Elia Gabarron

Ebola, Twitter, and misinformation: a dangerous combination?

The recent Ebola outbreak in west Africa has affected countries deeply in need of foreign aid.1 People desperately need correct information on how to prevent and treat Ebola. Despite the poverty, the increasing spread of computers, tablets, and smartphones in the region creates an opportunity for the rapid dissemination of information through the internet and social media, but there is no guarantee that …

Social media in health - what are the safety concerns for health consumers?

Recent literature has discussed the unintended consequences of clinical information technologies (IT) on patient safety, yet there has been little discussion about the safety concerns in the area of consumer health IT. This paper presents a range of safety concerns for consumers in social media, with a case study on YouTube. We conducted a scan of abstracts on ‘quality criteria’ related to YouTube. Five areas regarding the safety of YouTube for consumers were identified: (a) harmful health material targeted at consumers (such as inappropriate marketing of tobacco or direct-to-consumer drug advertising); (b) public display of unhealthy behaviour (such as people displaying self-injury behaviours or hurting others); (c) tainted public health messages (i.e. the rise of negative voices against public health messages); (d) psychological impact from accessing inappropriate, offensive or biased social media content; and (e) using social media to distort policy and research funding agendas. The examples presented should contribute to a better understanding about how to promote a safe consumption and production of social media for consumers, and an evidence-based approach to designing social media interventions for health. The potential harm associated with the use of unsafe social media content on the Internet is a major concern. More empirical and theoretical studies are needed to examine how social media influences consumer health decisions, behaviours and outcomes, and devise ways to deter the dissemination of harmful influences in social media.

Tweet content related to sexually transmitted diseases: no joking matter.

Background Online social media, such as the microblogging site Twitter, have become a space for speedy exchange of information regarding sexually transmitted diseases (STDs), presenting a potential risk environment for how STDs are portrayed. Examining the types of “tweeters” (users who post messages on Twitter) and the nature of “tweet” messages is important for identifying how information related to STDs is posted in online social media. Objective The intent of the study was to describe the types of message emitters on Twitter in relation to two different STDs—chlamydia and human immunodeficiency virus (HIV)—as well as the nature of content tweeted, including how seriously the topic was treated. Methods We used the Twitter search engine to look for tweets posted worldwide from August 1-7, 2013, and from September 1-7, 2013, containing the words “chlamydia” or “HIV”, and the hashtags “#chlamydia” or “#HIV”. Tweeters were classified by two independent reviewers according to the type of avatar of the user (human, logo, or fantasy), the identification of the emitter (identifiable, semi-identifiable, or non-identifiable), and the source (private company, general media, scientific media, non-governmental, individual account, academic institution, government department, or undefined). Tweet messages were also independently classified according to their nature (serious or jokes/funny), and whether their main message was factual or of a personal nature/experience. Results A total of 694 tweets were posted by 426 different users during the first 7 days of August and September, containing the hashtags and/or simple words “chlamydia” and/or “HIV”. Jokes or funny tweets were more frequently posted by individual users (89%, 66/74), with a human avatar (81%, 60/74), from a non-identifiable user (72%, 53/74), and they were most frequently related to chlamydia (76%, 56/74). Serious tweets were most frequently posted by the general media (20.6%, 128/620), using a logo avatar (66.9%, 415/620), and with identifiable accounts (85.2%, 528/620). No government departments, non-governmental organizations, scientific media, or academic institutions posted a joke on STDs. A total of 104 of these analyzed tweets were re-tweeted messages, belonging to 68 unique tweets. The content was serious (99%, 67/68), factual (90%, 52/58), and about HIV (85%, 58/68). Conclusions Social media such as Twitter may be an important source of information regarding STDs provided that the topic is presented appropriately. Reassuringly, the study showed that almost 9/10 of tweets on STDs (chlamydia and HIV) were of serious content, and many of the tweets that were re-tweeted were facts. The jokes that were tweeted were mainly about chlamydia, and posted by non-identifiable emitters. We believe social media should be used to an even larger extent to disseminate correct information about STDs.

Use of social media for sexual health promotion: a scoping review

Background In order to prevent sexually transmitted infections (STIs), the World Health Organization recommends educating people on sexual health. With more than 2 billion active users worldwide, online social media potentially represent powerful channels for health promotion, including sexual health. Objective To review the scientific literature on the use of online social media for sexual health promotion. Design A search was conducted of scientific and medical databases, and grey literature was also included. The selected publications were classified according to their study designs, sexual health promotion main subject, target audience age, and social media use. Results Fifty-one publications were included; 4 publications presenting randomized intervention studies, 39 non-randomized intervention studies, and 8 observational studies. In 29 publications (56.9%), the main subject of the sexual health promotion was ‘general’ or to increase STI testing. Thirty publications (58.8%) specifically focused on youth or young people (aged 11–29 years). Fourteen publications that used social media either as unique channels for sexual health promotion interventions or as a tool supporting the sexual health promotion reported an effect on behavior (27%), and two of those studies found a reduction in the number of positive chlamydia and gonorrhea cases linked to social media intervention. Forty-four publications (86.3%) involved Facebook in some way. Conclusions Although billions of people worldwide actively use social media, we identified only 51 publications on the use of social media for promoting sexual health. About a quarter of the publications have identified promising results, and the evidence for positive effects of social media interventions for promoting sexual health is increasing. There is a need for more studies that explicitly discuss their theoretical framework, and that have strong research designs, in order to further increase the evidence base of the field.

eSalud y vídeos online para la promoción de la salud

Millones de personas buscan a diario informacion sobre salud en los miles de sitios web dedicados especificamente a este tema. Por ello, no es de extranar que Internet se haya convertido en la principal fuente de informacion en salud1,2, y que incluso este reemplazando a los medicos en esta funcion3. De entre todos los sitios web, servicios y plataformas online disponibles, las redes sociales estan sirviendo para cambiar la forma en que las personas interactuan y se comunican, y esto tambien sucede en todo lo relacionado con la salud4. La creciente popularidad y el mayor uso de las herramientas 2.0, como YouTube, Facebook, Twitter, blogs, wikis, etc., esta consiguiendo empoderar a los pacientes para que busquen ayuda online, encuentren informacion sobre aspectos relacionados con su salud o la de algun ser querido, se unan a otras personas con inquietudes o problemas similares4, e incluso creen sus propios contenidos5,6. Y cada vez mas aplicaciones moviles para la salud estan siendo integradas en estas redes sociales7. En todas estas redes sociales los videos se estan convirtiendo en un recurso en pleno auge, y aunque originalmente en su inmensa mayoria eran videos caseros creados por los propios usuarios, mostrando experiencias personales o dando consejos a otros pacientes8,9, hoy dia existe un creciente numero de instituciones u organismos oficiales que estan creando canales de comunicacion 2.010 y utilizan estas potentes plataformas para divulgar informacion sobre salud, y sus videos estan siendo cada vez mas visualizados por los pacientes/consumidores que buscan informacion de calidad procedente de fuentes fidedignas9,11. La difusion de informacion sobre salud en plataformas de video online presenta ventajas indiscutibles, como su bajo coste, su enorme potencial de hacer llegar informacion rapidamente a un amplio sector de la poblacion o el hecho de facilitar la interaccion con los usuarios12, pero tambien tiene desventajas, ya que en muchos casos no puede identificarse al autor de los videos, no se citan fuentes, se muestran opiniones personales como si fueran hechos cientificos12 o algunos aspectos quedan sin respuesta, por lo que puede ser dificil para el usuario valorar la calidad de sus contenidos. Cualquiera que desee comunicar contenidos sobre salud debe tener en cuenta que, sea cual sea el tema que se quiera transmitir, este puede encontrarse presente en las redes sociales4, y que debido a su uso cada vez mas popular y su capacidad de influenciar, las redes sociales se estan convirtiendo en una poderosa herramienta

Is There a Weekly Pattern for Health Searches on Wikipedia and Is the Pattern Unique to Health Topics

Background Online health information–seeking behaviors have been reported to be more common at the beginning of the workweek. This behavior pattern has been interpreted as a kind of “healthy new start” or “fresh start” due to regrets or attempts to compensate for unhealthy behavior or poor choices made during the weekend. However, the observations regarding the most common health information–seeking day were based only on the analyses of users’ behaviors with websites on health or on online health-related searches. We wanted to confirm if this pattern could be found in searches of Wikipedia on health-related topics and also if this search pattern was unique to health-related topics or if it could represent a more general pattern of online information searching—which could be of relevance even beyond the health sector. Objective The aim was to examine the degree to which the search pattern described previously was specific to health-related information seeking or whether similar patterns could be found in other types of information-seeking behavior. Methods We extracted the number of searches performed on Wikipedia in the Norwegian language for 911 days for the most common sexually transmitted diseases (chlamydia, gonorrhea, herpes, human immunodeficiency virus [HIV], and acquired immune deficiency syndrome [AIDS]), other health-related topics (influenza, diabetes, and menopause), and 2 nonhealth-related topics (footballer Lionel Messi and pop singer Justin Bieber). The search dates were classified according to the day of the week and ANOVA tests were used to compare the average number of hits per day of the week. Results The ANOVA tests showed that the sexually transmitted disease queries had their highest peaks on Tuesdays (P<.001) and the fewest searches on Saturdays. The other health topics also showed a weekly pattern, with the highest peaks early in the week and lower numbers on Saturdays (P<.001). Footballer Lionel Messi had the highest mean number of hits on Tuesdays and Wednesdays, whereas pop singer Justin Bieber had the most hits on Tuesdays. Both these tracked search queries also showed significantly lower numbers on Saturdays (P<.001). Conclusions Our study supports prior studies finding an increase in health information searching at the beginning of the workweek. However, we also found a similar pattern for 2 randomly chosen nonhealth-related terms, which may suggest that the search pattern is not unique to health-related searches. The results are potentially relevant beyond the field of health and our preliminary findings need to be further explored in future studies involving a broader range of nonhealth-related searches.

Combining multivariate statistics and the think-aloud protocol to assess Human-Computer Interaction barriers in symptom checkers

Symptom checkers are software tools that allow users to submit a set of symptoms and receive advice related to them in the form of a diagnosis list, health information or triage. The heterogeneity of their potential users and the number of different components in their user interfaces can make testing with end-users unaffordable. We designed and executed a two-phase method to test the respiratory diseases module of the symptom checker Erdusyk. Phase I consisted of an online test with a large sample of users (n=53). In Phase I, users evaluated the system remotely and completed a questionnaire based on the Technology Acceptance Model. Principal Component Analysis was used to correlate each section of the interface with the questionnaire responses, thus identifying which areas of the user interface presented significant contributions to the technology acceptance. In the second phase, the think-aloud procedure was executed with a small number of samples (n=15), focusing on the areas with significant contributions to analyze the reasons for such contributions. Our method was used effectively to optimize the testing of symptom checker user interfaces. The method allowed kept the cost of testing at reasonable levels by restricting the use of the think-aloud procedure while still assuring a high amount of coverage. The main barriers detected in Erdusyk were related to problems understanding time repetition patterns, the selection of levels in scales to record intensities, navigation, the quantification of some symptom attributes, and the characteristics of the symptoms.

Impact of Facebook Ads for Sexual Health Promotion Via an Educational Web App: A Case Study

Background: The authors present a case study of a public health campaign, including social media, and aiming at maximizing the use of web app on sexual health. Objective: To analyze the impact of a Facebook fan page, Facebook advertisements, and posters to maximize the number of visits to the educational web app. Methods: The campaign is assessed for 1 year, using data tracked through Facebook statistics and Google Analytics. Results: The site had 3670 visits 10.1 visitors/day, 95%CI 8.7-11.4. During the one-month Facebook Ads campaign, the site received 1263 visits 42.1 visitors/day, 95%CI 37.3-46.9, multiplying by over four the average number of visitors/day. 34.4% of all the participants were recruited during the one-month Facebook ads campaign. Conclusions: Facebook advertisements seem to be a good tool to promote an educational web app on sexual health targeting youth, and to reach a huge number of users rapidly and at a low cost.

Type 1 diabetes in Twitter: who all listen to?

Knowing what the conversation on Twitter regarding type 1 diabetes (T1D) is about can help in understanding the kind of information relevant to the individuals affected by the disease. The profile of Twitter users posting on T1D was collected and classified. The number of re-tweets was also registered. The tweets posted by non-governmental organizations (NGOs), communication media, and individuals affected by T1D had higher number of potential readers. More than a half of the tweets were posted by individuals affected by T1D, and their tweets were the most re-tweeted. The next most active users were NGOs and healthcare professionals. However, while tweets soliciting for research funds posted by the NGOs were the next most re-tweeted messages, tweets posted by healthcare professionals were the least re-tweeted. Twitter could be used more actively by healthcare professionals to disseminate correct information about T1D.

Social Media Use in Interventions for Diabetes: Rapid Evidence-Based Review

Background Health authorities recommend educating diabetic patients and their families and initiating measures aimed at improving self-management, promoting a positive behavior change, and reducing the risk of complications. Social media could provide valid channel to intervene in and deliver diabetes education. However, it is not well known whether the use of these channels in such interventions can help improve the patients’ outcomes. Objective The objective of our study was to review and describe the current existing evidence on the use of social media in interventions targeting people affected with diabetes. Methods A search was conducted across 4 databases (PubMed, Scopus, EMBASE, and Cochrane Library).The quality of the evidence of the included primary studies was graded according to the Grading of Recommendations Assessment, Development and Evaluation criteria, and the risk of bias of systematic reviews was assessed by drawing on AMSTAR (A MeaSurement Tool to Assess systematic Reviews) guidelines. The outcomes reported by these studies were extracted and analyzed. Results We included 20 moderate- and high-quality studies in the review: 17 primary studies and 3 systematic reviews. Of the 16 publications evaluating the effect on glycated hemoglobin (HbA1c) of the interventions using social media, 13 reported significant reductions in HbA1c values. The 5 studies that measured satisfaction with the interventions using social media found positive effects. We found mixed evidence regarding the effect of interventions using social media on health-related quality of life (2 publications found positive effects and 3 found no differences) and on diabetes knowledge or empowerment (2 studies reported improvements and 2 reported no significant changes). Conclusions There is very little good-quality evidence on the use of social media in interventions aimed at helping people with diabetes. However, the use of these channels is mostly linked to benefits on patients’ outcomes. Public health institutions, clinicians, and other stakeholders who aim at improving the knowledge of diabetic patients could consider the use of social media in their interventions.