Cardiac Patients' Experiences and Perceptions of Social Media: Mixed-Methods Study

Facial Reanimation Surgery: An Investigation on the Role of Online Information Sharing in Patient Education and Decision Making

Purpose: The emergence of facial reanimation surgery as a reconstructive option has sparked a growing interest among patients with facial paralysis, leading to an increase in patients seeking and sharing information on these surgical modalities. This study evaluated the role of social media in information-sharing on facial reanimation surgery. Methods: We identified 630 Facebook groups based on the initial keyword search for "facial paralysis" and "Bell's palsy." Groups with < 100 members, non-English content, or restricted access were excluded. Within each group, searches were conducted for terms related to surgery and posts were categorized as sharing information, seeking information, sharing support, seeking support, or sharing appreciation. Results: The search yielded 630 groups; 21 groups met the inclusion criteria (average size = 4037, largest = 31 400). Facial reanimation surgery was discussed in 15 groups, with 487 relevant posts tabulated. In the sharing information axis, posts were related to personal experiences (63%), alternatives (14%), link shares (7%), surgeon/center (5%), general recovery progression (8%), objective information on surgical modality (1%), objective information on nerve injury (1%), and general information on relevant medical research (1%). In the seeking information axis, posts were related to personal experience (71%), objective information (12%), surgeon/center (4%), second opinion (13%), and alternatives (1%). Conclusion: Social media is an essential source of information and support for people with facial paralysis. These study findings will inform the implementation of future knowledge translation efforts to maximize education and subsequent uptake of facial reanimation reconstructive surgery.

Patient Perception of Social Media Use by Orthopaedic Surgeons: A Pilot Study

Background

Social media (SM) use by orthopaedic surgeons is becoming increasingly common; nonetheless, it needs to be clarified how patients perceive the content posted by physicians.

Purpose

To characterize SM content posted by orthopaedic surgeons while investigating patient perceptions of this content and how it may influence their health care decisions.

Study Design

Cross-sectional study.

Methods

Posts on SM outlets by orthopaedic surgeons were reviewed and categorized. A survey to assess patient perception of these categories was administered between December 2021 and February 2022 in the clinics of 3 orthopaedic surgeons. Survey results were analyzed for differences in patient SM use and perception of SM content types.

Results

There were 250 completed surveys. SM use was high among all age groups; however, the 18 to 24 years (87.1%) and 25 to 34 years (86.4%) age groups were more likely than older age groups to report daily use (P = .002). Overall, 17% of patients reported using SM to see information about their health care at least once per month, 21% reported reviewing the SM account of a physician at least once per month, 19% reported that they were likely or very likely to view the SM account of their physician, and 23% reported that SM content was likely or very likely to influence which physician they see. Patients held the most consistently positive view of posts that educated patients, discussed sports team coverage, and provided patient testimonials. Patients had consistently neutral views of posts educating colleagues, discussing presentations at national meetings, displaying aspects of surgeons' personal lives, and supporting marginalized groups. Several post categories elicited highly polarized responses-including those discussing research publications and showing surgical techniques or pictures/videos taken during surgery. Respondents had a consistently negative response to posts making political statements.

Conclusion

SM is likely a useful tool to help physicians interact with patients. Physicians who wish to interact with patients should consider posting content viewed most positively-including posts educating patients, discussing sports team coverage, and providing patient testimonials. Content that is viewed less favorably should be posted sparingly or with a sensitive tag.

Cardiac Rehabilitation Facebook Intervention: Feasibility Randomized Controlled Trial

BACKGROUND

The adherence to cardiac rehabilitation is low. Social media has been used to improve motivation and cardiac rehabilitation completion, but the authors did not find Facebook interventions for these purposes in the literature.

OBJECTIVE

The purpose of this study was to determine the feasibility of the Cardiac Rehabilitation Facebook Intervention (Chat) for affecting changes in exercise motivation and need satisfaction and adherence to cardiac rehabilitation.

METHODS

The Behavioral Regulation in Exercise Questionnaire-3 and Psychological Need Satisfaction for Exercise were used to measure motivation and need satisfaction (competence, autonomy, and relatedness) before and after the Chat intervention. To support need satisfaction, the intervention included educational posts, supportive posts, and interaction with peers. The feasibility measures included recruitment, engagement, and acceptability. Groups were compared using analysis of variance and Kruskal-Wallis tests. Paired t tests were used to assess motivation and need satisfaction change, and Pearson or Spearman correlations were used for continuous variables.

RESULTS

A total of 32 participants were lost to follow-up and 22 were included in the analysis. Higher motivation at intake (relative autonomy index 0.53, 95% CI 0.14-0.78; P=.01) and change in need satisfaction-autonomy (relative autonomy index 0.61, 95% CI 0.09-0.87; P=.02) were associated with more completed sessions. No between-group differences were found. Engagement included "likes" (n=210) and "hits" (n=157). For acceptability, mean scores on a 1 (not at all) to 5 (quite a bit) Likert scale for feeling supported and in touch with providers were 4.6 and 4.4, respectively.

CONCLUSIONS

Acceptability of the Chat group was high; however, intervention feasibility could not be determined due to the small sample size. Those with greater motivation at intake completed more sessions, indicating its importance in cardiac rehabilitation completion. Despite challenges with recruitment and engagement, important lessons were learned.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02971813; https://clinicaltrials.gov/ct2/show/NCT02971813.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/resprot.7554.

What Lessons Can Be Learned for the Agroecological Transition From the Use of Social Media in Preventive Medicine?

In agriculture, web-based social media are increasingly used to share knowledge concerning best practices. One goal of agroecology is to reduce the use of synthetic chemical inputs. Agroecology represents a contrast with intensive agriculture in that it better manages interactions with life forms. It is crucial to help people share their knowledge to accomplish the agroecological transition. This paper proposes an analogy between the use of social media to facilitate (1) caring for plants in the context of agroecology and (2) preventing human diseases in the context of medicine. The authors created a bibliography of scientific publications related to social media use in preventative medicine to identify best practices for social media use (and the associated drawbacks) that can be applied to develop social media dedicated to agroecology.

Receptiveness and Responsiveness Toward Using Social Media for Safe Firearm Storage Outreach: Mixed Methods Study

BACKGROUND

Childhood and adolescent firearm injury and death rates have increased over the past decade and remain major public health concerns in the United States. Safe firearm storage has proven to be an effective measure to prevent firearm injury and death among youth. Social media has been used as an avenue to promote safe firearm storage, but perceptions of this tool remain unknown.

OBJECTIVE

The aim of this study was to determine receptiveness and responsiveness in promoting firearm lock box and trigger lock giveaway events on social media, and to describe the characteristics of participants who learned of these events through social media.

METHODS

We performed a mixed methods study combining a content analysis of Facebook event post comments, quantitative analysis of positive and negative feedback on social media, and a descriptive analysis of event participant characteristics. Through a qualitative content analysis approach, we thematically coded comments from each event's social media page posting. Interrater reliability and κ statistics were calculated. We calculated the prevalence of positive and negative feedback data. Further, we calculated descriptive statistics for demographic characteristics gathered from day-of-event intake surveys. Differences between collected measures were analyzed with χ2 and t tests according to how the participant found out about the event (social media vs other means). Using concurrent analysis, we synthesized the results from both the qualitative and quantitative aims.

RESULTS

Through qualitative content analysis, 414 comments from 13 events were coded. Seven themes emerged through the comment coding process with the most common being "positive receptiveness" (294/414, 71.0%). From quantitative analysis of the social media content, we found higher levels of positive feedback compared to negative feedback. The average number of event post "likes" was 1271.3 per event, whereas the average count in which "hide post" was clicked was 72.3 times per event. Overall, 35.9% (1457/4054) of participants found out about the event through social media. The participants who learned about the event through social media were on average significantly younger than those who learned about the event through other means (-6.4 years, 95% CI -5.5 to -7.3). Among the group that learned of the event through social media, 43.9% (629/1433) identified as female, whereas 35.5% (860/2420) identified as female among the group that learned of the event through other means.

CONCLUSIONS

There was overall positive receptiveness and responsiveness toward firearm lock box and trigger lock giveaway events when promoted on social media. Compared with other promotional tools, social media has the ability to reach those who are younger and those who identify as female. Future studies should extend this research to determine whether there is a difference between rural and urban settings, and consider other social media platforms in the analysis.

Patients' experiences of the complex trust-building process within digital cardiac rehabilitation

The development of digital solutions is becoming increasingly important in facing global challenges. Therefore, research on this topic is important in taking into account cardiac patients’ experiences of the rehabilitation process for the design of digital counseling solutions. The aim of the present qualitative study was to explore the different meanings that patients give to the rehabilitation process using a Glaserian grounded theory (GT) approach. Qualitative interviews were conducted with 30 participants from a rehabilitation center in Finland. The findings indicated a “complex trust-building process” core category comprising five categories of trust-building in rehabilitation: feeling that one has hit rock bottom, facing and coping in a crosscurrent, understanding together as a peer group, moving toward a healthier lifestyle with technology, and finding self-awareness. The complex process of trust-building involved interactions among emotion, cognition, and acceptance and support processes. Therefore, digital rehabilitation should be incorporated into counseling based on patients’ psychosocial, physical and emotional needs to help patients become aware of their own feelings and thoughts during the rehabilitation process.

Delivering healthcare remotely to cardiovascular patients during COVID-19 : A rapid review of the evidence

BACKGROUND

Although attention is focused on addressing the acute situation created by the COVID-19 illness, it is imperative to continue our efforts to prevent cardiovascular morbidity and mortality, particularly during a period of prolonged social isolation which may limit physical activity, adversely affect mental health and reduce access to usual care. One option may be to deliver healthcare interventions remotely through digital healthcare solutions. Therefore, the aim of this paper is to bring together the evidence for remote healthcare during a quarantine situation period to support people living with cardiovascular disease during COVID-19 isolation.

METHODS

The PubMed, CINAHL and Google Scholar were searched using telehealth OR digital health OR mHealth OR eHealth OR mobile apps AND COVID-19 OR quarantine search terms. We also searched for literature relating to cardiovascular disease AND quarantine.

RESULTS

The literature search identified 45 potentially relevant publications, out of which nine articles were included. Three overarching themes emerged from this review: (1) preparing the workforce and ensuring reimbursement for remote healthcare, (2) supporting mental and physical health and (3) supporting usual care.

CONCLUSION

To support people living with cardiovascular disease during COVID-19 isolation and to mitigate the effects of quarantine and adverse effect on mental and physical well-being, we should offer remote healthcare and provide access to their usual care.

Patients' Use of Social Media for Diabetes Self-Care: Systematic Review

BACKGROUND

Patient engagement with diabetes self-care is critical to reducing morbidity and mortality. Social media is one form of digital health that is available for diabetes self-care, although its use for peer-to-peer communication has not been systematically described, and its potential to support patient self-care is unclear.

OBJECTIVE

The primary aim of this systematic review was to describe the use of social media among patients (peer-to-peer) to manage diabetes and cardiovascular disease (CVD). The secondary aim was to assess patients' clinical outcomes, behavioral outcomes, quality of life, and self-efficacy resulting from peer-to-peer social media use.

METHODS

We conducted a literature search in the following databases: PubMed, EMBASE, Web of Science, CINAHL, and PsycINFO (January 2008 through April 2019). The inclusion criteria were quantitative studies that included peer-to-peer use of social media for self-care of diabetes mellitus (with all subtypes) and CVD, including stroke.

RESULTS

After an initial yield of 3066 citations, we selected 91 articles for a full-text review and identified 7 papers that met our inclusion criteria. Of these, 4 studies focused on type 1 diabetes, 1 study included both type 1 and 2 diabetes, and 2 studies included multiple chronic conditions (eg, CVD, diabetes, depression, etc). Our search did not yield any individual studies on CVD alone. Among the selected papers, 2 studies used commercial platforms (Facebook and I Seek You), 3 studies used discussion forums developed specifically for each study, and 2 surveyed patients through different platforms or blogs. There was significant heterogeneity in the study designs, methodologies, and outcomes applied, but all studies showed favorable results on either primary or secondary outcomes. The quality of studies was highly variable.

CONCLUSIONS

The future landscape of social media use for patient self-care is promising. However, current use is nascent. Our extensive search yielded only 7 studies, all of which included diabetes, indicating the most interest and demand for peer-to-peer interaction on diabetes self-care. Future research is needed to establish efficacy and safety in recommending social media use among peers for diabetes self-care and other conditions.

Participant Experiences of an Infant Obesity Prevention Program Delivered via Telephone Calls or Text Messages

A 3-arm randomised controlled trial implemented in 2017, recruited participants from four Local Health Districts (LHDs) in New South Wales (NSW) to test an early obesity prevention program delivered via telephone calls (telephone) or text messages (SMS). This sub-study explored participants' experience and satisfaction with the program. A multimethod design was used. Quantitative satisfaction questions were completed by participants when their child was six-months old. A purposive sample of participants with varying satisfaction levels was invited for in-depth qualitative interviews. Data were analysed using Excel (quantitative) and inductive thematic analysis (qualitative). Of the 1155 participants recruited: 947 (293 telephone; 338 SMS; 316 control) completed the six-month survey; 34 (14 telephone; 13 SMS; 7 control) were interviewed. Participants' overall program satisfaction was 100% (telephone) and 85% (SMS). Participants' qualitative responses demonstrated appreciation of: personalised stage-based information; opportunity to communicate with health professionals (telephone); linked Healthy Beginnings booklets and SMS mostly as nudges (SMS). There is a clear need for stage-based information, and supplemented modes of delivery i.e., text messages along with telephone calls; with text messages solely seen as nudges or reminders. However, individual preferences vary according to information needs at any given time, time constraints on new mothers and hence, multiple modes of information provision are recommended in order to reach a wider population and for better engagement. Choice and flexibility in mode of delivery has the potential to provide equitable access to information, empowering women with infants to practice recommended health behaviours for infant obesity prevention.

Characteristics Associated With Facebook Use and Interest in Digital Disease Support Among Older Adults With Atrial Fibrillation: Cross-Sectional Analysis of Baseline Data From the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF) Cohort

BACKGROUND

Online support groups for atrial fibrillation (AF) and apps to detect and manage AF exist, but the scientific literature does not describe which patients are interested in digital disease support.

OBJECTIVE

The objective of this study was to describe characteristics associated with Facebook use and interest in digital disease support among older patients with AF who used the internet.

METHODS

We used baseline data from the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF), a prospective cohort of older adults (≥65 years) with AF at high stroke risk. Participants self-reported demographics, clinical characteristics, and Facebook and technology use. Online patients (internet use in the past 4 weeks) were asked whether they would be interested in participating in an online support AF community. Mobile users (owns smartphone and/or tablet) were asked about interest in communicating with their health care team about their AF-related health using a secure app. Logistic regression models identified crude and multivariable predictors of Facebook use and interest in digital disease support.

RESULTS

Online patients (N=816) were aged 74.2 (SD 6.6) years, 47.8% (390/816) were female, and 91.1% (743/816) were non-Hispanic white. Roughly half (52.5%; 428/816) used Facebook. Facebook use was more common among women (adjusted odds ratio [aOR] 2.21, 95% CI 1.66-2.95) and patients with mild to severe depressive symptoms (aOR 1.50, 95% CI 1.08-2.10) and less common among patients aged ≥85 years (aOR 0.27, 95% CI 0.15-0.48). Forty percent (40.4%; 330/816) reported interest in an online AF patient community. Interest in an online AF patient community was more common among online patients with some college/trade school or Bachelors/graduate school (aOR 1.70, 95% CI 1.10-2.61 and aOR 1.82, 95% CI 1.13-2.92, respectively), obesity (aOR 1.65, 95% CI 1.08-2.52), online health information seeking at most weekly or multiple times per week (aOR 1.84, 95% CI 1.32-2.56 and aOR 2.78, 95% CI 1.86-4.16, respectively), and daily Facebook use (aOR 1.76, 95% CI 1.26-2.46). Among mobile users, 51.8% (324/626) reported interest in communicating with their health care team via a mobile app. Interest in app-mediated communication was less likely among women (aOR 0.48, 95% CI 0.34-0.68) and more common among online patients who had completed trade school/some college versus high school/General Educational Development (aOR 1.95, 95% CI 1.17-3.22), sought online health information at most weekly or multiple times per week (aOR 1.86, 95% CI 1.27-2.74 and aOR 2.24, 95% CI 1.39-3.62, respectively), and had health-related apps (aOR 3.92, 95% CI 2.62-5.86).

CONCLUSIONS

Among older adults with AF who use the internet, technology use and demographics are associated with interest in digital disease support. Clinics and health care providers may wish to encourage patients to join an existing online support community for AF and explore opportunities for app-mediated patient-provider communication.

Social Media Use and Preferences in Patients With Inflammatory Bowel Disease

INTRODUCTION

There has been growing interest in social media use in managing chronic illnesses. The aim of this study was to assess social media usage in a large sample of patients with inflammatory bowel disease (IBD).

METHODS

We performed a cross-sectional study within the Crohn's and Colitis Foundation's IBD Partners' internet-based cohort. We used bivariate analyses to compare patient characteristics by various factors associated with social media utilization. We used logistic regression models to determine factors independently associated with using social media to obtain IBD-related information.

RESULTS

A total of 1960 IBD patients were included. Most respondents reported spending between 30 and 60 minutes on social media sites per day. Thirty-two percent of respondents agreed that social media could be useful for disease management. Most respondents agreed that social media should be used to connect patients with IBD-related organizations and to obtain IBD-related information online. Fifty percent of respondents could not rate the quality of IBD information posted online. Concerns surrounding social media use included privacy/confidentiality and lack of trust of information posted. The most frequently used social media website was Facebook. Thirty-two percent of respondents used social media at least once in the last week to obtain or post IBD-related content. Factors independently associated with social media use for IBD included female gender (odds ratio [OR] 1.43; 95% CI,1.10-1.87), age (OR 0.99; 95% CI, 0.98-1.00), remission (OR 0.63; 95% CI, 0.50-0.79), and a diagnosis of Crohn's disease (CD) rather than ulcerative colitis (UC) (OR 0.74; 95% CI, 0.58-0.93).

CONCLUSIONS

Patients with IBD in this cohort expressed a substantial interest in using social media to aid in disease management. Use was higher in younger patients, females, and patients with active disease. Most patients were unsure of the quality of information posted online, which represents opportunities for clinicians to guide patients to appropriate resources.

What do Sport and Exercise Medicine (SEM) doctors look like online? A cross-sectional exploration of the social media presence of SEM doctors in the UK

Objectives

To explore the social media presence of Sport and Exercise Medicine (SEM) doctors from the UK. Secondary aims were to identify whether there were any differences in years since qualification or specialisation between those with and without social media profiles and websites.

Methods

A cross-sectional design was used to investigate the social media presence of UK-based doctors listed as Fellows of the Faculty of Sport and Exercise Medicine. These SEM doctors were identified via their presence on publicly available member lists. Data collected for each SEM Fellow included the presence of profiles on major social media platforms (Twitter, LinkedIn, YouTube and professional Facebook profiles) demonstrated by active profile use and the number of followers/subscribers per platform. The ownership of professional websites and websites hosted by private healthcare providers was also examined.

Results

A total of 175 SEM Fellows were identified and included for analysis. LinkedIn was the most popular platform for this cohort (n=115), followed by Twitter (n=73), while YouTube had far fewer profiles among the SEM Fellows (n=9). No professional Facebook profiles were identified for the SEM Doctors in this study. Almost a third (n=49) of SEM Fellows did not have a profile on any of the social media platforms examined in this study.

Conclusion

Social media is a powerful tool for health promotion and education. The use of these platforms by SEM Doctors and healthcare organisations warrants ongoing guidance and support to enable these practitioners to maximise the utility of these innovative technologies.

Cardiac Rehabilitees' Technology Experiences Before Remote Rehabilitation: Qualitative Study Using a Grounded Theory Approach

Background

Even though technology is becoming increasingly common in rehabilitation programs, insufficient data are as yet available on rehabilitees’ perceptions and experiences. It is important to understand their abilities when using technology for remote rehabilitation.

Objective

This is a qualitative study on technology experiences of persons affected by cardiovascular disease assessed before remote rehabilitation. The aim of the study was to explore rehabilitees’ experiences and attitudes toward technology before 12 months of remote rehabilitation.

Methods

Qualitative interviews were conducted with 39 rehabilitees in four focus groups. The subjects were aged 34 to 77 years (average age 54.8 years) and 74% (29/39) of them were male. They had been diagnosed with coronary artery disease and were undergoing treatment in a rehabilitation center. The interviews were conducted between September 2015 and November 2016. Data were analyzed using Glaser’s mode of the grounded theory approach.

Results

The result of the study was an “identifying e-usage” experience category, which refers to the rehabilitees’ notions of the use of information and communication technologies (e-usage) in the process of behavior change. The main category comprises four subcategories that define the rehabilitees’ technology experience. These subcategories are “feeling outsider,” “being uninterested,” “reflecting benefit,” and “enthusiastic using.” All rehabilitees expected that technology should be simple, flexible, and easy to use and learn. The results reflecting their technology experience can be used in e-rehabilitation programs. Rehabilitees who feel like outsiders and are not interested in technology need face-to-face communication for the major part of rehabilitation, while rehabilitees who reflect benefit and are enthusiastic about the use of technology need incrementally less face-to-face interaction and feel that Web-based coaching could offer sufficient support for rehabilitation.

Conclusions

The findings show that persons affected by heart disease had different experiences with technology and expectations toward counseling, while all rehabilitees expected technology to be easy to use and their experiences to be smooth and problem-free. The results can be used more widely in different contexts of social and health care for the planning of and training in remote rehabilitation counseling and education.

Trial Registration

ISRCTN Registry ISRCTN61225589; http://www.isrctn.com/ISRCTN61225589 (Archived by WebCite at http://www.webcitation.org/74jmrTXFD)

Facebook Groups for the Management of Chronic Diseases

The use of Facebook groups by health care researchers and professionals for chronic disease management, namely type 2 diabetes mellitus and coronary heart disease, is in its early stages and challenges are emerging. While Facebook groups offer great potential to deliver health support, research of Facebook groups for chronic disease management remains in its infancy, with robust evidence not yet available. Designing Facebook groups that are acceptable to users, health care researchers as well as health care professionals is a challenge, and there is a poor fit with traditional research and evaluation methods. Key recommendations for future research of Facebook groups for chronic disease management include: (1) iterative content development with input from the target patient population; (2) further understanding of the potential role of group "champions"; (3) ensuring the social media policies of health care institutions allow for real time online communication; and (4) utilizing comprehensive evaluation strategies, including the use of process evaluations.