Professional Social Media Use Among Orthopedic and Trauma Surgeons in Germany: Cross-Sectional Questionnaire-Based Study

BACKGROUND

Social media (SM) has been recognized as a professional communication tool in the field of orthopedic and trauma surgery that can enhance communication with patients and peers, and increase the visibility of research and offered services. The specific purposes of professional SM use and the benefits and concerns among orthopedic and trauma surgeons, however, remain unexplored.

OBJECTIVE

This study aims to demonstrate the specific uses of different SM platforms among orthopedic and trauma surgeons in Germany as well as the advantages and concerns.

METHODS

A web-based questionnaire was developed on the use of SM in a professional context by considering the current literature and the authors' topics of interest. The final questionnaire consisted of 33 questions and was distributed among German orthopedic and trauma surgeons via the mail distributor of the Berufsverband für Orthopädie und Unfallchirurgie (Professional Association of Orthopaedic Surgeons in Germany). The study was conducted between June and July 2022. A subgroup analysis was performed for sex (male vs female), age (<60 years vs ≥60 years), and type of workplace (practice vs hospital).

RESULTS

A total of 208 participants answered the questionnaire (male: n=166, 79.8%; younger than 60 years: n=146, 70.2%). In total, all of the participants stated that they use SM for professional purposes. In contrast, the stated specific uses of SM were low. Overall, the most used platforms were employment-oriented SM, messenger apps, and Facebook. Instagram emerged as a popular choice among female participants and participants working in hospital settings. The highest specific use of SM was for professional networking, followed by receiving and sharing health-related information. The lowest specific use was for education and the acquisition of patients. Conventional websites occupied a dominating position, exceeding the use of SM across all specific uses. The key benefit of SM was professional networking. Under 50% of the participants stated that SM could be used to enhance communication with their patients, keep up-to-date, or increase their professional visibility. In total, 65.5% (112/171) of participants stated that SM use was time-consuming, 43.9% (76/173) stated that they lacked application knowledge, and 45.1% (78/173) stated that they did not know what content to post. Additionally, 52.9% (91/172) mentioned medicolegal concerns.

CONCLUSIONS

Overall, SM did not seem to be used actively in the professional context among orthopedic and trauma surgeons in Germany. The stated advantages were low, while the stated concerns were high. Adequate education and information material are needed to elucidate the possible professional applications of SM and to address legal concerns.

Communication modality matters: Co-rumination via in-person versus digital modalities has different prospective associations with depression and friendship quality

INTRODUCTION

Co-rumination is an interpersonal emotion regulation strategy in which negative feelings and problems are discussed perseveratively with another person. Although co-rumination is salient in adolescence, research to date has focused on co-rumination occurring in person and has not kept pace with the surge in digital communication that begins in adolescence. This study examined the degree, associations among, and consequences (i.e., depressive symptoms, and friendship quality) of adolescents' co-rumination via in-person, text, social media, and phone modalities.

METHODS

Adolescents (n = 109; 51 girls, 57 boys, 1 nonbinary; Mage = 12.83 years) residing in Canada, completed self-report questionnaires on co-rumination, depressive symptoms, and friendship quality for up to 2 years.

RESULTS

Adolescents engaged in co-rumination across all modalities, particularly in-person. Findings indicated a negative association between in-person co-rumination at baseline and in-person co-rumination over time. Whereas less text co-rumination was associated with increased depressive symptoms over time, greater phone co-rumination was associated with increased depressive symptoms over time. Although greater in-person co-rumination was positively associated with friendship quality concurrently, it was negatively associated with friendship quality prospectively.

CONCLUSIONS

Taken together, co-rumination outcomes may vary depending on communication modality. Implications for adolescents' mental and social wellbeing are discussed.

Patient Perspectives on Communication Pathways After Orthopedic Surgery and Discharge and Evaluation of Team-Based Digital Communication: Qualitative Exploratory Study

BACKGROUND

The transition from hospital to home after orthopedic surgery requires smooth communication and coordination between patients and their team of care to avoid fragmented care pathways. Digital communication is increasingly being used to facilitate easy and accessible asynchronous communication between patients and health care professionals across settings. A team-based approach to digital communication may provide optimized quality of care in the postoperative period following orthopedic surgery and hospital discharge.

OBJECTIVE

This study was divided into two phases that aimed to (1) explore the perspectives of patients undergoing orthopedic surgery on current communication pathways at a tertiary hospital in Denmark and (2) test and explore patients' experiences and use of team-based digital communication following hospital discharge (eDialogue).

METHODS

A triangulation of qualitative data collection techniques was applied: document analysis, participant observations (n=16 hours), semistructured interviews with patients before (n=31) and after (n=24) their access to eDialogue, and exploration of use data.

RESULTS

Findings show that patients experience difficult communication pathways after hospital discharge and a lack of information due to inadequate coordination of care. eDialogue was used by 84% (26/31) of the patients, and they suggested that it provided a sense of security, coherence, and proximity in the aftercare rearranging communication pathways for the better. Specific drivers and barriers to use were identified, and these call for further exploration of eDialogue.

CONCLUSIONS

In conclusion, patients evaluated eDialogue positively and suggested that it could support them after returning home following orthopedic surgery.

Social Media Use in Dermatology in Turkey: Challenges and Tips for Patient Health

Social media has established its place in our daily lives, especially with the advent of the COVID-19 pandemic. It has become the leading source of information for dermatological literacy on various topics, ranging from skin diseases to everyday skincare and cosmetic purposes in the present digital era. Accumulated evidence indicates that accurate medical content constitutes only a tiny fraction of the exponentially growing dermatological information on digital platforms, highlighting an unmet patient need for access to evidence-based information on social media. However, there have been no recent local publications from Turkey analyzing and assessing the key elements in raising dermatological literacy and awareness in digital communication for patients. To the best of our knowledge, this study is the first collaborative work between health care professionals and a social media specialist in the medical literature. Furthermore, it represents the first author-initiated implementation science attempt focusing on the use of social media in addressing dermatological problems, with the primary end point of increasing health literacy and patient benefits. The multidisciplinary expert panel was formed by 4 dermatologists with academic credentials and significant influence in public health and among patients on digital platforms. A social media specialist, who serves as a guest lecturer on "How social media works" at Istanbul Technical University, Turkey, was invited to the panel as an expert on digital communication. The panel members had a kickoff meeting to establish the context for the discussion points. The context of the advisory board meeting was outlined under 5 headlines. Two weeks later, the panel members presented their social media account statistics, defined the main characteristics of dermatology patients on social media, and discussed their experiences with patients on digital platforms. These discussions were organized under the predefined headlines and in line with the current literature. We aimed to collect expert opinions on identifying the main characteristics of individuals interested in dermatological topics and to provide recommendations to help dermatologists increase evidence-based dermatological content on social media. Additionally, experts discussed paradigms for dermatological outreach and the role of dermatologists in reducing misleading information on digital platforms in Turkey. The main concluding remark of this study is that dermatologists should enhance their social media presence to increase evidence-based knowledge by applying the principles of patient-physician communication on digital platforms while maintaining a professional stance. To achieve this goal, dermatologists should share targeted scientific content after increasing their knowledge about the operational rules of digital channels. This includes correctly identifying the needs of those seeking information on social media and preparing a sustainable social media communication plan. This viewpoint reflects Turkish dermatologists' experiences with individuals searching for dermatological information on local digital platforms; therefore, the applicability of recommendations may be limited and should be carefully considered.

Health Care Professionals' Perspectives Before and After Use of eDialogue for Team-Based Digital Communication Across Settings: Qualitative Study

BACKGROUND

Orthopedic surgical treatment is a transversal task that requires the active involvement of patients, relatives, and health care professionals (HCPs) across various settings. However, after hospital discharge, communication is challenged and undertaken primarily by phone. New digital communication solutions have the potential to create a space for seamless and patient-centered dialogue across discipline and sector boundaries. When evaluating new communication solutions, knowledge about HCPs' needs and perspectives of use must be explored, as it is they who are responsible for implementing changes in practice.

OBJECTIVE

This study aimed to (1) investigate HCPs' perceptions of current communication pathways (phase 1) and (2) explore their experiences of using a simple messenger-like solution (eDialogue) for team-based digital communication across settings (phase 2).

METHODS

We used a triangulation of qualitative data collection techniques, including document analysis, observations, focus groups, and individual interviews of HCPs before (n=28) and after (n=12) their use of eDialogue. Data collection and analysis were inspired by the Consolidated Framework for Implementation Research (CFIR) to specifically understand facilitators and barriers to implementation as perceived by HCPs.

RESULTS

HCPs perceive current communication pathways as insufficient for both patients and themselves. Phone calls are disruptive, and there is a lack of direct communication modalities when communication crosses sector boundaries. HCPs experienced the use of eDialogue as a quick and easy way for timely interdisciplinary interaction with patients and other HCPs across settings; however, concerns were raised about time consumption.

CONCLUSIONS

eDialogue can provide needed support for interdisciplinary and cross-sectoral patient-centered communication. However, future studies of this solution should address its impact and the use of resources.

Sex on screens: the language of sexting and amateur pornography

Frequently referred to as 'sexting' or 'amateur pornography', digital sexual images and videos form an increasingly common part of adult sexual relationships. However, the vocabulary available to speak about these practices is limited, with 'sexting' often associated with young people in negative terms. This study is based on 23 interviews with adults in Australia who are 25 years and older. It explores the language adults employ to discuss and comprehend the creation and sharing of sexualised images and videos. Findings show that negative or positive connotations associated with the terms used to discuss sexual images and videos influenced the ways participants drew on, or rejected, terms to align digital practices with their sexual subjectivity. Reticence to engage in active communication about digital sexual practices, and participant's distancing of their own practices from the terms commonly understood to refer to such practices, made it difficult to engage in conversations about consent or desire in the context of digitally mediated sex. Findings provide insight into the ways that -digital sexual subjectivities are discursively framed and extend these implications for sexual health promotion with respect to how to frame messages of digital sexual safety in a sex-positive and open way.

Digital Communications Technology Use and Feelings of Anxiety, Depression, and Loneliness Among Older Adults During the COVID-19 Pandemic

Some have touted technology as a panacea for overcoming the isolation associated with COVID-19 mitigation policies; yet, these tools are not widely adopted by older adults. With data from the COVID-19 supplement to the National Health and Aging Trends Survey, we conduct adjusted Poisson regression modeling to examine digital communications use during COVID-19 and feelings of anxiety, depression, and loneliness during the COVID-19 pandemic among older adults (65+ years of age). Adjusted Poisson regression revealed that those who reported frequent use of video calls with friends and family (aPR = 1.22, 95% CI:1.06-1.41) and with healthcare providers (aPR = 1.22, 95% CI:1.03-1.45) were more likely to report feelings of anxiety than those not using these platforms; yet, reports of in-person visits with friends and family (aPR = 0.79, 95% CI: 0.66-0.93) and with healthcare providers (aPR = 0.88, 95% CI: 0.77-1.01) were associated with fewer feelings of depression and loneliness, respectively. Future research is needed to tailor digital technology to support older adults.

Intergenerational solidarity and digital communication during the Covid-19 pandemic in South Korea: Implications for dyadic well-being

Previous research has not considered how digital communication fits with the established intergenerational solidarity paradigm, although the paradigm has undergone other refinements over time. Consequently, less is known about how the use of digital communication creates new types of intergenerational solidarity between parents and adult children, and how they are associated with their well-being. With this foundation, we aimed to identify new dyadic patterns of intergenerational solidarity between parents and adult children during the COVID-19 pandemic in South Korea, with an emphasis on digital communication (texting, video call, and social media interaction), its intersection with other dimensions of solidarity, and its association with parents' and children's well-being (depressive symptoms, self-esteem, and life satisfaction). Using an online survey method, we collected data from 407 parent-adult child dyads between April and June 2022 from the Seoul Metropolitan area in South Korea. Three-step latent class analysis was used for data analysis. We identified four classes describing intergenerational solidarity between parents and adult children (tight-knit, distant-but-digitally-connected, conflictual, and independent). We found that among dyads of parents and adult children who had tight-knit and distant-but-digitally-connected relationships with each other, parents reported better well-being on all three outcomes, and children reported better life satisfaction compared to dyads who had conflictual relationships. Our findings suggest that incorporating digital communication into the intergenerational solidarity paradigm is useful to better understand the multidimensional characteristics of intergenerational relationships between older parents and their adult children.

How to communicate with patients in written asynchronous online conversations: an intervention study with undergraduate medical students in a cross-over design

Introduction

The patient-physician encounter is the core element in the treatment of patients and the diagnosis of disease. In these times of digitalization, patient-physician communication is increasingly taking place online: patients embrace new possibilities offered digitally, and physicians are encouraged to adapt accordingly. Since a huge part of online communication is written, this study aims to investigate how medical students communicate with patients online by focusing on their written competencies and whether an intervention might improve their competencies.

Methods

This study was performed in an explanatory cross-sectional manner with a cross-over design. Second-year medical students participated. An intervention was developed on how to formulate an appropriate written response to a patient's request and integrated a longitudinal communication class. The intervention consists of education on general set-up (e.g., greetings), syntax, spelling, content and kind of communication (e.g., appreciative attitude). After meeting a patient in a simulated role play medical students received the patient's request via a digital platform. The control group had the same simulated role play and the same task but they received the intervention on communication afterwards. Intervention and control group were statistically compared based on a checklist.

Results

Twenty-nine medical students took part in the study. The results showed that the medical students had basic competencies in dealing with written communication independent if they received the intervention (CG: M = 3.86 ± 1.23 vs. IG: M = 4.07 ± 1.03; p = 0.625). Similar results were also for the emotional competency ratings (M_CG = 3.36 ± 1.08; M_IG = 3.67 ± 0.98; p = 0.425).The intervention was able to lead to a more appreciative response toward patient.

Discussion

Intervention on basic competencies such as simple language and clear presentation might not be needed as an integral part in medical education. However, medical students should learn how to present empathic and authentic behavior in written online communication.

Has COVID-19 Been the Great Leveler? The Changing Use of Intergenerational Digital Communications Amongst Older People in England During the Pandemic

This research examines patterns of intergenerational digital contact before and during the COVID-19 pandemic in England, using data from the English Longitudinal Study of Ageing (ELSA) Wave nine and the first Wave of the ELSA COVID-19 Sub-study. Multivariate binary logistic regressions were applied to assess the determinants of frequent intergenerational digital communication. The findings indicate that when the pandemic began, many older persons shifted towards more frequent intergenerational digital contact, but a small minority shifted away. As a result, the pre-existing gender gap amongst older people in the use of digital communication technology narrowed, as did the disparity associated with family relationship closeness. However, pre-pandemic gaps in the intergenerational digital connection between internet users and non-users widened during the pandemic. Overall, the results suggest that the pandemic resulted in more frequent digitally-mediated social interactions within the family, which may strengthen ties between older and younger family members.

Public Engagement in Digital Recommendations for Promoting Healthy Parental Behaviours from Preconception through the First 1000 Days

Web-based digital interventions may play a central role for health promoting strategies in the first "1000 days", from conception through the first 2 years of life. We developed a web platform providing evidence-based recommendations in the first 1000 days through short videos, and we studied engagement by users from preconception through parenthood in the second year of life. We described the access to videos by topic and used a multilevel model to explore the user characteristics associated with access to the video recommendations. Overall, breastfeeding, physical activity and nutrition were the most popular topics (normalized views: 89.2%, 87.2% and 86.4% respectively), while content on paternal health and smoking and alcohol was less engaging (37.3% and 42.0%). Nutrition content was the most viewed in the preconception period and during the first two trimesters of pregnancy. Nutrition and breastfeeding were also the most popular topics for users with children less than 2 years old. Higher levels of health literacy were associated only with child health content. The study findings indicate that digital strategies should be adapted according to the time period in the first 1000 days. Alternative digital promotion strategies for the less engaging topics should be considered.

Can digital communication protect against depression for older adults with hearing and vision impairment during COVID-19?

OBJECTIVES

During social isolation imposed by the COVID-19 pandemic, older adults with impaired hearing and vision potentially experienced more communication challenges, increasing their risk for poor mental health. Digital communication (e.g. video calls, email/text/social media) may alleviate in-person isolation and protect against depression. We addressed this question using data from the National Social Life, Health, and Aging Project, a nationally representative panel study of community-dwelling older adults.

METHOD

2558 adults aged 55+ comprised the analytic sample. Interviewer rating at baseline (2015-16) classified those with vision impairment (VI) or hearing impairment (HI). Olfactory impairment (OI) was measured by objective testing. During COVID-19 (2020-21), respondents reported how often they contacted non-household family or friends and whether this was by phone, email/text/social media, video, or in-person. They also quantified frequency of depressive feelings.

RESULTS

Older adults with VI or HI but not OI at baseline were significantly less likely to report regular use of video calling and email/text/social media during the pandemic compared to those without impairment. Sensory impairments did not affect frequency of phone or in-person communication. Adults with VI or HI were more likely to experience frequent depressive feelings during COVID. Video calls mitigated this negative effect of VI- and HI-associated depressive feelings in a dose-dependent manner.

DISCUSSION

Among communication modalities, video calling had a protective effect against depressive feelings for people with sensory impairment during social isolation. Improving access to and usability of video communication for older adults with sensory impairment could be a strategy to improve their mental health.

Primary Healthcare Nurses' Views on Digital Healthcare Communication and Continuity of Care: A Deductive and Inductive Content Analysis

Primary healthcare in the Western world faces significant functional challenges, resulting in the implementation of digital communication tools. Nurses are key professionals in primary care and focusing on the impact of digital communication and continuity of care in primary care organisations is important. This qualitative descriptive study explores digital communication and continuity of care from primary healthcare nurses' perspective. Data from individual semi-structured interviews with 12 nurses were collected; deductive and inductive content analyses were performed. Three descriptive categories emerged from the deductive (digital communication as interpersonal, information, and management continuities) and inductive ('digital care does not suit everyone', 'new technology is contextually intertwined with daily work', and 'patient-positive aspects of digital information') phases. Additionally, a structural risk of obscuration of patients' needs by the contextual conditions emerged. To ensure digital communication-aligned continuity of care, compatible information technology systems should be developed. Allowing nurses to provide high-quality care based on their own values would enhance person-centred patient care.

Mediatization in Times of Pandemic: How German Grassroots Sports Clubs Employed Digital Media to Overcome Communication Challenges During COVID-19

The COVID-19 pandemic has had a major impact on all societal domains, including sports. Social distancing measures and the closure of sports facilities posed especially severe challenges for grassroots sports clubs, which thrive on joint activities and member social contact. Drawing on mediatization theory, the study examines the communication challenges faced by grassroots sports clubs and the perceived potential of digital media to overcome these obstacles during and beyond the pandemic. Based on in-depth interviews with 32 club officials of German grassroots sports clubs, the study identified ongoing uncertainty about COVID-19 regulations, preserving members' sense of belonging during social distancing, and involving everyone in formal processes as the major communication challenges. While most of the interviewees valued the potential of digital media to address these challenges, they acknowledged that the benefits of digital media for individual members would depend on their skill, motivation, and concerns, as well as on the availability of digital infrastructure. For that reason, digital media were not considered a substitute for face-to-face social contact or sporting activity but were seen to extend opportunities for communication and training. More generally, these findings raise new questions about the relationship between mediatization and social cohesion.

Exploration of Telemidwifery: An Initiation of Application Menu in Indonesia

The midwifery continuity-of-care model improves the quality and safety of midwifery services and is highly dependent on the quality of communication and information. The service uses a semi-automated chatbot-based digital health media service defined with the new term "telemidwifery". This study aimed to explore the telemidwifery menu content for village midwives and pregnant women in the Purwakarta Regency, West Java, Indonesia. The qualitative research method was used to explore with focus group discussion (FGD). The data collection technique was purposive sampling. The research subjects were 15 village midwives and 6 multiparous pregnant women. The results of this study involved 15 characteristics of menu content: (1) Naming, (2) Digital Communication, (3) Digital Health Services, (4) Telemidwifery Features, (5) Digital Check Features, (6) Media Services, (7) Attractiveness, (8) Display, (9) Ease of Use, (10) Clarity of Instructions, (11) Use of Language, (12) Substances, (13) Benefits, (14) Appropriateness of Values, and (15) Supporting Components. The content characteristics of this telemidwifery menu were assigned to the ISO 9126 Model standards for usability, functionality, and efficiency. The conclusion is that the 15 themes constitute the characteristic menu content required within the initiation of telemidwifery.

Revealing the self in a digital world: a systematic review of adolescent online and offline self-disclosure

Adolescence is an important stage of social development. While adolescents are prominent adopters of social media, little is known about whether digital interactions can fulfil the social needs of this age group. Here, we focus on one component of social interaction: self-disclosure. In a systematic review, we investigate the role of self-disclosure in adolescent relationships and the differences between online and offline self-disclosure. The results suggest that self-disclosure is associated with higher relationship quality and well-being. Online self-disclosure appears to be less fulfilling and beneficial for relationship quality than face-to-face self-disclosure. However, certain populations appear to benefit more from online than offline self-disclosure - such as highly anxious adolescents and boys aged 12-13 years, who prefer to first self-disclose online before engaging in offline self-disclosure. This suggests that both online and offline self-disclosure can play a role in fulfilling adolescent social needs.

Transforming habitus and recalibrating capital: University students’ experiences in online learning and communication during the COVID-19 pandemic

The COVID-19 pandemic has brought various challenges to the education domain globally. This study examines how a group of non-local university students studying at EMI universities in Hong Kong adjusted to the dominant online mode of learning and communication based on their lived experiences in learning and intercultural social networking during the pandemic. Employing the theory of digital literacies and Bourdieu's concepts of habitus and capital, we show how students expanded, redeveloped and transferred existing awareness, knowledge, competences and practices to engage in a range of digitally mediated academic and social activities in this condition. We conclude by discussing how the findings may inform refinement or readjustment of digitalized/zing international higher education.

Evaluating the Adequacy of Emoji Use in Positive and Negative Messages from Close and Distant Senders

Computer-mediated communication allows people to communicate across several contexts (e.g., friends, professional settings) by using video-based or text-based channels. In the latter case, communication lacks nonverbal cues (e.g., tone of voice) that are critical to message interpretation. Including emoji can help express emotion and reinforce or clarify the meaning of a message. However, the benefits of using emoji are likely to depend on the context (e.g., the relationship between interlocutors) and the messages' features (e.g., the valence of the message). To date, studies have not systematically and empirically examined how the use of emoji is perceived across different communication scenarios. In the current study, we asked 175 participants (49.5 percent women; M_age = 36.32, SD = 12.22) to imagine receiving either a negative or a positive message from 22 senders (e.g., friend; bank manager) and to indicate, for each case, how much they would like to receive an emoji and how useful and appropriate they considered the use of emoji. These ratings were combined into a single index of emoji use adequacy. Based on factor analysis, the 22 scenarios were aggregated in distant and close scenarios. Overall, results showed that participants considered emoji use more inadequate in distant (vs. close) scenarios and for negative (vs. positive) messages. These findings suggest that the perceived benefits of emoji use for text-based communication may not be generalized to all text-based communication contexts, such that relationship proximity and message valence should not be overlooked. Implications for the fields of consumer psychology and communication are discussed.

Relationship-based practice and digital technology in child and family social work: Learning from practice during the COVID-19 pandemic

Vital services provided by social workers to children in care or on the edge of care were largely delivered "online" during the COVID-19 pandemic. This paper explores the potential impact of these changes on vulnerable children and their families. Relationship-based practice is integral to social work and the shift to digital communication during the COVID-19 pandemic has led to accelerated practice changes and implications for relationship building both with and between service users. Going forward, social workers and other professionals are likely to move to an increasingly hybrid model of communication, combining both digital and face-to-face methods. This article identifies the impact of digital communication on relationships in professional practice, drawing on three studies of digital communication in the UK carried out at the University of East Anglia. The first considered how child protection social workers responded to the challenges of COVID-19, the second looked at how children in care were keeping in touch with their birth families and the third focused on the approaches being taken to moving children from foster care to adoptive families. Five themes related to relationships were identified across all three studies: the significance of the age and developmental stage of the child; the frequency of contact and communication; digital literacy/exclusion; the impact of the lack of sensory experience; and the importance of the relationship history. The article concludes with implications for utilising digital methods in building and maintaining relationships in practice and highlights the need to consider both the inner and outer worlds of those involved.

Investigating the Implementation of SMS and Mobile Messaging in Population Screening (the SIPS Study): Protocol for a Delphi Study

Background

The use of mobile messaging, including SMS, and web-based messaging in health care has grown significantly. Using messaging to facilitate patient communication has been advocated in several circumstances, including population screening. These programs, however, pose unique challenges to mobile communication, as messaging is often sent from a central hub to a diverse population with differing needs. Despite this, there is a paucity of robust frameworks to guide implementation.

Objective

The aim of this protocol is to describe the methods that will be used to develop a guide for the principles of use of mobile messaging for population screening programs in England.

Methods

This modified Delphi study will be conducted in two parts: evidence synthesis and consensus generation. The former will include a review of literature published from January 1, 2000, to October 1, 2021. This will elicit key themes to inform an online scoping questionnaire posed to a group of experts from academia, clinical medicine, industry, and public health. Thematic analysis of free-text responses by two independent authors will elicit items to be used during consensus generation. Patient and Public Involvement and Engagement groups will be convened to ensure that a comprehensive item list is generated that represents the public’s perspective. Each item will then be anonymously voted on by experts as to its importance and feasibility of implementation in screening during three rounds of a Delphi process. Consensus will be defined a priori at 70%, with items considered important and feasible being eligible for inclusion in the final recommendation. A list of desirable items (ie, important but not currently feasible) will be developed to guide future work.

Results

The Institutional Review Board at Imperial College London has granted ethical approval for this study (reference 20IC6088). Results are expected to involve a list of recommendations to screening services, with findings being made available to screening services through Public Health England. This study will, thus, provide a formal guideline for the use of mobile messaging in screening services and will provide future directions in this field.

Conclusions

The use of mobile messaging has grown significantly across health care services, especially given the COVID-19 pandemic, but its implementation in screening programs remains challenging. This modified Delphi approach with leading experts will provide invaluable insights into facilitating the incorporation of messaging into these programs and will create awareness of future developments in this area.

International Registered Report Identifier (IRRID)

PRR1-10.2196/32660

Importance of Digital Communication in Adolescents' Development: Theoretical and Empirical Advancements in the Last Decade

The past decade saw a sharp increase in the use of smartphones and digital communication platforms. This manuscript reviews advancements in the study of digital communication and adolescent development over the last decade. We highlight theoretical models that seek to explain the power of digital media in adolescents' lives. We then examine research conducted over the last decade on five aspects of digital media: (1) potential to contribute to adolescent development, (2) associations with mental health, (3) differential impact of active versus passive social media use, (4) cyberbullying, and (5) sexting. We conclude with a discussion of potential opportunities and challenges for studying the role of digital communication in adolescents' development during the coming decade.

"Japan LIVE Dashboard" for COVID-19: A Scalable Solution to Monitor Real-Time and Regional-Level Epidemic Case Data

Under pandemic conditions, it is important to communicate local infection risks to better enable the general population to adjust their behaviors accordingly. In Japan, our team operates a popular non-government and not-for-profit dashboard project - "Japan LIVE Dashboard" - which allows the public to easily grasp the evolution of the pandemic on the internet. We presented the Dashboard design concept with a generic framework integrating socio-technical theories, disease epidemiology and related contexts, and evidence-based approaches. Through synthesizing multiple types of reliable and real-time local data sources from all prefectures across the country, the Dashboard allows the public access to user-friendly and intuitive disease visualization in real time and has gained an extensive online followership. To date, it has attracted c.30 million visits (98% domestic access) testifying to the reputation it has acquired as a user-friendly portal for understanding the progression of the pandemic. Designed as an open-source solution, the Dashboard can also be adopted by other countries as well as made applicable for other emerging outbreaks in the future. Furthermore, the conceptual design framework may prove applicable into other ehealth scaled for global pandemics.

Digital or In-Person: The Relationship Between Mode of Interpersonal Communication During the COVID-19 Pandemic and Mental Health in Older Adults From 27 Countries

Social distancing has limited the spread of the coronavirus (COVID-19), but also changed communication patterns. However, studies of how mental health in older adults relates to the usage of different modes of interpersonal communication are sparse. The aim of this study was to analyze how COVID-19-related changes in the frequencies of using different modes of communication (digital or in-person) have influenced mental health in older adults from 27 countries. Our study was based on part of Wave 8 of the SHARE data set, which focused on the living situation of older adults during the pandemic. Findings suggest that in-person communication benefited mental health in people aged ≥60 years more than digital communication. The older the person, the less beneficial digital communication was for their mental health, especially during interactions with their children. Our findings are useful for researchers and practitioners interested in technologically meditated interventions.

SmartCards as Analogous Tools to Operate Tablet Computers for Elderly-A Feasibility Study

BACKGROUND

Older adults sometimes shy away from using modern digital communication devices due to lacking experience and fear of failure. Within the present project, SmartCards were developed as analogous means to operate tablet computers for older adults with little previous computer experience. We investigated whether the SmartCards-Tablet-System would (a) increase use of digital communication and (b) affect loneliness, autonomy, cognitive ability and wellbeing of the users.

METHODS

The suitability and acceptance of the system was evaluated during a three month trial period with seniors in retirement homes, seniors with home assistance care and a waiting control group.

RESULTS

Acceptance, duration of use and frequency of use were high in both experimental groups. Cognitive ability significantly improved after three months' use in both experimental groups. Effects on loneliness, autonomy and wellbeing could not be observed.

DISCUSSION

Our results indicate that seniors are very much able and curious to use modern digital devices if the interface and hardware are adjusted to their needs and capabilities without being stigmatizing. The use of modern communication services and the World Wide Web can promote contact of seniors with their (younger) relatives.

Examining Social Media Crisis Communication during Early COVID-19 from Public Health and News Media for Quality, Content, and Corresponding Public Sentiment

Rising COVID-19 cases in Canada in early 2021, coupled with pervasive mis- and disinformation, demonstrate the critical relationship between effective crisis communication, trust, and risk protective measure adherence by the public. Trust in crisis communication is affected by the communication's characteristics including transparency, timeliness, empathy, and clarity, as well as the source and communication channels used. Crisis communication occurs in a rhetorical arena where various actors, including public health, news media, and the public, are co-producing and responding to messages. Rhetorical arenas must be monitored to assess the acceptance of messaging. The quality and content of Canadian public health and news media crisis communication on Facebook were evaluated to understand the use of key guiding principles of effective crisis communication, the focus of the communication, and subsequent public emotional response to included posts. Four hundred and thirty-eight posts and 26,774 anonymized comments were collected and analyzed. Overall, the guiding principles for effective crisis communication were inconsistently applied and combined. A limited combination of guiding principles, especially those that demonstrate trustworthiness, was likely driving the negative sentiment uncovered in the comments. Public health and news media should use the guiding principles consistently to increase positive sentiment and build trust among followers.

At your 'online' service! A continuous service-learning program for college students during the COVID-19 pandemic

School health protocols in conducting face-to-face classes must be planned carefully to ensure that students will be safe from the effects of COVID-19. This is what the authors emphasized in a recent correspondence, which we re-echo in this paper in case the situation permits. However, a greater consideration must be given to colleges and universities where the aspect of community/social engagement of the students is already part of the curriculum. There is still a greater risk for students to go to the communities for service and social interaction. With this, we suggest that the service program can still continue through an enhanced electronic service-learning, which maximizes the human resources' capacity and highlights students' creativity with equally useful projects.

Health Transparency and Communication on the Government Websites of Ibero-American Countries: The Cases of Chile, Colombia, Ecuador, and Spain

Through the strategic use of health communication from their websites, government institutions can achieve greater promotion and prevent health issues for citizens, at whom such websites are aimed. Thus, the transparency of these sites is essential to favor issues such as participation, accountability, and good governance. In the present study, through content analysis, we examined how active transparency and communication in health is built through analyzing the information provided by the different administrative levels with competencies in this field (government, regions, and municipalities) from the following countries: Chile, Colombia, Ecuador, and Spain. The results were projected according to a double axis of analysis. On the one hand, we offer a description of the levels of management of this phenomenon (structural characteristics and available resources). On the other hand, we developed indices based on each of the countries to compare the typologies grouped in these Ibero-American countries. As a general conclusion, the results evinced insufficient transparency in common; however, the deficit was less in countries that had a public health system.

A Digital Patient-Provider Communication Intervention (InvolveMe): Qualitative Study on the Implementation Preparation Based on Identified Facilitators and Barriers

Background

Chronic health conditions are affecting an increasing number of individuals, who experience various symptoms that decrease their quality of life. Digital communication interventions that enable patients to report their symptoms have been shown to positively impact chronic disease management by improving access to care, patient-provider communication, clinical outcomes, and health-related quality of life. These interventions have the potential to prepare patients and health care providers (HCPs) before visits and improve patient-provider communication. Despite the recent rapid development and increasing number of digital communication interventions that have shown positive research results, barriers to realizing the benefits offered through these types of interventions still exist.

Objective

The aim of this study is to prepare for the implementation of a digital patient-provider communication intervention in the daily workflow at 2 outpatient clinics by identifying potential determinants of implementation using the Consolidated Framework for Implementation Research (CFIR) to tailor the use of digital communication intervention to the intended context and identify key aspects for an implementation plan.

Methods

A combination of focus groups, workshops, and project steering committee meetings was conducted with HCPs (n=14) and patients (n=2) from 2 outpatient clinics at a university hospital. The CFIR was used to guide data collection and analysis. Transcripts, written minutes, and notes were analyzed and coded into 5 CFIR domains using thematic analysis.

Results

Data were examined and analyzed into 18 CFIR constructs relevant to the study purpose. On the basis of the identified determinants, important intervention tailoring includes adjustments to the digital features and adjustments to fit the clinical workflow and a decision to conduct a future pilot study. Furthermore, it was decided to provide the intervention to patients as early as possible in their disease trajectory, with tailored information about its use. Key aspects for the implementation plan encompassed maintaining the identified engagement and positive attitude, involving key stakeholders in the implementation process, and providing the needed support and training.

Conclusions

This study offers insight into the involvement of stakeholders in the tailoring and implementation planning of a digital communication intervention in clinical practice. Stakeholder involvement in the identification of implementation facilitators and barriers can contribute to the tailoring of digital communication interventions and how they are used and can also inform systematic and targeted implementation planning.

The Enabling Role of ICT to Mitigate the Negative Effects of Emotional and Social Loneliness of the Elderly during COVID-19 Pandemic

(1) Background: The COVID-19 pandemic has been especially hard on the elderly owing to their particular vulnerability to the virus. Their confinement to prevent the spread of the virus resulted in social isolation, often linked to the unwanted loneliness that hinders their emotional well-being. The enabling capacity of ICT (Information and Communication Technology) to overcome the negative effects of this isolation requires special attention. The purpose of this research is to understand the impact of the use of ICT on the emotional well-being of elderly people during their confinement. (2) Methods: A qualitative exploration method based on four focus groups with elderly people aged 60 years or older and three in-depth personal interviews with experts in education of the elderly were carried out. (3) Results: Research results evidence a negative emotional impact of the confinement (lack of physical contact with their loved ones, fear and uncertainty, feeling of loneliness, sadness at the loss of family members) on the emotional well-being of study participants. Furthermore, the operational capacity of ICT to prevent infection, as well as their positive emotional and humanizing role in providing access to entertainment and hobbies, and in improving self-esteem was also acknowledged. (4) Conclusions: ICT have become a valuable ally for elderly people aged 60 years and older to mitigate the negative effects of social isolation and loneliness imposed by the confinement.

High-Performance and Self-Powered Alternating Current Ultraviolet Photodetector for Digital Communication

Self-powered ultraviolet photodetectors offer great potential in the field of optical communication, smart security, space exploration, and others; however, achieving high sensitivity with maintaining fast response speed has remained a daunting challenge. Here, we develop a titanium dioxide-based self-powered ultraviolet photodetector with high detectivity (≈1.8 × 10¹⁰ jones) and a good photoresponsivity of 0.32 mA W^-1 under pulsed illumination (λ = 365 nm, 4 mW cm^-2), which demonstrate an enhancement of 114 and 2017%, respectively, due to the alternating current photovoltaic effect compared to the conventional direct current photovoltaic effect. Further, the photodetector demonstrated a high on/off ratio (≈10³), an ultrafast rise/decay time of 112/63 μs, and a noise equivalent power of 5.01 × 10^-11 W/Hz^1/2 under self-biased conditions. Photoconductive atomic force microscopy revealed the nanoscale charge transport and offered the possibility to scale down the device size to a sub-10-nanometer (∼35 nm). Moreover, as one of the practical applications, the device was successfully utilized to interpret the digital codes. The presented results enlighten a new path to design energy-efficient ultrafast photodetectors not only for the application of optical communication but also for other advanced optoelectronic applications such as digital display, sensing, and others.

Tracking Websites' Digital Communication Strategies in Latin American Hospitals During the COVID-19 Pandemic

Since the advent of the Internet, websites have become the nerve center of the digital ecosystems of media, companies and all kinds of institutions. Currently, the impact of the global coronavirus pandemic has placed healthcare issues at the center of social debate, including hospitals and their websites as digital sources of trustworthy information. COVID-19 has intensified the need for quality information and the legitimacy of sources fighting the infodemic situation. In this regard hospitals become essential social actors in the spread of healthcare information. Within this framework, a qualitative study is presented with descriptive components and based on content analysis. This study examines 58 websites from the best hospitals included in the “América Economía” ranking health sector from Latin America. The study applies an analysis methodology based on previous research focusing on specialized web studies, defining an analysis model on six variables and 65 thematic indicators. The research concludes that hospitals occupying first positions in the medical services directory are not necessarily those that have the best websites. Similarly, it is worth noting that a quarter of the studied sample do not devote a specific space to reporting coronavirus information. Brazil, Colombia and Chile are the countries with the highest number of hospitals among those with the best websites. In conclusion, digital media, specifically websites, could constitute legitime resources of healthcare information consumption, so their accuracy and proper development seem to be significant to become genuine sources that not only could provide better healthcare services but help avoid the spread of misinformation about the COVID-19 pandemic.

Being the Voice of Reason Within Your School Community During a Pandemic and Beyond

The voice of a school nurse can be the voice of reason for a school community during a global health crisis. This article briefly examines how school nurses can best use their voices to be both sources of support and agents working against the spread of misinformation. Components of impactful communications will be explored, along with multiple modes of communication. At all times, and especially during unusual health events such as a pandemic, school nurses must create messages that are clear, evidence based, and empathetic toward the school community.

Changes in Digital Communication During the COVID-19 Global Pandemic: Implications for Digital Inequality and Future Research

Governments and public health institutions across the globe have set social distancing and stay-at-home guidelines to battle the COVID-19 pandemic. With reduced opportunities to spend time together in person come new challenges to remain socially connected. This essay addresses how the pandemic has changed people's use of digital communication methods, and how inequalities in the use of these methods may arise. We draw on data collected from 1,374 American adults between 4 and 8 April 2020, about two weeks after lockdown measures were introduced in various parts of the United States. We first address whether people changed their digital media use to reach out to friends and family, looking into voice calls, video calls, text messaging, social media, and online games. Then, we show how age, gender, living alone, concerns about Internet access, and Internet skills relate to changes in social contact during the pandemic. We discuss how the use of digital media for social connection during a global public health crisis may be unequally distributed among citizens and may continue to shape inequalities even after the pandemic is over. Such insights are important considering the possible impact of the COVID-19 pandemic on people's social wellbeing. We also discuss how changes in digital media use might outlast the pandemic, and what this means for future communication and media research.

Moving towards IoT Based Digital Communication: An Efficient Utilization of Power Spectrum Density for Smart Cities

The future of the Internet of Things (IoT) is interlinked with digital communication in smart cities. The digital signal power spectrum of smart IoT devices is greatly needed to provide communication support. The line codes play a significant role in data bit transmission in digital communication. The existing line-coding techniques are designed for traditional computing network technology and power spectrum density to translate data bits into a signal using various line code waveforms. The existing line-code techniques have multiple kinds of issues, such as the utilization of bandwidth, connection synchronization (CS), the direct current (DC) component, and power spectrum density (PSD). These highlighted issues are not adequate in IoT devices in smart cities due to their small size. However, there is a need to design an effective line-code method to deal with these issues in digital IoT-based communication for smart technologies, which enables smart services for smart cities. In this paper, the Shadow Encoding Scheme (SES) is proposed to transmit data bits efficiently by using a physical waveform in the smart cities’ ecosystem. SES provides a reliable transmission over the physical medium without using extra bandwidth and with ideal PSD. In it, the shadow copy of the repeating bitstream is forwarded, rather than repeating the actual stream again and again. The PSD is calculated with the help of mathematical equations to validate SES. MATLAB simulator is used to simulate SES and compared with other well-known digital line-code techniques. The bit error rate is also compared between SES and the chirp spread spectrum (CSS) for the specific data frames. The coordinates of the PSD graph are also shown in tabular form, which shows a vivid picture of the working conditions of various line codes.

The Role of Digital School-Home Communication in Teacher Well-Being

Well-functioning communication is crucial in all work communities. A respectful and trusty partnership between parents and teachers in schools is essential not only for pupils but also for the well-being of the whole organization. Communication is at the heart of such a partnership. Although most parent-teacher communication nowadays takes place on digital platforms, not much is known about the specific role of digital communication (DC) in building parent–teacher partnerships. In an attempt to find out we asked 400 Finnish parents and 80 teachers about their experiences of communicating digitally and the kind of matters they discussed, and how they thought feedback on pupils should be expressed. The data was content-analyzed. Three categories related to DC content were identified: study-related matters, behavioral issues, and sensitive issues. Parental and teachers’ expectations of how pupil feedback should be expressed also fell into three categories: a good balance of encouraging and corrective feedback, more encouraging feedback, and a constant emphasis on the child’s weaknesses. These results have research and practical implications for teacher well-being.

Implementation Research as Applied Science: Bridging the Research to Practice Gap

Implementation research is intended to address challenges posed by the slow adoption of evidence-based science by the medical and health promotion practice community. A case study approach is used to illustrate and discuss the use of Quality improvement and Evaluation as an applied approach to implementation science in contrast of more classic purposes of research. Quality improvement was the implementation model used to facilitate organizational change needed to adopt the use of texting to report sexually transmitted infection test results in over a fifth of Florida's larger county health departments. Both quantitative and qualitative methods were used to evaluate implementation. All seven participating county health departments were successful in enrolling clients in texting with extensive variation (24% to 72%) in texting enrollment at the end of the 10-month study. Statistically significant outcomes for those enrolled in texting were recorded through Florida's online sexually transmitted infection reporting system in the form of increased number of people receiving early (1-4 days) treatment and reductions in delayed (≥8 days) or no treatment. This study illustrates an applied approach to implementation research which may be critical to adapt emerging evidence and technologies to the multiple and complex characteristics of the diverse populations served by health promotion institutions.

Information Transmission in Dynamical Networks: The Normal Network Case

Reliable information processing is a hallmark of many physical and biological networked systems. In this paper, we propose a novel framework for modelling information transmission within a linear dynamical network. Information propagation is modelled by means of a digital communication protocol that takes into account the realistic phenomenon of inter-symbol interference. Building on this framework, we adopt Shannon information rate to quantify the amount of information that can be reliably sent over the network within a fixed time window. We investigate how the latter information metric is affected by the connectivity structure of the network. Here, we focus in particular on networks characterized by a normal adjacency matrix. We show that for such networks the maximum achievable information rate depends only on the spectrum of the adjacency matrix. We then provide numerical results suggesting that non-normal network architectures could benefit information transmission in our framework.

Digital communications and social media use in surgery: how to maximize communication in the digital age

Communication among patients, colleagues, and staff in healthcare has changed dramatically in the last decade. Digital technology and social media sites have allowed instantaneous access to information. The potential for information technology to improve access to healthcare, enhance the quality, and lower the cost is significant. Text messaging, tweeting, chatting, and blogging are rapidly replacing e-mail as the preferred means of communication in healthcare. This review will highlight how digital technology is changing the way surgeons communicate with colleagues and patients as well as provide some guidance as to how to avoid some of the pitfalls and problems that this form of communication can bring.

Timely Digital Patient-Clinician Communication in Specialist Clinical Services for Young People: A Mixed-Methods Study (The LYNC Study)

Background

Young people (aged 16-24 years) with long-term health conditions can disengage from health services, resulting in poor health outcomes, but clinicians in the UK National Health Service (NHS) are using digital communication to try to improve engagement. Evidence of effectiveness of this digital communication is equivocal. There are gaps in evidence as to how it might work, its cost, and ethical and safety issues.

Objective

Our objective was to understand how the use of digital communication between young people with long-term conditions and their NHS specialist clinicians changes engagement of the young people with their health care; and to identify costs and necessary safeguards.

Methods

We conducted mixed-methods case studies of 20 NHS specialist clinical teams from across England and Wales and their practice providing care for 13 different long-term physical or mental health conditions. We observed 79 clinical team members and interviewed 165 young people aged 16-24 years with a long-term health condition recruited via case study clinical teams, 173 clinical team members, and 16 information governance specialists from study NHS Trusts. We conducted a thematic analysis of how digital communication works, and analyzed ethics, safety and governance, and annual direct costs.

Results

Young people and their clinical teams variously used mobile phone calls, text messages, email, and voice over Internet protocol. Length of clinician use of digital communication varied from 1 to 13 years in 17 case studies, and was being considered in 3. Digital communication enables timely access for young people to the right clinician at the time when it can make a difference to how they manage their health condition. This is valued as an addition to traditional clinic appointments and can engage those otherwise disengaged, particularly at times of change for young people. It can enhance patient autonomy, empowerment and activation. It challenges the nature and boundaries of therapeutic relationships but can improve trust. The clinical teams studied had not themselves formally evaluated the impact of their intervention. Staff time is the main cost driver, but offsetting savings are likely elsewhere in the health service. Risks include increased dependence on clinicians, inadvertent disclosure of confidential information, and communication failures, which are mostly mitigated by young people and clinicians using common-sense approaches.

Conclusions

As NHS policy prompts more widespread use of digital communication to improve the health care experience, our findings suggest that benefit is most likely, and harms are mitigated, when digital communication is used with patients who already have a relationship of trust with the clinical team, and where there is identifiable need for patients to have flexible access, such as when transitioning between services, treatments, or lived context. Clinical teams need a proactive approach to ethics, governance, and patient safety.

Advocacy Communication and Social Identity: An Exploration of Social Media Outreach

Increasingly, advocacy organizations employ social networking sites as inexpensive and often effective ways to disseminate outreach messages. For groups working to reach lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, social media provide key platforms for connecting with target audiences. Although these young people increasingly utilize social media, little is known about how digital advocacy campaigns influence their sexual identity formation. This article applies concepts of social identity to examine how LGBTQ youth understand advocacy campaigns, how they perceive LGBTQ as a social category presented in campaigns, and what values they assign to LGBTQ group membership.

Engaging Adolescents Through Participatory and Qualitative Research Methods to Develop a Digital Communication Intervention to Reduce Adolescent Obesity

BACKGROUND

The complexity of the childhood obesity epidemic requires the application of community-based participatory research (CBPR) in a manner that can transcend multiple communities of stakeholders, including youth, the broader community, and the community of health care providers.

AIM

To (a) describe participatory processes for engaging youth within context of CBPR and broader community, (b) share youth-engaged research findings related to the use of digital communication and implications for adolescent obesity intervention research, and (c) describe and discuss lessons learned from participatory approaches.

METHOD

CBPR principles and qualitative methods were synergistically applied in a predominantly African American part of the city that experiences major obesity-related issues. A Youth Research Advisory Board was developed to deeply engage youth in research that was integrated with other community-based efforts, including an academic-community partnership, a city-wide obesity coalition, and a primary care practice research network. Volunteers from the youth board were trained to apply qualitative methods, including facilitating focus group interviews and analyzing and interpreting data with the goal of informing a primary care provider-based obesity reduction intervention.

RESULTS

The primary results of these efforts were the development of critical insights about adolescent use of digital communication and the potential importance of messaging, mobile and computer apps, gaming, wearable technology, and rapid changes in youth communication and use of digital technology in developing adolescent nutrition and physical activity health promotion.

CONCLUSIONS

The youth led work helped identify key elements for a digital communication intervention that was sensitive and responsive to urban youth. Many valuable lessons were also learned from 3 years of partnerships and collaborations, providing important insights on applying CBPR with minority youth populations.

Do Gender-Specific and High-Resolution Three Dimensional Body Charts Facilitate the Communication of Pain for Women? A Quantitative and Qualitative Study

BACKGROUND

Chronic pain is more prevalent among women; however, the majority of standardized pain drawings are often collected using male-like androgynous body representations.

OBJECTIVE

The purpose of this study was to assess whether gender-specific and high-resolution three-dimensional (3D) body charts facilitate the communication of pain for women.

METHODS

Using mixed-methods and a cross-over design, female patients with chronic pain were asked to provide detailed drawings of their current pain on masculine and feminine two-dimensional (2D) body schemas (N=41, Part I) or on female 2D and 3D high-resolution body schemas (N=41, Part II) on a computer tablet. The consistency of the drawings between body charts were assessed by intraclass correlation coefficient (ICC) and Bland-Altman plots. Semistructured interviews and a preference questionnaire were then used to obtain qualitative and quantitative responses of the drawing experience.

RESULTS

The consistency between body charts were high (Part I: ICC=0.980, Part II: ICC=0.994). The preference ratio for the masculine to feminine body schemas were 6:35 and 18:23 for the 2D to 3D female body charts. Patients reported that the 3D body chart enabled a more accurate expression of their pain due to the detailed contours of the musculature and bone structure, however, patients also reported the 3D body chart was too human and believed that skin-like appearance limited 'deep pain' expressions.

CONCLUSIONS

Providing gender-specific body charts may facilitate the communication of pain and the level of detail (2D vs 3D body charts) should be used according to patients' needs.

The Impact of Online Social Networks on Health and Health Systems: A Scoping Review and Case Studies

Interaction through online social networks potentially results in the contestation of prevailing ideas about health and health care, and to mass protest where health is put at risk or health care provision is wanting. Through a review of the academic literature and case studies of four social networking health sites (PatientsLikeMe, Mumsnet, Treatment Action Campaign, and My Pro Ana), we establish the extent to which this phenomenon is documented, seek evidence of the prevalence and character of health-related networks, and explore their structure, function, participants, and impact, seeking to understand how they came into being and how they sustain themselves. Results indicate mass protest is not arising from these established health-related networking platforms. There is evidence of changes in policy following campaigning activity prompted by experiences shared through social networking such as improved National Health Service care for miscarriage (a Mumsnet campaign). Platform owners and managers have considerable power to shape these campaigns. Social networking is also influencing health policy indirectly through increasing awareness and so demand for health care. Transient social networking about health on platforms such as Twitter were not included as case studies but may be where the most radical or destabilizing influence on health care policy might arise.