Sarah A. MacLean

“To each his own”: Discussions of vaccine decision-making in top parenting blogs

ABSTRACT Although social media provides a way for people to congregate with like-minded others, it can also play a role in spreading misinformation about public health interventions. Previous research demonstrates that parents who use the Internet to gather information on vaccination are more likely to hold anti-vaccination beliefs. There has been little examination of vaccination decision-making discussions on parenting blogs. This study seeks to fill that gap. Posts and comments on the top 25 top parenting blogs were analyzed using a mixed-method approach. Comments were analyzed using deductive coding scheme that examined whether content areas of interest were present or absent in vaccination discussions. Posts were coded inductively using a thematic analysis. Posts and comments were further coded as strongly vaccine-discouraging, vaccine-ambivalent, or strongly vaccine-encouraging. Finally, posts were grouped by year of publication and comments were analyzed within each group to examine the evolution of vaccination decision-making discussions in the parenting blogosphere over the past decade. Fifty-two percent of posts were categorized as strongly vaccine-discouraging and were most commonly associated with expressions of individual liberty. Comments were nearly 3 times as likely to strongly discourage vaccination than to strongly encourage it. Comments on the oldest posts (2006–2009), were more likely to strongly discourage vaccination (p = 0.008), whereas comments on newer posts (2013–2015), were more likely to strongly encourage vaccination (p = 0.003). These findings suggest there is a need for public health professionals to understand the concerns being expressed in these forums, and develop innovative ways to dispel anti-vaccination myths, as these views may create obstacles in the meeting the goals of the public health agenda.

Portrayal of generalized anxiety disorder in YouTube™ videos

Background: Individuals often search the Internet for information about their medical conditions, such as generalized anxiety disorder (GAD), a common mental health disorder. Aims: To describe the content of the most popular videos on YouTube™ related to GAD. Methods: Videos with at least 50,000 views in October 2016 were coded for information regarding symptoms, treatments and causes for GAD. Associations of content with factors such as popularity and focus on a personal experience were examined. Results: The search returned 95 videos, which had been collectively viewed 37,044,555 times. Most (65%) were uploaded by consumers and 56% were about a personal experience. The most common symptoms mentioned were worry or panic (72%) and social anxiety (46%). Many videos (63%) mentioned at least one treatment, but only 26% mentioned any cause of anxiety. Videos that focused on a personal experience were significantly less likely to mention other phobias (p = .036), panic disorder (p = .033) and sleep issues (p = .016). Conclusion: The majority of the most popular videos on YouTube™ related to GAD were produced by consumers. Improved understanding about what information is available and popular online can assist mental health professionals in aiding their patients and in producing media that is likely to be viewed.

Readability of information on colonoscopy preparation on the internet

Background: The incidence of colorectal cancer (CRC) has decreased in recent years, due in large part to increased screening, particularly through colonoscopy. This study aimed to examine the level of readability of information on colonoscopy preparation written on 100 websites that were found via an internet search. Methods: In this cross-sectional study, the content of the first 100 websites in English found via an internet search were analyzed using established readability scales. Websites were compared based on whether they had a commercial or non-commercial URL extension. Results: The majority of websites were found to have information of a difficult reading level. Less than 10% of websites had an easy reading level. Readability did not differ significantly based on URL extension. Conclusion: The information currently posted on the internet regarding preparation for colonoscopy is written at a difficult reading level. If information presented was both accurate and easier to read, it could benefit a greater proportion of the general public and help inform decisions about preparing for a colonoscopy.

Missed opportunities: Do states require screening of children for health conditions that interfere with learning?

Strong evidence supports the existence of Health Barriers to Learning (HBLs)—health conditions that when untreated or unmanaged can interfere with a child’s ability to learn and succeed in school. These HBLs include vision and hearing deficits, uncontrolled asthma, mental and behavioral problems, dental pain, persistent hunger, and the effects of lead exposure. However, 19% of US children aged 6 to 11 did not receive their annual checkup in the past year. School requirements for health screenings can help identify children with HBLs. This study explores which states require health screening for children in elementary school, and the extent to which the 7 HBLs are included. Methods Investigators reviewed websites of state departments of health and education, and legislation for all 50 states and DC. For states with mandated screenings and a required form, investigators applied structured analysis to assess HBL inclusion. Results No state mandated that schools require screening for all 7 HBLs. Less than half (49%) required comprehensive school health examinations and only 12 states plus DC required a specific form. Of these, 12 of the forms required documentation of vision screening, 11 of hearing screening, and 12 of dental screening. Ten forms asked about asthma and 9 required documentation of lead testing. Seven asked about general well-being, emotional problems, or mental health. None addressed hunger. When including states without comprehensive school health examination requirements, the most commonly required HBL screenings were for vision (80% of states; includes DC), hearing (75% of states; includes DC) and dental (24% of state; includes DC). Conclusion The lack of state mandated requirements for regular student health screening represents a missed opportunity to identify children with HBLs. Without state mandates, accompanying comprehensive forms, and protocols, children continue to be at risk of untreated health conditions that can undermine their success in school.

YouTube Videos as a Source of Information About Clinical Trials: Observational Study

Background Clinical trials are essential to the advancement of cancer treatment but fewer than 5% of adult cancer patients enroll in a trial. A commonly cited barrier to participation is the lack of understanding about clinical trials. Objective Since the internet is a popular source of health-related information and YouTube is the second most visited website in the world, we examined the content of the top 115 YouTube videos about clinical trials to evaluate clinical trial information available through this medium. Methods YouTube videos posted prior to March 2017 were searched using selected keywords. A snowballing technique was used to identify videos wherein sequential screening of the autofill search results for each set of keywords was conducted. Video characteristics (eg, number of views and video length) were recorded. The content was broadly grouped as related to purpose, phases, design, safety and ethics, and participant considerations. Stepwise multivariable logistic regression analysis was conducted to assess associations between video type (cancer vs noncancer) and video characteristics and content. Results In total, 115 videos were reviewed. Of these, 46/115 (40.0%) were cancer clinical trials videos and 69/115 (60.0%) were noncancer/general clinical trial videos. Most videos were created by health care organizations/cancer centers (34/115, 29.6%), were oriented toward patients (67/115, 58.3%) and the general public (68/115, 59.1%), and were informational (79/115, 68.7%); altruism was a common theme (31/115, 27.0%). Compared with noncancer videos, cancer clinical trials videos more frequently used an affective communication style and mentioned the benefits of participation. Cancer clinical trial videos were also much more likely to raise the issue of costs associated with participation (odds ratio [OR] 5.93, 95% CI 1.15-29.46) and advise patients to communicate with their physician about cancer clinical trials (OR 4.94, 95% CI 1.39-17.56). Conclusions Collectively, YouTube clinical trial videos provided information on many aspects of trials; however, individual videos tended to focus on selected topics with varying levels of detail. Cancer clinical trial videos were more emotional in style and positive in tone and provided information on the important topics of cost and communication. Patients are encouraged to verify and supplement YouTube video information in consultations with their health care professionals to obtain a full and accurate picture of cancer clinical trials to make an adequately informed decision about participation.

Alcohol and violence in 2017 National Football League Super Bowl commercials

Background: The National Football League (NFL) Super Bowl is a widely-viewed sports event and the commercials are especially popular among viewers. Previous research has demonstrated risky health behaviors in advertisements aired during sporting events. The purpose of this study was to analyze the content of the advertisements aired during the 2017 NFL Super Bowl. Methods: This cross-sectional study involved examining the content of all commercials, with an emphasis on health-compromising behaviors. The themes and highlights of the advertisements were analyzed based on whether there was a reference to alcohol or violence. Results: A total of 103 unique commercials were analyzed. The most common themes were humor (n=43), happiness (n=25), innovation (n=25), and enjoyment or relaxation (n=25).Alcohol was referenced in 13 (12.6%, 95% CI 7.5%, 20.4%) of the commercials. Advertisements with alcohol references were more likely to contain the themes of partying (odds ratio [OR]:16.2, 95% CI 1.4-193.4, P=0.041) and enjoyment or relaxation (OR: 4.7, 95% CI 1.4-15.6,P=0.014). There were 24 commercials with references to violence and these were more likely tobe promoting a movie (OR: 5.4, 95% CI 3.5-8.2, P<0.001) or television program (OR: 8.9,95% CI 2.6-30.26, P<0.001). Conclusion: Parents should consider whether it is appropriate for their children to watch a concentrated number of intense images containing references to alcohol and violence during this popular sporting event.

Attitudes and behaviors related to distracted driving in college students: a need for interventions in adolescence

Abstract Objective One of the biggest contributors to distracted driving among young people in the United States is technology. The objective of this study was to describe distracted driving behaviors among college students, with a specific focus on attitudes towards and use of social media. Methods With written permission, a survey was adapted from the Distracted Driving Public Opinion Poll distributed by the National Safety Council. The survey comprised 43 questions assessing attitudes and behaviors. A total of 411 students enrolled in a personal health course were invited to complete the survey. In total 324 surveys were completed, resulting in a response rate of 79%. Results Among students with a driver’s license, 95.2% reported engaging in distracted driving behaviors. The use of social media while driving was common, with 30.7% reporting that they glance at, read, or post to social media while driving, most commonly on Snapchat or Instagram. It was common for students to make or answer phone calls (72.0%), review or send text messages (54.6%), or glance at or read automatic notifications (43.3%). Almost all students (91.5%) reported that they believed a hands-free solution is safer than holding the phone while driving, but only 67.9% reported that they usually used a hands-free device. Students in a health major and students who drive in urban areas were more likely to engage in distracted driving behaviors. Conclusions These findings suggest a need for interventions, particularly those which target adolescents in an attempt to deter these behaviors as they transition into adulthood.