross-sectional study was conducted among undergraduate medical students from the 3 largest administrative regions of Saudi Arabia: Central, Western, and Eastern regions. Data was collected between February-July 2020 via online distribution of a self-administered questionnaire. Results showed that: (a) a total of 730 medical students participated; (b) about half of respondents were unsure or unaware of guidelines of both, online posting of medical information and physicians' online self-promotional activities (343/47% and 385/52.7%, respectively); (c) 610 (83.6%) students supported that healthcare providers report accounts sharing unreliable health information. Physicians' online promotional activities, and posting about successful cases, might shift physicians' focus from patient care to becoming more popular online. Care should be taken not to breach essential professional and ethical principles, such as protecting the confidentiality and privacy of patients. Raising awareness among patients and physicians, current and future ones, of the regulations governing these online health related interactions is imperative.

Immigration status as a determinant of health information-seeking behavior among undergraduates of color at an urban commuter college

Background: Health information-seeking behavior (HISB) of college students is of importance due to health information inconsistencies at a time when personal independence and concurrent personal health decision making may be increased. Currently, there is a dearth of research about the HISB of college students, especially from diverse backgrounds. Therefore, the purpose of this study was to identify and describe the sources college students use when engaging in HISB; and to explore associations between HISB and demographic factors. Methods: This cross-sectional study was conducted with undergraduate students at a diverse, public institution in New York City. The sample was drawn from an institutional social science research pool and asked to complete a survey on HISB. A total of 226 respondents completed the survey. Results: The believed accuracy of the information found online was positively correlated with related behaviors and beliefs. The number of followers on Instagram proved to be an important mediator of HISB of college students. The number of followers a health information provider has was fittingly positively correlated with the belief that social media is a helpful resource for health information r(233)=0.18, P=0.01. Students from families with two or more generations living in the United States accessed health professionals more frequently than students from one or less generation (χ²=8.107(2), P=0.017). Conclusion: Targeted educational programs designed to increase health information seeking skills, including discernment of information quality should be a priority for college students.

Use of Complementary and Alternative Medicine in the General Public of Western Saudi Arabia: A Cross-Sectional Survey

BACKGROUND

Complementary and alternative medicine (CAM) has been continuously used worldwide. Various cultures have used this path of healing, and to our date, people are still using it and some even prefer it to modern medicine. Thus, this study aims to analyze awareness, self-use, perceptions, beliefs, and attitudes toward CAM in the general public of Jeddah, Saudi Arabia.

METHODS

A descriptive observational cross-sectional study was conducted in the public places of Jeddah. Data were collected from 784 participants using a self-administered paper-based questionnaire, and statistical analysis was performed using Statistical Package for the Social Sciences (SPSS).

RESULTS

The majority of the population was aware of massage (91.8%), herbs (90.7%), nutritional supplements (89.8%), and prayers (88.1%). With regards to usage and effectiveness, prayers and spirituality is used by 75.5% of the population and considered to be the most effective by 76.0%. Respondents obtained information about CAM mostly from friends and relatives (76.6%), followed by media (67.2%), while lack of knowledge about CAM and lack of trained professionals are the most perceived barriers to CAM implementation. Data showed a significant association (p < 0.05) between gender, awareness, and self-use of CAM modalities. Yoga (44.2%) and herbs (72.6%) were mostly used by females, whereas males were mostly aware of cupping (90.4%) and cauterization (76.2%). Another significant association was found between the level of education, awareness, and self-use of CAM modalities indicating that those who were not educated were aware of and used cauterization the most, while those who went to college were more aware of yoga (75.4%). Lastly, having a relative in the healthcare field showed a significant association with awareness of yoga, prayers, and spirituality compared to other CAM modalities.

CONCLUSION

In conclusion, the present study revealed that the majority of the Western Saudi Arabian population was aware of several CAM modalities and practiced some form of CAM. However, awareness of specific types of CAM may relate to gender, educational level, and relationship to the medical field.

COVID-19 Information in Sweden: Opinions of Immigrants with Limited Proficiency in Swedish

COVID-19 has highlighted the importance of health information for prevention of communicable disease. Knowledge about groups that have high risk is important to prevent disease transmission. In Sweden, immigrants have been identified as one such group. Yet, little is known about where they have sourced information about COVID-19 and their opinions toward it. The aim of this study was to describe the COVID-19 information sources used by immigrants with limited proficiency in Swedish as well as their opinions on how comprehensive the information has been, the importance of the recommendations and their possibility to follow them. A cross-sectional survey was conducted via introductory Swedish language classes in Region Uppsala (n = 855). The results showed the immigrants were using different information sources, with the majority using school, media and social media. The immigrants' opinions about COVID-19 information differed. Most reported they knew where to find information; however, over two-fifths reported the recommendations from the authorities should be more extensive. The majority reported it is important to follow the recommendations, whereas the possibility to follow the recommendations was more mixed. Age differences in opinions toward COVID-19 information were detected. Although the results were largely positive, there still appears to be a need for improvement in how immigrant groups with limited ability in the host country´s language are reached. Effective health communication that engages the whole nation is an important factor authorities should commit to as we face the current pandemic. This research suggests that an approach tailored by age could be helpful.