Osman Hassan Ahmed

‘What's happening?’ A content analysis of concussion-related traffic on Twitter

Background Twitter is a rapidly growing social networking site (SNS) with approximately 124 million users worldwide. Twitter allows users to post brief messages (‘tweets’) online, on a range of everyday topics including those dealing with health and wellbeing. Currently, little is known about how tweets are used to convey information relating to specific injuries, such as concussion, that commonly occur in youth sports. Objective The purpose of this study was to analyse the online content of concussion-related tweets on the SNS Twitter, to determine the concept and context of mild traumatic brain injury as it relates to an online population. Study design A prospective observational study using content analysis. Methods Twitter traffic was investigated over a 7-day period in July 2010, using eight concussion-related search terms. From the 3488 tweets identified, 1000 were randomly selected and independently analysed using a customised coding scheme to determine major content themes. Results The most frequent theme was ‘news’ (33%) followed by ‘sharing personal information/situation’ (27%) and ‘inferred management’ (13%). Demographic data were available for 60% of the sample, with the majority of tweets (82%) originating from the USA, followed by Asia (5%) and the UK (4.5%). Conclusion This study highlights the capacity of Twitter to serve as a powerful broadcast medium for sports concussion information and education.

iSupport: do social networking sites have a role to play in concussion awareness?

Purpose. The Facebook web site is an exceptionally fast-growing social networking site (SNS) containing membership groups with discussion boards on a wide variety of issues. This study uses content analysis to scrutinise postings on Facebook groups related to concussion and examine the purpose of these postings. Method. 472 Facebook groups related to concussion were screened by three researchers using a specifically developed coding scheme to examine demographic information and the purpose of the posting. In those cases where agreement was not obtained, post-analysis discussion allowed consensus to be reached. Results. From the 17 Facebook groups which met the inclusion criteria, 145 postings were included for analysis. The predominant demographic group which posted on the Facebook discussion boards were North American males. In the main part, individuals utilised the Facebook group to relate personal experiences of concussion (65%), although it was also used to seek (8%) or offer advice (2%). Supporting quotes were extracted. Conclusions. This study highlights the evolving nature of healthcare support in the twenty-first century and the rich information present relating to concussion on SNSs such as Facebook. Although the information being shared on these sites is important, the peer-to-peer interaction may be the key aspect of this health education medium.

Big hits on the small screen: an evaluation of concussion-related videos on YouTube

Background YouTube is one of the largest social networking websites, allowing users to upload and view video content that provides entertainment and conveys many messages, including those related to health conditions, such as concussion. However, little is known about the content of videos relating to concussion. Objective To identify and classify the content of concussion-related videos available on YouTube. Study design An observational study using content analysis. Methods YouTubes video database was systematically searched using 10 search terms selected from MeSH and Google Adwords. The 100 videos with the largest view counts were chosen from the identified videos. These videos and their accompanying text were analysed for purpose, source and description of content by a panel of assessors who classified them into data-driven thematic categories. Results 434 videos met the inclusion criteria and the 100 videos with the largest view counts were chosen. The most common categories of the videos were the depiction of a sporting injury (37%) and news reports (25%). News and media organisations were the predominant source (51%) of concussion-related videos on YouTube, with very few being uploaded by professional or academic organisations. The median number of views per video was 26 191. Conclusions Although a wide range of concussion-related videos were identified, there is a need for healthcare and educational organisations to explore YouTube as a medium for the dissemination of quality-controlled information on sports concussion.

The conceptual and practical ethical dilemmas of using health discussion board posts as research data.

Background Increasing numbers of people living with a long-term health condition are putting personal health information online, including on discussion boards. Many discussion boards contain material of potential use to researchers; however, it is unclear how this information can and should be used by researchers. To date there has been no evaluation of the views of those individuals sharing health information online regarding the use of their shared information for research purposes. Objective To explore the views of contributors to online diabetes discussion boards with regards to if (and how) they feel their contributions to boards should be used by health researchers. Methods A qualitative approach was employed using online semistructured asynchronous (email) interviews. Interpretative description methodology was used to assess the interview transcripts, and quotations were extracted and anonymized to support each theme. Results 26 interviews were carried out. Participants agreed that forum posts are in the public domain and that aggregated information could be freely used by researchers. This was agreed to be a good way of ensuring that the view of people living with diabetes is being heard in research. There was no consensus on the need for permission to use individual information, such as quotations, with some people happy for this to be freely used and others feeling that permission is necessary. Conclusions Participants acknowledged the dichotomy of having placed information into the public domain in an unrestricted way, with some interviewees also wanting to retain control of its use. The Internet is a new research location, and rather than trying to apply traditional ethical norms to this new genre, a new modus operandi is required. The authors propose introducing new norms for presenting research carried out with online discussion boards.

Smartphone and tablet apps for concussion road warriors (team clinicians): a systematic review for practical users

Background Mobile technologies are steadily replacing traditional assessment approaches for the recognition and assessment of a sports concussion. Their ease of access, while facilitating the early identification of a concussion, also raises issues regarding the content of the applications (apps) and their suitability for different user groups. Aim To locate and review apps that assist in the recognition and assessment of a sports concussion and to assess their content with respect to that of internationally accepted best-practice instruments. Methods A search of international app stores and of the web using key terms such as ‘concussion’, ‘sports concussion’ and variants was conducted. For those apps meeting the inclusion criteria, data were extracted on the platform, intended users and price. The content of each app was benchmarked to the Sport Concussion Assessment Tool 2 (SCAT2) and Pocket SCAT2 using a custom scoring scheme to generate a percentage compliance statistic. Results 18 of the 155 apps identified met the inclusion criteria. Almost all (16/18) were available on an iOS platform and only five required a payment to purchase. The apps were marketed for a wide range of intended users from medical professionals to the general public. The content of the apps varied from 0% to 100% compliance with the selected standard, and ‘symptom evaluation’ components demonstrated the highest level of compliance. Conclusions The surge in availability of apps in an unregulated market raises concerns as to the appropriateness of their content for different groups of end users. The consolidation of best-practice concussion instruments now provides a framework to inform the development of future apps.

Life transitions and online health communities: reflecting on adoption, use, and disengagement

Online health communities are places where people can come together in order to exchange social support at a particular point in an individuals life. There are, however, relatively few accounts that look across multiple communities across the lifespan. In this paper, we reflect on four case studies of research on different online health communities in order to identify patterns in how individuals selectively adopt, use, and disengage from these communities throughout their lives. We argue that users leaving communities is not necessarily a failing of the sites design or purpose; rather, it is a logical reaction to changing life circumstances. In characterizing this pattern, we contribute a set of implications for design and management that bear consideration by online community designers, developers, moderators, and end users. Ultimately this may lead to a smoother transition from community to community and ensure that social support needs are being met more consistently in response to changing life circumstances.

Ethical Considerations in Using Facebook for Health Care Support: A Case Study Using Concussion Management

Social networking sites (SNS) are now part of everyday life, and SNSs such as Facebook, YouTube, and Twitter are among the most accessed Web sites on the Internet. Although SNSs are primarily used for staying in touch with friends and family, they are increasingly being used for health‐related purposes for a variety of conditions, including concussion awareness. As health interventions begin to be more commonly provided through SNSs (particularly Facebook), ethical issues have been raised with regard to confidentiality, privacy, and trust; these issues need to be addressed. This article outlines some of the key considerations when providing a concussion intervention through Facebook and discusses potential solutions to these issues.

Smartphone apps for the self-management of low back pain: A systematic review

Guidelines for low back pain (LBP) often recommend the use of self-management such as unsupervised exercise, booklets, and online education. Another potentially useful way for patients to self-manage LBP is by using smartphone applications (apps). However, to date, there has been no rigorous evaluation of LBP apps and no guidance for consumers on how to select high-quality, evidence-based apps. This chapter reviews smartphone apps for the self-management of LBP and evaluates their content quality and whether they recommend evidence-based interventions. This chapter shows that generally app developers are selecting interventions that are endorsed by guidelines, although their quality is low. There are many apps available for the self-management of LBP, but their effectiveness in improving patient outcomes has not been rigorously assessed. App developers need to work closely with healthcare professionals, researchers, and patients to ensure app content is accurate, evidence based, and engaging.

Enhancing performance and sport injury prevention in disability sport: moving forwards in the field of football

According to the WHO, approximately 15.6% of the world population live with some form of disability, including 70 million children world-wide aged between 15 and 18 years.1 The benefits of exercise for individuals living with disability have been highlighted in the literature,2 and participation in team sports, such as football, provides additional benefits (such as facilitating social inclusion, creating peer group networks and challenging perceived social stereotypes). While prevention of injury is an important issue for all athletes, the impact of a sporting injury to an individual with a disability may severely affect their ability to function independently on a daily basis. For example, an athlete with a lower limb amputation who sustains a major injury such as an ACL and osteochondral injury could suffer long-term health consequences. In addition, gaining access to healthcare services and rehabilitation may be more challenging for individuals with a disability.3 Given the many health and social benefits of sporting participation in the disabled population and the …

A picture tells a thousand words: A content analysis of concussion-related images online

BACKGROUND AND AIM Recently image-sharing social media platforms have become a popular medium for sharing health-related images and associated information. However within the field of sports medicine, and more specifically sports related concussion, the content of images and meta-data shared through these popular platforms have not been investigated. The aim of this study was to analyse the content of concussion-related images and its accompanying meta-data on image-sharing social media platforms. METHODS We retrieved 300 images from Pinterest, Instagram and Flickr by using a standardised search strategy. All images were screened and duplicate images were removed. We excluded images if they were: non-static images; illustrations; animations; or screenshots. The content and characteristics of each image was evaluated using a customised coding scheme to determine major content themes, and images were referenced to the current international concussion management guidelines. RESULTS From 300 potentially relevant images, 176 images were included for analysis; 70 from Pinterest, 63 from Flickr, and 43 from Instagram. Most images were of another person or a scene (64%), with the primary content depicting injured individuals (39%). The primary purposes of the images were to share a concussion-related incident (33%) and to dispense education (19%). For those images where it could be evaluated, the majority (91%) were found to reflect the Sports Concussion Assessment Tool 3 (SCAT3) guidelines. CONCLUSIONS The ability to rapidly disseminate rich information though photos, images, and infographics to a wide-reaching audience suggests that image-sharing social media platforms could be used as an effective communication tool for sports concussion. Public health strategies could direct educative content to targeted populations via the use of image-sharing platforms. Further research is required to understand how image-sharing platforms can be used to effectively relay evidence-based information to patients and sports medicine clinicians.